The Safety of Raw Milk

“Got Milk? Make Sure It’s Pasteurized” --Title of an article in September-October 2004 FDA Consumer Magazine

John Sheehan, director of the Food and Drug Administration’s division of Dairy and Egg Safety, says drinking raw milk is “like playing Russian roulette with your heath,” and that they see “a number” of illnesses related to the consumption of raw milk. Raw milk can contain bacteria campylobacter, escherichia, listeria, salmonella, yersinia, and brucella. The CDC claims that more than 300 people got sick from drinking raw milk or eating raw milk products in 2001, and nearly 200 in 2002.

The FDA reports that between 1998 and 2005, raw milk or cheese was implicated in 39 outbreaks in 22 states, causing an estimated 831 illnesses, 66 of which resulted in hospitalization and one in death. However, this accounts for only 0.4 percent of all cases of food born illness.

The Weston A. Price Foundation, an organization dedicated to the legalization of raw milk, believes that even 0.4 percent is an exaggeration. In a slide-by-slide rebuttal of the FDA’s PowerPoint presentation attacking raw milk, WAPF identifies multiple potential sources of bias in outbreak investigations. Investigators often ignore other potential sources of illness when they find out that someone consumed raw dairy. For example, infected people can spread disease to previously uncontaminated milk or dairy products. Demonstrating that raw milk cheese is contaminated is not the same as proving that it is the source of contamination.

Federal and state agents can be quick to blame dairy farms for outbreaks of disease, even with little to no evidence. For example, in 1966 the L.A. County Department of Health Services reported seven cases of Q fever (Coxiella burnetti) among people who lived near dairies. Raw milk sales were and are legal in California, and the Department concluded that the best way to control C. burnetti would be to require the pasteurization of all milk, even though the disease is contracted through inhalation and none of the infected individuals had consumed raw milk.

The judgments in favor of pasteurization seem arbitrary, and farmers are suspicious that state governments are simply looking for an excuse to shut down raw dairy operations. Kathryn Russell’s farm was investigated when one of her shareholders became ill. Russell insisted on having her family veterinarian present to take control samples when the state investigators came to test for diseases. Investigators later called her and informed her that they had lost their original samples and needed to return. Once again, Russell insisted upon having her veterinarian present to take control samples. The investigators never returned.

In Ohio, only one dairy provided raw milk in 2002. The dairy had been operating since 1958 and provided milk to 1.35 million customers. Between 2002 and 2003, 62 people were infected with Salmonella, 40 of whom were customers. All 31 stool samples taken from the dairy cows tested negative, and county health authorities concluded after the investigation that pasteurization may not have prevented the outbreak. However, the county health authorities suspended the sale of raw milk “temporarily until further notice” and suggested that the dairy relinquish its license to sell raw milk, which it did. Ohio’s only source of raw milk had been shut down.

The handling of this case contrasts sharply with a case in Pennsylvania where 38 people tested positive for the antibiotic resistant S. typhimurium in 2000. The milk implicated in this case was pasteurized, and investigators concluded that the contamination probably occurred after pasteurization. However, instead of shutting down the dairy, the Pennsylvania Department of Agriculture integrated employee training with its routine inspections, and the dairy hired a consultant to help it meet FDA standards. The investigators further concluded that the majority of milk contamination occurs after pasteurization, and is not a result of insufficient pasteurization.

Supporters of raw milk say the FDA makes two important mistakes: it addresses the safety of raw milk outside of the context of food safety in general, and it promotes pasteurization as the only way to make milk safe for human consumption. Consuming raw milk is risky, of course, but supporters don’t believe that raw milk is any riskier to consume than hot dogs, store bought spinach, or even pasteurized milk, which has caused massive outbreaks of disease when machinery failed.

What troubles many public health officials is that individuals who believe in the health benefits of raw milk feed it to people who are the most susceptible to illness: children, the elderly, and individuals who are already ill and suffering from weakened immune systems. Many consumers of raw milk believe that the probiotic agents in raw milk provide health benefits that keep children healthy, reducing the prevalence of asthma and allergies as well as many diseases. For the same reason, people who suffer from autoimmune diseases often seek out raw milk in order to bolster their natural defenses. For many state officials, this behavior pushes the issue beyond a matter of consumer choice and justifies bans on raw milk sales and cow share operations.

Doctors are also split on how to view raw milk. Some people have been turned away by doctors who refuse to treat them until they stop drinking raw milk. One woman I interviewed who lives on a farm became extremely ill with a gastro-intestinal problem. When she went to her doctor, however, instead of telling her to quit raw milk, he encouraged her to eat yogurt made with raw milk as the best treatment.

With the FDA and CDC vehemently opposed to raw milk, and supporters attacking the safety of pasteurized milk, it is difficult to make heads or tails out of the situation. While some doctors blame raw milk almost immediately for illness, others prescribe it as a cure and drink it regularly. The same goes for many employees of state agriculture and health departments. Is raw milk worth the risk? Is there really a greater risk in consuming raw milk than there is in consuming anything else?