Raw milk cheese can really suck

Fresh cheeses are a main garnish of Mexican food. Consumption of artisanal fresh cheeses is very common and most of them are made from unpasteurised cow milk.

unknownA total of 52 fresh unpasteurised cheeses of five different types were purchased from a variety of suppliers from Tabasco, Mexico. Using the most probable number method, 67% and 63% of samples were positive for faecal coliforms and E. coli, respectively; revealing their low microbiological quality.

General hygienic conditions and practices of traditional cheese manufacturers were poor; most establishments had unclean cement floors, all lacked windows and doors screens, and none of the food-handlers wore aprons, surgical masks or bouffant caps. After analysing all E. coli isolates (121 strains) for the presence of 26 virulence genes, results showed that 9 (17%) samples were contaminated with diarrheagenic E. coli strains, 8 harboured non-O157 Shiga toxin producing E. coli (STEC), and one sample contained both STEC and diffusely ad-herent E. coli strains. All STEC strains carried the stx1 gene. Potential uropathogenic E. coli (UPEC) strains were isolated from 15 (29%) samples; the most frequent gene combination was fimA-agn43. Two samples were contaminated with Salmonella. The results demonstrated that unpasteurised fresh cheeses produced in Tabasco are of poor microbiological quality and may frequently harbour foodborne pathogens.

Food safety authorities in Mexico need to conduct more rigorous surveillance of fresh cheeses. Furthermore, simple and inexpensive measures as establishing programs emphasizing good hand milking practices and hygienic manufacturing procedures may have a major effect on improving the microbiological quality of these food items.

Mexican unpasteurised fresh cheeses are contaminated with Salmonella spp., non-O157 Shiga toxin producing Escherichia coli and potential uropathogenic E. coli strains: A public health risk

International Journal of Food Microbiology 237 (2016) 10–16, DOI: http://dx.doi.org/10.1016/j.ijfoodmicro.2016.08.018

R Guzman-Hernandez, A Contreras-Rodriguez, R Hernandez-Velez, I Perez-Martinez, A Lopez-Merino, MB Zaidi, T Estrada-Garcia

Fancy food ain’t safe food: Listeria in UK goat’s milk cheese edition

According to the Mirror, a top artisan cheesemaker has been forced to recall a batch of goat’s cheese after staff discovered potentially deadly bacteria in the product.

Neal's Yard DairyNeal’s Yard Dairy, which is considered the forerunner of the British wholefood movement, discovered listeria in its Hay on Wye goats cheese during routine testing.

According to the Food Standard Agency (FSA) listeria monocytogenes can cause flu-like symptoms and can even lead to deadly meningitis.

FSA inspectors were alerted to the bacteria in the unpasteurised product by staff at the Neal’s Yard Creamery cheesemaking side of the business.

Described as London’s foremost cheese store, Neal’s Yard Dairy was founded in 1979 by Nick Saunders and Randolph Hodgson as a cheesemaker’s shop.

One of their first customers to the new store was Monty Python comedian John Cleese.

As a result of the tainted cheese, Neal’s Yard Creamery recalled all the Hay on Wye range and put up signs in all stores and market stalls that were supplied with the affected product.

The tainted batch was discovered when the cheesmaking side of the business, Neal’s Yard Creamery, tested its own products produced in Herefordshire.

Around 66 affected cheeses were found to have been sold to customers and the company recalled the products on May 20, before the Food Standards Agency official told them to do so today.

Ciders and juices can cause illnesses; here’s a big list

Every fall since 2010 there’s been at least one juice or cider related outbreak in North America. Some beverages were pasteurized, many weren’t. CiderPic1Right now there are two outbreaks linked to unpasteurized ciders in California and Illinois.

Here’s a list of all the ones we’ve been able to find (going back to 1924) – 84 outbreaks leading to over 3500 illnesses.

Click here to download the entire list.

Screen Shot 2015-11-05 at 3.18.55 PM

 

1 toddler dead, 4 sick, so protesters will demand raw milk be sold for drinking in Victoria

Just weeks after health types in the Australian state of Victoria (that’s where Melbourne is) declared a three-year-old had died and four other children sickened from consuming raw milk, natural types are planning a drink-in Saturday to get even more unpasteurized milk on store shelves.

