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15The Safety of
Raw versus Pasteurized Milk
It is very difficult to get a man to understand something when his
salary depends on not understanding it.
UptonSinclair
Drinking raw milk is like playing Russian roulette with your
health.
JohnF.Sheehan,Director
U.S.FoodandDrugAdministration
DivisionofDairyandEggSafety
SeveralissuesarecentraltotherawmilkcontroversyinAmerica
today. Some are scientific and some essentially legal. Even the scientific
issuesareshroudedin legalitiesandpolitics,butwe’llapproachthem
inastraightforwardandpracticalmanner.Oneissueisthequestionof
safety:Howsafeisrawmilk?We’llanswerthatquestionbyconsidering
thehistoricalrecordsofbothrawandpasteurizedmilkasagentsassoci-
ated with disease, and by looking at scientific evidence delineating the
numerouscomponentsinrawmilkthatkillpathogensandstrengthen
theimmunesystem.
Another scientific issue involves the health benefits of raw milk
263
264 The Untold Story of Milk
comparedtopasteurized—asubjectthathasbeenexploredinmanyof
theprecedingpages.We’lllookatthisissueagaininChapters16-18as
weexplorewhyandhowgreenpasturesandcontentedcowsproduce
nature’smostnearlyperfectfoodforchildrenandadults.
Legal issues surrounding the raw milk controversy are complex
and many of their ramifications are beyond the scope of this book. But
we’llconsideranumberofpracticalquestions.Istheallegedevidence
aboutthedangersofrawmilksostrongthatthegovernmentshouldpro-
hibititsbeingsoldorevengivenaway,asindeedhasoccurredinsome
statesandcountries?Evenmorefundamental,doesourconstitutional
governmenthavetherighttomakelawsoutlawingafoodthathassus-
tainedmuchofhumanity throughout recordedhistory? In the faceof
restrictive and unfair laws, what legal structures exist that may allow
dairyfarmerstolegallymakerawmilkproductsavailabletoconsumers
forreasonablecompensation?Howareproducersandconsumersofraw
milkworkingtogethertochangeexistinglawsthatpreventfarmersfrom
sellingrawmilkanditsproductsontheopenmarket?
Theanswerstothesequestionsareshapingthewayadetermined
minorityofAmericanshasbuiltagrassrootsmovementtomakeaready
supplyofrawmilkandrawmilkproductsavailableforthemselves,their
familiesandanyoneelsewhodesiresit.Thesecommittedindividuals—
farmers,consumers,activists,alternativemedicalpractitionersandtheir
patients,journalists,local,stateandfederalgovernmentrepresentatives
andothersinpubliclife—andthelegalissuestheyareconfrontingare
thesubjectofChapter19.Fornow,weconsideramorestraightforward
matter:thesafetyofrawversuspasteurizedmilk.
Thepositionofthepublichealthandconventionalmedicalcom-
munities on raw milk is unequivocal: they are dead-set against it. In
1986,anFDArulingbannedtheinterstateshipmentofrawmilk,but-
ter and cream across state lines. For many years, officials in every state
havepushedforlawsbanningallsalesofrawmilk,withstrongsupport
fromtheCenters forDiseaseControl (CDC)and theFDA.Within the
lastthirtyyears,legislationhasbannedretailsalesofrawmilkinmost
states and restricted sales to the farm where the milk is produced in
many others. But no state has passed legislation against the purchase,
The Safety of Raw versus Pasteurized Milk 265
possessionorconsumptionofrawmilk.Thisfactalonearguesthatthe
incentivetobanrawmilksalesisbasedoneconomicratherthanpublic
healthconcerns.FDAassertionsthatrawmilkis“inherentlydangerous
andshouldnotbeconsumed”1serveasasmokescreen for legislation
thathelpscentralizethedairyindustryandeliminatecompetitionfrom
smallindependentfarmers.
Health officials frequently draw attention to studies claiming that
rawmilkhascausedillness—mostoftenissuingpressreleasesagainst
rawmilkduringoutbreakscausedbyotherfoods.Howeverasweshall
see,mostofthesepublishedreportsexhibitextremebiasonthepartof
investigators and contain numerous flaws. In fact, many studies claim-
ingthis“inherentlydangerous”foodasacauseofdiseaseactuallyexon-
eraterawmilkasaculprit.
RAWMILKISINHERENTLYSAFE
While government officials have painted raw milk as a dangerous
soupofpathogenicbacteria,agreatdealofobscure,peerreviewedre-
search has revealed a very different picture. After all, raw milk is the first
foodofeverymammalontheplanet.Thecalfthatisborninthemuck
andmanureimmediatelygetsupandbeginstosuckonitsmother’sun-
sanitary teat; likewise, the puppy crawls across filthy bedding to find its
mother’sunwashednipple.Ifrawmilkisaninherentlydangerousfood,
howisitthatthefamilyofmammalshassurvived?
Mammals including humans have survived because raw milk
contains multiple, redundant systems of bioactive components that
canreduceoreliminatepopulationsofpathogenicbacteriawhilealso
strengtheningtheimmunesystemofthesucklinginfant.
Earlyresearchersrecognizedfactorsresponsibleforthegermicidal
propertyofrawmilk,asdescribedinthe1935textbookFundamentals
of Dairy Science.2In1938,researchersfoundthatrawmilkwouldnot
supportthegrowthofawiderangeofpathogens,notingthatheatedmilk
supportsthegrowthofharmfulbacteriabyinactivating“inhibins.”3
Todaywehavedetailedknowledgeaboutthese“inhibins.”Thetwo
majorcomponents,which formthebackboneof thisamazingsystem,
are the enzymes lactoperoxidase and lactoferrin. The lactoperoxidase
266 The Untold Story of Milk
enzymeusessmallamountsoffreeradicalstoseekoutanddestroybad
bacteria.4 It is found inallmammaliansecretions including tearsand
saliva.5Levelstendtobehigherinanimalmilk—goatmilkcontainsten
timesmorelactoperoxidasethanhumanmilk.6Soeffectiveislactoper-
oxidase at killing pathogens that officials in other countries are explor-
ingthepossibilitiesofusinglactoperoxidaseforensuringthesafetyof
otherfoods,andevenasanalternativetopasteurization.7
Peroxidase enzymes such as lactoperoxidase are common in the
livingtissuesofplantsandanimalsandplayanimportantroleininnate
immunitytoinfection.Theyareharmlesstoanimalandplanttissuebut
stronglyinhibitthebacterialmembraneenzymesthatarecriticaltobac-
terialsurvival.Theseenzymesinitiatetheproductionofpowerfuloxidiz-
ingagents(peroxides),whicharebasedonsulphurgroups.
Lactoperoxidase was discovered in milk one hundred years ago
when cheesemakers observed that at certain times of the year start-
erbacteriaadded tomilkwouldnotwork.This tookplaceduring the
bloomingofcertaingrasseshighinsulphurcompounds,whichareread-
ilyoxidizedtothiocyanatesbylactoperoxidase.Thethiocyanatesformed
aresostronglyantimicrobial,theyinhibitnotonlythepathogenicand
spoilagebacteriabutalsothelacticacidbacteriausedbythecheesemak-
ers.8
Thesecondmajorantimicrobialenzymeinmilkislactoferrin,which
worksbystealingironawayfrompathogensandcarryingitthroughthe
gutwall intothebloodstream.Thus,thisenzymedoesadoubleduty,
killingoffawiderangeiron-lovingpathogenswhilehelpingtheinfantto
absorballtheironcontainedinthemilk.Inaddition,lactoferrinstimu-
latestheimmunesystem.9
AccordingtoarecentreviewintheJournal of Experimental Ther-
apeutics and Oncology, lactoferrin exhibits fungistatic, bacteriostatic,
bactericidalandantiviralpropertiesandinhibitsthegrowthofparasites.
It is effective against E. coli, S. typhimurium, Bacillus subtilis, Pseu-
domonas aeruginosa,Vibrio cholerae,Haemophilus influenzae,S. au-
reus,Klebsiella pneumoniae,Candida albicans,Candida crusei,Tinea
pedis, Toxoplasma gondii, Plasmodium falciparum, Herpes simplex,
hepatitisCvirus,humanpapillomavirusandvariousotherpathogens.
The Safety of Raw versus Pasteurized Milk 267
It is not effective against beneficial bacteria such as bifidobacteria and
lactobacillusspecies.10
One of the main iron-loving pathogens is the tuberculosis bacil-
lus. In a study involving mice bred to be susceptible to tuberculosis,
treatment with lactoferrin significantly reduced the burden of TB or-
ganisms.11 Another iron-loving microorganism is Candida albicans, a
yeastubiquitouslypresentinthedigestivetract,whichcancauseserious
health problems when conditions favor its overgrowth. Mice injected
withCandida albicanshad increasedsurvival timewhentreatedwith
lactoferrin.11Otherresearchindicatesthatlactoferrincanbeusedtocut
visceralfatlevelsbyasmuchasfortypercent,andthatthecompound
has many other health benefits.12Youcanevenpurchaselactoferrinasa
supplement—or benefit from its actions simply by drinking raw milk.
In 2004, the FDA approved lactoferrin for use as an anti-
microbialspraytocombatvirulentE. coli O157:H7contaminationinthe
meatindustry!TheFDApressreleasepraisedtheproductasaninnova-
tivewaytoprotectthenationfromfood-borneillness.“Innovativetech-
nologyisacriticalbuildingblockinpreservingthestrongfoundationof
theU.S.foodsupply,”saidDr.LesterCrawford,DeputyCommissioner
of the Food and Drug Administration. “We must continue to encour-
age scientific research and new technology to maintain this nation’s safe
foodsupply.”13
Since the dawn of mammalian history, nature has provided this
“innovative technology” to nursing infants to protect their vulnerable
andsensitivedigestivesystemsfromtheinsultsofinvadingpathogens.
Perhaps this is one reason why responsibly handled raw milk rarely
leadstogenuinecasesoffood-borneillness.
Physiciansfromearliertimesoftenreferredtomilkaswhiteblood,
adesignationthatmodernscienceprovestobecorrect.Akeyplayerin
raw milk’s anti-microbial and immune support system is white blood
cells,orleukocytes,exactlythesameasthosefoundinblood.Leukocytes
formthebasisofmilk’ssafetynet,consumingforeignbacteria,yeasts
andmolds.Theyalsoproducehydrogenperoxidetoactivatethelacto-
peroxidasesystemandanaerobiccarbondioxide,whichblocksaerobic
microorganisms.14 Raw milk contains B-lymphocytes, a type of white
268 The Untold Story of Milk
blood cell that aids the immune system by producing specific antibodies;
macrophages,whichengulfforeignproteinsandbacteria;neutrophils,
whichkillinfectedcellsandstimulatetheimmunesystem;T-lympho-
cytes,whichmultiplywhenbadbacteriaarepresentandproduce im-
mune-strengtheningcompounds;andimmunoglobulins(IgM,IgA,IgG1
andIgG2),orantibodies,whichtransferimmunityfromtheanimalpro-
ducingthemilktotheanimalorpersonconsumingthemilk,especially
incolostrum.15
Many other components in raw milk play the dual roles of fighting
pathogensandsupportingtheimmunesystem.Theseincludepolysac-
charides,whichencouragethegrowthofgoodbacteria in thegutand
protectthegutwall;oligosaccharides,whichprotectothercomponents
inrawmilkfromdestructionbyenzymesandstomachacidswhilepre-
venting bacteria from attaching to the gut lining; medium-chain fatty
acids,whichdisruptthecellwallsofpathogenswhilestrengtheningthe
immune system; lysozymes and other enzymes that disrupt bacterial
cellwalls;hormonesandgrowthfactors,whichstimulatematurationof
gut cells and prevent “leaky gut;” fibronectin, which increases the anti-
microbial activity of macrophages and helps repair damaged tissues; B12
-
bindingprotein,whichinhibitsbacterialgrowthinthecolonbyreducing
levels of vitamin B12
, while also helping the infant absorb all the B12
inthe
milk; glucomacropeptide, which inhibits bacterial and viral adhesion,
suppresses gastric secretion and promotes the growth of beneficial bac-
teria; bifidus factor, which promotes the growth of Lactobacillus bifidus,
oneofthehelpfulbacteriafamiliesthatcrowdoutdangerousmicroor-
ganisms;andthelactobacillithemselves,whichproliferateinrawmilk
overtimeandcrowdoutbadbacteria.16
Allthesefactorsworktogethertoinactivatepathogens“individu-
ally,additivelyandsynergistically,”asoneresearcherputit.17Thesepro-
tective factors“cantargetmultipleearlysteps inpathogenreplication
andtargeteachstepwithmorethanoneantimicrobialcompound.”At
thesametime,thesecompoundsworktostrengthentheimmunesystem
andthegutwall.
Ofcourse,thismarveloussynergisticsystemcanbeoverwhelmed
if milk is produced in filthy conditions, but when the cows are healthy
The Safety of Raw versus Pasteurized Milk 269
andtheproductionmethodsclean,theyensureaproductthatisinher-
entlysafe.
Pasteurization largely wipes out these numerous protective fac-
tors,inactivatingthevariousleukocytes,antibodies,enzymesandbind-
ing proteins, while reducing the activity of medium-chain fatty acids,
lysozymes, oligosaccharides, hormones and growth factors, and benefi-
cial bacteria. Ultrapasteurization—most milk is ultrapasteurized these
days—inactivateslysozyme,andallbutthemediumchainfattyacidsare
inactivatedininfantformula.18
Lactoperoxidaselosesbiologicalactivityat178degreesFahrenheit.
Itthereforesurvivespasteurization(about160degreesFahrenheit)but
nottheultra-highheattreatment(UHT)of230degreesFahrenheitused
in the production of today’s long-life milks. However, even at regular
pasteurizationtemperatures,lactoperoxidasewillbegreatlyreducedin
potencybecausepasteurizationpartiallydestroysthehydrogenperoxide
presentinthemilkandalsodestroysthetwosystemsthatgeneratehy-
drogenperoxide,namelyleukocytesandlacticacidbacteria.19
Inapublicationdenouncingtheconsumptionofrawmilk,theFDA
citesonestudyclaimingthatpasteurizationdoesnotinactivatelactofer-
rin.20 But the authors of this study used not milk but purified lactoferrin,
with its iron component removed. Although lactoferrin is more heat-
stable when the iron is removed, accomplishing this removal of iron
requires incubating purified lactoferrin with citric acid at 41 degrees
Fahrenheit for twenty-four hours and running it through a gel filtration
system.Sucha“lactoferrinproduct”bearsverylittleresemblancetothe
lactoferrininrawmilk.
In1977,researchersshowedthattheoriginallower-temperature,
longer-timepasteurizationofhumanmilkat145degreesFahrenheitfor
thirty minutes destroys sixty-five percent of the lactoferrin.21Theydid
not evaluate the antibacterial efficacy of the remaining thirty-five per-
cent,whichmayhavebeendamagedorcompletelydestroyed.Heating
human milk to 185 degrees Fahrenheit for fifteen minutes caused ninety-
sixpercentdestructionofitslactoferrin.Again,wedonotknowwhether
theremainingfourpercentretaineditsantibacterialpotency.(Remem-
ber,ultrapasteurizationtakesmilktoevenhighertemperatures.)
270 The Untold Story of Milk
Thus,pasteurizationlargely inactivatesrawmilk’sbuilt-insafety
system.Proofofrawmilk’santi-microbialpropertiescomesfromwhat
areknownas“challengetests,”wherepathogensareaddedtorawmilk
andthenmonitoredovertime.Forexample,whenthepathogencam-
pylobacter is added to raw milk, the levels decrease—in chilled milk
from thirteen thousand per milliliter to less than ten per milliliter in
ninedays.Atroomtemperature,thedeclineisevenmorerapid.22Inone
study,researcherscreditedtheactionoflactoperoxidaseinkillingadded
fungalandbacterialagents,butdecline inpathogennumbers ismost
likelydue to thewholecomplexofantimicrobial factors.23Recently in
California, Organic Pastures Dairy Company subjected their raw milk
andcolostrumtochallengetestsmonitoredbyanindependentlabora-
tory.Pathogencountsdeclinedover timeand insomecaseswereun-
detectable within a week. The laboratory concluded, “Raw colostrum
andrawmilkdonotappeartosupportthegrowthofsalmonella,E. coli
O157:H7orListeria monocytogenes.”24
Milk’santi-microbialpropertiescanbeveryfrustratingtoresearch-
ers.In1985,ateamofscientiststriedtoblamerawmilkforanoutbreak
ofCampylobacter jejuniinavillagewherevirtuallyeveryonedrankraw
milkfromasinglefarm.Theyfoundtheorganisminrubbishheapsand
watering holes, but not in the milk or milk filters. Frustrated with this
result,theyculturedsamplesrightonthefarminsteadofcarryingthem
in sterile containers to a sterile working space in the laboratory as is
usually done, and the milk and milk filters proved contaminated. They
claimedthereasontheyhadtoculturethemilkonthefarmwasbecause
theC. jejuniwasunable to tolerate the“naturalantibacterialeffectof
freshmilk”fortheseveralhoursittooktotransportthemilktothelab,
buttheyofferednoexplanationofhowthemilkcouldhavemadeany-
onesickifalltheC. jejuniwithinitdiedwithinhoursofmilking.When
they tried quantifying two of the positive samples after some unspecified
time,themilkturnedupnegative.Whentheytriedsubtypingtwoother
samplessoonaftercollection,theyfailedbecausethebacteriacouldnot
survive long enough for them to finish the procedure.25
Pasteurizedmilkwillnotpassthesechallengetests.Shouldpatho-
genscontaminatepasteurizedmilk,verylittleoftheprotectivesystem
The Safety of Raw versus Pasteurized Milk 271
remainstokeepthemincheck.Andsincepasteurizedmilkcomesfrom
largefactorieswithwidedistributionnetworks,contaminatedpasteur-
izedmilkoftenresultsinhundredsifnotthousandsofillnessesandeven
afewdeaths,asweshallsee.
