How This Happened
The FDA found a goldenseal product was linked to an infant death. The death was caused by microbial contamination of powdered Goldenseal. This bacterial contamination of the Goldenseal root powder is similar to what might occur from microbial contamination of a dried food.
Apparently, some midwives have been applying Goldenseal powder to the umbilical cord stump of newborns as an antimicrobial. This application has resulted in an infant death due to microbial contamination of the Goldenseal powder. This is incredibly sad, but we can learn from it. We should be certain a product is sanitary if we are applying it to an open wound and this includes umbilical stumps. I will explain this in more detail below.
Where The Goldenseal Linked to the Infant Death Came From
The company Maison Terre, who sold the Goldenseal root powder, had purchased it from Starwewst Botanicals and repackaged it for retail sale.The FDA analysed the product and found it was contaminated with microorganisms that included Enterobacter cloacae, Cronobacter sakazakii, Cronobacter dublinensis, and others. Cronobacter species have been linked to most of the neonatal meningitis cases over the past 30 years. Outbreaks have been linked to a variety of products including infant formula, cotton, as well as other packed consumer products. This is not a new story.
More About The Product Sold And Recall Information
The Goldenseal Root Powder is yellow-colored, and comes in a clear plastic bag with a net weight of 1 oz., and consumers are being urged to dispose of any unused product.
The recalled Goldenseal Root Powder was distributed nationwide in the USA to customers who ordered through Amazon.com, purchased between Jan. 25, 2015 and Aug. 4, 2020. Maison Terre of Little Rock, Arkansas urges customers who purchased Goldenseal root powder not to consume or apply it and to dispose of it or contact Maison Terre for a return shipping label and refund. It is notifying its customers by email through Amazon.com, and information regarding the recall, questions about returns or refunds, and other information is available by contacting Maison Terre at 501-888-9438 Mon-Fri, 10 a.m. to 4 p.m. CST or at firstname.lastname@example.org.
Notice To Companies Selling Goldenseal Powder
All companies selling Goldenseal products should test for microbes. Some methods of processing Goldenseal would result in death of the microbes, but raw product such as found in teas or capsules is especially suspect. It is thought that the microbe that was the causative factor was most likely Cronobacter sakazakii which is known to cause infections in infants. This bacteria has been found in 12-13% of market vegetables, infant formulas and tampons. It can remain on dry material for up to two years. In individuals with a weakened immune system or as with infants, who have a not yet fully developed immune system, this bacteria may cause infection and death.
Cronobacter infection in infants
Cronobacter can cause diarrhea and urinary tract infections in people of all ages. In older individuals or other people with weakened immune systems, the infection can be serious. In infants the infection can be deadly. Babies under 3 months, premature infants and infants with a weakened immune system are at highest risk. Infections typically cause sepsis or meningitis. A meningitis infection can result in a brain abscess or other complication that can cause long-term neurological issues.
How Common Is This, And Where Is The Bacteria Usually Found?
Sickness from Cronobacter is not common according to the CDC. https://www.cdc.gov/cronobacter/infection-and-infants.html
The contamination was found to originate in the factory processing of the baby formula in some cases while others appeared to be contamination in the home or elsewhere.
The CDC gets 4-6 cases reported each year and they usually occur in the first day or weeks of the infant’s life. They list the initial symptoms as being a fever, poor feeding, crying and low energy.
These germs can live in dry foods, such as powdered infant formula, powdered milk, herbal teas, and starches. Anybody can get sick from Cronobacter, but infection can be very serious in infants. When a source of a baby’s Cronobacter infection has been found, nearly all have been associated with consumption of reconstituted powdered infant formula. Powdered infant formula is not sterile. Manufacturers report that, using current methods, it is not possible to eliminate all germs from powdered infant formula in the factory
What Protects A Baby From Cronobacter And Other Infections
- If using a breast pump, clean and sanitize it as well as the baby bottles
- Liquid baby formula is thought to be safer than dry powder
- If the baby is less than 3 months old, born prematurely or has a weakened immune system, boil water for powdered infant formula and cool to no less than 158 F before pouring into a sterilized feeding container.
- Use formula within 2 hours of preparing it. Throw away left over formula or refrigerate for up to 24 hours.
- Practice good hygiene. Wash your hands often. If soap is not available use hand sanitizer that is 60% or more of alcohol which kills Cronobacter germs.
When Should You Wash Your Hands
- Before preparing and feeding bottles or foods to your baby
- Before touching your baby’s mouth
- Before touching pacifiers or other things that go into your baby’s mouth
- After using the toilet or changing diapers
Cronobacter can cause diarrhea and urinary tract infections in people of all ages. The elderly or those with compromised immune systems may experience more severe symptoms such as bloodstream or respiratory infections.
- Can grow at temps from 5-44 C
- Is resistant to the acid in our stomach
- Forms biofilms making them resistant to disinfectants
- Has mostly been found in plant and organic material but also found in cheese, meat, powdered milk, dry cereal and spices
Steps can be taken by manufactures to detect Cronobacter in their final product:
- Educate laboratory personnel on how to identify Cronobacter morphology or use an identification system that can detect this organism
- Test raw ingredients for Cronobacter
- Test final products for the presence of Cronobacter
- Conduct environmental monitoring samples to detect Cronobacter in the manufacturing facility
My Personal Thoughts
I don’t use powdered herbs on open wounds and would not put it on an umbilical stump. I understand that this has been done in some cultures through-out history, but I have never felt this is a sanitary practice. I am not certified for obstertrics, but in the many years of assisting goats, cows and other animals during birth on my farm I did not use powdered herbs on the umbilical stump as it does not seem safe. I usually used nothing unless I was concerned about a situation where there might be contamination such as with fecal involvement. In those cases, I used soap and water, followed by a dip in iodine. I did that only a couple times although I had over 100 births on my farm. Many farmers use iodine on the umbilical stump as a preventative for all births.
Anytime someone uses a raw dried herb or food on an open wound they are taking the chance that the food or herb may be contaminated with something. Although I commonly eat food directly pulled out of the garden without washing it and would have no issue with applying a spit poultice of food or herb to a wound if it is from my garden or a pristine environment where I was hiking and I needed a first aid item. However, I would not apply an herbal spit poultice from herb that was picked alongside a road or from the general market. Additionally, if using an herb on an open wound, I would first cook it or make it into a tincture (in the case of this bacteria the tincture needs to be 60% alcohol or higher) or some other safely processed form of herbal medicine before I would ingest it or use it on an open wound. Fresh herbs should be washed before eating them and dried herbs should be suspect for contamination unless you know how it was grown, harvested, dried and stored. Even then, you can’t be assured they are free of bacteria. Some companies are very open about their practices and these are the ones you want to purchase from if you are rightly concerned about contamination. They will tell you if the product was tested for microbes or not.
Some herbs are decocted and since you decoct for a minimum of 20 minutes this will usually kill most bacteria. Using high alcohol to tincture an herb is another method to kill bacteria. As mentioned 60% alcohol kills Cronobacter.
The herbal company I use to own, routinely examined herbal powders for contamination before using them as raw products in our capsules or we purchased them from a supplier who had. This is a good manufacturing practice that companies should use when they are selling a dried powdered. A certificate of microbial inspection should be available at the company who makes the herbal product being sold. I don’t think companies should be forced to test for cornobacter in all dried herbal products since it is rarely an issue, but I bet the companies that do test will have more customers flock to their doors.