Spew milkThree of the four children – all under five — developed hemolytic uremic syndrome, usually associated with shiga-toxin producing E. coli, such as E. coli O157, and the other developed cryptosporidiosis.

How many others developed milder forms of illness is unknown.

In response to the outbreak in early Dec., Victoria Consumer Affairs Minister Jane Garrett ordered a gag-inducing chemical to be poured into all raw milk sold in stores from Sunday, ensuring no one is able to drink it (raw milk is legally sold as bath milk, side-by-side with pasteurized milk; that would be an expensive bath).

The move has apparently infuriated food activists, who are now planning a protest on Saturday to demand that the unpasteurized product be made available for drinking.

The government’s approach so far has been a very knee-jerk reaction,” said organic food store owner Rebecca Freer, who is planning the “drink-in” outside the minister’s Brunswick East office.

I think they’re in denial that there’s a large subculture of raw milk drinkers, who are well-informed, educated people.”

The Australian Raw Milk Movement is encouraging people to “BYO cup” and drink raw milk outside Garrett’s office.

Supporters of drinking unprocessed milk like Ms Freer dispute the product’s link with the child’s death and instead stress the supposed health benefits from consuming a natural product.

colbert.raw.milkBut they never mention the other kids who developed HUS.

“It’s our consumer right to define what we eat and drink,” she said. “Australia is really backwards on this issue.”

After being contacted by Guardian Australia, Freer posted to the Australian Raw Milk Movement’s Facebook wall that she had been contacted by journalists and that “the fight is on.”

“I think it is fair to say we are in the midst of a violent resistance,” she wrote.

Nutritionist Arabella Forge, who will speak at Saturday’s protest, said current food safety laws could be amended to get raw milk on store shelves without compromising food safety.

“What we’re really asking for is a system of regulation that supports safe, raw milk,” she said. “People should have access to this product.”

CSIRO research microbiologists Narelle Fegan and Edward Fox, who have studied raw milk safety on Victorian farms, have both warned against drinking raw milk, even from farms with the highest of standards.

“When the milk comes out of the animal it should be sterile, but then it’s immediately contaminated by its environment,” Dr Fegan said. “When things go wrong they can go wrong pretty badly with people getting seriously ill.”

Dr Fox said there was no evidence that raw milk was more nutritious – a common claim made by raw milk supporters.

“Pasteurised milk is as nutritional as raw milk and it has, due to the pasteurisation process, a lower associated risk,” he said.

Victoria’s chief health officer, Dr Rosemary Lester, has also stood behind her recent raw milk health warnings.

Ms Garrett defended her decision to add a bittering agent to raw milk on Thursday, saying it’s meant to prevent illness and death.

“The actions we have taken are designed to stop people from putting themselves and their children at risk,” she said.

Meanwhile, in Adelaide, South Australia, a court heard a temperature rise in samples taken from a farm owned by a couple being prosecuted for selling unpasteurised milk to when it was tested would have caused a “marginal” rise in bacteria readings.

santa.barf.sprout.raw.milkMoo View Dairy owners Mark and Helen Tyler, who on Wednesday brought a cow to the front of the court building, are contesting charges of breaching the food act by selling the raw milk commercially.

The couple have been operating a “House Cow Share Scheme” where people can buy shares in one of their cows which entitles them to a percentage of the milk produced by the herd.

The raw milk was also found to have higher than the legally acceptable amount of bacteria — leading to one of the two counts of selling food in contravention of the food standards code against them in April and May, 2013.

In cross examination on Thursday, SA Dairy Authority general manager John Crosby said that rise would only have had a “marginal affect” on the milk’s bacteria count.

Mr Tyler and shareholder Rachel Tyson, who on Wednesday came to court dressed in a cow suit in a sign of support for the couple, are expected to give evidence on Friday.

Australian raw milk producer awaits impact

In the increasingly bizarre statements from raw milk producers in Australia, add Simon Schulz, of the Schulz Organic Dairy, who told Australian Dairy Farmer while their raw milk was clearly labeled as not for human consumption, he has no way of knowing if customers choose to drink it and that raw milk was subject to all the same hygiene standards as human consumption milk, with the exception of pasteurization.

colbert.raw.milkLabeling raw milk as not for human consumption and as “bath” or “cosmetic” milk has long provided a loophole for suppliers. 