RAW VERSUS PASTEURIZED BREAST MILK
Muchoftheresearchthathasrevealedtheamazinganti-microbial
andimmunesupportivepropertiesofrawmilkhasbeencarriedouton
humanmilk.However,thesediscoveriesapplytothemilkofallmam-
mals;infact,aswehaveseen,protectivecomponentssuchaslactoper-
oxidaseareoftenhigherinthemilkofanimals.
Human milk requires the same antimicrobial system as animal
milk because human milk is not pathogen-free. The notion that hu-
maninfantssuckledasterileproduct,asscientistsformanyyearsbe-
lieved,hasgivenwaytotherealizationthathumanmilkcontainsmany
pathogens.Forexample,scientistsinFinlanddetectedseveralstrainsof
Staphylococcus aureus,“knownasacausativeagentofmaternalbreast
infections and neonatal infections” in human breast milk samples.26
Scientists in Canada report that breast milk “is a body fluid capable of
transmittingblood-bornepathogenswheningested.”27
Infact,inascreeningprogramforexpressedbreastmilkinChina,
testingrevealed“thealarmingfactthatourstudygrouphadthehigh-
est rate of contamination ever reported.”28 Pathogenic bacteria in the
milk included enterococci and Staphylococcus aureus. The research
teamspeculatedthatthehighrateofcontamination“couldbeduetothe
Chinesetraditionofavoidingbathingforonemonthafterchildbirth.”
Apparently,mother’smilkpicksupnumerouspathogensfromtheskin;
andonetheoryholdsthatimmunesignalsforpathogensarealsotrans-
ferredtobreastmilkviaductsthatconnectwiththedigestivetract.29
Theprotectivefactorsinmilkinhibitnotonlyexistingpathogens
butalso“anticipatenewmutationsandnewpathogens...”30Theimmu-
nological factor IgA, for example “appears to reflect long-term maternal
immunologicmemory.”31ThisexplainstheChinesewisdom—shocking
toinvestigators—ofnotbathingforamonthaftergivingbirth.Whenthe
infantsucklesmilkcontainingpathogens,theimmunologicalfactorsin
272 The Untold Story of Milk
thatsamemilkcanprogramtheinfantforprotectionagainstamyriad
ofpathogens,andcanprotecthimforlife!Thesestudiescanonlyinspire
aweandwonderattheexquisiteprocessesthatsupportbiologicallife.
Otherstudiesonhumanmilkshowthatheatingreducestheability
ofmilktoprotectagainstinfections.In1984,researchersinIndiacar-
riedoutarandomizedcontrolledtrialinvolvingtwohundredtwenty-six
high-risknewborns,givencombinationsof formulaandrawandpas-
teurizedhumanmilk.Thehighestrateofinfectionoccurredinthegroup
given pasteurized human milk plus formula (thirty-three percent).
Thosegivenrawhumanmilkplusformulahadasixteenpercentrateof
infectionandthosegivenpasteurizedhumanmilkalonehadjustovera
fourteenpercentrateofinfection.Thelowestrateofinfectionwasabout
tenpercentinthegroupgivenrawhumanmilkonly.32
Scientists in Africa looked at ways of storing human milk. No
growthofpathogenswasobservedinrawhumanmilkstoredfourhours
at high temperature (eighty-six to one hundred degrees Fahrenheit),
eight hours at room temperature (fifty nine to eighty-one degrees Fahr-
enheit)andtwenty-fourhoursatrefrigeratortemperature(thirty-nine
to fifty degrees Fahrenheit).33 They concluded that “although freezing
temperature(thirty-twotothirty-ninedegreesFahrenheit)seemedsaf-
estforbreastmilkstorage,short-termstorageinafreezerwasnotrec-
ommendedduetothelikelyhazardsofthethawingprocess.”Another
studyfoundthatrawhumanmilkwassafeforhumanconsumptionfor
uptoseventy-twohoursrefrigerated.34Longer-termstoragebyfreezing
didnotcausesafetyproblems.
Unfortunately,humanmilkdonatedtobreastmilkbanksisrou-
tinelypasteurizedbeforefreezing,therebydestroyingthemanyprotec-
tivemechanismsthathumanmilkcanconferonprematurebabies.And
accidentsdohappen.ArecentoutbreakofPseudomonas aeruginosain
aneonatalintensivecareunitcausedbyacontaminatedmilkbankpas-
teurizerresultedinthirty-onecasesofinfectionandfourdeaths.35
Pasteurizationnotonlycompromisesthesafetyofbreastmilk,it
alsocompromisesitsnutritionalvalue.Forexample,researchersin1986
publishedarandomizedcontrolledstudytoassesstheeffectofpasteur-
ization of breast milk on the growth of very-low-birth-weight infants.
The Safety of Raw versus Pasteurized Milk 273
Infants bottle fed untreated milk from their own mothers grew more
rapidlythanthosefedpasteurizedpooledpretermmilk.36Anotherstudy
carriedoutinthesameyearalsofoundreasonsforconcernabouttheef-
fectofheatsterilizingbreastmilk.Researcherscomparedtheresultsof
feedingpooledpasteurizedbreastmilkwiththeirownuntreatedmoth-
er’s milk to very-low-birth-weight babies. Those receiving unpasteur-
ized human milk had significantly more rapid weight gain. Researchers
attributedthelowerweightgaininbabiesfedpasteurizedhumanmilk
tothedestructionoflipase,anenzymeneededtoutilizemilkfat.37
Fromastudypublishedin1977welearn:“Humanmilkwassub-
jectedtoheattreatmentsofgradedseverityandexaminedforitscontent
of immunoglobulins, lactoferrin, lysozyme, vitamin B12
-andfolate-bind-
erproteins,andlactoperoxidase.Holderpasteurization[146degreesF
for30minutes]reducedtheIgAtiterby20percent,anddestroyedthe
smallcontentofIgMandmostofthelactoferrin.Lysozymewasstable
to this treatment,butwithan increase in temperature therewaspro-
gressive destruction, to near 100 percent at 212 degrees F. The same
wasbroadlytrueofthecapacityofmilktobindfolicacidandprotectit
against bacterial uptake; with vitamin B12
thebinderwasmorelabileat
167degreesFthanat212degreesF.The[heat-treated]milkcontained
nodetectablelactoperoxidase.”38
Government officials widely support giving raw milk to infants—as
longasthatrawmilkishumanbreastmilk.Accordingtoadocument
postedattheCentersforDiseaseContolwebsite,“Mother’smilkisthe
safest food for young infants. Breastfeeding prevents salmonellosis and
manyotherhealthproblems.”Yetthesamewebsitecontainsthefollow-
ingwarningagainstsalmonella:“Cookpoultry,groundbeef,andeggs
thoroughlybeforeeating.Donoteatordrinkfoodscontainingraweggs,
orrawunpasteurizedmilk.”39Formotherswhoareunabletobreastfeed
forwhateverreason,orwhosimplychoosenottodoso,thelogicalalter-
nativeishomemadeformulabasedonrawmilkfromanothermammal,
but official government policy adamantly opposes giving raw milk from
animals to infants, recommending manufactured formula instead, a
product that is highly synthetic and which has its own safety issues. Be-
tween 1982 and 1994 alone, there were twenty-two significant recalls of
274 The Untold Story of Milk
infantformulaintheUnitedStatesduetohealthandsafetyproblems.40
(Formoreoninfantformulabasedonrawmilk,seeChapter16.)
Thus,whileresearchonhumanmilkhasrevealednumerouspro-
tective components in raw milk, the bureaucrats in our government
agenciesaremiredinforty-year-oldscience.Nexttimeoneoftheseun-
enlightenedsoulstellsyouthatthemilkyougiveyourchildrenhastobe
pasteurizedfortheirprotection,askthemwhetherthepathogen-loaded
breastmilkmothersgivetheirinfantsneedstobepasteurizedaswell.
THEDANGERSOFPASTEURIZEDMILK
Public health officials claim that pasteurization is “the only way to
ensurethatmilkissafetodrink.”Indeed,milkingeneral—bothpasteur-
izedandraw—isaparticularlysafefood.Forexample,in1997,milkand
milkproductsaccountedforonlytwo-tenthsofonepercentofallreport-
edcasesoffood-borneillness.41Barring post-pasteurization contamina-
tion,residualamountsofprotectivefactorsthatremainafterpasteuri-
zationareprobablyadequatetocombatmostheat-resistantpathogens
foundincommercialmilk.
Nevertheless, pasteurized milk sometimes causes illness, and
when it does, the outbreak usually involves many individuals. A 1976
outbreakofYersina enterocoliticafrompasteurizedchocolatemilksick-
enedthirty-sixchildren,sixteenofwhomrequiredappendectomies.42In
1982,thesameorganismsickenedseventeenthousandpasteurizedmilk
consumersinseveralstates.Thetaintedmilkwastracedtoapasteur-
izingplantinMemphis,Tennessee.43A1983outbreakofListeria mono-
cytogenessickenedforty-ninepeopleinMassachusettsandcausedfour-
teendeaths.44Almosttwohundredthousandindividualsmayhavebeen
sickenedfromtheoutbreakofSalmonella typhimuriumthattookplace
intheMidwestin1984-85,45discussedinChapter12.
Duringthe1990s,themostseriousincidentsincludedanoutbreak
causing over two thousand Salmonella enteritidis illnesses from pas-
teurizedicecreaminMinnesota,SouthDakotaandWisconsin46andan
outbreakofYersina enterocoliticainpasteurizedmilkthatsickenedten
children,threeofwhomwerehospitalized.47
Andtherehavebeenrecentoutbreaksaswell.In2000,Salmonella
The Safety of Raw versus Pasteurized Milk 275
typhimurimfrompasteurizedmilksickenedalmostonehundredindi-
vidualsinPennsylvaniaandNewJersey.48Campylobacter jejunifrom
pasteurized milk sickened two hundred inmates in a Colorado prison
in 200549 and almost sixteen hundred inmates in a California prison
in2006.50 In2007, threepeople inMassachusettsdied fromListeria
monocytogenesinpasteurizedmilk.51YetnoonefromtheFDAorother
governmentagenciesdescribespasteurizedmilkas“inherentlydanger-
ous”orcallsforitsremovalfromthemarketplace.
THEDANGERSOFOTHERFOODS
AccordingtoaCenterforScienceinthePublicInterest(CSPI)re-
port,between1990and2004thefollowingoutbreaksoccurred:
31,496illnesses,639outbreaksfromproduce
16,280illnesses,541outbreaksfrompoultry
13,220illnesses,467outbreaksfrombeef
11,027illnesses,341outbreaksfromeggs
9,969illnesses,984outbreaksfromseafood
The largest percentage of outbreaks came from seafood (thirty-
threepercentofthetotal)whilethelargestpercentageofillnessescame
fromproduce(thirty-eightpercentofthetotal).Whiledairyfoods(both
pasteurizedandraw)contributetolessthanonepercentofallreported
food-borneillnesses,theriskfromotherfoodsislarge.52
AccordingtoRobertTauxe,CDCChiefoftheFood-borneandDi-
arrhreal Diseases Branch, food-borne pathogens such as campylobacter,
E. coli O157:H7, Yersina enterocolitica, cryptosporidium and listeria,
have emerged only within the past twenty-five years. In contrast, the
five pathogens that plagued the early decades of the 1900s, when pas-
teurization was implemented, those causing brucellosis, botulism, ty-
phoidfever,trichinosisandcholera,combinedaccountforonlyoneone-
hundredthpercentoffood-borneillnessestoday.Mostofthoseareas-
sociatedwithforeigntravel.53
Tauxereportsthatthirteenrecentlyemergedpathogensarerespon-
sibleforamajorityoftheseventy-sixmillioncasesoffood-borneillness,
276 The Untold Story of Milk
three hundred thousand hospitalizations, and five thousand deaths an-
nually,andheestimatesthatoneinfourAmericansexperiencesafood-
borneillnesseveryyear.Thefollowingaresomemajorpathogensand
theirreportedcasesperannum:
Campylobacter 1,963,000
Salmonella 1,342,000
E. Coli O157:H7 92,000
Yersina enterocolitica 87,000
Listeria 2,000
The majority of food-borne illness is caused by Norwalk-like vi-
ruses(noroviruses),whichaccountforoverninemillioncasesperyear.
Thesevirusesareresistanttobothfreezingandhightemperatures.CDC
currentlydoesnotconductactivesurveillancetomonitoroutbreaksof
gastroenteritiscausedbynoroviruses.
Many factors common to modern life explain the emergence of
thesenewpathogens—overuseandmisuseofantibiotics,crowdedfeed-
lots,low-qualityandlow-costanimalfeed,globalizationofthefoodsup-
ply,andreducedhumanimmunityduetopoornutrition.
TheCSPIstatisticsmaybeanunderestimation.Eggscontaminat-
edwithsalmonella—welookedathownearlyalleggsareproducedin
Chapter11—aresaidbysomeauthoritiestosickenthreehundredthou-
sand and kill hundreds of Americans each year.54 A nationwide study
publishedbytheUSDAin1996foundthatoversevenpercentofground
beef samples taken at processing plants were contaminated with sal-
monella and almost twelve percent were contaminated with listeria.55
Incontrastwiththesituationinthiscountry,Swedenbeganaprogram
overfortyyearsagotoeliminatesalmonellafromitslivestock,andonly
aboutone-tenthofonepercentofSwedishcattleharborsalmonellato-
day.SalmonellahasalsobeenalmostcompletelyeliminatedfromSwed-
isheggs.56
It’snotjustsalmonellaandlisteriathattaintAmericanmeatand
processed foods. Thirty percent of ground beef samples taken at pro-
cessing plants were contaminated with the pathogen Staphylococcus
The Safety of Raw versus Pasteurized Milk 277
aureus andoverhalfwithClostridium perfringens.“Allofthesepatho-
genscanmakepeoplesick,”wroteEricSchlosserinFast Food Nation.
“Food poisoning caused by Listeria generally requires hospitalization
and proves fatal in about one out of every five cases. In the USDA study,
78.6percentofthegroundbeefcontainedmicrobesthatarespreadpri-
marily by fecal material. The medical literature on the causes of food
poisoning is full of euphemisms and dry scientific terms: coliform levels,
aerobic plate counts, sorbitol, MacConkey agar and so on. Behind them
liesasimpleexplanationforwhyeatingahamburgercannowmakeyou
seriouslyill:Thereisshitinthemeat.”57
Andit’salsoinwhitemeat.Overseventypercentofchickensam-
plestestedinWashington,DCgrocerystoresin1999-2000cameback
positive for campylobacter; almost fifteen percent of turkey samples
contained the pathogen. By contrast, the same survey found that less
thantwopercentofporksamplestestedpositivefortheorganismand
onlyone-halfpercentofbeefsamples.58
Organisms that cause illness are ubiquitous—and tenacious.
E. coli and Salmonella enteritidis can survive on coins for a week or
more,andSalmonella enteritidis can survive on glass or Teflon for up to
seventeendays.59
Milk substitutes also harbor pathogens. A 1998 survey found five
typesofmicroorganismsinfourbrandsofstoredsoymilksamples.Dur-
ingstorageatforty-onedegreesFahrenheit,microbialcountsincreased
sharplyaftertwotothreeweeks.60Dry,powderedfoodsarenotsafeei-
ther.A1978survey foundsalmonella inmany“health food”products
including soy flour, soy protein powder and soy milk powder.61
The same thing that contaminates our meat and eggs—manure
from confinement animal operations—is also a major source of con-
tamination in fruitsandvegetables.Documentedoutbreaksofhuman
infections associated with consumption of raw fruits, vegetables and
unpasteurizedfruit juiceshaveincreaseddramatically inrecentyears.
AccordingtotheCentersforDiseaseControlandPrevention,intheU.S.
the number of reported produce-related outbreaks per year doubled
betweentheperiod1973-1987and1988-1992.Theseincludesalmonel-
losislinkedtotomatoes,seedsprouts,cantaloupe,applejuice,andor-
278 The Untold Story of Milk
angejuice;Escherichia coli O157:H7 infectionassociatedwithlettuce,
sproutsandapplejuice;enterotoxigenicE. colilinkedtocarrots;shig-
ellosislinkedtolettuce,scallionsandparsley;choleralinkedtostraw-
berries;parasiticdiseases linkedtoraspberries,basilandapplecider;
hepatitisAviruslinkedtolettuce,raspberriesandfrozenstrawberries;
andNorwalkorNorwalk-likeviruslinkedtomelon,saladandcelery.62
In1997,fruits,vegetablesandsaladcontributedtothirty-sixoutbreaks
comparedtoonlynineforchicken,threeforeggsandtwoformilk.63
Inthefallof2006,aparticularlyvirulentoutbreakofE. coli O157:
H7tracedtospinachgrowninCalifornia’sSalinasValleysickenedover
twohundredindividualsandcausedthreedeaths.61Thiswasfollowedby
alettuceoutbreakthatmadeseventy-onepeopleill.65Inbothoutbreaks,
manypeopleendedupinthehospital,mostwithbloodydiarrhea,but
in a few cases, the bacteria released toxins into the bloodstream that
causedthekidneysandotherorganstoshutdown.
Investigators noted that potential environmental risk factors for
E. coli contamination at or near the fields included the presence of wild
pigs,theproximityofirrigationwellsusedtogrowproduceforready-to-
eatpackagingandsurfacewaterwaysexposedtofecesfromcattleand
wildlife.66In other words, infected manure from animals and wildlife
wasthelikelycauseoftheoutbreak.Andthemostlikelysourceofin-
fectedmanure—whichisusedasfertilizerandalsoendsupinwellwater
and irrigation water—is confinement animal operations, including con-
finement dairy operations.
