Over the last thirty-plus years of practice, I have been a vocal advocate for robust public health involvement in disease prevention—especially foodborne illness. It is beyond me to comprehend why public health would remain mute in the face of at least 165 sick, 20 hospitalized, and 40 percent of the ill five years or younger—especially raw milk, a risky elixir.

The more I think about this, the harder it is to figure out why public health would sit on the scientific fact that a food producer of a known high-risk food is sickening hundreds. This includes overwhelming epidemiological evidence of the same WGS pattern in humans and milk. Setting aside the “food freedom” argument for a moment, people should be able to eat or drink what they want and feed their kids the same; what about simply informing the public of the facts and letting the public decide for themselves?

CDPH Mission Statement: “To advance the health and well-being of California’s diverse people and communities.”

CDPH failed in its Mission when it failed to alert the public that a producer of raw milk in the State of California had sickened at least 165 (likely larger) with Salmonella, Campylobacter, or E. coli both in the State of California and three other unnamed States. And nearly 40% of those sickened were five or younger. All sickened by Salmonella people’s stool cultures were a whole genome sequence that matched each other to raw milk samples. These facts would have been an opportunity to alert the public to the risk and educate and “[t]o advance the health and well-being of California’s diverse people and communities.”

Instead, CDPH sent out this sad excuse for a public announcement yesterday—still saying nothing of value “[t]o advance the health and well-being of California’s diverse people and communities.”

CDPH takes its charge of protecting public health seriously and works closely with all partners when a foodborne illness outbreak is identified. After being alerted by San Diego County Public Health last October about multiple Salmonellosis cases, CDPH conducted a robust public health investigation in concert with local officials and the California Department of Food and Agriculture (CDFA), which regulates raw milk producers in California. On October 24, 2023, CDPH posted a food recall notice on its website (see attachment). (That notice was later archived upon conclusion of the investigation.) The department also notified the public of the recall on social media multiple times (see links below). CDPH, working with CDFA, asked firm management at Raw Farm for a voluntary recall. Raw Farm was cooperative and posted a recall on October 25. Because most illnesses were reported in San Diego County, San Diego County Public Health led the public notification process (media releases are available on their website, including one on October 20 and October 25). The outbreak and case investigation handled by CDPH ended on May 4, 2024. Centers for Disease Control and Prevention (CDC) was aware of the investigation and assisted with some coordination with cases in other states.

Interestingly, this week, Harvard Health published Why drinking raw milk can be dangerous.

Despite some claims to the contrary, drinking raw milk is not safe. Health experts say that germs in raw milk could make you seriously ill.

What is raw milk?

Raw milk comes from animals such as cows and goats. It is not pasteurized to kill germs.

Some people think raw milk tastes better than milk that has been pasteurized. Among the health claims surrounding raw milk are that it can cure lactose intolerance, treat allergies, and support gut health. However, extensive research has shown that none of these myths are true.

Drinking raw milk can be hazardous to your health, explains infectious disease specialist Dr. Michelle Chan of Beth Israel Deaconess Hospital. “I’m alarmed that drinking raw milk has become a trend,” she said. “There’s a good reason why foods and drinks are pasteurized now.”

What are the health risks of consuming raw milk?

Raw milk can carry dangerous germs that can cause food poisoning. Most people with food poisoning experience some combination of abdominal cramping, vomiting, and diarrhea.

Salmonella, E. coli, Listeria, and Campylobacter are germs that may be found in raw milk and can cause foodborne illness.

Anyone who drinks raw milk can become sick. But it is especially dangerous to:

• babies, young children, and teenagers
• pregnant women
• older adults
• People with a weakened immune system, including those with cancer, diabetes, or HIV/AIDS, and those who have had an organ transplant.

In the U.S., selling raw milk across state lines is illegal, and raw milk is banned in about half of U.S. states. Among states that allow it, most specify that it must come directly from a farmer.

Good hygiene practices on farms can lower the risk of contamination; however, they cannot guarantee that their raw milk is safe from dangerous germs.

