By Susan C. Kahler
Unpasteurized dairy products marketed for their purported health benefits, some labeled as "real milk" or promoted as coming from "real cows that eat real feed" belie what may lurk inside.
Consumption of raw dairy products is associated with more numerous and more severe outbreaks of illness than is consumption of pasteurized products.
A daylong AVMA convention session devoted to the raw milk conundrum Sunday led off with Dr. Casey E. Barton Behravesh's presentation summarizing government investigations of outbreaks involving dairy products from 1996-2003. Eighty-seven percent of the outbreaks were in states allowing raw milk sales, she reported.
The 123 outbreaks comprised 2,837 cases, 232 hospitalizations, and three deaths. Seventy-four outbreaks resulted from unpasteurized products, 48 from pasteurized products, and one was undetermined. According to Dr. Barton Behravesh, children under 20 are most commonly affected, along with the elderly and immunocompromised.
Interstate transport and sale of raw milk is not legal, and state laws vary. One way that people are trying to circumvent state and federal public health laws are by selling or buying cow shares or herd shares, a marketing approach in which a consumer purchases a share of a cow, goat, or sheep and receives a portion of the milk produced. The Washington State Department of Agriculture considers this sales, so licensing is still required.
Attorney William D. Marler of Marler Clark, addressing legal implications, believes cow share agreements are an attempt to "condo-lize" cows to get around raw milk regulations or bans.
Dr. John P. Sanders Jr. debunked what he called some myths about raw milk. He noted that commercial pasteurization machines didn't become available until 1895, and that the first compulsory pasteurization law was passed in Chicago in 1908. The incidence of milkborne disease in the U.S. has been sharply reduced since then, he said. In 1938, milkborne outbreaks constituted 25 percent of all disease outbreaks; now they account for less than one percent.
Among the alleged benefits of raw milk that he said are disproven or not supported by evidence are that it activates enzymes that kill pathogens; and boosts immunity. Raw milk is not a probiotic because it doesn't meet the scientific criteria for an adequate dose of live microbes that have been documented in target-host studies to confer a health benefit.
"Many negatives are being assigned to pasteurized milk. Little, if any, are substantiated by the literature," Dr. Sanders said.
"More and more people are caring about how their food is produced," said Dr. Michele T. Jay-Russell. Supporters of the "real milk" campaign have values that include saving family farms, no additives, lots of butterfat, no homogenization or pasteurization, and "real cows that eat real feed."
A hot topic right now, Dr. Jay-Russell said, is whether an animal's diet impacts fecal shedding of pathogens. On-farm management practices including diet are an active area of research, she said, but outbreaks have been traced to grass-fed and pastured animals given no grain.
Speaker Claudia Coles of the WSDA said, "We do find pathogens in raw milk samples and we find a lot of single illnesses." Single cases often go unreported.
Dr. Michael A. Payne of California said it's important to realize that despite the food safety risks of raw milk, less than 0.5 percent of U.S. milk is consumed unpasteurized. The problem is that raw milk is responsible for about twice as many outbreaks as pasteurized products.
Right now, California does not have the political will to ban raw milk, he said, so the best thing is to make the processing as safe as possible.
That was a view echoed by other speakers, such as Jay Gordon, a dairy producer and head of the Washington State Dairy Federation. "Reduce the risk curve," he said, and get rid of the black market. "Then it's your choice. "