The Centers for Disease Control cites increased consumption of
fruits and vegetables, which Americans are urged to eat as “part of a
healthydiet,”asafactorinthehugeincreaseinfood-borneillnessfrom
plant foods. There are no requirements for pasteurizing these foods
we’re supposed to eat more of; in fact, consumers are encouraged to
eatthemraw.FDAadvisesconsumersthatallproduceshouldbethor-
oughlywashedbeforeitiseaten,butinthelatestoutbreaks,washingthe
producewouldnothavepreventedillness.That’sbecausethesebacteria
cangrowinsidetheleavesoflettuce,spinachandothervegetablesand
fruit,wheresurfacetreatmentscannotreach.Inaddition,microbescan
organize themselves into tightly knit communities called biofilms,which
The Safety of Raw versus Pasteurized Milk 279
coatfruitsandvegetablesandprotectthebacteriafromwaterandanti-
microbialsolutions.67
Therawmilkmovementprovidesarealsolutiontotheproblemof
food-borneillness—becauserawmilkconsumersmakesuretheirmilk
comesfromsmall,pasture-basedfarmsandhealthyanimalsunlikelyto
harborpathogensandunlikelytocontributetowaterpolution;andbe-
causerawmilkbuildsimmunitytodisease-causingorganismsthatare
simplyanaturalpartoftheworldinwhichwelive.
REPORTS OF ILLNESS FROM RAW MILK: A HISTORY OF BIAS
Soifrawmilkisinherentlysafe,whydowesooftenhearthatraw
milk causes illness? What about all the reports in the scientific literature
linkingoutbreaksofdiseasetorawmilk?Theanswerliesintheattitude
of bias against raw milk held by most scientists and government offi-
cials. So ingrained is this prejudice that researchers may not even be
awareoftheirlackofimpartiality.Yetacarefulreadingofthepublished
literaturerevealsalonghistoryofunfoundedassumptions,inappropri-
atesamplingtechniquesandtorturedconclusionsusedtobuildacase
against raw milk. Often a single biased report that finds an association
ofrawmilkwithillness—andanassociationisnotthesameasaproven
cause—serves as justification for shutting down a raw milk dairy or pass-
ingmorerestrictivelaws.Infact,thepatternofrawmilk“incident”lead-
ingtorestrictionofaccesstorawmilkhappenssofrequentlythatsome
rawmilkactivistshaveraisedthespectreofdeliberatesabotage.
Formanyyears,thestateofGeorgiawasarawmilkstate,duein
largeparttothepersistenceofMathisDairyinDekalb,oneofthelast
certified raw milk dairies in the country. Numerous attempts to pass
legislationagainstrawmilkinthestatehadfailed,thankstothepopu-
larity of the dairy and its iconic mascot, Rosebud the cow. But a 1983
outbreakofcampylobacterinAtlantagaveauthoritiestheammunition
theyneeded.Rawmilkwasbanned inGeorgiaasa resultof the inci-
dent.Thereportontheoutbreak,publishedintheAmerican Journal of
Epidemiology, noted that “extensive testing failed to find campylobacter
oranyotherpathogensinanymilkproductsfromthedairy.Allsafety
measureshadbeenfollowedfaithfully.”Yettheauthorsconcluded,“The
280 The Untold Story of Milk
onlymeansavailabletoensurethepublic’shealthwouldbeproperpas-
teurizationbeforeconsumption.”68Ironically,thisstudywaspublished
shortly before the massive 1984-85 outbreak traced to a pasteurizing
plantinMelrosePark,Illinois,inwhichalmosttwohundredthousand
midwesternersweresickenedbysalmonellafrompasteurizedmilk.
Raw milk sales are not allowed in the state of Wisconsin. But in
Juneof2000,theownersofClearviewAcresinSawyerCountystarted
acowshareprogramtomeettheburgeoningdemandforrawmilk.The
programhadapprovalfromtheWisconsinDepartmentofAgriculture,
Trade and Consumer Protection (DATCP), which suggested a format
used by another state-authorized cow-share program in Wisconsin.
However, Clearview owners were not satisfied with the two-page con-
tract that DATCP suggested, finding that it did not contain enough pro-
vision for testing and safety. The revised contract allowed for greater
safetyprotocols,andtheprogramwassoonsupplyingmilktothreehun-
dredindividuals.
During a twelve-week period beginning November 10, 2001, an
outbreakofCampylobacter jejuni causeddiarrhea,abdominalcramps
and fever in hundreds of people in northwestern Wisconsin. Officials
blamedtheoutbreakontheconsumptionofrawmilk fromClearview
Acres, an accusation formalized in a DATCP report issued June 28,
2002andpostedontheCDCwebsite.69Accordingtoareport,seventy
out of seventy-five persons confirmed with the illness drank unpasteur-
izedmilkfromthedairy.
Theownersofthedairydidtheirownresearchbycontactingemer-
gencyroomsinthearea.Accordingtotheirestimates,thecampylobacter
infection afflicted as many as eight hundred individuals—most of whom
didnotdrinkrawmilk—throughoutnorthwestWisconsin.Reportsofill-
nesscontinuedforeightweeksafterprovisionofrawmilktocow-share
holdershadceased.
Only twenty-four of three hundred eighty-five cow-share owners
became ill—eight confirmed cases and sixteen probable family members
of the eight confirmed. Most of these had consumed hamburger at a lo-
calrestaurant.Noillnessoccurredintheremainingthreehundredsixty-
oneindividualsconsumingrawmilkfromClearviewAcresdairy.70
The Safety of Raw versus Pasteurized Milk 281
The discrepancy in government figures and those of Clearview
Acres was due to interview tactics by local officials. Afflicted individu-
alswhoshowedupatthenearest localhospitalwerequestionedasto
whetherornottheydrankrawmilk.Medicalpersonneltestedonlythose
whoansweredyes.Allothersweregivenanantibioticandsenthome
without further investigation—and thus not included in the official
countofthosewhogotsick.Reportsof illness inotherhospitalswere
ignored.
ClearviewAcreswasaGradeAdairywithanexcellenthistoryof
cleanliness.Infact,inOctober2001,ClearviewAcresreceivedthesec-
ondhighestratingofallfarmsreceivingfederalinspection.Therating
wasninety-nineoutofapossibleonehundred.Thedairyregularlytest-
editsmilkforthepresenceofpathogens.Alltests,includingthosefor
campylobacter,hadbeennegative.Duringtheoutbreak,DATCPtested
ClearviewAcresmilkforcampylobacterinstatelaboratoriesandclaimed
theresultswerepositive.ClearviewAcres’owntestswerenegative.
DocumentsreleasedinthecourtcaseinvolvingClearviewAcresin-
dicatethatthestateinstitutedanundercoveroperationshortlyafterthe
cow-shareprogrambegan,withtheexpresspurposeofshuttingdown
the operation. When state tests of Clearview Acres milk consistently
cameupnegative,thestateattemptedtotakeawaythefarm’sGradeA
permit,butwasstymiedforlackofjurisdiction.Finally,DATCPblamed
ClearviewAcresmilkonthelocalcampylobacteroutbreakandissueda
cease-and-desistorder.
Thebiasinsamplingtechniques,underreportingofwidespreadill-
ness,suspiciousresultsofthestate’scampylobactertestandthedocu-
mented clear intent on the part of officials to shut down the cow-share
operationwouldpreventanyhonestinvestigatorfromconcludingthat
the raw milk from Clearview Acres had caused the outbreak. Yet this
report still remains on the CDC website, and officials often cite the Wis-
consinoutbreakasanargumentagainsttheconsumptionofrawmilk.
Ohiohasprohibitedthesaleofrawmilksince1997withagrandfa-
therclauseallowinganyfarmerlicensedtosellrawmilkbefore1965to
continue.Thelastfarmtoholdarawmilkpermit,Young’sDairyinYel-
lowSprings,voluntarilygaveitupinJanuaryof2003afteranoutbreak
282 The Untold Story of Milk
ofsalmonellathatsickenedforty-sevenpeople,sixteenofwhomworked
on the farm. The strain originated elsewhere in the state and officials
couldnotpositivelyattributetheproblemtoYoung’s.71Nevertheless,the
stateputconsiderablepressureonthedairy—threateningtotakeaway
theirGradeA licenseandclosedownthepasteurizedportionof their
business—whichthencloseddowntherawmilkportionoftheiropera-
tion.
Theoutbreakandsubsequentdecisionbythedairycamejustone
week after the Ohio Farm Bureau Federation voted to support an effort
aimedatpermittingmorepeopletosellrawmilk.Themajorityofthe
morethanfourhundreddelegates to thegroup’sannualmeetings,all
activeorretiredfarmersfromacrossthestate,statedthatfarmerswho
wantedtosellrawmilkshouldbeabletoobtainalicensetodoso.Then
cametheincidentatYoung’sDairy.Coincidence?Wethinknot.
LISTERIA AND RAW MILK: BUILDING A CASE IN PENNSYLVANIA
Listeria monocytogenes is a dangerous pathogen that can cause
fever,muscleachesandgastrointestinalsymptomssuchasnauseaand
diarrhea. But although raw milk has been blamed for many types of
illness,ithasnothistoricallybeenassociatedwithListeria monocyto-
genes (L. mono.).Inresponsetoafreedomof informationrequestby
theWestonA.PriceFoundation,submittedinearly2007,theCenters
forDiseaseControlprovideddataonrawmilkoutbreaksfortheperiod
1973-2005. The report listed no cases of food-borne illness from fluid
raw milk caused by listeria during the thirteen-year period.72 (There
wereanumberofcasesthatlinkedMexican-stylerawmilkcheesewith
listeria—moreonthislater.)
Suddenly, however, raw milk and listeria were in the news. On
April7,2007,thePennsylvaniaDepartmentofAgriculture(PDA)issued
apressreleasestatingthatrawmilkfromthefarmofClarkandElaine
DuncanhadtestedposiviveforL. mono.Themilkinspectorhadtaken
thesampleonMarch31andobtainedtheresultsonApril4.Uptothat
point,PDApolicyallowedrawmilksales tocontinueunlessasecond
milksamplealsocamebackpositive,butthenewheadofdairysafety,
Bill Chirdon, immediately suspended milk sales after the single negative
The Safety of Raw versus Pasteurized Milk 283
test.TheDuncanssentasampletoaprivatelabtheweekfollowingtheir
suspensionandthatcamebackpositiveaswell.However,therewereno
reportedillnessesfromthedairy’scustomers.
OnApril4,thesamedaytheDuncans’testresultscamebackposi-
tive,PDAtoldArnoldandEstherDillerofPineyRidgeFarminnorth-
western Pennsylvania that they were suspending their raw milk sales
becausetheirmilkhadtestedpositiveforlisteria.ArnoldDillersubse-
quentlysentasampletoanindependentlab,whichcamebacknegative.
As a condition for resuming sales on their farm, their inspector gave
themalistoftaskstoaccomplishforreinspection.Afterrepeatedlyfail-
ingtocleanapieceofmilkingequipmenttothesatisfactionofthein-
spector,theDillersturnedintheirlicensetoPDA.
TheDillershadobtainedtheirpermitnotlongbefore,in2006,in
responsetoincreasingconsumerdemand,andthusbecameoneofthe
fewpermittedrawmilkdairiesinwesternPennsylvania—mostPennsyl-
vaniadairiesholdingpermitsareintheeasternpartofthestate.Some
oftheDillers’customerspickedupthemilkatalocalhealthfoodstore.
Shortlybeforethestate’spositivelisteriatests,aPennsylvaniafoodand
safetyinspectorwitnessedtherawmilkinawalk-incoolerandvoiced
disapproval,eventhoughnolawprohibitsthepractice.Oneoftheircus-
tomers was a state representative who had earlier told PDA officials how
happyhewastobeabletogetrawmilkfromtheDillers.Inwhatseemed
likeanattempttodiscouragethelawmakerfromremainingacustomer,
thenightbeforePDAissuedthepressreleaseaboutthepositivetestre-
sults,theagencyfaxedacopyofittotherepresentative.
Notlongaftertheirsalesweresuspended,theDillersweretoldby
astateemployeefromHarrisburgthatiftheyvoluntarilygaveuptheir
rawmilklicense,theirproblemswiththestatewouldclearup.Instead,
theDillersre-applied,andinresponsetoconsiderablepressurefromthe
localchapterleaderoftheWestonA.PriceFoundation,whoinsistedon
a meeting with Bill Chirdon, their permit was reinstated—after consid-
erablefootdragging—inAugustof2008.
The most suspicious example of biased PDA policy involved the
Beulah Land Jersey Farm, owned by Dennis and Joanne Wenger. The
Wengers sold milk for pasteurization to Dairylea and also had a raw
284 The Untold Story of Milk
milkpermit.OnApril8,bothU.S.Dairy(astate-approvedindependent
lab)andthePDAtooksamples fromthebulktank.Thenextday, the
milkhaulerforDairyleapickedupmilk.OnApril11,PDAinformedthe
Wengersthattheirtestwas“presumptivepositive”for listeriaandre-
quested they discontinue selling raw milk. Additionally, the PDA test
resultsshowedasomaticcellcount(SCC)ofoveronemillion.OnApril
14, the PDA called to say that the test had confirmed “positive” for liste-
ria and that they would have to discontinue raw milk sales. By this time
theWengershadreceivedtheresultsfrombothU.S.DairyandDairylea
showingSCCundertwohundredthousand.TheWengersfaxedcopies
ofthesetestresultstoPDA.
On April 15, 16 and 17, MicroBac (another state-approved inde-
pendentlab)cametothefarmtotakesamplesfromthebulktankfor
listeriatesting.OnApril16,DennisWengercalledtwostatesenatorsto
informthemaboutthelargediscrepancyinsomaticcellcountsbetween
PDA’stestresultsandthoseofU.S.DairyandDairylea.Laterthatday,
Mr. Wenger received a call from Bill Chirdon, who insisted that the PDA
laboratories“nevermadeamistake.”
After some discussion, Chirdon offered to retest the Beulah Land
JerseyFarmmilk.Thenextday,onApril17,thestatecametotakesam-
ples.TheSCCtestresultsforthissamplewereconsiderablylowerthan
the first PDA test but still much higher than those obtained by the other
twolabs.
OnSaturday,April19,theWengersreceivedthetestresultsfrom
the first sample taken by MicroBac—negative for listeria. On the follow-
ing Monday, the state lab made a highly unusual call to MicroBac to
find out the results of the Wengers’ samples. MicroBac refused to release
theinformationwithouttheWengers’consent.Thestatethencalledthe
Wengerstoinformthemthattheirsamplewasnegative.Thiswasfol-
lowed by a call from MicroBac saying that the second and third samples
hadalsotestednegative.PDAreinstatedtheWengers’rawmilkpermit
onApril22.
Itisimportanttostressthefactthatnotoneofthesedairies’cus-
tomersgotsickfromlisteria,inspiteofthePDA’spositivetestresults.
Yetpressreleaseslinkingrawmilkwithlisteriaremainongovernment
The Safety of Raw versus Pasteurized Milk 285
websites and now abound on the internet. The sudden advent of findings
raises the strong suspicion that the PDA wanted to build a case link-
ing raw milk with L. mono. where none existed before. As a result of
theseincidents,manyfarmershaveturnedintheirpermitsorhavenot
renewed them,andareclaiming theirconstitutional right tosellmilk
directly to consumers without a license. As Dennis Wenger stated, “I
never questioned the state inspection system before, but now I don’t
trustthematall.”
Health officials have withheld another important fact: microbi-
ologistscurrentlybelievethatonlyafewofthehundredsoftypesofL.
mono. areactually pathogenic.73Thus,when initial tests for L. mono.
comebackpositive, thosechargedwith testingprotocols forrawmilk
should stipulate further tests to determine the specific strain. Unfortu-
nately, such testing is expensive and never definitive. Read on.
THE SOFT SCIENCE OF MICROBIOLOGICAL TESTING
Mostpeoplehaveahighregardforscience,andtheyassumethat
theresultsoflaboratorytestsareprecise—thattheyaretheTruthwith
acapitalT.However,inreality,microbiologicaltestingismoreartthan
science,andfraughtwithpitfalls.Everystepoftestingprocedurespro-
videsthepossibilityforerror:samplescanbecontaminated,mishandled
orevenmislabeledandanalyticalresultscanbemisleadingandmisin-
terpreted.Mostimportant,testingrequirespersonalskillandjudgment
that can significantly impact the ultimate results.
Microbiological testingmustaccomplishthreethings:determine
whether a bacterium is present; then determine the specific type of
bacteriumfromthousandsofotherswithsimilarcharacteristics;andif
present determine how many there are. In other words, find, distinguish
andcount.74
The typical laboratory technique for finding bacteria begins with
sample collection—which must be performed carefully to avoid con-
taminationandpreventthenumerouswaysinwhichthesample’scon-
tentmaybechanged.Thesampleistheninoculatedintoanenrichment
liquidtoencouragegrowthofcertainbacteriaandsuppressothers.To
isolate individual bacteria colonies, the enrichment liquid is streaked
286 The Untold Story of Milk
across a petri dish containing nutrients solidified in agar. Standardized
careful streaking—usually done by hand—helps create individual bac-
teriacoloniescontainingthousandsofbacteriaandmakethemvisible.
Thistraditionalmeansof“isolation”isbasedontheideathatifspread
thinenough,eachseparatecolonywillgrowfromasinglebacterium.If
thereweredifferenttypesofbacteriainthesample,sothethinkinggoes,
eachwouldseparateoutanddevelopintoindividualcoloniesthatcould
be further tested for identification.
Countingofteninvolvesmakingcarefulserialdilutionssothatone
tubecontainslowenoughnumberstomakecountingpossible,andthen
performingseveraltestsoneach.Onetraditionalcountingtechniquere-
liesontablestodeterminethe“mostprobablenumber.”Forexample,if
thetablegivesacountofninety-threecolony-formingunitspermillili-
ter,thestatisticalanalysisacknowledgesthattheactualnumberinthis
examplecouldbeaslowaseighteenorashighasfourhundredtwenty.