Bird flu and raw milk

In March 2024, a multistate outbreak of bird flu in dairy cows occurred, the first time bird flu viruses had been found in cows.

Limited information exists about whether the virus could be transmitted to humans through raw milk from infected cows. A letter published in the New England Journal of Medicine reported high levels of the virus in raw milk from infected cows. The FDA recommends that farmers not manufacture or sell raw milk from cows showing symptoms of bird flu or cows who have been exposed to it.

In a study designed to simulate commercial milk processing, the FDA and USDA found that the most commonly used pasteurization time and temperature requirements effectively inactivated the bird flu virus in pasteurized milk.

What is pasteurization?

Pasteurization is a process that kills germs in foods by using heat. Pasteurized milk is heated to at least 145° Fahrenheit and then quickly cooled. The process was invented by scientist Louis Pasteur in 1864.

Does pasteurized milk have the same nutritional benefits as raw milk?

Multiple studies have found no evidence that raw milk is more nutritious than pasteurized milk. According to the CDC and FDA, pasteurized milk offers the same nutritional benefits as raw milk but without the risks.

Drinking raw milk means taking a big chance with your health, Dr. Chan believes. “My advice,” she said, “is to take heed of the research, be aware of the risks associated with drinking raw milk, and avoid drinking it.”

Also, today, Physician’s Weekly posted – “Less than Half of Adults Know Dangers of Raw Milk.”

A new survey shows that few Americans understand the health risks of drinking raw milk, so experts are redoubling their efforts to spread the word.

The push dovetails with the discovery of bird flu virus in milk from infected cows this spring. The H5N1 virus is widespread in wild birds worldwide and is causing outbreaks in poultry and U.S. dairy cows. As of June 21, four human cases of the H5N1 flu had been reported in the United States.

“It is important that anyone planning to consume raw milk be aware that doing so can make you sick and that pasteurization reduces the risk of milk-borne illnesses,” said Patrick Jamieson, director of the Annenberg Health and Risk Communication Institute at the University of Pennsylvania.

Milk from cows, sheep, goats, and other animals that has not been pasteurized to kill harmful germs is called raw or unpasteurized. The U.S. Centers for Disease Control and Prevention say consuming unpasteurized milk and products made from it can expose people to germs such as E. coli, listeria, and salmonella.

While the U.S. Food and Drug Administration says the commercial milk supply — which is pasteurized — is safe from the H5N1 virus, raw milk is another story.

In June, before the four human cases of bird flu were reported, the Annenberg Institute surveyed 1,031 American adults online and by phone to gauge their knowledge about the risks associated with unpasteurized milk.

While 47% of respondents knew that raw milk is less safe to drink, 24% either wrongly believed that pasteurizing milk does not effectively kill bacteria and viruses or were unsure whether it does.

Respondents who were 65 or older, college-educated, or lean Democrat were more likely to understand the benefits of pasteurization and to believe that it does not destroy nutrients in milk. City dwellers were more likely to consider raw milk less safe than rural counterparts (49% versus 32%).

Meanwhile, only 4 in 10 Republicans (37%) believe raw milk is less safe than pasteurized.

“The difference in views of raw milk that we see between Democrats and Republicans is difficult to disentangle from the difference between rural and urban dwellers,” Kathleen Hall Jamieson, director of the Annenberg Public Policy Center, said in a center news release. “Those in rural areas are both more likely to identify as Republicans and to consume raw milk.”

A separate analysis showed that wher one lives does not predict beliefs about pasteurization. Still, many Americans have misguided notions about it.

Fewer than half (43%) knew that pasteurization “does not destroy nutrients” in milk; 16% think it does, and 41% were unsure.

Interestingly, 18- to 29-year-olds were more likely than seniors to believe pasteurizing milk destroys nutrients (25% versus 5%), and Republicans were much more likely to believe that than Democrats (23% versus 8%).

The survey was conducted June 7-10 and has a margin of error of plus or minus 3.5 percentage points.