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Raw milk from a California farm has been linked to dozens of salmonella illnesses, a much larger outbreak than previously known, according to newly released state documents.

As of February, at least 165 people were recorded as having been sickened by salmonella infections linked to products from the Fresno, California-based Raw Farm. Health officials say it is the largest reported salmonella outbreak linked to raw milk in the United States in the past decade.

The announcement of the extent of the outbreak came as health officials warned the public not to consume unpasteurized milk because a bird flu virus is circulating in American dairy cows. The bird flu, known as type A H5N1, has been detected in more than 140 American dairy herds, and federal health officials say the virus has been detected in high levels in raw milk.

State and local health officials had not informed the public of the full extent of the salmonella outbreak since October, when authorities in San Diego reported about a dozen cases. At that time, Raw Farm voluntarily recalled milk and cream sold between October 11 and November 6.

But the number of cases continued to mount, according to documents obtained by Bill Marler, a Seattle-based food safety attorney who provided the documents to The Associated Press. Marler said he represents 16 clients who allegedly became ill in the outbreak.

Investigators compared samples from sick people with samples from the farm and a retail store, the documents say. More than 60% of the people interviewed with confirmed infections said they had consumed Raw Farm products. People infected were from four states, but the vast majority – 162 – were from California. Four of the people with salmonella were also infected with campylobacter and/or dangerous E. coli bacteria, the documents say.

Nearly 40 percent of the cases affected children under five, authorities said. Twenty people were hospitalized. No deaths were reported.

California health officials said Wednesday they conducted a “thorough” investigation in collaboration with local teams and state agriculture agencies and informed the public about the outbreak through the recall notice in October and social media posts in October, November and December. The outbreak ended on May 4, officials said. It is not clear whether additional cases were reported after February.

Raw Farm owner Mark McAfee acknowledged that his products were part of the outbreak. He said a single cow was infected with salmonella last fall and later removed from the herd. He said he implemented additional testing protocols in response to the outbreak.

Jessie McGee, 35, of San Pedro, California, said she plans to sue Raw Farm because her 6-year-old daughter was hospitalized in October with a confirmed infection linked to the outbreak. McGee said she read online about the purported health benefits of raw milk and began drinking Raw Farm products and giving them to her daughter and 2-year-old twins. All three children and McGee became ill, she said, but her older daughter's symptoms of high fever and abdominal cramps were the worst.

After this ordeal, McGee said she would no longer drink unpasteurized milk.

“None of the potential benefits you could get from milk are worth it,” she said.

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