Variabilityinresultsisconstantlypresent.Forexample,samples
takenfromthesamebulktankwillvaryaccordingtohowthesample
was collected, whether the milk was thoroughly stirred, whether the
sampleswerekeptintheinspector’spocket,howlongbeforethesample
wastestedandwhethertheyweretestedinthesameordifferentlabo-
ratories.Whencountingisperformedusinghighlyadvancedautomated
machines,additionalerrorscanbecommittedbythelabtechnician,or
resultfrommachinedysfunctionorincorrectcalibrationoftheequip-
ment.
Todeterminethetypeofbacteriapresentoncetheyhaveisolated
acolony,techniciansusevariousteststodetecttheproductionofame-
tabolite,gasorenzyme,achangeinpHorhemolysis(thebreakingopen
ofredbloodcells).Forexample,coliformcoloniesproducegasandturn
blue whena special compound isadded toamanufacturer’s specially
formulatedpetridish.
Thereareliterallyhundredsoftestkitsavailabletodeterminethe
kindofmicroorganismpresent,allintenselymarketedbythemanufac-
turers. If funding or patience is limited, wrong kit choices on the first few
attempts may result in a failure to identify the specific type of bacteria.
And as every step of the testing procedure must be defined and followed
The Safety of Raw versus Pasteurized Milk 287
exactly, and requires the personal skill, judgment and honesty of the
technician,opportunitiesforerrorarenumerous.Simpleclericalerror
inrecordingtestresultsisoneofthemostcommonsourcesofincorrect
results.
Andthenthereistheproblemofdeliberatebias.Asexplainedby
Dr. Ted Beals, a pathologist with many years of laboratory experience,
wheninvestigatorshavepreconceivedideasaboutwhattheyarelooking
for, they have ways of finding it. They can
s Stoppursuingaquestionassoonas theyget theanswer they
want;
s Keeptryinguntiltheygettheanswertheywant;
s Failtoadmittopossiblemisinterpretationiftheygettheanswer
theywant;
s Saynothingiftheydon’tgettheanswertheywant.
During the period of alleged L. mono. contamination described
earlier, officials from the Pennsylvania Department of Agriculture spoke
with pride about their newly equipped state laboratory, which uses a
rapidtestingsystem,theVIDAS30,developedbythefoodindustry,to
get quick preliminary results. But even this system requires overnight
incubation of samples and specialized growth conditions, and often
further “gold standard” testing fails to confirm the results obtained by
therapidtestingsystem.Inaddition,theequipmentwasdevelopedby
theindustrytoerronthesideoffalsepositives.Thisisappropriatefor
internalqualitytestingbythefoodcompany.Forindustry,somefalse
positiveresultsforpathogensareacceptableusingtherapidtestingsys-
tem.Thefoodcompanycanthenplayitsafebywithholdingfoodfrom
distribution until further confirmation, or nonconfirmation, is obtained.
However,falsepositivepreliminaryresultsusedbyregulators,toforce
the shut down of a dairy operation before confirmation, is scientifically
inappropriateandcanbedevastatingtosmallfamilydairies.
Thereisalsothequestionofwhethersuchrapidtestingtechniques
areevenappropriateforuseonalivingfoodlikerawmilk,whichnatu-
rallycontainsbacteriathatcanconfuseamachineprogrammedtode-
288 The Untold Story of Milk
tectashortlistofcharacteristicsthatmightbepresentinorganismsthat
donotcausedisease.Andstandardoperatingproceduresareextremely
specific for each test, each sample type and each type of equipment. Rap-
idtestingequipmentwasnotdevelopedforfreshrawmilkintendedfor
directconsumption.Ithasbeenstandardizedforrawmilkintendedfor
pasteurizationorpasteurizedmilk,soitisneitherfairpolicynorgood
sciencetousethesametestingprotocolforthetwoproducts.
Ifpreliminarytestresultsarepositive,suchasforlisteria,thelabo-
ratorythenusesaculturingtechniqueintendedtosuppressthegrowth
ofanythinginthecultureotherthanbacterialikelisteria.Thisisafair
testifthemilkispasteurized,becausepasteurizedmilkisadeadfood
withnogoodbacteriatoout-competepathogens.Australianmicrobiolo-
gistRonHull,PhD,hascarriedouttestsshowingthatinrawmilk,the
threatof listeriagoesawaywithtimebecausegoodbacteriagradually
increaseandeventuallyrenderlisteriaharmless.75
Furthermore,onlyafewstrainsofListeria monocytogenesareas-
sociatedwithdiseaseoutbreaks.76OnceL. mono.hasbeendetected,ad-
ditional(andoftenexpensive)testsareneededtodeterminewhetherthe
bacteriaareofthevirulenttypethatcausesillnessinhumans.Andeven
if a laboratory finds a small number of pathogenic organisms—some new
techniques are so sensitive they can find a single bacterium in very large
samples—thisdoesnotmeanthattheconsumptionofaglassofrawmilk
testingpositivewillnecessarilycausedisease.Withmostorganisms,it
takesthousandsorevenmillionsofvirulentorganismstomakesome-
onesick.
Comparingrawmilktopasteurizedmilkislikecomparingafresh
product with a cooked product. For this reason, a zero tolerance ap-
proachisappropriateforpasteurizedmilkbutnotforrawmilk,because
rawmilkcontainsgoodbacteriapresent tooverwhelmanypathogens
present.What’sneededarestudiestoquantifyhowhightheinfectious
doseinrawmilkwouldhavetobebeforeitcouldcauseillnessinhu-
mansconsumingtheproduct.
USDA publishes an infectious dose for most food-borne patho-
gens even though they acknowledge that it is unlikely to be the same
inallfoodsorindifferentpeople.77 But the agency has never conducted
The Safety of Raw versus Pasteurized Milk 289
studiestodeterminewhattheinfectiousdoseforpathogenswouldbein
freshrawmilkintendedforhumanconsumption.
Thecurrentzerotolerancestandardforlisteriainrawmilkisnot
appropriatebecause,astheexperienceinPennsylvaniahasshown,large
numbersofpeopleconsumingrawmilkreportedastestingpositivefor
listeriaarenotgettingsick.Thepolicycauseseconomichardshipforraw
milkproducersandsupply interruptions forconsumers.The fact that
thePennsylvaniaDepartmentofAgriculturedidnotuntilrecentlysus-
pend a raw milk permit when the first test was positive shows a funda-
mentalacceptanceofthisconcept—thatthetolerancelevelsforlisteria
andotherpathogensinrawmilkisnotzero.
According to Dr. Beals, microbiological testing should be used on
the farm, where a farmer can use routine periodic testing to monitor
thehealthofhisherd, thehandlingofmilkandthecleanlinessof the
containers and equipment. The appropriate use of laboratory testing
forpathogensoccursafteranillnessisreported.Thentestingsamples
from the sick person can be used to track the specific virulent bacteria
todeterminewhetherfoodwasthesourceoftheinfection.Sophisticated
fingerprint characteristics can be essential to pinpoint the exact source
andallowforcorrectiveactionstominimizerisktootherpeoplewithout
unnecessarily harming the precarious cash flow of small farmers.
SURVEY TECHNIQUES: MORE BIAS
Wheninvestigatorsputtogetherareportonanoutbreakoffood-
borne illness intended for publication in a scientific journal, they depend
notonlyonlaboratorytestresults,butalsoondataabouttheindividuals
whogotsick.Andthisdatacanbechosenandmanipulatedinsuchaway
as to give the conclusion the investigators are seeking. Dr. Beal’s postu-
lateslistedaboveapplyequallywelltosamplingmethodsastheydoto
testing protocols—ask questions that elicit the answer you want, stop
askingquestionswhenyougettheansweryouwant,denyanypossibility
ofmisinterpretationwhenyougettheansweryouwant,andsaynothing
about data that conflict with the answer you want. . . then proclaim the
answer you wanted to the public via scientific articles and alarmist press
releases.
290 The Untold Story of Milk
If health officials can possibly link an incidence of disease with raw
milk,theywill.TheoutbreakinnorthernWisconsin,describedearlier,
providesatypicalexample.Hospitalpersonnelwereabletocreateasta-
tisticalassociationbetweenillnessandrawmilkbyexcludingthosewho
weresickbutdidnotdrinkrawmilk.Foodquestionnairesusedtode-
terminethesourceofillnessalwayscontainaquestionaboutrawmilk
consumption. Often it is the first question.
AtaPennsylvaniaSenatehearingonrawmilkheldinSeptember,
2007, one attendee related the following story. After consuming un-
derdone chicken in a local restaurant, her daughter became violently
illandwastakentothehospital.Thediagnosiswaslisteriosis.Several
weeks later she received a call from the health department. Their first
question:“Didyourdaughterdrinkrawmilk?”Thewomanassuredthe
healthdepartment thatherdaughterdidnotdrinkrawmilkand told
them she suspected the underdone chicken her daughter had eaten. But
thequestionerwasdistinctlyuninterestedinthechicken.Afterrepeat-
ing thequestionseveralmore times, “Areyousureyourdaughterdid
not consume raw milk?” the official terminated the conversation. This
occurred during the period, described earlier, when the Pennsylvania
DepartmentofAgriculture(PDA)wasclaimingthatmilkfromseveral
rawmilkdairieswascontaminatedwithListeria monocytogenes.
Here’s another disturbing report from a Pennsylvania activist,
which occurred during the same period: “Recently I had occasion to
speakwithadairyfarmerwhohadbeeninthenewsandwasthesubject
ofharassmentbythePennsylvaniaDepartmentofAgriculture.Ilearned
thatafamilymemberhadbeenharassedbytelephonewhenherbaby
camedownwithsalmonellapoisoning.Therestofthefamilyhadeaten
chickenfromafastfoodrestaurantanddrankrawmilkfromthispar-
ticularfarm,yetonlythebabybecameill.Thebabyhadnotconsumed
eitherfoodbutwasonformula—notbreastmilk,notrawcow’smilk,not
store-bought cow’smilk.Yet thedailyharassmentbyphone fromthe
Pennsylvania health department had brought the mother to near col-
lapseasshetriedtocareforherseveralhealthyyoungchildrenandthe
illbaby.Thehealthdepartmenttriedtotrick,cajoleandbullyherinto
sayingthatthebabycouldhaveormighthavehadsomerawmilkfrom
The Safety of Raw versus Pasteurized Milk 291
thisfarm.Uponacallfromthefarmeraskingthemtocontactthefarm’s
lawyerinsteadofharassingthefamily,PDAharassmentsubsided.How-
ever,otherfarmclientswerealsoharassed.Onepatientsaidhehadnot
beentogetmilkbecauseofanillnesssohehadnotevenhadanyraw
milkinthehousewhenhebecameillwithsalmonella.”78
IntheOhioincidentthatledtotheclosingofYoung’sDairy,the
infectionwasknowntohavebegunelsewhereinthestate;andthedairy
wasalsoapettingzoo.Visitorstofarmsandpettingzoos,especiallychil-
dren,oftengetsickiftheydonothaveanynaturalimmunitytoafarm
environment. If they happen to drink raw milk at the same time, the
milkisblamed,notthefarm.
A major source of food-borne illness is runoff water from confine-
mentfarms.Yetinvestigatorsrarelytestthewaterwhensearchingfor
a culprit. In fact, in most cases of food-borne illness where raw milk
isasuspect,investigatorsrarelyhaveasampleofrawmilktotest.The
wheelsofbureaucracymoveslowlyandbythetimeaninvestigationhas
begun, thenecessarysamplehasbeenconsumedorpoureddownthe
drain.
Then there is the problem of selective reporting. Cases of food-
borneillnessthatoccurwithinareasonabletimeaftertheconsumption
ofrawmilkarelikelytobereportedatamuchhigherratethanother
casesoffood-borneillnessbecauseoftheaggressivecampaignthatthe
FDA,CDC,andvariousstateagencieshavewagedtomonitorrawmilk
closely and “educate” the public about its dangers. This alone could
causeastatisticalassociationtoappear,onethatprovesnothingexcept
theexistenceofreportingbias.
AdocumentpublishedbytheWestonA.PriceFoundationprovides
thefollowinghypotheticalscenario.“Alargeoutbreakofsalmonellaaf-
fects ten thousandpeople.Mostof themhaveminorsymptomsrang-
ingfromqueasinesstodiarrhea.Tenofthemcalltheirdoctorsandask
whethertheyshouldworryaboutit.Thedoctorsaskthemiftheyhave
recentlydrunkrawmilk,eatenrawmeatorpoultry,visitedapettingzoo
orplayedwithaturtle—theusualsuspects.Mostofthemhavenot,so
thedoctorsaysnottoworryaboutitandtocallbackinaweekifitper-
sists or in a few days if it gets worse. But when one patient responds that
292 The Untold Story of Milk
hehasdrunkrawmilk,thedoctorisalarmed.Shetakesastoolsample
andalertsthehealthauthoritiessotheycanmonitorthepopulacefor
anoutbreak.Theauthoritiesrunanewscampaignsuggestingapossible
associationbetweensalmonellaandrawmilkfromalocalfarm,andre-
iteratethewarningthat‘drinkingrawmilkisplayingRussianroulette
withyourhealth’andthatsalmonellainfectionscanproducepermanent
disabilitiessuchas‘reactivearthritis’iftheygountreated.Outoftheten
thousandpeoplesufferingfromqueasinessortransientdiarrhea,about
onehundredhavedrunkrawmilk;thirtyofthempanicandcall their
physician or the health authorities. The nine thousand nine hundred
whodidnotdrinkrawmilktakecomfortinthefactthattheyonlyeat
safefoodssuchascookedchickenandrinsedspinachandthereforeonly
reporttheirillnessattheusualrateofone-tenthofonepercent.Presto:
astatisticalassociationisborn.”79
And, as any statistician can tell you, correlation does not prove
causation. According to author Gary Taubes, “What we derive from
epidemiologic studiesareassociationsandhypotheses. . .Youcannot
proveanyhypothesistrue.Allyoucandoisrefutethehypothesesand
seewhichonesyouhaveleft.”80
Or,asthesayinggoes,“Epidemiologyislikeabikini.Whatisre-
vealedisinteresting.Whatisconcealediscrucial.”
MEXICAN-STYLERAWMILKCHEESE:ANEASYTARGET
SeveralseriousoutbreaksofdiseasehaveinvolvedMexican-style
rawmilkcheese—so-called“suitcasecheese”orqueso fresco—whichis
aparticularlyeasytargetforinvestigativebias.Consideranepidemicof
listeriosisinLosAngelesCounty,whichinvolvedonehundredforty-two
reportedcasesbetweenJanuary1throughAugust15,1985.Ninety-three
casesoccurredinpregnantwomenortheiroffspring.Therewereforty-
eight deaths: twenty fetuses, ten neonates and eighteen nonpregnant
adults.MostofthevictimswereHispanic.
Ina1988reportontheepidemic,entitled“Epidemiclisteriosisas-
sociatedwithMexican-stylecheese,”leadauthorM.J.Linnanandhis
team wrote, “An investigation of the cheese plant suggested that the
cheese was commonly contaminated with unpasteurized milk.”81 But
The Safety of Raw versus Pasteurized Milk 293
there was never any evidence that the contamination of this cheese—
whichwassoldasapasteurizedproduct—wasrelatedtocontaminated
rawmilk!82
Theinitialinvestigationfoundthat,comparedtouninfectedcon-
trols, infected patients were over five times more likely to have eaten
Mexican-style cheese, over four times more likely to have engaged in
sexual intercourse in theprecedingmonth(remember,manyof those
whobecamesickwerepregnant,thereforewerelikelytobemarriedor
havepartners),and justover four timesas likely tohaveconsumeda
rootvegetablecalledjicama(remember,mostofthevictimswereHis-
panic).
Asecondaryinvestigationfoundthattheassociationwithcheese
was due specifically to the use of a cheese produced by Jalisco Mexican
Products.Theinvestigatorsdidnotpursuetheassociationswithsexual
intercourseorjicamaanyfurther.
Investigatorsfoundthematchingstrainoflisteriainmultipleun-
openedpackagesofthecheeseonJune12,1985andinitiatedarecallof
theproductthefollowingday.Despitetherecall,theoutbreakcontinued
producingnewcasesatfullforcethroughtheendofJuly.
The team then tested the cheese for alkaline phosphatase (ALP)
activity.CompletedestructionoftheenzymeALPisconsideredthestan-
dardtestforsuccessfulpasteurization.TheyfoundexcessiveALPactiv-
ity in nine out of eighty samples of cheese. But investigation of the fac-
toryshowedthatthepasteurizerwasworkingproperly.
TheauthorsprovidednodatashowingarelationshipbetweenALP
levels and contamination with live listeria, and of twenty-seven dairy
farmsthatsuppliedrawmilktothecheeseplant,theyfoundnocasesof
listeriosisinanyoftheherds.Furthermore,allrawmilksamplestested
negativefortheorganism.Yettheresearchersconcludedthattheout-
breakwascausedbycheese“commonlycontaminatedwithunpasteur-
izedmilk.”
ThepresenceofALPinsomeofthecheesesamplesallowedtheau-
thors of the Linnan report to blame raw milk for the outbreak. But three
yearslater,researchersshowedthatMexican-stylesoftcheesescontain
both heat-stable and heat-labile forms of microbial ALP.83 Moreover,
294 The Untold Story of Milk
somecheesebacteriaproduceALPthatcannotbedifferentiated from
ALPindigenoustomilk.In2007,theindustryintroducedanewdetec-
tionmethodtocorrectthisproblem.84Thus,thistestwhenperformed
in1985wasnotavalidmeansfordemonstratinginadequatepasteuriza-
tioninthistypeofcheese.Themilkorcheesewasclearlycontaminated
at the cheese manufacturing plant, either before pasteurization, after
pasteurization,orboth.
Jalisco sued Alta Dena Dairy, one of its suppliers, for a portion
of the estimated one hundred million dollars in damage claims filed by
victimsofthelisteriosisepidemic.In1989,however,ajuryabsolvedAlta
Denaofallresponsibilityfortheepidemic,citingcompletelackofevi-
dencethatitsrawmilkwascontaminated.
