A new in-depth study of raw milk illnesses in the U.S. by a university researcher concludes that “the outbreak rate has effectively decreased by 74% since 2005.”
The 38-page study, which includes 138 footnotes and was published in the refereed PLOS Current Outbreaks, also concludes that the risk of illnesses has actually declined in the face of increased consumption: “The potential for foodborne illness continues to be a small but real risk from consuming unpasteurized fluid milk, but analysis of data over a twelve year period demonstrates that increased access to this product within the United States has not led to increased outbreak rates. On the contrary, total reported unpasteurized milk-associated outbreaks have declined since 2011, despite increased production, and outbreak rates proportional to estimated consumption rates have declined by 74% over the twelve year period.”
The study’s authors—Joanne Whitehead, a researcher at the University of Victoria in Canada; and Byrony Lake, a professional researcher and policy analyst in Canada— suggest broader implications beyond providing insights into the long-running debate over raw milk safety by arguing that “given the potential for significant public health benefits which could be gained from a reduction in immunological disorders, a re-evaluation of the risk/benefit profile of unpasteurized milk is in order.”
This new study is significantly at odds with two studies from the U.S. Centers for Disease Control, which conclude that risk from raw milk is much more serious than from pasteurized milk, and that the risk is rising.
The new study allows that data used to analyze dairy safety, no matter who is doing the assessment, is incomplete and even confusing because of varying reporting by states and because of the highly variable legal situation with regard to raw milk among the states. The authors clearly explain in the study their challenges in obtaining and evaluating data from individual states about such matters as the number of new raw dairy permits issued and the number of illnesses recorded. Among their specific research findings:
- Beginning in 2005, the trend for several years was of rising illness rates, followed by a declining rate, as shown in the graphic at the top of this post. “Excluding data for 2009 (indications of a data integrity problem), annual reported outbreaks related to unpasteurized fluid milk started at a low of 10 in both 2005 and 2006 and rose to peak at 18 in both 2010 and 2011. After this peak, outbreaks then saw a general decrease: 14 in 2012, 16 in 2013 and 2014, 11 in 2015, and 13 in 2016. This results in an annual average of 14 outbreaks for the most recent 5 year span, from 2012 to 2016 inclusive.”
- Fears that broadening legalization of raw milk would lead to higher illness rates appear unfounded. “To further examine the hypothesis that legalization leads to higher outbreak rates, one can examine whether a change in legal status within a specific jurisdiction affects the outbreak rate within that jurisdiction……There was no change in absolute number of outbreaks (6 outbreaks in each 4 year period) and a slight reduction in relative outbreak rates due to population growth during this time.”
- Safety education makes a difference in reducing raw milk illnesses. “Regarding education, a challenge for dairies has been a lack of on-farm food safety programs. This changed in 2010 when the Farm-to-Consumer Legal Defense Fund made training materials available and the Raw Milk Institute began developing a HACCP-based on-farm food safety program. The decline in frequency of outbreaks coincides with the introduction of these targeted education programs. The tentative conclusion can be drawn that, similar to what was seen in the meat processing industry, the implementation of on-farm food safety systems for unpasteurized milk production may be related to the observed reduction in outbreak rates. Data from Pennsylvania supports this connection….outbreaks occurred each year from 2006 to 2014, then no outbreaks were reported for 2015 or 2016, then one outbreak occurred in 2017. An interesting correlation is that in November 2014, Pennsylvania State University’s College of Agricultural Sciences hosted a workshop on unpasteurized milk safety in collaboration with the Raw Milk Institute. In addition, in 2014 the proprietor of the largest Pennsylvania unpasteurized milk farm was trained and listed with the Raw Milk Institute. This farm had been responsible for outbreaks in 2012 and 2013 (CDCIDs 15533 and 15482) including one associated with 148 out of 258 (57%) unpasteurized milk related illnesses reported nationwide in 2012. No outbreaks have been associated with this farm’s products since training and listing. While it is impossible to show causation, this correlation of fewer outbreaks with the implementation of a HACCP-based on-farm food safety training program has implications for further studies of the role which education and extension programs may play in the safe production and handling of unpasteurized milk.”
