Most people would be horrified if they went to a restaurant bathroom and saw the chef not bother to wash his hands after using the toilet. It’s a good thing raw milk fad health buyers do not understand cow milking for the same reason.

A new review finds that consumers are nearly 100 times more likely to get foodborne illness from drinking raw milk than they are from drinking pasteurized milk, which is a lower figure than the Centers for Disease Control, which puts that number at 150X. Though a tiny fraction of milk drinkers risk consuming the raw kind, the raw kind accounts for over 50 percent of milk-related foodborne illness.

Given the results, the scholars from the Johns Hopkins Center for a Livable Future join the chorus discouraging participants in the raw milk fad.

The analysis was prepared at the request of the Maryland House of Delegates’ Health and Operations Committee as lawmakers considered undoing regulations that currently prohibit the sale of raw milk in Maryland. In the 2014 legislative session, House Bill 3 aimed to legalize the on-farm sale of raw milk but was tabled as legislators considered the issue.

Raw milk has become more popular in recent years, even though it is only available for direct purchase at farms in states that allow it. Advocates claim that raw milk healthier and cleaner with all of that extra bacteria. More speculative claims are that it reduces lactose intolerance and allergies. Pasteurization, named after Louis Pasteur, has saved a billion lives because it destroys microbes that enter the milk supply from fecal contamination, dairy operations, cow udders, bovine diseases or other sources. The treated milk is then hermetically sealed to prevent recontamination.

“Ultimately, the scientific literature showed that the risk of foodborne illness from raw milk is over 100 times greater than the risk of foodborne illness from pasteurized milk,” says report lead author, Benjamin Davis, a CLF-Lerner Fellow and doctoral candidate in the Johns Hopkins Bloomberg School of Public Health’s Department of Environmental Health Sciences. “Although potential benefits related to the consumption of raw milk would benefit from further investigation, we believe that from a public health perspective it is a far safer choice to discourage the consumption of raw milk.”

For their study, a team of investigators led by Keeve Nachman, PhD, director of the Public Health and Food Production Program at CLF and an assistant professor with the Bloomberg School, screened approximately 1,000 articles and reviewed 81 published journal articles relevant to the health risks and benefits of consuming raw cow’s milk.

Microbial contaminants commonly found in milk include infectious Salmonella, Campylobacter, and Listeria species along with the Escherichia coli type O157:H7. These bacteria can cause foodborne illness in humans, including diarrhea, vomiting, cramping, fevers, and sometimes more serious consequences such as kidney failure or death.

“The risks of consuming raw milk instead of pasteurized milk are well established in the scientific literature, and in some cases can have severe or even fatal consequences,” notes co-author Cissy Li, a CLF research assistant and doctoral candidate with the Bloomberg School’s Department of Environmental Health Sciences. “Based on our findings, we discourage the consumption of raw milk, especially among vulnerable populations such as the elderly, people with impaired immune systems, pregnant women, and children.”