Queensland raw milk producers say Victoria reaction to death and 3 HUS cases is ‘knee-jerk’

Moves by the Victorian Government to introduce new laws aimed at preventing people from drinking unpasteurized milk have prompting questions about whether other states will do the same.

vacvaccine.bs.dec.14Under the changes being introduced in Victoria, suppliers will forced to either pasteurise the product, or add an agent to make it taste bitter.

The changes come after the death of a three-year-old boy earlier this month, after he drank raw milk earlier this month.

Victoria’s Consumer Affairs Minister, Jane Garrett, says the new laws aim to make bath milk undrinkable, by adding an ingredient to make it taste bitter.

“If people do accidentally confuse raw milk with pasteurised milk, they will either be drinking a product that is safe because it’s been pasteurised, or it will have the foulest taste known to human kind and they will not be able to continue drinking it,” she said.

There are less than ten raw milk producers in Queensland, but some are already nervous that similar regulations could be introduced in the Sunshine State.

Following the child’s death in Victoria, Queensland Health came out strongly against the sale of unpasteurised milk.

At the time, Queensland Health’s chief medical officer Dr Jeanette Young said she would like to see big changes in the rules governing ‘bath milk.’

Yesterday a spokesperson for the Queensland Health Minister said the Government’s position had not changed since then.

The state’s producers of unpasteurised milk say there is no need for greater regulation.

Cleopatra’s Bath Milk manager Trevor Mahaffey says the decision in Victoria is a knee-jerk reaction and he doesn’t believe the Queensland Government will follow suit.

He says buyers should be allowed to make their own decisions.

“It’s a shame that the minister down there (in Victoria) hasn’t looked at both sides of the argument and spoken to people from both sides,” he said.

Mr Mahaffey also said it had not been proven the child in Victoria had died as a result of drinking unpasteurised milk.

stupid.jenny.dec.14But, three other kids developed hemolytic uremic syndrome, a kidney ailment consistent with shiga-toxin producing E. coli.

Even more baffling was the comments from Queensland Dairy Farmers Organisation president, Brian Tessman, who says it is up to the government to decide how it legislates around raw milk.

“They need to decide is it an acceptable risk or not and either decide if they should ban it or put a quality assurance system on it,” he said.

“They need to go on the science and I am not a scientist and we don’t have anyone at the QDO with the scientific qualifications needed to make that decision.”

Maybe they should get some. Or shut-up.

Raw milk, choice and kids

In May 1943, Edsel Bryant Ford, the son of auto magnate Henry Ford, died at the age of 49 in Detroit, of what some claimed was a broken heart.

Biology, however, decreed that Ford died of undulant fever, apparently brought on by drinking unpasteurized milk from the Ford dairy herd, at the behest of his father’s mistaken belief that all things natural must be good.

pasteurShortly thereafter, my mother – then a child — developed undulate fever, which my grandfather, with no knowledge of microbiology, attributed to the dairy cows on his farm in Ontario, Canada.

He got rid of the cows and went into potatoes, and then asparagus.

Earlier this month, the latest in a seemingly endless number of outbreaks attributed to raw or unpasteurized milk, contributed to the death of a 3-year-old in Victoria, Australia, and left at least three other children under the age of five with hemolytic uremic syndrome, a side effect of infection with shiga-toxin producing E. coli.

In addition to the personal tragedies, every outbreak raises questions about risk and personal choice.

It’s true that choice is a good thing. People make risk-benefit decisions daily by smoking, drinking, driving, and especially in Brisbane, cycling.

But the 19th-century English utilitarian philosopher, John Stuart Mill, noted that absolute choice has limits, stating, “if it (in this case the consumption of raw unpasteurized milk) only directly affects the person undertaking the action, then society has no right to intervene, even if it feels the actor is harming himself.”

Excused from Mill’s libertarian principle are those people who are incapable of self-government — children.

Society generally regulates what is allowed for children – most parents aren’t having a scotch and a smoke with their 3-year-olds.

Celebrity chefs, would-be farmers and the wannabe fashionable can devoutly state that grass-fed cattle are safer than grain-fed by spinning select scientific data — except that the feces of cattle raised on diets of grass, hay and other fibrous forage do contain E. coli O157:H7 as well as salmonella, campylobacter and others.