- Raw milk production continues to increase. “It is apparent from licensing statistics and consumer websites that unpasteurized milk is currently being produced on a larger scale than in past decades…. Compiling license and permit numbers for (just) nine states shows an increase over twelve years from 76 to 347 licensed unpasteurized milk dairies (+357%). Assuming that license and permit numbers are a reasonable proxy for consumption, and factoring in U.S. population growth (9.3% over the twelve year period), the ratio between outbreak rate and consumption rate shows a pronounced decline, with the 2016 outbreak-to-consumption ratio only 26% that of 2005.”
- The U.S. might want to consider having the federal government regulate raw milk, to gain more consistency around the country. “The federal ban on interstate trade in unpasteurized fluid milk has not eliminated either multi-state outbreaks or the emergence of unregulated interstate buying clubs. As 43 states representing 92.6% of the U.S. population currently (March 2018) permit legal access to unpasteurized milk, and legalization does not correlate with increased outbreak rates, expanded legalization along with the development of a federal regulatory framework could be considered, similar to national systems already in effect in other nations such as England, France, Germany, and New Zealand.”
This is an impressive study—impressive in significant measure because it takes on this complicated subject, with all its inconsistencies and nuances, and covers it much more adroitly than any of the CDC assessments. The only area not covered, raw milk opponents might argue, is a breakout of the kinds of illnesses that are occurring from tainted raw milk. The CDC and others have argued that there a growing percentage of the raw milk illnesses that are occurring are from E.coliO157:H7, which can lead to complications in children.
That may be a topic for a follow-on study, because failure to agree on the overall scope of the problem at hand invariably leads to confused, and confusing, arguments. Hopefully this study will lead to some meeting of the minds on where we’ve been and where we are heading in terms of raw milk risk. The signs, from a public health perspective, look much more positive than we’ve been lead to believe.
Thank you David. This study was a first and challenged the CDC and its comingling of milk intended for further processing verses milk intended for direct raw consumption.
My favorite chart shows the RAWMI effect. It shows the dramatic drop off in outbreaks and illness after producers recieved training and standards were published at RAWMI. Even though just 17 dairies are Listed by RAWMI, the expectations and standards have been set high. All other raw milk dairies see and feel the change and evolve to the better!
We have just begun to change the world. One very child at a time. One clean dairy at a time !
Mark
Mark, repeat after me: i before e except after c
Leisure, weird, protein, sufficient, science
In my recent peer review publication, I suggested that training and education of fresh raw milk dairy farmers could improve safety. Securing fresh food from fertile soil, challenges to the organic and raw milk movements
https://www.cambridge.org/core/journals/renewable-agriculture-and-food-systems/article/securing-fresh-food-from-fertile-soil-challenges-to-the-organic-and-raw-milk-movements/18325E375E068A538E07EF4E6F6ABA22
As indicated by this new peer reviewed publication, apparently so.
As long as the government is not in charge of the training and education, absolutely!
Joe,
Brillliant science is nothing but recognizing the obvious.
Clean udders, healthy cows with good post milking management…produces clean very low risk raw milk.
Is that obvious? Is that a secret?
It is about as clear as clear can get and about as obvious as obvious can get. Now we have a strong piece of science that shows this clearly.
I am very pleased to see the results of RAWMI and early WAP food safety training efforts finnaly becoming fruitful.
Mark,
In many respects you are carrying forward into a new era the original good management practices recommended over a century by Dr. Henry Coit, MD when he established the Medical Milk Commission way of producing Certified Milk. Keep up the good work!
David, we should be careful about how the findings of this article are described, because the anti-raw milk people will find anything they can to dismiss this.
David, we should be careful. That 74% decrease is *only* found when one controls for both population growth and estimated consumption trend, using licensing numbers to provide a *general estimate* of consumption trends (= increase or decrease). There is no way to be accurate about this — it is only an estimate. We can’t get too excited about this 74% – its a “ballpark estimate”.
