I know indeed that the mainstream public health community has a nearly paranoid fear of unpasteurized milk. No wonder this attitude prevails considering CDC’s position, and the frequent posting on ProMED and elsewhere for every pathogen found in raw milk, whereas most other foodborne disease outbreaks rarely reach the same publicity and reactions. The one-day recall of Organic Pastures milk was not due to any illness, simply a positive PCR sample of bulk milk that resulted in rapid identification of source with one cow with sub-clinical campylobacter mastitis got culled. Organic Pastures, approved by California State to produce raw milk, must stay within the same bacteriological limits as applies to pasteurized milk, namely less than 10 coliforms per ml milk and standard plate counts less than 1,500 cells per ml milk. OPDC is consistently below this limit and has a test and hold system, so that no milk leaves premises and is sold before results of production is tested and within limits.
Source attribution in outbreak data does not constitute a full risk characterization. Only a very small fraction of food-borne disease can be traced back to the source, and it is much easier to trace back a niche commodity than a commodity that everybody consumes. Thereby we get a false impression that certain products such as raw milk is causing so much more disease than maybe chickens, eggs or ground meat. Quantitative microbial risk assessments should be used to assess risk with raw milk or pastured eggs, and those risks should be compared to other raw produce, such as lettuce, strawberries, peanuts etc, that consumers prefer to consume raw, or products that are handled raw such as chicken and ground beef.
I believe that we need to differentiate measures applied to the conventional production to the small scale niche production. When 4% of the population are producing food for 96% of the population, naturally we are forced to concentrate and industrialize production. We need to assure the safety of this large-scale production in terms of dangerous microbial hazards, since the impact is so great. There are so many consumers of one broiler flock or one layer hen facility. We have come far, and the Salmonella control programs and other food safety programs are necessary.
However, the niche small commodity organic or small farm production is not a threat to public health in general or the conventional production. In a country of freedom of choice, people should be able to choose their risks. People can choose to smoke, drink alcohol, eat potato chips and candy, even though the risks associated with these habits are high. Some people are on the other hands making food choices that appeal to their ethical or health thinking. They are willing to pay 1 dollar per free-range egg (as I saw on the farmers market in New York this spring). This is a very small percent of the population. If we get a few Salmonella cases in this small population, it is not going to have a huge public health impact and they are mostly aware of the risks. These consumers are choosing those risks, because they feel that those products provide some other benefits in terms of taste, source or even health. Let them. I know some of these consumers are a bit paranoid and unscientific in their thinking, but so are people that feed their kids donuts for breakfast or let their kids drink coke.
Within the raw milk sector, there has now been a non-profit organization set up by the stake-holders to produce very safe high quality fresh milk (www.rawmilkinstitute.org). The standards set by this organization are much higher than what authorities are asking and involves requirements for farm-specific risk analysis and management plans and transparency. I believe that the small sector is able to regulate itself. Consumer pressure, internet media communication and increased transparency not only puts pressure on conventional production but also on the local small-scale farm production. I hope that the public health authorities will focus more of their efforts on reversing the trends of obesity, type 2 diabetes, metabolic disease and other ‘welfare’ diseases, rather than to go on witch hunts for ‘organic or small farm-source’ production that is such a niche sector. Information such as an egg for breakfast is important to prevent obesity and optimize performance in school needs more attention, than the fact that backyard flocks have not been Salmonella tested.