Ten years ago, Ontario’s former chief medical health officer, said, “Some people feel that unpasteurized milk is either not bad for their health (they don’t believe the health risks) or they actually believe that it has healing properties because it’s all natural and untainted by government interference.”

Except poop happens, especially in a barn, and when it does people, usually kids, will get sick. That’s why drinking water is chlorinated and milk is pasteurized — one more example of how science can be used to enhance what nature provided.

Yes, lots of other foods make people sick, but in the case of milk, there is a solution to limit harm – pasteurization.

Society has a responsibility to the many — philosopher Mill also articulated how the needs of the many outweighed the needs of the one — to use knowledge to minimize harm.

The only thing lacking in pasteurized milk is the bacteria that make people, especially kids, seriously ill.

Adults, do whatever you think works to ensure a natural and healthy lifestyle, but please don’t impose your dietary regimes on those incapable of protecting themselves: your kids.

Dr. Douglas Powell is a former professor of food safety in Canada and the U.S. who now resides in Brisbane and publishes barfblog.com

dpowell29@gmail.com

Always the kids: ‘He turned grey’ says mother of child who fell ill after drinking raw milk

A Melbourne mother has described how her son turned grey when he became seriously ill after drinking raw milk.

bath.milkThe one-year-old boy suffered kidney failure after contracting hemolytic-uremic syndrome – a serious complication of an E. coli infection.

The Melbourne baby’s mother, who spoke to Fairfax Media on the condition of anonymity, said her son developed diarrhea and vomiting, which lasted 10 days, after he had sips of her smoothies made with Mountain View Organic Bath Milk.

“He turned grey, became extremely lethargic and extremely thirsty and was he still sporadically vomiting,” she said.

By the time he reached the Royal Children’s Hospital Emergency Department in late October, his kidneys were failing.

“He had 20 per cent kidney function,” the mother said.

The baby remained in hospital for a week as doctors worked to increase his red blood cells. He is now expected to make a full recovery.

University of Melbourne food microbiology expert Said Ajlouni said he was aware some people may drink raw milk to treat serious medical conditions but warned against it, saying children and people with depressed immunity were more susceptible to infection.

The Australian Medical Association’s Andrew Miller said drinking unpasteurized milk could be fatal or lead to lifelong disabilities, multiple organ failure or brain damage.

colbert.raw.milk“Because these kind of outcomes are relatively rare, people may get away with it [drinking unpasteurized milk] for a period of time, but there are reasons we have food safety laws and that’s so we don’t see children die unnecessarily,” he said.

The mother acknowledged she had been blinded by the wider trend towards raw food, but said she was not aware of the serious risks associated with raw milk.

“If I had heard of anything like this happening to anyone I wouldn’t have brought into my home – I wouldn’t have consumed it myself,” she said.

“It was a wake-up call to make sure I’m no longer blinded by the latest trends. It was a wake-up call to make sure I’m making informed decisions for my family.”

Australian raw milk company defends product after 3yo’s death; urgent recall after ACCC steps in

A day after proclaiming it would continue to sell its unpasteurized bath milk following the death of a three-year old boy, Mountain View Farm is now urgently recalling the product.

raw.milk.headlineOf the four other children – all under five-years old who were sickened, three developed hemolytic uremic syndrome (HUS) and one cryptosporidiosis.

The recall comes after the case was referred to the Australian Competition and Consumer Commission, which said the milk had been recalled due to “a number of recent health concerns” in young children who consumed the milk, and is sold in one and two liter containers.

The ACCC said it would also lead a national investigation of consumer law regulators into possible breaches by suppliers selling raw milk as a cosmetic product.

“The message from health agencies is clear: do not drink unpasteurized milk,” ACCC deputy chair Delia Rickard said. “If you have this product, do not drink it in any circumstances. Return it to the place of purchase for a full refund.”

Authorities have expressed frustration with current regulations allowing the sale of unpasteurized milk in Australia because technically it is not being sold as food.

Dr Rosemary Lester, Victoria’s Chief Health Officer said she had written to Victorian Consumer Affairs and the ACCC about the issue.

“This is correctly labeled as not [for human consumption], so it’s in the domain of consumer law, not food law,” she said.