In contrast, the part we CAN get excited about are the hard, concrete numbers that don’t rely on estimates – especially the trend from 2010 to 2016:
– Legalization: Increased 16.7% from 36 states in 2010 to 42 in 2016 (Figure 3).
– Outbreak rates: Decreased 30% from 0.058/M in 2010 to to 0.040/M by 2016 (paragraph above Figure 1).
This is what we need to publicize that since 2010 there has not been a direct correlation between outbreaks and legalization. Thus, there is no reason NOT to legalize raw milk. And Figure 6 pretty much shows evidence indicating the reason why.
That article is a goldmine of other information, but these are the points that stick out for me – the numbers since 2010.
Vera, good point about the role of consumption data. There is no precise consumption info to be had. One of the impressive things about this study is the researchers’ realistic, and sincere, approach to consumption, in contrast to the CDC’s cynical approach. A very low estimate on consumption was the foundation of the agency’s shocking, and pathetic, assessment a few years back that raw milk is 150 times more dangerous than pasteurized milk: “If you consider the number of outbreaks associated with raw milk in light of the very small amount of milk that is consumed raw, the risk of outbreaks linked to raw milk is at least 150 times greater than the risk of outbreaks linked to pasteurized milk.”
https://www.cdc.gov/foodsafety/rawmilk/rawmilk-outbreaks.html
(Copy-and-paste typo there – sorry about the repetition.)
When I was looking at the CDC statistics about 10 years ago, one of the problems that I found was with the way that “raw milk outbreak” was defined. Several incidents of food-borne illness resulting from the ingestion of bathtub cheese were attributed to the milk and not the processing. In many instances, the statement was made, “Although there was no evidence of contamination, it was assumed that the illness could be attributed to raw milk because of the exposure.”
So the CDC assumed that the illness was from raw milk, despite any evidence. I can recall at least 3 instances of raw milk hysteria. One was under-cooked chicken, one was eggs that had been broken out and left to sit overnight, and one was hamburgers. I would not be surprised to find that these were still classified as raw milk outbreaks. I know that the hamburger one is. Many members of the general public still believe it.
It aLLlways was DOWN and possibly more than 74%.
start calling up every department of ag and markets and ask for the dairy division.throughout the whole u.s of A. AND ask them if there have been any outbreaks of any illnesses PERTAINING TO RAW MILK AND THE NAMES OF THE FARMS…. each state has many counties …it can take a while .its virtually nil. YOU CANT FIND ANY .and thats when its registered with government agencies.!!!! where are all the outbreaks …where are they ????????
THERE HAVE BEEN MORE OUTBREAKS OF LETTUCE…PEANUT PRODUCTS,CRACKERS…ETC… THAN ANY RAW MILK EVER HAD INCLUDIING CONFINED COWS …NON ORGANIC RAW MILK FARMERS.
and I purposely was drinking milk that allegedly had L.monocytogenes in it…. Vera on this blog has said that is the worst kind of bacteria to get sick from compared to other listerias
I never got sick nor did my granddaughter..!!!!!!!
someone said Marc mccafree did a study that even though “bad” bacteria was in the milk..there was sooooo much good bacteria from this raw grass fed organic milk that it canceled out thew bad bacteria.Maybe thats what happened to me and my granddaughter (baby at the time) and I’m older with a compromised immune system.
Listeria is not associated with raw milk. It is associated with post pasteurized milk contamination.
Look at the CDC data and review the last deaths listed from milk. They are all listeria and pasteurized dairy products. Ice cream, cheeses, and milks. All pasteurized and all listeria.
The two deaths from raw milk cheeses were imported bathtub suit case cheeses from Mexico. Totally illegal.
Another CDC Data screw up. That’s not American raw milk!!
Marc thats crazy …thats insane… listeria mostly found in post pasteurization…I never knew this….and they still come after the raw milk producers…
ok but how do you explain a government agency coming into a farm and telling the farmer that he has L.Monocyotogenes(I know these farmers near Canadian border my brother use to know near Canton,new York ) They shut him down.Vera says that L.Monocytogens is the bad form of Listeria.
him and his brother and sister are raw milk producers with a license..Their milk is not pasteurized.Why did they say that they had L.Monocytogenes??
