“Dead Milk” 23, “Magic Milk” 202
So, who is winning?
I was asked to talk with Sally Fallon Morrell on the Kojo Nnamdi show on WAMU Public Radio in D.C. last week in what the host determined to be the “Raw Milk Wars.” The producer who called me said that she had tried to find someone, anyone, in public health to go on the show, but everyone refused. So, she was left with me.
Sally, who has become famous for her pronouncement that raw milk is “magic” was pleasant enough, as were the host and the callers — even my friend Harry. Some of the comments on the WAMU were a bit harsh, but after two decades of being a lawyer, I am more than used to that. I especially warm to the comments by members of the “Teat Party.”
I was struck by a number of things Sally said during the show. One assertion she said made me think I need to do the experiment she suggested of putting Campylobacter in raw milk, leaving it in the fridge for two days with the bottle cap off and, like magic, the Campylobacter disappears.
I was not at all surprised that she mentioned that between 3% of people in the U.S. consume raw milk — recent CDC’s FoodNet data supports that. In comparison, 78.5% of people in the survey reported drinking pasteurized milk. That is about 26 times more people drinking pasteurized milk than raw milk, so wouldn’t you expect most illnesses to be from pasteurized milk since so few people actually drink raw milk? This gets me back to the “Dead Milk” 23, “Magic Milk” 202 score — who is winning?
I have been keeping track of “Outbreaks, Illnesses and Recalls Linked to Raw (Unpasteurized) and Pasteurized Dairy Products, United States since January 1, 2010 – July 30, 2011.” Here is the breakdown:
-18 raw dairy outbreaks with 202 illnesses, 24 hospitalizations, and no deaths (16 fluid raw milk, 2 aged raw milk cheese)
– pasteurized dairy outbreak with 23 illnesses, 2 hospitalizations, and no deaths
– queso fresco Mexican-style cheese outbreak with 5 illnesses and hospitalizations, no deaths
– sporadic illnesses and hospitalizations from illegal Mexican-style cheese, no deaths
Recalls (no illnesses reported)
– 1 raw dairy (5 fluid raw milk, 6 aged raw milk cheese)
– queso fresco Mexican-style cheese
– chocolate milk due to inadequate pasteurization
– imported Italian cheese made from pasteurized milk
I know, I know David, some of the raw milk outbreaks and recalls are from raw milk that is intended to be pasteurized, but someone simply could not wait and drank the milk raw. However, many of the above outbreaks and recalls involved raw milk truly intended to be consumed that way, and the outbreaks and recalls still happened. Some have also suggested to me that if the cows or goats had been fed grass only, they would be free of pathogens. This is clearly untrue because most of the “real milk” outbreaks came from grassfed animals on pasture on small, family farms. Given the amount of pasteurized milk and cheese consumed in the U.S. yearly versus the amount of raw milk and cheese consumed, 23 illnesses (although unacceptable) from heat-treated milk sure seems like the winning side when the raw milk side is sickening 202.
I am sure that David, Young Bill or Sally might well dispute the numbers above or claim the outbreaks did not happen, or the recalls were not necessary, or there is simply a grand conspiracy to try and pry the glass of raw milk or slice of cheese out of their cold dead hands. That is a debate public health should be engaged in.
There was one assertion — well, lie — that Sally made that I cannot let pass. She flatly said that the 2006 E. coli O157:H7 outbreak that sickened two of my clients severely was not linked to Organic Pastures Dairy raw milk — Sally, it was. Here are the facts — not the “magic:”
On Sept. 18, 2006, the California Department of Health Services (CDHS) opened an investigation into a possible outbreak of E. coli O157:H7 infections after receiving reports of two patients who had been hospitalized with HUS. One was culture-confirmed as infected with E. coli O157:H7. Interviews revealed that both patients had consumed unpasteurized cow milk sold by Organic Pastures in the week prior to the onset of illness.
In the following days, four additional cases of E. coli O157:H7 were identified. All of the additional cases had consumed raw milk or raw cow product sold by Organic Pastures. Isolates of the E. coli O157:H7 cultured from the five culture-positive patients had indistinguishable “genetic fingerprints,” as determined by pulsed-field gel electrophoresis (PFGE) testing. These PFGE patterns were new to the national PulseNet database. In other words, the pattern associated with all of these children was unique, and had not been seen before in conjunction with any other outbreaks of E. coli O157:H7. In addition, the PFGE pattern differed markedly from the patterns associated with the outbreak of E. coli O157:H7 associated with Dole fresh-bagged baby spinach that had peaked a few weeks prior to these illnesses.
CDHS conducted an epidemiological and environmental investigation of the cluster of illnesses. A review of 50 consecutive E. coli O157:H7 cases reported to CDHS from October 2004 to June 2006 revealed that 46 of 47 cases asked about raw milk consumption reported no raw milk consumption. In contrast, five of the six patients in the cluster being investigated reported definite consumption of Organic Pastures raw dairy products. The sixth denied consuming the raw milk, but his family routinely consumed Organic Pastures raw milk during the suspected time frame. Two of the children (one that was stool culture negative for E. coli O157:H7) developed hemolytic uremic syndrome (HUS).
The California Department of Food and Agriculture conducted an environmental investigation. As part of the investigation, fecal samples were collected from dairy cows at Organic Pastures. E. coli O157:H7 was isolated from five of the samples, although the PFGE patterns differed from the pattern associated with the outbreak. Testing of Organic Pastures product revealed abnormally high aerobic plate counts and fecal coliform counts. CDHS ultimately concluded: “the source of infection for these children was likely raw milk products produced by the dairy.” The CDC published this report in 2008.
And, if you want to dig deeper into that outbreak, see this post: “Organic Pastures Dairy E. coli O157:H7 Raw Milk Product Outbreak 2006.” Download the documents, read them and realize that the defendant had no response — no facts and no experts to support Sally’s contention that the illnesses were caused by spinach. Given that all of the six consumed Organic Pastures raw milk and not all of the six consumed spinach and none of them consumed Dole spinach, it is time for Sally to stop the big lie.
It is past time for the raw milk industry — yes, you are an industry — to embrace the facts and embrace the truth about raw milk outbreaks. It is time to put the conspiracy theories away and learn from mistakes. Learning is the only way to avoid being on the losing side of outbreaks and that is something we all can agree is worth it.