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‘Clear Link’ Between Drinking Raw Milk And Illness: European Food Safety Agency

No Cheese For Infants; Only 1%, Fat-Free Milk Would Be Allowed For Kids Over 2 Years Old; Yogurt Would Be OK For Adults As Milk Alternate

There is a “clear link between drinking raw milk and human illness,” with the potential for “severe health consequences” in some individuals, according to a recent “Scientific Opinion” from the European Food Safety Authority (EFSA).

The opinion focuses on raw milk for drinking only and not on milk or dairy products obtained after processing. European Union (EU) legislation defines raw milk as milk that has not been heated to more than 40 degrees C (104 degrees F) or undergone any treatment that has an equivalent effect.

In many European countries, including Germany, France, the Netherlands, Belgium, Denmark, Italy, Ireland, and parts of the United Kingdom, raw cow’s milk can be sold at the farm directly to the consumer. Certain other countries, including Spain, Poland and Norway, do not allow the sale of raw milk to consumers.

Consumer interest in raw drinking milk is growing in the EU and raw milk producers are using new routes of sale for raw milk through vending machines and Internet sales. Consumption of raw drinking milk appears to be low among the general population, but in specific groups large amounts are consumed, the opinion noted. Prevalent among this group of consumers is the belief that raw milk possesses particular health properties or attributes, in addition to the existing nutritional components.

Traditionally, raw drinking milk is either consumed on-farm or sold directly from a farm shop or via local delivery. In some parts of Europe, vending machines are used for dispensing raw drinking milk for sale, and these may be located on-farm or in retail settings. Of those EU member countries that permit the sale of raw drinking milk through vending machines, Italy has the largest number (1,066 in 2013), followed by Slovakia (182 in 2012), Austria (121 in 2013), France (93 in 2013), the Czech Republic (14 in 2013) and Lithuania (six in 2013).

Between 2007 and 2012, there were 27 reported outbreaks in the EU involving raw drinking milk. Of these, 21 were attributed to Campylobacter spp., predominantly C. jejuni, one to Salmonella Typhimurium, two to shigatoxin-producing Escherichia coli, and three to the virus tick-borne encephalitis virus (TBEV).

Four of the 27 outbreaks were due to raw milk from goats, while the remainder were attributed to raw milk from cows.

The published literature was also considered, which highlighted additional outbreaks of TBEV and outbreaks of Brucella melitensis, Mycobacterium bovis, and STEC, although some of these were prior to 2007. No outbreaks attributable to Listeria monocytogenes in raw drinking milk were reported between 2007 and 2012.

Owing to the lack of epidemiological data, the burden of disease linked to the consumption of raw drinking milk could not be assessed.

Antimicrobial resistance has been reported in several EU countries in isolates of Campylobacter spp., Salmonella spp., STEC and Staphylococcus aureus, from raw milk or associated equipment such as milk filters, and may be significant for public health, the opinion stated. Strains of Campylobacter spp., and particularly C. jejuni, exhibiting resistance predominantly to tetracyclines but also to some other antimicrobials have been reported in two EU countries.

The steps in the production to consumption chain for raw drinking milk “present many opportunities for contamination by microorganisms,” some of which may be transmissible to humans, the opinion said.
Intrinsic contamination of milk can arise from systemic infection in the milk-producing animal as well as from localized infections, such as mastitis. Extrinsic contamination of milk can arise from fecal contamination and from the wider farm environment associated with the collection and storage of milk.

The panel that prepared the scientific opinion identified several recommendations:
• There is a need for improved risk communication to consumers, particularly susceptible/high risk populations, regarding the hazards and control methods associated with consumption of raw drinking milk.
• To provide a better evidence base to inform future prioritization and ranking approaches, studies should be undertaken to systematically collect data for source attribution for the hazards identified as associated with raw drinking milk and collect data to identify and rank emerging milkborne hazards.
• Because of the diverse range of potential microbiological hazards associated with milk-producing animals, hazard identification should be revisited regularly.
• The models reviewed in the opinion only involved raw cow’s milk.

There is a need for validated growth and survival models for pathogens in raw drinking milk of different milk-producing species, particularly in relation to the temperature and storage time of raw drinking milk from the producer up to the point of consumption.