Vicki Jones, the owner of Mountain View Farm, said she drank the milk herself, but her product was clearly labeled as not for human consumption.

“We label it as bath milk, for cosmetic use only, not for consumption. It’s quite bold, so it’s easy to see,” she said.

“I drink it, but it is a raw product, I can’t say that it’s safe to drink.”

But Ms Jones said the company would change its labels to make them even clearer.

mountain.view.farm“What do I say to [the people who drink the milk]? It’s clearly labeled. At the end of the day what they do with the milk after they purchase it is their choice,” she said.

“Whether they listen to me is out of my hands. … We would probably just put the link to the Health Department website or print what their warnings are.”

Ms Jones said she was aware of the incident and had been contacted by health authorities following the death of the child.

“Apparently [the child’s family] had purchased our milk, but I have been told the child had been previously seriously ill and that he had passed away, and that he had consumed our milk,” she said.

“The health department had taken samples of our milk [for] Salmonella, E. coli, dysentery and all the results have come back negative, or not detected.”

She also said her company ran their own tests on the milk every week for bacteria and it always came back negative.

In a Facebook post on Thursday, the company lamented, “waking up to the disgusting front page of the Herald Sun” on Thursday.

“Shame on the reporter and the people that were behind that piece of rubbish that was written. …

“To the health department, you have opened a hornets nest, not for raw milk, but for exposing the garbage that consumers are fed, the chemical laden pesticides, herbicides, antibiotics that are used to grow food to feed families.

Shame on the system that allows this, shame on Food Safety standards, that permit and make up the levels they deem safe. Look at how many people are sick, why our hospitals are overflowing.

“Why is good quality food so expensive and out of reach of young families on low wages, the very people that need to feed our future generation.”

The organic farm has previously mocked the U.S. food authority for labeling unpasteurized milk as unsafe.

A photo shared by the Facebook page of the business on November 20 implies the U.S. Food and Drug Administration (FDA) authorizes the use of harmful substances while wrongly demonizing raw milk.

Jones defended using the image on her Facebook page, saying she questioned many substances in foods and the FDA should do the same.

mountain.view.farm.2Asked whether the image was misleading because of what it implied about raw milk, Jones said: “Maybe the FDA need to revisit the use of chemicals in food.

“I question the use of some chemicals used in food production and the effect it has on children.”

Some people took to the Mountain View Facebook page to criticize the company following news of the child’s death. “Where is the warning that you claim is on your Facebook page against drinking raw milk,” one person wrote.

Others defended the company, describing the media coverage as a “witch-hunt.”

David Tribe, a University of Melbourne professor and friend of the barfblog.com, collected several images from the Mountain View web site, which are included here.

Dr. Lester said she was worried unpasteurized milk was intentionally being given to children despite being labeled not for human consumption.

“There are two issues that concern me – one is the movement out there that people think that something raw is wholesome and better for you, which is clearly not the case,” said.

“Secondly was the potential for confusion with milk that really is for human consumption, given these products are being sold alongside milk for human consumption.”

It was not clear whether the child in this particular case was intentionally given the raw milk. 

I child dead, 4 sick in Australia from raw milk; US says outbreaks quadrupled

Amidst reports that the number of U.S. outbreaks caused by non-pasteurized milk increased from 30 during 2007–2009 to 51 during 2010–2012, a child in Victoria (that’s in Australia) has died and four have become ill from raw milk.

868179-068aae70-8035-11e4-9659-e3748623bf5fUnpasteurised milk is illegal to sell for human consumption in Australia, but the product consumed by the child was classed as cosmetic so was allowed on the shelves.

The child recently died on the Mornington Peninsula after drinking what was marketed as a cosmetic product and labeled “bath milk”, the Victorian Health Department said.

The U.S. Centers for Disease Control and Prevention said Wednesday that the average number of outbreaks from contaminated unpasteurized milk more than quadrupled from three a year between 1993 to 2006 to about 13 between 2007 and 2012.

Overall, there were 81 outbreaks in that last period, sickening nearly 1,000 people, including 73 who were hospitalized. The CDC said that more than 80 percent of the illnesses happened in states where retail sales of raw milk are legal.

Most outbreaks were caused by Campylobacter spp. (77%) and by nonpasteurized milk purchased from states in which nonpasteurized milk sale was legal (81%). Regulations to prevent distribution of nonpasteurized milk should be enforced.