According to theLinnanreport, thisoutbreakof listeriawas the
third one traced to a specific food product. The first occurred in 1981 and
wastracedtocoleslaw.Thesecond,inwhichforty-ninepatientsbecame
illandfourteendied—occurredin1983andwastracedtopasteurized
milk. Health officials often warn pregnant women not to consume raw
milkorMexican-stylecheese—butneveraboutthedangersofconsum-
ingcoleslawandpasteurizedmilk.
Mexican-style cheese was the whipping boy for a large outbreak
of listeriosis that occurred in North Carolina between October, 2000
and January, 2001. Several years later, in 2005, a team led by P. D.
MacDonald published a report on the epidemic.85 The results of their
case-controlstudymayhavebeenbiasedfromthebeginningas“Dur-
ingthestudy,rumorsspreadthatthesuspectedvehicleofinfectionwas
homemadeMexican-stylecheese.”Thepatientswerequestionedseveral
monthsaftertheevent,and“rumors”mayhavehelpedthemselectively
rememberconsumingqueso fresco.
Nevertheless, investigators found that case patients were almost
five times as likely as controls to have eaten hot dogs. According to a
2003 risk assessment jointly published by the FDA, USDA and CDC,
non-reheatedhotdogsareoverthreehundredeightytimesaslikelyas
fresh,softcheesetocauselisteriosis.86Nohotdogsweretestedforthe
presence of listeria, even though during the period of the outbreak, a
massive recall of listeria-infected hotdogs—nine hundred thousand
The Safety of Raw versus Pasteurized Milk 295
pounds of them—took place in ten southeastern states.87 Barbequed
chickenwasalsorecalledatthetime—butthecompanyproducingthe
productrefusedtocomplywiththerecall.88
Instead, the MacDonald team pointed the finger at the raw milk
usedtoproducesoftcheese.Thetitleoftheirreport:“Outbreakofliste-
riosisamongMexicanimmigrantsasaresultofconsumptionofillicitly
producedMexican-stylecheese.”
Inthebodyofthereport,weread,“ForHispanicwomen,werec-
ommendtargetededucationanddietarycounselingaboutthehazardsof
eatingfreshcheese,undercookedhotdogs,delimeatsandotherready-
to-eatmeatproductsimplicatedasvehiclesforlisteriosisduringpreg-
nancy.” But only “illicitly produced Mexican-style cheese” got star bill-
inginthetitle.
Oftheseveralsourcesofrawmilkusedforthecheese,listeriawas
presentinthebulktankrawmilkofonemanufacturing-gradedairy,and
itmatchedisolatesrecoveredfromtenfemalecasepatients,fromcheese
bought from a door-to-door vendor and from unlabeled cheese from
twoHispanicmarkets.MacDonaldandhisteamfailtomentionwhether
theyobtainedmatchingisolatesfromthelisteriosis-infectedhotdogs.
UnliketheJaliscocase inCalifornia,where listeriawasfoundin
unopenedpackagesoffactory-madecheese,someofthesamplestested
inNorthCarolinawerealreadyopenedandcamefromtherefrigerators
of individuals who had become ill. The finding of listeria in the cheese
doesnot,therefore,meanthatthecheesecausedanillness.Itisequally
likely that the sick person contaminated the cheese. And because the
queso frescointhiscasewasanartisanproduct,likelyvectorsofdisease
includecuttingboards,kitchencountersandfoodpreparationutensils
in small kitchens where the standards of sanitation may not be ideal. But
sincetheoutbreakoccurredinaHispaniccommunitywhereeveryone
consumed Hispanic food, including Mexican-style raw cheese, it was
easy for the researchers to create a statistical association of raw milk
cheesewiththeoutbreak.
296 The Untold Story of Milk
THE PUBLISHED LITERATURE ON RAW MILK OUTBREAKS:
BUILDING THE CASE AGAINST RAW MILK
TheNationalConferenceonInterstateMilkShipmentsisanon-
profit organization that represents the interests of the dairy industry.
Thegroupmeetseveryotheryeartodiscusstopicsofconcerntocon-
ventional milk processers. At the group’s May, 2005 meeting, Cindy
Leonard,MS,oftheFDA’sDivisionofDairyandEggSafetypresented
a PowerPoint presentation prepared by JohnF. Sheehan, head of the
division.Thepresentationaimedatdefusingtheargumentsofrawmilk
proponents,namelythatrawmilkisinherentlysafeandmorenutritious
than pasteurized milk. Mr. Sheehan’s take-home message: raw milk
providesnonutritionaladvantageoverpasteurized,andtheonlywayto
makerawmilksafeistopasteurizeit.89
Sheehan refers to fifteen studies linking illness with raw milk or
Mexican-style raw cheese. Of the fifteen papers referenced, eighty per-
centlinkedrawmilktoillnesswithoutapositivemilksample,andtwo-
thirdsfoundnovalidstatisticalassociationwithrawmilk.TheFDApre-
sentation misrepresented the findings of almost half the reports. In a
third,theauthorsdiscoveredalternativelikelysourcesofinfectionbut
didnotpursuethemandinthirteenpercentofthestudies,investigators
foundnoevidencethatanyonehadevenconsumedarawmilkproduct.
Inonestudy,theoutbreakdidnotevenexist!90
More to the point, not one of the fifteen studies demonstrated that
pasteurizationwouldhavepreventedtheoutbreak.(We’llexaminethe
claim that raw milk has no health benefits in Chapter 16.)
Anotherreviewofcasesalledgingillnesscausedbyunpasteurized
milkandcheesecomesfromtheCentersforDiseaseControl.91Forthe
period1998to2005,theagencyliststhirty-nineoutbreaksassociated
withrawdairyproductsresultingineighthundredthirty-oneillnesses,
sixty-six hospitalizations and one death. Of these, more than half are
newspaper reports and health department press releases, not articles
published in the scientific literature. In eighty-two percent of cases,
there was no valid milk sample and in seventy-eight percent, officials
couldnotprovideavalidstatisticalassociationwithrawmilk.Innine-
ty-sevenpercentof thecases,noevidence isprovidedto indicatethat
The Safety of Raw versus Pasteurized Milk 297
pasteurizationwouldhavepreventedtheoutbreak.Twooftheincidents
weretracedtopasteurizedmilkandonetopasteurizationfailure.Three
of the reports cited were either unpublished or not verifiable. Most im-
portantly, thedeathreportedinthesummaryappearsnowhereinthe
table.92Moresloppygovernmentworkacceptedasgospelinthecourtof
publicopinion.
Bill Marler is a high-profile attorney who specializes in food-borne
illness litigation. His law firm won the highly publicized Jack-in-the-
Box and Odwalla juice cases, in which dozens of people in Washington
StatebecameillandseveraldiedfromE. Coli O157:H7.In2008,Marler
focusedhisattentiononrawmilk,postingablog93andpublishingtwo
positionpapersfullofFDA-inspiredlanguageagainstrawmilkandraw
milkproducts.94
Interestingly,upto thatpoint,Marlerhad lost theonerawmilk
case he had taken, which involved a 2001 outbreak of E. coli O157:
H7 thatsickenedat least twohundredpeopleatProspectElementary
SchoolinruralRobesonCounty,NorthCarolina.Anepidemiologicalre-
portblamedtheoutbreakonhomemadebuttermadefromrawcream
servedtostudentsasaclassroomdemonstration.Thejudgeruledthat
theschoolhadgovernmentalimmunityandcouldnotbesued.95
OneofMarler’spositionpaperscontainsalistofonehundredtwo
references from scientific journals purporting to implicate raw milk in
disease.Itisobviousthatthelistwascompiledbyaninternorlawstu-
dentwhosimplydidasearchfor“raw,”“milk”and“outbreak”without
actuallyreadingthestudies.Onlyseventy-threeoutofthetotalreporton
actualillnesses;eightreportonthepresenceofpathogensinthemilkof
bulkholdingtanks(hencemilkdestinedforpasteurization)andtwenty-
one are reviews, editorials or letters to the editors of scientific journals.
Infact,anumberofthecitationsarereportsofoutbreakstracedtopas-
teurizedmilk,reviewsfocusingonthedangersofpasteurizedmilk,or
letterstotheeditorsupportingtherightofconsumerstopurchaseraw
milk.
Of the studies implicating raw milk in food-borne illness, a full
ninety-sixpercenthadeithernovalidpositivemilksampleornovalid
statisticalassociation.Severalofthestudiesservedasaplatformtohurl
298 The Untold Story of Milk
insultsatrawmilkadvocatesordiscussmethodsforhurtingthecom-
mericalinterestsoffarmers.Onestudyauthorcomplainedthatbecause
raw milk advocates “have lost their case in the scientific and medical
communities,”theyhaveturnedtothelegalandpoliticalarenatotake
advantage of the “current climate of heightened concern for personal
libertiesandfreedomofchoice,andfrequentrejectionofscience.”96
SALMONELLAINRAWMILKANDOTHERFOODS:
THE DOUBLE STANDARD
Infectionwithsalmonellaspeciesaccounts forasubstantialpor-
tionoffood-borneillnessinthiscountry,withanestimatedmillionand
one half cases and five hundred deaths annually.97Aninfectivedoseof
salmonella requires at least one million organisms. Ground beef is a
commonandpersistent source;USDAregulationsallow forup to ten
percentofthesamplestakenatagivenplanttocontainsalmonella,but
theselimitsareoftenexceeded.Highlevelsofsalmonellaingroundbeef
indicatehighlevelsoffecalcontamination.
Meanwhile,knownsourcesofsalmonellaareroutinelyfedtocat-
tle.Quotingagain fromFast Food NationbyEricSchlosser:“Astudy
publishedafewyearsagoinPreventive MedicinenotesthatinArkansas
alone,about3millionpoundsofchickenmanurewerefedtocattlein
1994. According to Dr. Neal D. Barnard, who heads the Physicians Com-
mitteeforResponsibleMedicine,chickenmanuremaycontaindanger-
ous bacteria such as salmonella andcampylobacter, parasites such as
tapewormsandGiardia lamblia,antibioticresidues,arsenicandheavy
metals.”98
An example of the difficulty USDA officials have in enforcing regu-
lationsagainstthemeatpackingindustryisprovidedbythe1999caseof
a ground beef plant in Dallas, owned by Supreme Beef Processors, which
failedaseriesofUSDAtestsforsalmonella.Uptoforty-sevenpercent
of the company’s ground beef contained salmonella—nearly five times
higherthanwhatUSDAregulationsallow.YettheUSDAcontinuedto
purchase large quantities of meat from Supreme Beef for use in schools.
Indeed, Supreme Beef Processors was one of the nation’s largest sup-
plierstotheschoollunchprogram,annuallyprovidingnearlyhalfofits
The Safety of Raw versus Pasteurized Milk 299
ground beef to schools. On November 30, 1999, the USDA finally re-
movedinspectorsfromthecompany’splant,shuttingitdown.
The next day, Supreme Beef sued the USDA in federal court, claim-
ingthatsalmonellawasanaturalorganism,notanadulterant,andcon-
tending that the USDA should not have removed inspectors from the
plant.FederalJudgeA.JoeFishorderedinspectorsbackintotheplant,
pendingresolutionofthelawsuit.Theplantshutdownlastedlessthan
one day. Six months later the judge issued a decision, ruling that the
presenceofhighlevelsofsalmonellaintheplant’sgroundbeefwasnot
proofthatconditionstherewere“unsanitary.”
“Fish endorsed one of Supreme Beef’s central arguments: a ground
beefprocessorshouldnotbeheldresponsibleforthebacteriallevelsof
meat thatcouldeasilyhavebeen taintedwithsalmonellaata slaugh-
terhouse.TherulingcastdoubtontheUSDA’sabilitytowithdrawin-
spectors from a plant [and thus shut the plant down] where tests re-
vealed excessive levels of fecal contamination. Although Supreme Beef
portrayeditselfasaninnocentvictimofforcesbeyonditscontrol,much
ofthebeefusedattheplanthadcomefromitsownslaughterhousein
Ladonia,Texas.ThatslaughterhousehadrepeatedlyfailedUSDAtests
forsalmonella.”99
Incontrast,considerthestoryofrawmilkandsalmonellainCali-
fornia. The California State Health Department and several county
healthdepartments,mostnotablythoseofLosAngelesandSanDiego
counties,conspiredforsomethirtyyearstoharassAltaDenaDairyand
nearlyeveryotherrawmilkdairy inthestate,andtoputthemoutof
business. The Steuve brothers—Ed, Harold and Elmer—founded Alta
DenainMonroviain1945withsixty-onemilkcowsandtwobulls.Dr.
Pottengerwasaregularcustomer.In1950thefamilypurchasedamuch
larger operation in Chino. The dairy became certified for raw milk pro-
duction in 1953 and grew rapidly. By the 1980s, the dairy milked over
eightthousandcowsdailyandownedeighteenthousandanimals.With
eighthundredemployees,AltaDenawasthelargestproducer-distribu-
tor in the nation, selling over twenty thousand gallons of certified raw
milkdaily.AltaDenaproducts,includingrawmilkandrawbutter,but-
termilk, ice cream, kefir and yogurt, were sold in health food stores in
300 The Untold Story of Milk
everystate.Foroverfortyyears,AltaDenaprovedthatsafeandhealthy
rawdairyproductscouldbeproducedanddistributedonalargescale
withliterallynoprovencasesof illnesscausedbytheirproducts.This
fact did not deter the various county health officials and the California
State Health Department from their campaign to destroy Alta Dena.
Eventually, the Department’s chosen weapon would be salmonella, a
weapontheyusedonlyafterfailingwiththeallegedthreatofanumber
ofotherdiseasestogeneratefearofrawmilkinthepublicandacostly
ongoinglegalmorassforAltaDena.
The first assault occurred in 1965, when a San Diego County health
officer named Askew summarily issued an order banning all raw milk in
thecounty,claimingtohavefoundStaphylococcus aureusinAltaDena
milk.Whilethesebacteriacanbeinvolvedineverythingfromskinin-
fectionstopneumonia,theyareubiquitousintheenvironmentandare
carriedbyabouthalfofthehumanpopulation.Manypasteurizeddairy
productscontainlowlevelsofS. aureus,withresiduesofhigherlevels
present before pasteurization.100 S. aureus poisoning is usually traced
to processed foods such as ham and cream-filled pastries. Although S.
aureuscancausemastitisincowsandstaphylococcalpoisoninghason
occasionbeenattributedtoawidevarietyofdairyproductsinthepast,
theonlyfourmajoroutbreaksreportedintheUnitedStatessince1970
have involved dairy products, namely processed butter products and
pasteurizedtwopercentchocolatemilk.101
IllnesscausedbyS. aureusisbriefandintense,withnausea,vom-
iting,diarrheaandcramps.Acutesymptomslastonlyafewhours,with
thepatientfullyrecoveredwithinadayortwo.102Noonehadbecome
illwhenAltaDenamilkwasbannedinSanDiegoCounty.“Thehealth
officer stated publicly that he was going to do away with raw milk in the
stateofCalifornia,”writesDr.WilliamCampbellDouglassinThe Milk
Book,“ifitwasthelastthingheeverdid.”103
According to Douglass, health officer Askew was asked at a hear-
ing of the County Board of Supervisors whether to his knowledge any-
one had ever become sick from drinking certified raw milk in San Diego
County. He answered, “No, but it could happen.” The Board urged him
tolifttheban,yetherefusedtodoso.Thecountry’slargestproducer-
The Safety of Raw versus Pasteurized Milk 301
distributordairycouldnotsellitsrawmilkinSanDiegoCounty,andthe
banremainedineffectforthreeyears.Finally,afterathree-yearbattle,
the Fourth District Court of Appeals ruled that the health officer had ex-
ceededhisauthority.Meanwhile,in1967,theCaliforniaMedicalSociety
passedaresolutioncallingforthepasteurizationofallmilkinCalifor-
nia.Threeothercountiessummarilybannedrawmilk,butvociferous
publicoppositionsucceededinremovalofthebans.
ItwasinJanuaryof1969thattheLosAngelesCountyHealthDe-
partmentattackedAltaDena.TheLos Angeles Timesannounced,with
bannerheadlinesbasedoninformationsuppliedbytheHealthDepart-
ment,thatAltaDenarawmilkwasbannedwiththepresumptionofcon-
taminationbytheorganismsthatcauseQfever.Thisobscureviral-like
diseaseiscausedbytheparasiteCoxiella burnetii,whichiscarriedin
ticksandsometimesintheruminantanimalsthatticksinfect.
Theparasitecausesnosymptomsintheanimals;mostcasesofQ
feveroccur in farmersandmeat factoryemployeeswhowork inclose
contactwithanimals,andthediseaseappearstobetransmittedbyin-
halationoftheparasite.Thesymptomsarefever,painandintensehead-
ache,andmostpatientsrecoverfullywithtwotofourweeksofantibiotic
treatment.104
C. burnetiihasbeenfoundinmilkfromcowscarryingtheparasite,
andregular consumersof rawmilk sometimeshaveantibodies to the
parasitewithoutshowinganyevidenceofdisease.Thisimpliesthatex-
posurestimulatestheimmunesystemtodevelopresistance.Tworeports
inthemedicalliteraturehavelinkedrawmilkconsumptionwithafew
dozencasesofQfever(onearticlewaspublishedin1968,afewmonths
beforetheLosAngelesCountyleveledcharges),buttheassociationre-
mains totally unproven. In fact,Eliott Ryser states that “inonestudy
inwhichcontaminatedrawmilkwasingestedbyhumanvolunteersill-
nessdidnotoccur.”Otherstudiesshowedthattheparasitesurvivedthe
temperaturesnormallyusedforpasteurizationformostofthetwentieth
century.105 On balance, it appears unlikely that Q fever has ever been
transmittedbytheconsumptionofrawmilk.
