The risks associated with drinking raw milk need to be better communicated to consumers, concludes a Scientific Opinion published Tuesday by the European Food Safety Authority (EFSA). EFSA’s Panel on Biological Hazards (BIOHAZ) was tasked with identifying the main microbiological hazards associated with drinking raw (unpasteurized) milk from various animals, assessing the public health risk arising from raw milk consumption, assessing whether raw milk is a significant source of antimicrobial-resistant bacteria, assessing additional risks associated with the sale of raw milk through vending machines and online, and ranking potential control options to reduce public health risks arising from raw milk consumption. In the report, the panel stated that there are “clear links” between drinking raw milk and human illnesses associated with Campylobacter, Salmonella, Shiga toxin-producing Escherichia coli (STEC), Brucella melitensis, Mycobacterium bovis and tick-borne encephalitis virus. However, BIOHAZ said it was unable to conduct a quantitative microbiological risk assessment for these hazards because a lack of country and EU-wide data. In summarizing the 27 outbreaks between 2007 and 2012 involving raw milk in the EU, the panel noted that 21 were attributed to Campylobacter — predominantly C. jejuni — one to Salmonella Typhimurium, two to STEC and three to tick-borne encephalitis virus. Most of the outbreaks were due to raw cow’s milk, but four came from raw goat’s milk. Antimicrobial resistance has been reported in several EU countries in isolates of Campylobacter, Salmonella, STEC and S. aureus from raw milk or associated equipment, such as milk filters, and “may be significant for public health,” stated the report. Strains of Campylobacter exhibiting resistance, predominantly to tetracyclines, have been reported in two member states, the EFSA panel noted. Antimicrobial resistance in isolates of Salmonella from raw milk have only been reported in the UK. Although STEC O157 is the most commonly associated with raw milk outbreaks in the EU, “little information is available about the occurrence of antimicrobial resistance in such outbreak strains,” the report stated. And antimicrobial resistance in isolates of Listeria monocytogenes from raw milk has only rarely been reported in EU countries. The sale of raw milk through vending machines is permitted in some EU countries, but consumers are usually instructed to boil the milk before drinking it in order to eliminate microbiological risks. When it comes to Internet sales, there are no data on the microbiological or temperature controls for products from the bulk milk tank through to the point of consumption. “Good animal health and husbandry, together with the application of good agricultural practices (GAPs) and good hygienic practices (GHPs), are essential to minimise opportunities for contamination of [raw milk] with pathogens in the production to consumption chain,” stated the opinion. However, no single step was identified that could provide a significant reduction in risk. Ultimately, the panel recommended that, “There is a need for improved risk communication to consumers, particularly susceptible/high risk populations, regarding the hazards and control methods associated with consumption of [raw milk].”