Pasteurization is an effective way to improve milk safety; however, in the United States, illness related to consumption of nonpasteurized milk continues to be a public health problem. The first statewide requirements that dairy products be pasteurized were enacted in Michigan in 1948 (1). In 1987, the US Food and Drug Administration banned the interstate sale or distribution of nonpasteurized milk. However, the laws regulating intrastate sales are set by each state (2). Regulations for intrastate sales of nonpasteurized milk vary from complete bans to permitting sales from farms or retail outlets (2). Even in states in which sale of nonpasteurized milk is illegal, milk can often be obtained through other means. For example, some states allow cow-share or herd-share agreements, in which buyers pay farmers a fee for the care of a cow in exchange for a percentage of the milk produced (3,4).

Consumption of nonpasteurized milk has been associated with serious illnesses caused by several pathogens, including Campylobacter spp., Shiga toxin–producing Escherichia coli, and Salmonella enterica serotype Typhimurium (3,4). Despite the health risks associated with consuming nonpasteurized milk, the demand for nonpasteurized milk has increased (3,5,6). Recently, many state legislatures have considered relaxing restrictions on the sale of nonpasteurized milk (2,6). We report that the number of outbreaks associated with nonpasteurized milk increased from 2007 through 2012.

The Study

A foodborne disease outbreak is defined as the occurrence of >2 cases of a similar illness resulting from ingestion of a common food. State and local health departments voluntarily report outbreaks to the Foodborne Disease Outbreak Surveillance System of the Centers for Disease Control and Prevention through a standard web-based form (www.cdc.gov/nors). We reviewed outbreaks reported during 2007–2012 in which the food vehicle was nonpasteurized milk. Outbreaks attributed to consumption of other dairy products made with nonpasteurized milk, such as cheese, were excluded. We analyzed outbreak frequency, number of illnesses, outcomes (hospitalization, death), pathogens, and age groups of patients. Data on the legal status of nonpasteurized milk sales in each state were obtained from the National Association of State Departments of Agriculture (79) and an online search of state regulations. The sources from which nonpasteurized milk was obtained or purchased were categorized according to the description from the state outbreak reports, when available.

colbert.raw.milkDuring 2007–2012, a total of 81 outbreaks associated with nonpasteurized milk were reported from 26 states. These outbreaks resulted in 979 illnesses and 73 hospitalizations. No deaths were reported. The causative agent was reported for all outbreaks. Of the 78 outbreaks with a single etiologic agent, Campylobacter spp. was the most common pathogen, causing 62 (81%) outbreaks, followed by Shiga toxin–producing E. coli (13 [17%]), Salmonella enterica serotype Typhimurium (2 [3%]), and Coxiella burnetii (1[1%]) (Figure 1). Three outbreaks were caused by multiple pathogens (Figure 1). The number of outbreaks increased from 30 during 2007–2009 to 51 during 2010–2012. During 2007–2009, outbreaks associated with nonpasteurized milk accounted for ≈2% of outbreaks with an implicated food; during 2010–2012, this percentage increased to 5%. The number of outbreaks of Campylobacter spp. infection also increased, from 22 during 2007–2009 to 40 during 2010–2012.

How milk was obtained was reported for 68 (84%) outbreaks. Nonpasteurized milk was obtained from dairy farms (48 [71%] outbreaks), licensed or commercial milk sellers (9 [13%]), cow- or herd-share arrangements (8 [12%]), and other sources (3 [4%]). Of the 81 outbreaks, 66 (81%) were reported from states where the sale of nonpasteurized milk was legal in some form: Pennsylvania (17 outbreaks), New York, Minnesota (6 outbreaks each), South Carolina, Washington, and Utah (5 outbreaks each). A total of 15 (19%) outbreaks were reported in 8 states in which sales were prohibited. Among these outbreaks, the sources of nonpasteurized milk were reported as a dairy farm (6 outbreaks), cow or herd share (4 outbreaks), and unknown (5 outbreaks).