Noone inLosAngelesCountyhadreportedanysymptomsofQ
fever. Alta Dena defied the LA County Health Board ban, continuing to
302 The Untold Story of Milk
sellrawmilkinthecounty,andwastakentocourt.Meanwhilethedairy
labeleditsrawmilkas“petfood,notforhumanconsumption.”Harold
Steuve,presidentofthedairyandthemayorofMonroviaatthetime,
wasarrestedforcontemptofcourt.OnlywhenAltaDena’sexpertwit-
nesses testified that Q fever was caused by inhalation of the parasite and
notbyconsumptionofrawmilkdidprosecutorsdropthecharges.
A1966LosAngelesCountyHealthDepartmentreportonQfever
provesthehealthdepartment’sbias.Thereportdescribessevencases,
sixofwhichlived“inorarounddairies.”Noneofthesevendrankraw
milk.Contactwithanimalsandsubsequentairbornespread,thereport
admitted,wasthevectorforinfection,butclaimedthat“themostpracti-
calsolutionnowavailable”wastheuniversalpasteurizationofallmilk.
The California State Health Department led the next attack, in
1974,withastatewidebanofAltaDena’srawmilk,citingthethreatof
brucellosis.AllAltaDenacowshadofcoursebeenvaccinatedagainst
thediseaseandwereroutinely testedasanextraprecaution.Theban
forcedthedairytogotocourtonceagainandtoretesttheentireherd.
No brucellosis was found, and Alta Dena resumed sales of raw milk. But,
onceagain,theSteuveslostthousandsofdollarsinlegalandtestingex-
penses,andanuntoldamountofsalesduetoadversepublicity.
HavingfailedtoshowthatAltaDenarawmilkhadevercausedany
oftheclassicmilk-borneillnesses,thestatezeroedinonsalmonella.In
themid1970sthestatemadenumerousstatementsclaimingthatsal-
monella-contaminatedrawmilkwasproducedbyAltaDenaandother
Californiarawmilkdairies.In1978,theSteuvebrothersledCalifornia
rawmilkproducersinseekingaCaliforniastateSenatebillrequiringthe
StateHealthDepartmenttooverseerawdairyfoodsinamannersimilar
tothatofotherfoodproducts.OnJune4th,aweekbeforetheSenate
billwastocomeupfordebate,astatelaboratoryclaimedtohavefound
salmonella in Alta Dena milk. The State Health Department delayed
five days before releasing the information, while the public bought and
consumedthemilk—milkthestatewouldsubsequentlydeclareapublic
healthhazard.ThenonJune9th,twodaysbeforetheSenatedebatewas
to begin, the Department notified the press of the alleged contamina-
tion,claimingthatanepidemicofsalmonellapoisoningwasimminent.
The Safety of Raw versus Pasteurized Milk 303
The only epidemic was an outbreak of inflammatory news reports.
FromSanRafaeltoSacramento,fromVenturatoVallejo,rawmilkpro-
ducersstoodaccused:“RawMilkWarning,”“SomeRawMilkFoundto
beContaminated,”“ContaminatedRawMilkOrderedOffShelves.”Ra-
dioannouncementswarnedthepublicnottodrinkrawmilkfromAlta
Denadairy.Noonegotsick,butinthehysteriatheSenatebillfailed.
Afewdayslater,afterreviewingrelevantdocuments,theLos An-
geles Herald ExamineraccusedCaliforniaStateHealthDepartmentof-
ficials of falsifying bacterial reports in order to defeat the Senate bill.
Two independent laboratories—onethatdid testing for theLosAnge-
lesCountyMedicalMilkCommissionandtheotherthatdidconsider-
abletestingforthestate—returnednegativeresultsforsalmonella.The
Health Department laboratory had either falsified its results, or the test-
ingmethodshadbeensosloppythatthemilksampleswerecontaminat-
edduringthetestingprocedures.TheHerald Examiner articlehinted
ataconspiracytoeliminaterawdairyproductsamongmembersofthe
StateHealthDepartment.
Other State Health Department tactics bolstered the conspiracy
charge.Inseveralinstances,productsforwhichtherewasnoevidence
of contamination at all—falsified, inaccurate, or otherwise—were de-
stroyed. Officials forced a food store manager to pour ninety gallons of
certified raw milk down a toilet. Health officers punched holes in Alta
Denarawcheese,andpouredChloroxoverit.TheDepartmentleakeda
“staffreport”toNew Age,awidelyreadCaliforniamagazine,whichpub-
lishedexcerptsinAugust1978.“Evidencepointstoacontinuinghealth
hazard to the public consuming Alta Dena’s raw certified milk,” reported
New Age,andquotedamedicalepidemiologistwhoclaimedthatAlta
Denarawmilkwaskillingcancerpatients.
Theepidemiologistandtwoofhiscolleagues,bothofwhomworked
withtheCaliforniaStateHealthDepartment,publishedareportinthe
British Medical Journal statingthat twenty-twopatients,mostlywith
leukemiasandlymphomas,haddiedbetween1971and1975,sometime
after“exposure”toAltaDenarawmilk.106Publicationinaforeignjour-
nalmadetheauthorsrelativelyimmunetolawsuits.Sincethen,thear-
ticle has been widely quoted as scientific fact in American journals.
304 The Untold Story of Milk
The governor’s office in California received over seventeen thou-
sand letters, telegrams and phone calls in defense of Alta Dena with-
in two months of the Herald Examiner report. The furor died down,
but the number of letters alone grew to over fifty thousand. The State
Health Department was undeterred, repeating unconfirmed allega-
tions of salmonella contamination later in 1978 and again in 1979. Both
times,newspapersgeneratedtheusualscareheadlines:“PoisonedMilk
Recalled,”“StateIssuesWarningAboutAltaDenaMilk,”and“Tainted
MilkOrderedOffMarketShelves.”Againtheallegationswerefalse,no
one got sick and Alta Dena carried on. But one by one, other raw milk
producersinthestatewentoutofbusiness.
In1983,NevadastateinspectorsseizedAltaDenarawmilkfrom
ahealthfoodstoreandclaimeditcontainedsalmonella.Themilkwas
twenty-onedaysold,pastitsexpirationdate.Fourdifferentlabs,includ-
ingtheCaliforniaStateHealthDepartmentlabandonecountylab,sub-
sequentlyanalyzedthemilkandfoundnosalmonella.TheFDAspent
threedaysinvestigatingtheAltaDenaDairyandfoundnothingofim-
portance.TheCaliforniaStateHealthDepartmentnevertheless issued
warningstothepeopleofCalifornianottodrinkAltaDenarawmilk,or
evengiveittotheirpets.
Also in 1983, the report describing five serious salmonella cases
attheVeteransAdministrationMedicalCenterinSanDiegowaspub-
lished.107 Three of the five patients were regular consumers of Alta Dena
rawmilk,andoneofthem,apatientwithadvancedcancerwhohadbeen
receivingextensivechemotherapy,diedwithanacutesalmonellainfec-
tion.
Ignoring all the evidence on the benefits of raw milk and the desire
ofmanypeopletoconsumeit, theDepartmentusedthepossibilityof
occasional salmonella contaminationasanexcuse towageavendetta
againstAltaDenaandCalifornia’sotherrawmilkproducers.
In1984,anarticle inVogueheadlined“ARawMilkWarning:A
New and Dangerous Health Fad” featured statistics published in the
newsletterofanorganizationcalledCaliforniaCouncilAgainstHealth
Frauds.Thereportclaimedthatrawmilkdrinkerswereatincreasedrisk
ofsalmonellainfection,“whichcanresultinhighfeversandbloodydi-
The Safety of Raw versus Pasteurized Milk 305
arrhea.”Thesesymptomsareextremelyrareformostsalmonellainfec-
tions.Peoplewhodrinkrawmilkareonehundredeighteentimesmore
atrisk,saidthearticle.Thisexaggerationwasobtainedbymanipulating
figures originally published in 1944.
In19,ConsumersUnionoftheUnitedStatesjoinedwithCalifor-
nia’s conventional dairy producers to file suit against Alta Dena Dairy
foradvertising,allegedly falsely, thatrawmilkwashealthfulandpas-
teurized was not. The State Health Department concurrently claimed
thatrawmilkproductswereapublichealthhazardandprohibitedAlta
Denafromdistributingandsellingitsrawmilkpendingsettlementof
the Consumers Union suit. In 1992, the court ruled that Alta Dena’s
health claims were illegal and ordered all raw milk sold in California
tocarryagovernmentwarning.TheSteuvesthensoldAltaDenaDairy,
butcontinuedtoproduceanddistributerawdairyproductsunderthe
Steuve’sNaturallabel.
In1997,JohnLeedom,MD,oneofthesixmembersoftheLosAn-
geles County Medical Milk Commission, publicly stated that not only
licensed grade A raw milk but also certified raw milk should be banned
inLosAngelesCounty.AltaDenaproducedlicensedgradeArawmilk
that was also certified by the Commission; California’s other licensed
grade A raw milk producers were not certified. Three other commission-
erssidedwithLeedom.According toJamesPrivitera,MD,oneof the
twocommissionerswhofavoredkeepingrawmilkavailable,themajor-
ityimplementedregulationssorestrictiveandprejudicialthatitbecame
impossibleforrawmilkproducerstostayinbusiness.AltaDena’snew
ownersatthatpointstoppedsellingrawmilk,andSteuve’sNaturalraw
milkhasnotbeenavailablesinceMay,1999.We’llpickupthestoryof
what’shappenedwithrawmilkinCalifornialaterinthischapter.
DEATHS ATTRIBUTED TO RAW MILK: MORE BAD SCIENCE
Illnessattributedtorawmilktendstobemildandofshortdura-
tion;occasionally,however,areportlinksrawmilkwithdeath.Oneof
themostwidelycitedinvolvesthecancerpatientattheVeteransAdmin-
istration,mentionedabove,whoconsumedAltaDenamilk.Herdeath
wasattributedtoavirulent formofthebacterium,Salmonella dublin
306 The Untold Story of Milk
(S. dublin). As with most infections, people with suppressed immune
systems(suchasAIDSpatientsorpeopletakingcorticosteroidsorche-
motherapy)havethegreatestriskfromorganismslikesalmonella.
Thereport,publishedintheWestern Journal of MedicineinMay,
1983 was entitled “Invasive Salmonella dublin Infections Associated
withDrinkingRawMilk.”108Theauthorconductedayear-longstudyin
1980and1981attheVeteransAdministrationMedicalCenter(VAMC)in
SanDiego.Duringthatyear,fourteencasesofsalmonellainfectionhad
been diagnosed at the hospital; five of them were S. dublin infections.
The ages of these five individuals ranged from fifty-six to ninety-seven,
andallbutonehadaseriouspreexistingchronicdiseaseorweretaking
immunosuppressivecorticosteroidorchemotherapydrugs.Threeofthe
five had drunk raw milk from Alta Dena dairy within the previous two
weeks.
The eighty-five-year-old woman had chronic leukemia, diagnosed
in1979.Toquotefromthearticle,“InSeptember1981shewastreated
for the first time with cyclophosphamide [a highly toxic chemotherapy
agent which impairs natural immunity to infection] and prednisone
threetimesaday.Aweeklaterdiarrhea,feverandchillsdevelopedand
shehadasyncopalepisode[temporarylossofconsciousnessduetoafall
inbloodpressure]...blood,urine,andstoolculturesallgrewS. dublin
...shediedonthe17thhospitalday...Thiswoman’simmunestatus
wascompromisedbyboththeleukemiaandthetherapy.Shepresented
inshockwithanoverwhelmingSalmonellabacteremia[bacteriainthe
blood].”ThreeoftheotherfourpatientswithS. dublininfectionswere
sickenoughtorequireantibiotictherapyandadmissiontothehospital;
onewashospitalizedforseveralweeks.
This story presents another example of the gulf between biased
scienceandthefactsofthecase.Thedoctorsofferednoproofthatthe
rawmilkthewomandrankcarriedsalmonella.Andwhateverthesource
ofinfection,wereitnotfortheimmunosuppressivedrugs,noneofthe
individualswouldhavebecomeinfectedwithsalmonella.Howlonghad
the eighty-five-year-old woman been drinking raw milk with impunity
before her first week of chemotherapy, at the end of which she became
deathlyill?Thearticledoesnotaddressthisquestion.Aboutthemany
The Safety of Raw versus Pasteurized Milk 307
benefits of raw milk, the author says only, “I will not comment on the
validityofthenutritionalclaimsthataremadeforrawmilk.”
Another case occurred in 1975 and involved an infant who was
switchedfrombreast-feedingtorawgoatmilkattwomonths.Thechild
begantohaveloosegreenstoolswithsomestreakingofbloodandapur-
plishdiscolorationofthegums.AfterreceivingaDPTimmunizationat
five months, the child began to vomit three or four times a day and was
admittedtothehospitaloneweeklater.Ontheeleventhdayafterad-
mission,hereceivedabloodtransfusionusingbloodthathadevidence
of a Toxoplasmosis gondii infection, and this evidence was found in
the child a few days later. The infant was severely deficient in folic acid,
which is present at only one-fifth the level in goat milk as it is in cow milk
orhumanmilk.
Thereportonhisdeathcarriedthetitle,“Toxoplasmosisinanin-
fant fed unpasteurized goat milk.”109 None of the milk samples tested
positiveforT. gondii,buttheauthorsblamedtheinfant’ssymptomson
T. gondiisupposedlyacquiredfromdrinkingrawmilkanyway,andof-
fered no discussion of how his severe folic acid deficiency may have con-
tributedtohissymptoms.
Otherdeathsattributedtorawmilkarefoundinreportsoninfec-
tionallegedlyduetoMexican-stylerawmilkcheese.Asdiscussedearlier
inthischapter,rawMexican-stylecheeseisaneasytarget.IntheCali-
forniaoutbreak,rawmilkwasexoneratedbyajury;intheNorthCaro-
linaoutbreak,investigatorsignoredothermorelikelyvectorsofdisease,
basedtheirconclusionsontestsofopenedsamples,andengagedinin-
terviewtechniquesdesignedtoachievetheforegoneconclusionthatraw
milkwastoblame.
TYPHOIDFEVER,SCARLETFEVERANDDIPHTHERIA:
BAD SCIENCE FROM THE PAST
Whileillnessattributedtorawmilkinmoderntimesinvolvesacute
gastrointestinalepisodesthatareusuallyshort-livedanddonotrequire
medical treatment, fifty or one hundred years ago, raw milk was rou-
tinelyblamedforahostofdiseasesoftendepictedasdeadly.Thesedis-
easesincludedtyphoidfever,scarletfever,diphtheria,tuberculosisand
308 The Untold Story of Milk
undulantfever.Althoughthesediseasesoccuronlyrarelytoday—many
havenotbeenlinkedtomilkatallsincethe1950s—theyareoftentrotted
out in official publications, media stories and hearings on legislation af-
fecting the sale of raw milk. Public health officials imply that should raw
milkbecomemorewidelyavailable,theolddiseaseswouldbebackwith
us,threateningmanypeoplewithdisease.
AnexampleisfoundinElliotRyser’schapter“PublicHealthCon-
cerns”inApplied Dairy Microbiology:110“Outbreaksofmilk-borneill-
ness date from the inception of the dairy industry. Bacterial infections
includingdiphtheria,scarletfever,tuberculosisandtyphoidfeverpre-
dominated before WorldWar IIandwere almost invariably linked to
consumptionofrawmilk....”Noreferenceisgivenforthisincorrectin-
formation.Noristherementionofthefactthatpasteurizedmilkcaused
theworstmilk-borneoutbreakof typhoid feverever; in1927 inMon-
treal, almost five thousand people were stricken and four hundred fifty-
threediedduringafour-monthperiodinanepidemicthatwastracedto
negligenceatalocalpasteurizingplant.111
Rysercontinues:“...earlysurveillanceeffortssoonledtopassage
of the first Model Milk Ordinance, which stressed nationwide pasteuri-
zationandtheeventualreductionintheincidenceofmilk-borneenteric
diseaseswithnomilk-bornecasesofdiphtheria,scarletfever,tubercu-
losis, or typhoid fever reported in more than 40 years. . . . Banning the
interstate shipment of all raw milk products, both certified and noncerti-
fied, in 1986 helped reduce the number of raw milk-related outbreaks.
Sporadicillnessescontinuetobereported,however,particularlyamong
farmfamilieswhoroutinelyconsumemilkfromtheirowndairyherds.”
Againnoreferencesaregiven, this timefor thestatementabout farm
families.Takentogether,thesepassagesarenotonlymisleadingbutalso
veryconfusing.Let’sexaminethemandseewhy.
First we have the sentence “Bacterial infections including diphthe-
ria, scarlet fever, tuberculosis and typhoid fever predominated before
WorldWarIIandwerealmostinvariablylinkedtoconsumptionofraw
milk.”Dr.Ryserappearstohavetoldusthatrawmilkcausedmostcases
oftheseillnesses.Thatassertionwouldbeblatantlyuntrue—butthatis
notquitewhatheistellingus.Forifwecheckbacktothesentencebe-
The Safety of Raw versus Pasteurized Milk 309
fore (“Outbreaks of milk-borne illness date from the inception of the
dairy industry”), we see that he may be referring only to cases of the
diseasesthatweremilk-borne.
But as indicated above, Ryser does not reference the “almost invari-
ably”statement.Howmuchmilk-bornediseasewasactuallyattributed
torawmilkintheyearsleadinguptoandduringWorldWarII?Inher
seriesofarticles“WhyMilkPasteurization?”publishedintheRural New
Yorker, Jean Bullitt Darlington provided some revealing statistics pub-
lishedbytheOntarioDepartmentofHealthandtheU.S.PublicHealth
Service.Fortheyears1934through1941,thetotalnumberofcasesof
typhoidfeverreportedfortheprovinceofOntario,fromallcauses,was
just under two thousand, with two hundred forty five deaths. The total
numberofcasesreportedasmilk-bornewassixteen,withtwodeaths.112
Therecordsdonottellushowmanyofthesefewcaseswereassociated
with raw milk and how many with pasteurized. But it is clear that Ryser’s
associationoftyphoidfeverwithrawmilkishighlymisleading.Infact,
lessthanonepercentofthetotalcasesoftyphoidintheeight-yearperi-
odwerereportedasmilk-borne,andlessthanonepercentofthedeaths
werefromcasesthatwerereportedasmilk-borne.
