Increased Outbreaks Associated with Nonpasteurized Milk, United States, 2007–2012 - Volume 21, Number 1—January 2015 - Emerging Infectious Disease journal - CDC

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Increased Outbreaks Associated with Nonpasteurized Milk, United States, 2007–2012 - Volume 21, Number 1—January 2015 - Emerging Infectious Disease journal - CDC

Volume 21, Number 1—January 2015

Dispatch

Increased Outbreaks Associated with Nonpasteurized Milk, United States, 2007–2012

On This Page

• The Study
• Conclusions
• Suggested Citation

Figures

• Figure 1
• Figure 2

Tables

• Table

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Elisabeth A. Mungai , Casey Barton Behravesh, and L. Hannah Gould 

Author affiliations: Atlanta Research and Education Foundation, Atlanta, Georgia, USA (E.A. Mungai); Centers for Disease Control and Prevention, Atlanta (E.A. Mungai, C.B. Behravesh, L.H. Gould)

Suggested citation for this article

Abstract

The number of US outbreaks caused by nonpasteurized milk increased from 30 during 2007–2009 to 51 during 2010–2012. Most outbreaks were caused by Campylobacter spp. (77%) and by nonpasteurized milk purchased from states in which nonpasteurized milk sale was legal (81%). Regulations to prevent distribution of nonpasteurized milk should be enforced.

Pasteurization is an effective way to improve milk safety; however, in the United States, illness related to consumption of nonpasteurized milk continues to be a public health problem. The first statewide requirements that dairy products be pasteurized were enacted in Michigan in 1948 (1). In 1987, the US Food and Drug Administration banned the interstate sale or distribution of nonpasteurized milk. However, the laws regulating intrastate sales are set by each state (2). Regulations for intrastate sales of nonpasteurized milk vary from complete bans to permitting sales from farms or retail outlets (2). Even in states in which sale of nonpasteurized milk is illegal, milk can often be obtained through other means. For example, some states allow cow-share or herd-share agreements, in which buyers pay farmers a fee for the care of a cow in exchange for a percentage of the milk produced (3,4).

Consumption of nonpasteurized milk has been associated with serious illnesses caused by several pathogens, including Campylobacter spp., Shiga toxin–producing Escherichia coli, and Salmonella enterica serotype Typhimurium (3,4). Despite the health risks associated with consuming nonpasteurized milk, the demand for nonpasteurized milk has increased (3,5,6). Recently, many state legislatures have considered relaxing restrictions on the sale of nonpasteurized milk (2,6). We report that the number of outbreaks associated with nonpasteurized milk increased from 2007 through 2012.

Ms. Mungai is a surveillance epidemiologist at the Atlanta Research and Education Foundation and at the Centers for Disease Control and Prevention. Her interests include infectious disease epidemiology and food safety.

References

1. Steele JH. History, trends and extent of pasteurization. J Am Vet Med Assoc. 2000;217:175–8 . DOIPubMed
2. Weisbecker A. A legal history of raw milk in the United States. J Environ Health. 2007;69:62–3 .PubMed
3. Oliver SP, Boor KJ, Murphy SC, Murinda SE. Food safety hazards associated with consumption of raw milk. Foodborne Pathog Dis. 2009;6:793–806.DOIPubMed
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5. Buzby JC, Gould LH, Kendall ME, Timothy FJ, Robinson T, Blayney DP. Characteristics of consumers of unpasteurized milk in the United States. J Consum Aff. 2013;47:153–66.
6. David SD. Raw milk in court: implications for public health policy and practice. Public Health Rep. 2012;127:598–601 .PubMed
7. National Association of State Departments of Agriculture. NASDA releases raw milk survey 2011 [cited 2012 Nov 2].http://www.nasda.org/file.aspx?id=3916
8. National Association of State Departments of Agriculture. Dairy division of national association of state departments of agriculture raw milk survey, November, 2004 [cited 2012 Nov 2]. http://www.nasda.org/File.aspx?id=1582
9. National Association of State Departments of Agriculture. NASDA releases raw milk survey 2008. [cited 2012 Nov 2]. www.nasda.org/File.aspx?id=2149
10. Longenberger AH, Palumbo AJ, Chu AK, Moll ME, Weltman A, Ostroff SM. Campylobacter jejuni infections associated with unpasteurized milk—multiple states, 2012. Clin Infect Dis. 2013;57:263–6. DOIPubMed

Figures

• Figure 1. Outbreaks associated with nonpasteurized milk, by etiologic agent and year, United States, 2007–2012. Three outbreaks involved multiple pathogens: Campylobacter spp. and Salmonella enterica serotype Typhimurium; Shiga toxin–producing Escherichia coli...
• Figure 2. Percentage of patients affected by outbreaks associated with nonpasteurized milk, by age and etiologic agent, United States, 2007–2012.

Table

• Table. Source of milk in outbreaks associated with nonpasteurized milk, by legal status of state sales, United States, 2007–2012

Suggested citation for this article: Mungai EA, Behravesh CB, Gould LH. Increased outbreaks associated with nonpasteurized milk, United States, 2007–2012. Emerg Infect Dis [Internet]. 2015 Jan [date cited]. http://dx.doi.org/10.3201/eid2101.140447

DOI: 10.3201/eid2101.140447