Conclusions

Within this 6-year period, the number of outbreaks associated with nonpasteurized milk increased. The number of outbreaks caused by Campylobacter spp. nearly doubled. The average number of outbreaks associated with nonpasteurized milk was 4-fold higher during this 6-year period (average 13.5 outbreaks/year) than that reported in a review of outbreaks during 1993–2006 (3.3 outbreaks/year) (4). This increase was concurrent with a decline in the number of states in which the sale of nonpasteurized milk was illegal, from 28 in 2004 to 20 in 2011 (79) and with an increase in the number of states allowing cow-share programs (from 5 in 2004 to 10 in 2008) (8,9). The decision to legalize the sale of nonpasteurized milk or allow limited access through cow-share programs may facilitate consumer access to nonpasteurized milk (5). The higher number of outbreaks in states in which the sale of nonpasteurized milk is legal has been reported elsewhere (4).

The legal status of nonpasteurized milk sales in 1 state can also lead to outbreaks in neighboring states. In a 2011 outbreak of Campylobacter spp. infections associated with nonpasteurized milk in North Carolina, where sales of this product were prohibited, milk was purchased from a buying club in South Carolina, where sales were legal. Another outbreak of Campylobacter spp. infection in 2012 implicated nonpasteurized milk from a farm in Pennsylvania, where sales are legal; cases from this outbreak were reported from Maryland, West Virginia, and New Jersey, all of which prohibit sale of raw milk (10). All patients residing outside Pennsylvania had traveled to Pennsylvania to purchase the milk (10).

Outbreaks associated with nonpasteurized milk continue to pose a public health challenge. Legalization of the sale of nonpasteurized milk in additional states would probably lead to more outbreaks and illnesses. This possibility is especially concerning for vulnerable populations, who are most susceptible to the pathogens commonly found in nonpasteurized milk (e.g., children, senior citizens, and persons with immune-compromising conditions). Public health officials should continue to educate legislators and consumers about the dangers associated with consuming nonpasteurized milk; additional information can be obtained at http://www.cdc.gov/foodsafety/rawmilk/raw-milk-index.html. In addition, federal and state regulators should enforce existing regulations to prevent distribution of nonpasteurized milk.

Ms Mungai is a surveillance epidemiologist at the Atlanta Research and Education Foundation and at the Centers for Disease Control and Prevention. Her interests include infectious disease epidemiology and food safety.

References

Steele JH. History, trends and extent of pasteurization. J Am Vet Med Assoc. 2000;217:175–8 . DOIPubMed

Weisbecker A. A legal history of raw milk in the United States. J Environ Health. 2007;69:62–3 .PubMed

Oliver SP, Boor KJ, Murphy SC, Murinda SE. Food safety hazards associated with consumption of raw milk. Foodborne Pathog Dis. 2009;6:793–806. DOIPubMed

Langer AJ, Ayers T, Grass J, Lynch M, Angulo FJ, Mahon BE. Nonpasteurized dairy products, disease outbreaks, and state laws—United States, 1993–2006. Emerg Infect Dis. 2012;18:385–91. DOIPubMed

Buzby JC, Gould LH, Kendall ME, Timothy FJ, Robinson T, Blayney DP. Characteristics of consumers of unpasteurized milk in the United States. J Consum Aff. 2013;47:153–66.

David SD. Raw milk in court: implications for public health policy and practice. Public Health Rep. 2012;127:598–601 .PubMed

National Association of State Departments of Agriculture. NASDA releases raw milk survey 2011 [cited 2012 Nov 2]. http://www.nasda.org/file.aspx?id=3916

National Association of State Departments of Agriculture. Dairy division of national association of state departments of agriculture raw milk survey, November, 2004 [cited 2012 Nov 2]. http://www.nasda.org/File.aspx?id=1582

National Association of State Departments of Agriculture. NASDA releases raw milk survey 2008. [cited 2012 Nov 2]. www.nasda.org/File.aspx?id=2149

Longenberger AH, Palumbo AJ, Chu AK, Moll ME, Weltman A, Ostroff SM. Campylobacter jejuni infections associated with unpasteurized milk—multiple states, 2012. Clin Infect Dis. 2013;57:263–6. DOIPubMed

Suggested citation for this article: Mungai EA, Behravesh CB, Gould LH. Increased outbreaks associated with nonpasteurized milk, United States, 2007–2012. Emerg Infect Dis [Internet]. 2015 Jan [date cited]. http://dx.doi.org/10.3201/eid2101.140447