FiguresfortheUnitedStatesdemonstratethatRyser’scontention
thatmilk-bornediseases“...werealmostinvariablylinkedtoconsump-
tionof rawmilk”notonlyhasnobasis in fact,butpresentsapicture
thatistheoppositeofthefacts.TheU.S.PublicHealthServicereported
thatintwenty-twoyears,1922-1944inclusive,reportslinkedatotalof
almost thirty-eight thousand cases of all kinds of diseases to all vari-
etiesofmilkandmilkproducts,pasteurizedandraw,withanaverage
ofseventeenhundredtwenty-sixcasesperyear.For1944inparticular,
therewereonethousandfourhundredforty-ninemilk-relatedcases,of
whichonlyfourhundredthirtywereattributedtorawmilk.Therewere
twentydeaths—onlyoneofwhichwasattributedtotheconsumptionof
rawmilk.113,114
Asnotedabove,Ryserreports,“...theeventualreductioninthe
incidence of milk-borne enteric diseases with no milk-borne cases of
diphtheria,scarletfever,tuberculosis,ortyphoidfeverreportedinmore
than 40 years. . . . Banning the interstate shipment of all raw milk prod-
310 The Untold Story of Milk
ucts, both certified and noncertified, in 1986 helped reduce the number
ofrawmilk-relatedoutbreaks.”Hereitappearsthatbanningrawmilk
hadtheeffectofreducingtheincidenceofdiphtheria,scarletfever,tu-
berculosis and typhoid fever. But since Ryser has just told us that there
havebeennomilk-bornecasesduring the last fortyyears,he isactu-
allyclaimingareductioninthe“numberofmilk-relatedoutbreaks”of
“entericdiseases”(typicallymildgastrointestinalillness).Hisnextsen-
tenceis,“Sporadicillnessescontinuetobereported,however,particu-
larlyamongfarmfamilieswhoroutinelyconsumemilkfromtheirown
dairyherds.”Theimplicationonceagainisthatthesesporadicillnesses
includediphtheria,scarletfever,tuberculosisandtyphoidfeverwhenin
facttheyare“entericdiseases,”afewdaysofdiarrhea.Ryserprovides
noreferencetodocumentthisassertion.Itisimpossibletosaywithcer-
taintywhetherthiswritingisdeliberatelymisleadingorsimplyinept.
Inthisandearlierchapters,we’veexaminedgrossexaggerations
by public health authorities on the extent of problems caused by raw
milk—aconstantthemethroughthemedicalliteratureofthepastone
hundredyears.InChapter5,Idescribedpartofa1929addressbyWil-
liamDodgeFrost,PhDandDoctorofPublicHealth,inwhichheana-
lyzedthequestionofhowmanyofthecasesoftyphoid,scarletfeverand
diphtheriaintheUnitedStatesintheyears1906through1925couldbe
attributedtotheconsumptionofmilk.HereIquotesomeoftheactual
figures that formed the basis of Dr. Frost’s conclusions:
“Thetableshowsthattheproportionofmilk-bornetyphoidtothe
totalamountoftyphoidvariesfrom0.17to0.94of1percentandthat
theaverageforthe20-yearperiodisaboutone-halfof1percent(0.53
percent).
“Inthecaseofscarletfever,theyearlypercentagesrangefrom0.05
to0.37of1percentwithanaverageof0.106percent.
“Thepercentages fordiphtheriarangefrom0.0to0.18of1per-
cent,withanaverageof0.028percent.
“Themilk-borneare0.221of1percentofthetotal[forallthreedis-
eases]orpractically1casemilk-borneto450casesacquiredsomeother
way.”115
This evidence about typhoid fever, scarlet fever and diphtheria
The Safety of Raw versus Pasteurized Milk 311
shouldbeconsideredalongwiththatofMrs.Darlington.Considertoo
thefactthattherehavebeennomilk-bornecasesofthesediseasesre-
portedduringthepastfortyyears,despitethecontinuedlegalavailabil-
ity of raw milk in some thirty-five states, and the fact that millions of
farm families during the last forty years have continued to drink raw
milk.Isitnotabundantlyclearthatanyallusiontopotentialproblems
withthesediseasestoday,asawarningagainstrawmilkbecomingmore
widelyavailable,isacompleteanduttersmokescreen?
OnceagainquotingMrs.Darlington,whose1947articlesremain
asrelevanttodayasever:“Ifevidenceforthecasefor[compulsory]pas-
teurization is so difficult to find that it must needs be distorted and in
somecaseseveninvented—whichisclearfromthemostrecentpublic-
ityonthesubject—anhonestmindcannotfailtograspthatthecasefor
[compulsory]pasteurizationisaveryweakcaseindeed.”116
RAWMILKANDE. COLI O157:H7
Smallsocialgatheringsusedtobethesourceofmostcasesoffood
poisoning.Suchoutbreaksstilldooccur,butnewkindsofoutbreaksare
moretypicalnow,outbreakscausedbychangesinthewayfoodispro-
duced.AccordingtoDr.RobertV.Tauxe,headoftheFood-borneand
Diarrheal Diseases Branch at the CDC, America’s centralized, industrial-
izedsystemoffoodprocessinghascreatedoutbreaksthathavethepo-
tentialtosickenmillionsofpeople.117
Food-borne illness from milk products usually involves gastro-
intestinal illness precipitated by the bacteria salmonella and campy-
lobacter. Incidents involving these two organisms have accounted for
mostdairy-relatedillnessesreportedsincetheearly1980s.Recently,the
newvirulentformofE. coli(E. coli O157:H7)hascauseddairy-related
outbreaksofillness,whichhavereceivedconsiderableattentionbecause
oftheparticularlysevereorfatalcomplicationssometimesproducedby
theorganisms.(MostformsofE. colidonotcauseillness,andinfact
play a beneficial role in the digestive tract, and even with E. coli O157:
H7,onlyafewofitsstrainsarepathogenic.)InApplied Dairy Microbi-
ology,Ryserreports,“at least60casesofrawmilk-associatedillness”
duetoE. coli O157:H7.Inthesameparagraph,hedocumentsmorethan
312 The Untold Story of Milk
500hamburger-relatedcasesofE. coli O157:H7illnessthatcausedthe
deaths of four children in 1993—the now famous Jack-in-the-Box case
that occurred in Washington state. At least fifteen additional outbreaks
linkedtotheconsumptionofundercookedgroundbeefoccurredinthe
1980s. In Canada, sixteen hundred cases were reported in 1992, and
fourteenhundredwerereportedintheUnitedStatesin1994.118
RyseralsodocumentsanumberofE. coli O157:H7outbreaksthat
involvedpasteurizedmilk,citingfaultypasteurizationorpost-pasteuri-
zationcontamination.Asusual,Rysercitestheseoutbreaksasadditional
reasonforcompulsorypasteurization.Writingofoneoutbreakinvolving
eighteenseverecasesinMontanain1994,however,heactuallyprovides
uswithfairwarningthatoneshouldavoidallpasteurizeddairyproducts
(thoughthiswascertainlynothisintent):“Thisoutbreakdoesraiseseri-
ousnewpublichealthconcernsregardingthepossiblepresenceoftoxic
strainsofE. coli in factory environments and their entry into finished
productsaspost-processingcontaminants.”119Itappearsthatwhat’sin
themilkisthesamethingEricSchlossertoldusisinthemeat.
Oneoutbreakattributedtorawmilkandoftencitedinthescientif-
ic literature took place in 2001 on Vancouver Island in British Columbia.
Thereport,entitled“Escherichia coli O157OutbreakAssociatedwiththe
Ingestion of Unpasteurized Goat’s Milk in British Columbia,” describes
five cases of E. coli O157:H7.120
The first case occurred in a one-year-old child who had consumed
rawgoat’smilkandalsohadvisitedapettingzoo—acommonsourceof
illness. The authors did not describe any follow-up of the petting zoo
lead.Twochildrenofthesamefamilybecameillsoonafter,buttheau-
thorsdidnotreportwhether theyhaddrunkrawmilk.Threemonths
earlier,thefamilyhadjoinedacooperativethatsuppliedthemwiththe
milk, of which eighteen other families were members, none of whom
reportedillness.Twochildrenofanotherfamilywhovisitedthecoop-
erativefarmbecameill,buttheauthorsdidnotreportwhethertheyhad
purchasedorconsumedanyrawmilk.
Two out of seven bottles of milk purchased by the first family were
testedfortheorganism,oneofwhichwasfound“presumptively”posi-
tiveafter“enrichment”withatestingsubstance;theothersampletested
The Safety of Raw versus Pasteurized Milk 313
negative.Theauthorsdidnotreportwhethertheinfectedbottlehadal-
readybeenopened,nordidtheyreporttestinganymilkobtainedfrom
thefarmitself.Theydidnotdiscussthepossibilitythattheinfectedper-
sonshadcontaminatedthemilkafterbecomingill,nordidtheyreport
testinganyotherfoodsfromthefamily’shouseorthewateronthefarm.
Theinvestigationprovidesanexcellentexampleofthemethodologyde-
scribed above: look until you find the answer you want; stop looking
when you find the answer you want.
While health officials build a case against E. coliinrawmilk,the
factremainsthatotherfoods,suchasundercookedmeat,arethemost
likelycandidates tocause the typeofepidemics thatDr.Tauxeof the
CDCismostconcernedabout—thosethatsickenmillionsofpeople.
The organism was first identified in 1982. This pathogen has be-
comewidelydispersedinthefoodsupplywiththeriseofhugefeedlots,
slaughterhousesandhamburgergrinders.MeatproductioninAmerica
isevermorecentralized:mostofthebeefconsumedintheUnitedStates
is now slaughtered in thirteen large packing houses. Eric Schlosser,
author of Fast Food Nation, provides the following description: “The
meat-packingsystemthatarosetosupplythenation’sfastfoodchains—
anindustrymoldedtoservetheirneeds,toprovidemassiveamountsof
uniformgroundbeefsothatallofMcDonald’shamburgerswouldtaste
the same—has proved to be an extremely efficient system for spreading
disease.Thelargemeatpackingcompanieshavemanagedtoavoidthe
sort of liability routinely imposed on the manufacturers of most con-
sumerproducts.Todaythegovernmentcandemandthenationwidere-
callofdefectivesneakers,butitcannotorderameatpackingcompany
toremovecontaminated,potentiallylethalgroundbeeffromfastfood
kitchensandsupermarketshelves.”121
Another danger from confinement farms is runoff water, which
carriesE. coli:O157:H7ontocropsandintohouseholds.Thisisapar-
ticularlyseriousprobleminWashington,astateinwhichadispropor-
tionate number of cases has occurred. Between 1990-1999, twenty-three
such outbreaks were reported in Washington state, afflicting at least two
hundred eighty-eight individuals, from sources as diverse as fish, lettuce
andlasagna,aswellasfromgroundbeef.122Theworstoutbreakoccurred
314 The Untold Story of Milk
inOctober1996,whenseventyindividualsbecamesickenedfromcon-
taminatedapplejuice—thefamousOdwallajuicecase.Thishighlypub-
licizedoutbreakledtofederalregulationsrequiringthepasteurization
ofallfruitjuicesoldinretailoutlets.123
InlateNovemberof2005,anoutbreakofillnessattributedtoviru-
lent E. coli O157:H7 afflicted eight Washington state individuals who
had consumed raw milk, sparking a flurry of news reports, vaulting the
subjectofrawmilkintothenationalmedia—andalsoraisingthespectre
ofdeliberatesabotage.
The milk came from Dee Creek Farm, a small family farm near
thetownofWoodlandinCowlitzCounty,insouthwesternWashington
State.Theowners,AnitaandMichaelPuckett,operatedacowsharepro-
gram, one of several in the state. State officials knew about the Pucketts’
operation—thePuckettsdescribed theiroperationearlier thatyear, in
July, toClaudiaColes,headof theDepartmentofAgriculture’s safety
program,ataconferenceonsmallfarmoperations.Coleslistenedand
askedleadingquestionsbutdidnotexpressdisapproval.Alaterreport
quotedherassaying,“Wecan’tdoanythingabout itunlessthere isa
healthproblem.”
ThePuckettswerenewtodairying.Theydidnothavefancyfacili-
tiesbutwerecarefultofollowgoodsanitarypracticesasrecommended
byseveralotherdairymeninthearea.Thecowsgrazedonpasturebut
cameintoabarnformilking.ThePuckettswashedtheteatswithiodine
andmilkedwithamilkingmachineintoaclosedstainlesssteelbucket
whichtheycarefullywashedbeforemilking.Theythentransportedthe
bucketsintotheirkitchenwheretheytransferredthemilkintogallon-
sizedglassjarsownedbytheshareholders.Itwastheshareholders’duty
toprovidecleanjars,butthePuckettsthenwashedthejarsagaininthe
dishwasher, just to be safe. The filled jars went immediately into the
freezerforninetyminutesandthenintotherefrigerator.
The various shareholder families had organized themselves into
groups for milk pick-up. Each day of the week, one family picked up
milkatthefarmforadozenorsoothershareholders.Whenthepickup
personarrivedatthefarm,thePuckettsplacedtheglassjarsintoalarge
coolerwithblueice.Eachgroupoffamilieshadapickuplocation,such
The Safety of Raw versus Pasteurized Milk 315
asafrontporch,wherethecoolerwasleftunattended.Familiesforeach
grouphadawindowofthreetoninep.m.tocomebyandretrievetheir
milkfromthecooler.ThePuckettshadexplainedthepickupsystemto
agentsfromtheDepartmentofHealthandtheDepartmentofAgricul-
ture on one of their visits to the farm; the officials offered no feedback,
neitherpositivenornegative.
MichaelPuckettoftenpickeduptheemptycoolerearlythefollow-
ingmorning,onthewayhomefromhisnightjob.Abouttwoweeksbe-
foretheincident,hewassomewhatunnervedbythepresenceofacar
parked across the street of the pickup house. A driver sat behind the
steeringwheel.Puckettstalled toseehow long thecarwouldremain.
Twentyminutespassed,atwhichtimeapolicecararrivedandthewait-
ingcarmovedoff.124
The first Dee Creek shareholder to become sick was a child from
afamilythatpickedupmilkonMondayfromthemilkingofNovember
26or27,atthepickuphousewhereMichaelhadnoticedtheparkedcar.
Soon other children fell ill and several were hospitalized. Health officials
quickly confirmed the culprit as a strain of virulent E. coli O157:H7.
The newspapers reported seventeen or eighteen confirmed cases
offood-borneillnessfromvirulentE. coliinDeeCreekFarmsharehold-
ers—the first of many exaggerations to appear in the media. Accord-
ing to the Washington Department of Health, there were only seven;
according to a farm spokesperson, there were actually eight confirmed
cases,sixpeople(fromfourfamilies)fromtheMondaypickupgroupof
thirteenfamiliesandtwofromtheTuesdaypickupgroupofsixfamilies.
In all, five were hospitalized, from three families, all from the Monday
pickup group. One was released after treatment with IV for dehydra-
tion, one was released after three days and one after five days, but two of
thechildren,fromtwodifferentfamilies,remainedhospitalizedinseri-
ousconditionforaroundamonth.OnememberofthePuckettfamily
testedpositivebutdidnotgetsick,andthreeotherindividualsamong
theshareholderfamilieshadsymptomsbutdidnottestpositive.Infact,
of the other eleven “cases,” at least eight of them specifically tested nega-
tive.Oneimportantpoint:DeeCreekFarmstoppeddistributionandad-
visedtheirshareholderstoceaseconsumptionoftheirmilkdaysbefore
316 The Untold Story of Milk
theDepartmentofHealthevenacknowledgedthattheyknewaboutthe
issueandcontactedthefarm.
TheWashingtonStateDepartmentofAgriculture(WSDA)visited
thefarmthreetimesduringtheweekofDecember12toconductathor-
ough investigation, taking samples of milk and swabs from all five cows
on the farm. At that point, the Pucketts had put away the equipment
theyusedfortheirshareholdersandweremilkingonlyfortheirpigs.
This theyexplained to the inspectors,notinghowtheydid thingsdif-
ferentlywhen theymilked forhumanconsumption.Mrs.Pucketthad
toremindtheinspectorstohosedownandsterilizetheirbootsbefore
theyenteredthemilkingbarn—thefarmwasverymuddyatthetime,as
wereallfarmsintheregion,becauseofarecord-breakingrainyseason.
WSDAincludedembarassingphotographsofmud-splatteredcowsand
equipmentintheirreportontheinvestigation.
Predictably,themediacoverageoftheincidentleanedheavilyon
healthdepartmentreports,describedas“ashowcaseofsensationalism
and unprofessional journalism.” However, TV interviews did include
manyconsumerswhoexpressedpassionatesupportofrawmilk.Inone,
ashareholderpouredaglassofDeeCreekFarm’smilkthatshestillhad
inherrefrigeratorforherfamilytodrink.Thenewspapersreportedthat
the law offices of William D. Marler had contacted two of the three af-
flicted families.
On December 21, the Clark County Health Department issued a
reportstatingthattheWashingtonStateDepartmentofAgriculturehad
confirmed E. coli O157:H7inDeeCreekFarmmilk—ClarkCountywas
thesceneofanoutbreakofE. coli O157:H7atacountyfairearlierinthe
year.ClaudiaColeslefttwotelephonemessages,onetothePuckettsand
onetotheirdaughter,apologizingfortheClarkCountyreportandstat-
ing that at that point, they had found no specific pathogens in the milk.
