Not so long ago, milk was this country’s number 1 food safety concern. Before milk was routinely pasteurized beginning in the 1920s, it regularly caused large outbreaks of deadly diseases. Now in 2011, raw, unpasteurized milk has made its way back into some Americans’ diets and is once again causing outbreaks of disease.
Hello, I’m Dr. Robert Tauxe, internal medicine physician and infectious disease epidemiologist at the Centers for Disease Control and Prevention (CDC). I’m pleased to speak with you today as part of the CDC Expert Video Commentary Series on Medscape about the dangers — as well as some persistent myths and misperceptions — surrounding raw milk or products made from raw milk.
Milk is an important and nutritious natural food, but the recurrent outbreaks related to unpasteurized milk and milk products require that we work together to put out accurate and consistent messages about the serious illnesses that can be caused by consuming raw milk.
First, let’s dispel some common myths about raw milk.
Myth #1. Raw milk is healthier and more nutritious than pasteurized milk.
Not so! All of the nutritional benefits of drinking milk are available from pasteurized milk without the risk for disease that comes with drinking raw milk.
Myth #2. Drinking raw milk can prevent or cure diseases such as asthma, allergies, heart disease, or cancer.
No. There are no health benefits from drinking raw milk that cannot be obtained from drinking pasteurized milk that is free of disease-causing bacteria.
Myth #3. Milk is safe as long as it is labeled “organic.”
Again, this is not true. Even raw organic milk is not safe. Only organic milk that has been pasteurized is safe to drink.
Myth #4. Milk and raw milk products like soft cheeses and yogurts are safe if they come from healthy animals.
No, even the healthiest of animals can carry pathogens, such as Escherichia coli O157, Campylobacter, and Salmonella that can contaminate milk.
Myth #5. If animals are raised in sanitary conditions on humane farms, this ensures that their milk is safe.
It may surprise many to know that the dairy farm environment, even when every precaution is taken, is a reservoir for illness-causing germs. Even if the farm’s raw milk tests come back negative, it is no guarantee that the milk, or the products made from the milk, are always free of those pathogens.
Myth #6. Drinking raw milk may not be safe, but no harm will come from eating products (cheeses, yogurts) made from raw milk.
Unfortunately, this too is quite false. In fact, both people who died in outbreaks related to unpasteurized milk between 1999 and 2008 died of infections caused by fresh Mexican-style cheese made from raw milk. These unfortunate cases show how raw milk made into fresh cheese can cause dangerous infections.
Now that we’ve put to rest the myths about raw milk, let’s discuss the recent facts about the illnesses caused by consuming raw milk and raw milk products. In the 10 years from 1999 to 2008, 86 outbreaks related to unpasteurized milk were reported to CDC, leading to 1676 illnesses, 191 hospitalizations, and 2 deaths.
That is about 8 outbreaks per year. Most of them were due to either E. coli O157, Campylobacter, or Salmonella. Especially concerning was that, of the 86 outbreaks reported to CDC, 79% involved at least 1 person under the age of 20. Some of the most severe illnesses can occur in young children, like kidney failure due to E. coli O157. And remember, E. coli O157 can spread from one young child to another in a day care or nursery school.
Some states permit sale of raw milk and, not surprisingly, about 80% of these outbreaks occurred in states that permit the sale of raw milk. Finally, because not all foodborne outbreaks are investigated or reported to CDC, the actual number of outbreaks that occur is likely to be greater than the number reported.
Our recommendations are simple and straightforward.
* Pasteurization of milk is a fundamentally important food safety measure;
* CDC strongly supports measures to promote pasteurization and restrict the sale of raw milk; and
* Specifically for clinicians, we urge you to educate your patients about the dangers of consuming raw milk or raw milk products.
Robert V. Tauxe, MD, MPH , is Deputy Director, Division of Foodborne, Waterborne and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention. Dr. Tauxe is Deputy Director of the division that is charged with prevention and control of foodborne, waterborne, and fungal infections at the Centers for Disease Control and Prevention. The Division monitors the frequency of these infections in the United States, investigates outbreaks, and develops strategies to reduce the disease, disability, and deaths that they cause.
Dr. Tauxe graduated cum laude from Yale University, in New Haven, Connecticut, in 1975, and received his medical degree from Vanderbilt Medical School in Nashville, Tennessee. In addition, he holds a Masters in Public Health degree from Yale University. Dr. Tauxe’s interests include bacterial enteric diseases, epidemiology and pathogenesis of infectious diseases, epidemiologic and clinical consequences of bacterial genetic exchange, antimicrobial use and resistance to antimicrobial agents, and teaching epidemiologic methods. Dr. Tauxe has supervised many domestic and overseas epidemiologic investigations. Dr. Tauxe has authored/co-authored 254 scientific journal articles, letters, and book chapters.