And I never got sick from it!!!!!!!!!!!!!!!!!!!!!! …drank the milk and ate the yogurt for 3 weeks.Can you explain this Marc.Im really puzzled.I do believe that it is very rare to get “sick” from raw milk
marc upstate New York also a raw cheese producer last year had “listeria” in his cheese.It was not pasteurized it was raw …im really confused now His cheeses are not Post pasteurization
and also a farmer in Pennsylvania…a few years back he was selling his milk to California…some woman died..they blamed it on ‘alleged ” Listeria.He is a raw milk producer not pasteurized…Im confused Marc…Please explain
I did not say that listeria is never found in raw dairy products. What I did say was that it is rarely associated with death or illness on the raw side.
An analysis of listeria deaths and illnesses at the CDC revealed that there were very few illnesses linked to raw dairy products and few if any deaths. In stark contrast, there were many deaths and thousands of illnesses linked between listeria and post pasteurized contamination.
The reported deaths from listeria and raw cheese is a rare piece of data.
Before jumping to conclusions we need to know more about the cheese making process.
Was it truly raw or thermalized and called raw.
I remember when I investigated that outbreak, the milk came from a dairy unrelated ( not owned ) by the cheese maker.
The vat temp was unknown. That’s a huge warning flag. We know that many raw cheeses are actually heated to just under pasteurized temps and Called raw. This is legal but it sure cheats nature and the consumer looking for raw cheese. It also brings on the threat from listeria.
Responding to Bioterror Concerns by Increasing Milk Pasteurization Temperature Would Increase Estimated Annual Deaths from Listeriosis
(Stasiewicz et al., 2014 Journal of Food Protection)
“Conservative estimates of the effect of pasteurizing all fluid milk at 82 C rather than 72 C are that annual listeriosis deaths from consumption of this milk would increase from 18 to 670, a 38-fold increase”
(page 703) “These changes to the potential for outgrowth have been calculated to increase the risk of death from listeriosis due to consumption of pasteurized fluid milk by approximately 40-fold. Such an increase would have an appreciable public health impact if all milk in the United States were processed according to the increased pasteurization temperature based on the fact that milk is estimated to be responsible for approximately 18 listeriosis deaths per year in the United States.”
From the Whitehead and Lake (2018) paper:
“Supplementary Information
“All supplementary material is available at http://figshare.com/s/866c3d82f50105ff5dab ”
Download “Supplementary Table 1” from Figshare. It contains the complete dairy-related outbreak data-set for this paper. If you’d like to see what dairy foods are associated with L. monocytogenes and what are not, this is where to look.
Yes, the same CDC that grossly over-hypes (lies) about the number of flu deaths annually to get us all to line up for the toxic flu shots. No surprise.
New Jersey Dept Ag is having a dairy summit Thursday Oct 11th at 9-4pm.
Burlington Co. Agricultural Center, 500 Centerton Rd, Moorestown, NJ
Pre-registration required. Call 609-292-6382
Yes, the same CDC that Robert F Kennedy Jr., describes as “a cesspool of corruption”
It is mind boggling to think that institutions that are entrusted with the public’s health can go about persistently deceiving so many people in so many ways. That’s what we get when we surrender our freedom to choose for the sake of someone’s biased and putative modus operandi with regards to so-called food safety and disease prevention.
Dr Joe,
Thank you for reminding us about the study on listeria and 40 food increase in deaths if heat temps are increased just 10 degrees F.
What really got me on this study was the bold announcement that “ currently 18 consumers die every year “ from listeria in pasteurized. dairy products.
Thus study was funded and backed by the pasteurized dairy industry.
What a huge admission.
Where are the deaths ? Is there a huge cover up? At present the Cdc shows only a few deaths each year from listeria related to pasteurized dairy products.
What’s going on here???
A peer reviewed PhD study is supposed use current data. Why would the researchers assume data or make it up? They claimed that 18 people die each year and those numbers would grow to more than 650 with increased temps ??
This is a very big question.