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Choosing the Path Against Pathogens

October 1, 2013

My career started 40 years ago in the state of New Jersey’s public health department. My first job out of graduate school involved inspecting restaurants, processing plants and warehouses, where the quality and safety of food products sometimes was compromised by both sins of omission and sins of commission, allowing that food to become tainted.

Now, as my professional career nears its end, I find it disheartening that one of the greatest public health measures of all time continues to be under assault. I’m speaking of efforts to roll back the requirement that milk sold within states be properly pasteurized. The joint effort between states and the Food and Drug Administration to ensure that milk sold interstate be pasteurized is part of the bedrock of our national food safety system. But the effort to encourage individual states to take a different path, by permitting in-state sales of raw milk, is deeply concerning to me as a former public health officer and as a national dairy industry representative, because these efforts are wrong-headed and the trend is going the wrong direction.

That’s why the National Milk Producers Federation (NMPF) has been so vocal, as various states – including, several years ago, my home state of New Jersey – have considered, and in some cases approved, laws liberalizing the sales of raw milk. Last month, NMPF joined with the International Dairy Foods Association, and a robust coalition of state farm, food and health organizations, to challenge a pending state senate bill in Wisconsin that would expand the availability of raw milk in America’s Dairyland. Anyone who professes a concern about providing consumers with quality dairy products – and safety is part and parcel of the idea of “quality” – should be joining us in expressing opposition to this kind of initiative.

The potential perils of raw milk are manifest, and I shouldn’t have to belabor that point. There’s hardly a month that goes by when raw milk isn’t implicated in the headlines as causing some type of illness. Beyond mere anecdotes, the Centers for Disease Control (CDC) reported in 2012 that between 1993 and 2006, unpasteurized dairy products resulted in 73 known outbreaks – causing 1,571 cases of foodborne illness, 202 hospitalizations, and two deaths. Even more damning, the CDC also concluded that unpasteurized milk was 150 times more likely to cause food‐borne illness outbreaks than pasteurized milk, and such outbreaks had a hospitalization rate 13 times higher than those involving pasteurized dairy products.

Supporters of the Wisconsin state bill assert that most major dairy states, including California, already allow some form of raw milk marketing (the equivalent of my kids once saying “but all my friends are doing it!”). Yet, the CDC has reported nearly 75% of raw milk‐associated outbreaks have occurred in states where sale of raw milk was legal. Legalizing a product doesn’t make it any safer, especially since we know that raw milk is inherently dangerous, whether it’s obtained from small farms or large, from cow‐share programs, or even from licensed raw milk vendors. As a public health officer in New Jersey, I often found it was easier to rectify the visible sources of foodborne contamination, as opposed to finding pathogens that couldn’t be seen. That’s why there are no assurances that milk from certified or inspected raw milk farms would be any safer.

The other argument made by proponents is that consenting individuals should have the right to choose what they ingest. That argument may work for tobacco or alcohol, but an honest assessment of the issue has to account for the risks to children. Kids frequently are the ones given raw milk; they can’t fully comprehend the hazards involved, and therefore aren’t in a position to consent to those risks. This is not just a legal point, but an ethical matter as well.

That’s because nearly two‐thirds of all outbreaks associated with raw milk or raw milk products involve children. In 2011, five children in California were infected with E. coli O157:H7 after drinking raw milk; three required hospitalization with hemolytic uremic syndrome (HUS), a serious condition that may lead to kidney failure. In Wisconsin, at a school event in 2011, 16 people consuming donated raw milk, including several fourth grade students, later suffered from diarrhea, nausea and vomiting from Campylobacter infections.

Supporting the sales of raw milk – or even turning a blind eye to it – would be the easier path for the national dairy industry, but it’s not the right one. And all of us, regardless of where we are in our careers, ultimately end up regretting the times when we chose the easy path, not the right one.