ItwasatapressconferenceonJanuary16thatWashingtonState
officials announced a positive finding of E. coli O157:H7intwosamples
of milk and five environmental samples from Dee Creek farm, of a strain
thatmatchedthoseculturedfromthestoolofthesickchildren.There-
portstatedthat“RawmilkboughtanddistributedfromDeeCreekFarm
wasconsumedbyallaffectedpeoplepriortotheirbecomingill,”andthat
The Safety of Raw versus Pasteurized Milk 317
“DeeCreekFarmillegallysoldrawmilk.”Thestatereportconcluded:
“TheWSDAFSPinvestigationalongwiththeepidemiologicalworkby
theCountyHealthDepartmentsdemonstratesthattheillegalrawmilk
providedbyDeeCreekFarmswasthesourceoftheE. coli O157:H7that
sickenedatleast18peopleinWashingtonandOregon.”117
While state officials expressed confidence that the outbreak was
causedbyrawmilk,theyignoredmanyimportantfacts.First,andmost
important,wasthefactthatindependentlabstestingDeeCreek’smilk,
followingthesametestingprotocolusedbythestate,foundnoE. coli
O157:H7,noteven inthesamesamplesthestateclaimedtestedposi-
tive.
Anotherfact:therewasatleastoneconcurrentoutbreakofinfec-
tionfromE. coli O157:H7,affectingseveralfamilymembers,inthearea.
OneboyendedupinthesamehospitalastheDeeCreekkids,incriti-
calcondition,andwasstillthereafteramonth,possiblywithlong-term
brain,nerve and kidney damage. Several of his family members were
also confirmed with E. coli O157:H7.
Neitherthestatenorthemediathoughtitrelevanttoreportthese
illnesses.Wecanonlyguesswhethertherewereotherunreportedcases
ofE. coli O157:H7atthesametime.(Allthreeraw-milkdrinkingchil-
drenhavesincerecovered.)
Onemorefact:justtwomonthsbeforetheDeeCreekincident,in
September2005,E. coli O157:H7wasfoundinwatersamplesinanorth
Spokanewaterdistrict,promptingahealthalert.
ThentherearethetacticsoftheWashingtonStateDepartmentof
Agriculture—reminiscentofthoseusedagainstAltaDenainthe1970s
and 1980s. The state kept its final report secret until the day before the
introduction of new raw milk legislation banning cow shares and an-
nounced “proof positive” at a press conference. Dee Creek Farm and
others involved learned of the final report and the press release from the
media,notthestate.
To make their case for the new legislation, officials claimed that
DeeCreekhadbarredentrytothefarm.Infact,thePuckettshadnever
barredentrytothefarm,onlyrequestedthatinspectionstakeplacewhen
theydidnothaveotherobligations(suchasmeetingwiththeirattorney
318 The Untold Story of Milk
or visiting the doctor), to which officials agreed. (When confronted with
theselies,MichaelTokosofWSDAapologizedandagreedthatthePuck-
etts did not ever bar entry.) The whole affair smacks of well-planned
orchestration, perfectly timed to influence anti-cow-share legislation.
AnotherparticularlyvirulentoutbreakofE. coli O157:H7 illness,
onewediscussedearlier,occurredinCaliforniaduringaten-weekpe-
riod, beginning in August, 2006.Over half the two hundred four vic-
timswerehospitalized;thirty-onecasesinvolvedatypeofkidneyfailure
calledhemolyticuremicsyndrome(HUS),andtherewerethreedeaths.
HUS, by the way, usually occurs when the patient afflicted by virulent E.
coliisgivenantibiotics,whichcanleadtoabuildupofShigatoxinthat
cancausekidneyfailure.125
Using PFGE analysis, investigators finally matched the particular
strainofE. coli O157:H7—out of over thirty-five hundred known unique
E. coli O157:H7 strains—to fresh salad spinach grown in the Salinas
valleyandalsotocattlefecesfromacattleranchuphillofthespinach
fields.126 Several companies voluntarily recalled their spinach as the
industry scrambled to find ways to prevent future outbreaks—spinach
growersalonesufferedtwohundredmilliondollarsinlostsalesin2006
andmoreinearlieroutbreaks.
But the problem is complex. If, as most investigators suspect, run-
off water from confinement farms is a source of the organism, it will be
a continuing source of infection—which apparently cannot be washed
off,asE. colicanresidewithinthetissueoftheleavesaswellasonthe
surface.Cloroxrinsesandcoldstoragehaveprovenequallyineffectivein
preventingillness.127
VirulentE. coli almost certainly originates with the confinement
of livestock,so it is ironicthata lotofthemediaattentionduringthe
outbreakfocusedonarawmilkdairyfarmerfromFresnowhograzeshis
dairycowsongrass.MarkMcAfee,theoutspokenpresidentandfounder
ofOrganicPasturesDairy,evendevelopedamobilemilkingparlorso
his cows could always be on pasture. His raw milk products, includ-
ing butter, cream, yoghurt, kefir and cheese, sell in health food stores
throughoutCalifornia,whereretailsalesofrawmilkandrawmilkprod-
uctsarelegal.ItwasrawmilkproductsfromOrganicPasturesDairythat
The Safety of Raw versus Pasteurized Milk 319
replaced those from Steuve’s after California health officials forced the
closureoftheSteuvebrothers’rawmilkbusiness.
McAfee instituted a private testing program when he went into
businessin1999,frequentlysubjectingthemilkproducts,thefarmenvi-
ronment,thecowsandtheirmanuretolaboratoryanalysis.Atthetime
oftheoutbreak,hehadperformedoverthirteenhundredtests,notonce
finding a human pathogen.
Then came reports that several children had been hospitalized
fromE. coli O157:H7,allofwhomhadconsumedrawmilk.According
to the FDA, five were ill and four hospitalized. In reality, only two were
hospitalized,bothofwhomhadbeengivenantibioticsinspiteofexpress
instructions on their armbands forbidding antibiotics. McAfee visited
bothchildreninthehospital.Themotherofonechilddeniedtheillness
had anything to do with raw milk and the other child had consumed
spinachtwodaysbeforetheillness.
“Justtobesafe,”theCaliforniaDepartmentofFoodandAgricul-
ture(CDFA)quarantinedallOrganicPasturesrawmilkproducts.Astate
teamdressedupinprotectivegearshowedupatthefarmandtestedand
retested the cows, the milk and the manure on the farm. They found
pathogensonlyintwoheifers,whichwerenotbeingmilked.McAfeehad
purchased the heifers from a confinement dairy—he says the pathogen
finding taught him a lesson, and he will never bring outside cows into
hisherdagain.Inanyevent,thestrainfromtheheifersdidnotmatch
thestrainthathadsickenedthechildren.Thestateliftedthequarantine
twoweekslaterandeventuallypaidapartialcompensationtoOrganic
Pasturesforlossofsales.
But the link between California raw milk and E. coli O157:H7dieda
slowdeath.AnFDAanti-rawmilkPowerPointpresentionpostedonthe
Internetseveralmonthslatercontainedseveralslideslinkinga“Califor-
niarawmilkdairy”tofourHUShospitalizationsfromE. coli O157:H7.
TheslideswereremovedafteranangryletterfromMcAfeethreatened
theagencywithalawsuit.128InaJune,2008courtcaseinvolvingraw
milk,attorneysfortheMarylandDepartmentofHealthandMentalHy-
gienecited“childreninCaliforniadrinkingrawmilk,gettingsickfromE.
coli andalmostdying,”inargumentsopposingcow-sharesagreements.
320 The Untold Story of Milk
And when attorney Bill Marler convinced two of the victims to sue the
dairy,morereportsaboutthecaseappearedinthenewspapers.Marler
placed an inflammatory video, full of distortions, about the sick children
onYouTube.com,but removed itafter receivinga letter fromMcAfee
enumeratingitserrors.Still,allthefreepublicityatthetimeoftheout-
breakledtoatwelvepercentincreaseinsalesforOrganicPastures.
THESAFETYOFRAWVERSUSPASTEURIZEDMILK
Wenowcometothesixty-fourthousanddollarquestion.Whatis
theriskofillnessonaper-servingbasisforrawmilkcomparedtopas-
teurized milk and also to other foods? The obvious bias in published
reports makes this a difficult question to answer, but we can try.
FromajointUSDA/FDA/CDCpaperonListeria monocytogenes,
published in September, 2003, the authors estimated that there are five
hundred fifteen times more illnesses from L. mono.peryearduetodeli
meatsandtwenty-ninetimesmoreillnessesfromL. mono.peryeardue
topasteurizedmilkcomparedtorawmilk.129Onaper-servingbasis,the
authorsestimatedthatdelimeatsaretentimesmorelikelytocauseill-
nessthanrawmilk—yetwehearnowarningsfromtheFDAthat“Deli
meatsareinherentlydangerousandshouldnotbeconsumed.”
The CDC attributes nineteen thousand five hundred thirty-one ill-
nessestotheconsumptionofpasteurizedmilkandmilkproductsfrom
1980-2005, just over ten times the number of illnesses attributed to
rawmilkduringthesameperiod.TheCDCestimatesthat3.5percent
ofAmericanhouseholdsdrinkrawmilkonaregularbasis.Usingthis
estimate,thereareovertwiceasmanyillnessesattributedtorawmilk
comparedtopasteurizedmilkonaper-servingbasis.Adjustingforbias
inthenumbersattributedtorawmilk,however,pasteurizedmilkmay
be over five times more dangerous than raw milk on a per-serving ba-
sis.130OnestatisticianconcludedfromtheCDCnumbersthatyou’dhave
todrinkoverthreemillionglassesofrawmilkbeforeyoumightexpect
togetanillnessofanykindduetothemilk.131
Here’sanotherwaytocrunchthenumbers.Thereareaboutsixty
government-reportedillnessesfromrawmilkperyear—anumberthat
is probably greatly exaggerated—and about one-half million raw milk
The Safety of Raw versus Pasteurized Milk 321
drinkers in the U.S.—a number that is conservative. But using these fig-
ures, the rateof illness fromrawmilkcanbecalculatedataboutone
one-hundredthofonepercentperyear—theactualpercentageisprob-
ablymuchlower.Therateofillnessfromotherfoodsisabouttwenty-
five percent—seventy-six million cases per year in a population of about
three hundred million. Thus even using inflated government statistics
on illness from raw milk, you are over twenty-five hundred times more
likelytocontractillnessfromotherfoodsthanfromrawmilk.
JUSTHOWDANGEROUSAREPATHOGENS,ANYWAY?
Arecurringtheme inthisbookhasbeenthe importanceofeach
individual’s immunity in resisting the potentially harmful effects of
pathogenicbacteria.ThistopicemergedinaJanuary5th,2000Los An-
geles Timesarticletitled“TheGreatEggPanic:Newproposalsrekindle
the debate over eggs’ safety. But some scientists say the fears are over-
blown.”132
“Newgovernmentproposalsdesignedtochecksalmonellapoison-
ingcouldforceroutinepasteurizationorirradiationoftheAmericanegg
supply,” the article reads. Officials argue that because three hundred
thousandAmericansaresickenedandhundredsdieeachyearfromsal-
monellaineggs,eggsshouldbeirradiated.“Today’segg,thenewwis-
dom dictates, is too frequently contaminated with a bacterium called
Salmonella enteritidistobeeatenaseggsalwayshavebeen:sunnyside
up,inmayonnaise,crackedrawoverhotpastaandgratedwithParme-
sancheeseorsimplysoft-boiledandspoonedworshipfullyfromacup.”
Other officials disagree, including Peter Barton Hutt, former chief coun-
selfortheFDA.Hecallsthestatisticalmodelingthatproducesthefood
poisoningstatistics“theclosestthingIcanthinkofinthismodernage
toaOuijaboard.”NowalectureronfoodsafetyatHarvardUniversity,
Huttsays,“Thestatisticsareallovertheplacebecausenoneofthemare
anygood.Theyareallwildguesses.”133
Sowhileitisclearthatmanycommerciallyproducedeggscontain
salmonella,it’snotatallclearhowmany,orhowmanyproblemsthis
may lead to, or why some people are afflicted while most are not.
AccordingtoJohnR.Roth,aprofessorofbiologyattheUniversity
322 The Untold Story of Milk
ofUtah,whohasbeenstudyingsalmonellaforfortyyears,“...probably
it[salmonella]existsinverymanyorganismsatalowlevelwhereit’snot
a pathogen but living as part of the gut flora.” The idea of banishing it,
hesays,isabsurd.“Salmonellaisdistributedprettywidely,andifyou’re
willing to look closely enough, you’d probably find it almost everywhere.
Sometimesitmakesamistakeandgetsacrossthegutwallandintoan
organism.Thenithasallthesemechanismsforsurvivingknownasviru-
lence.”134
Inthevastmajorityofcases,thatvirulencemanifestsasanirrita-
tion in the gut wall where the immune system fights off the bacteria,
and symptoms range from loose stools to flu-like illness. In rare cases,
theinfectionreachesthebloodstream,andoccasionallythesecasesmay
befatal.Salmonella-inducedfatalitiesalmostalways involve individu-
alswhoareimmunosuppressedfrompreviousdrugtherapy.According
totheCenters forDiseaseControl inAtlanta,between1985and1998
there were seventy-nine verified deaths from this cause, about five per
year—one-tenth the number of people killed in the U.S. each year by
lightning.135
Roth’sassertionthatsalmonella is literallyeverywhere is impor-
tant, for it confirms two things. First, there is no point in sanitizing the
foodsupply,becausecontaminationwithsalmonellaandotherorgan-
ismscanjustaseasilyoccurafterpasteurization,irradiationorwhatever
otherprocessisusedtosanitize.Second,theindividualswhobecomeill
asaresultofexposuredosobecausetheir immunesystemsarefunc-
tioningabnormally.
Actually, regular exposure to organisms such as salmonella can
buildresistanceandimmunity.Ineffect,wecanmakeourselvesstron-
gerandhealthierbyeatingrawfoodsthatmaycontainorganismscon-
sidered“pathogenic.”Thatiswhyregularrawmilkdrinkersaremuch
lesslikelytobecomeillduringoutbreaksofillnessattributedtorawmilk
than first-time raw milk drinkers. According to a 1985 report, “Persons,
regardlessofage,whoareroutinelyexposedtoCampylobacter jejuniby
vehiclessuchasrawmilkmaydevelopsomeprotectiveimmunity.[This
is]supportedbyseveralserologicalstudies...”136
Duringonecampylobacteroutbreak“...noneofthechronicraw
The Safety of Raw versus Pasteurized Milk 323
milkdrinkersbecameillafteringestinglargeamountsofthesamemilk
thatcausedahighattackrateamongthosepersonswhowereacutely
exposed....Presumablythisphenomenonisduetopreviousexposure
toCampylobacterwithsubsequentdevelopmentof immunity . . . this
investigation confirms the presence of these antibodies [to Campylo-
bacter] in persons chronically exposed to raw milk and for the first time,
to our knowledge, shows an association between high antibody levels
and immunity to infection under field conditions.”137
Quite simply, these studies confirm the fact that raw milk drink-
ersdeveloppowerfulimmunityandresistancetopathogenicorganisms.
Thesamejournalsthatprovidethisinformationhavecontinuedtode-
mandacompletebanonrawmilk, includingabanonfarmersgiving
theproductawaytoneighborsandfriends.Yetinthisageofwidespread
threatfromvirulentmicroorganisms,rawmilkprovestobetheonefood
thatcanprovideimmunitytothepathogensintheotherfoodswecon-
sume.
GRASS-FED,FULL-FATRAWMILKISSAFEST
Back in 1936, Edwin Jordan, author of A Textbook of General Bac-
teriology,pointedoutthat“Thecharacterofpasturewasearlyobserved
toaffect thekindandabundanceof thespecies [ofbacteria] found in
milk;the lackofpasture inmorerecentyearshasbeendemonstrated
tohaveaprofoundeffect.”138 Numerous studies have confirmed the fact
that current feeding methods utilizing large quantities of grains have
had a profound influence on the kind and abundance of bacteria found
inmilk,muchtothedetrimentofthehealthoftheanimalsandthequal-
ityofthemilk.
Ofparticularrelevanceisthedevelopmentofacid-resistantstrains
ofbacteriainmoderncattle.Accordingtoa1998Sciencemagazinear-
ticle, cattle fed mostly grain have a lower (more acidic) intestinal pH
andaremorelikelytoharborpathogenicbacteriathancattlefedmostly
grass and hay. The abnormally low pH in which the bacteria develop
makes these bacteria acid-resistant. “The ability of bacteria to act as
food-bornepathogensdependsontheircapacitytosurvivethelowpH
of the [human] gastric stomach and to colonize the intestinal tract of
324 The Untold Story of Milk
humans,”theauthorswrite.“Cattlethatwerefedgrainhadonemillion-
foldmoreacid-resistantE. colithancattlefedhay.”139
These acid-resistant pathogenic bacteria from heavily grain-fed,
overlyacidiccattlehaveanincreasedabilitytosurvivetheacidenviron-
ment of the human stomach and subsequently colonize the intestinal
tractandcausedisease.Thisisamajorreasonwhyrawmilk(ormeat)
fromgrass-fedcowsissomuchsaferthanmilkfromanimalskeptlarge-
ly or entirely in confinement and fed mostly grains.
The butterfat in milk is another factor that protects us from ill-
ness.Inadditiontocontainingantimicrobialshort-andmedium-chain
fattyacids,butterfatisacarrierforimportantvitaminsthatstrengthen
theimmunesystem.Anothersubstance,calledglycosphingolipids,pro-
tectsagainstgastrointestinalinfections,especiallyintheveryyoungand
theelderly.Inastudy involvingpasteurizedmilk,childrenwhodrank
skimmed milk had diarrhea at rates three to five times great than chil-
drenwhodrinkwholemilk.140
Milkwasdesignedbynaturetobeaperfectfood—butinorderfor
milktobeaperfectfood,andacompletelysafefood,itshouldbepro-
ducedandconsumedasnatureintended...fromcowsonpasture,with
allthebutterfat,andunpasteurized.Natural,richandraw!