Sunday, June 8, 2008

Tuberculosis and Mexican cheese

Quite by chance, on the day I was writing my last blog article on raw milk, the Orange County Register published an article by Doug Irving on an outbreak of tuberculosis in San Diego. See

Mycobacterium bovis is relatively rare in humans, but can be serious and difficult to treat. It is thought that the disease jumped from cattle to humans somewhere between 8000 and 4000BC, when cattle were domesticated. There is archaeological evidence that humans suffered the disease, pulmonary tuberculosis, which may have been contracted through consumption of raw milk. The human specialized form M. tuberculosis was probably spread by migrating Indo-Europeans and by 1000BC it had spread to the whole of the known world.

It appears that in the San Diego area, the disease is spreading primarily through the Latino population and scientists there believe that it may be being brought into the country from Mexico in queso fresco, a popular soft crumbly cheese that may be produced as a cottage industry.

The article in the OC Register contains some inaccuracies. Not all milk sold in the USA must be pasteurized; it depends on the particular State legislation. In addition, the article implies that the outbreak has suddenly flared. However, the actual study by UCSD Medical Center and county health officials, showed that between 1994 and 2005, there were 3,291 cases of active infection reported by the county's Tuberculosis Control Program and of those, about 8 percent were ill with M. bovis. Roughly the same pattern was observed in 2007.

The sale of raw milk cheeses in New Zealand is currently limited and subject to strict controls. See

Extra hard Italian Parmesan-style raw milk cheeses like Grana Padano, Pamigiano Reggiano, Romano, Asiago and Montasio have a low water activity of about 0.693, which prevents the growth of bacterial pathogens.

Thursday, June 5, 2008

It had to happen!

In the USA, the argument about raw milk still rages. We now see the spectacle of lawyers claiming that consumers are being deprived of their rights to choose their food, while others sue the suppliers for selling dangerous milk.

The raw milk lobby claims that pasteurization robs the milk of its nutritional value and the natural enzymes that help the human digestive system. I am not aware of any scientific evidence to support this. They also vociferously claim that pasteurization kills the “good bacteria”. The zealous consumers claim that their rights are being trampled if they are prevented from buying the product. The regulators point to the dangers of consuming raw milk, such as the diseases caused by Salmonella, Campylobacter, Escherichia coli, Listeria and others, a point conveniently ignored by the raw milk proponents.

The hazards of consuming raw milk have been known for a long time. In Ontario around 1900, over 10% of all childhood tuberculosis was thought to be caused by unpasteurized milk. The rate of tuberculosis infection and many other milk-borne diseases in children fell dramatically after enactment of a law in 1938 requiring milk to be pasteurized; this was hailed as a major achievement.

The fact is that between 1998 and 2005, a total of 45 outbreaks resulting in more than 1,000 illnesses, 104 hospitalizations and two deaths due to raw milk or soft raw milk cheese were reported to the Centres for Disease Control and Prevention. There have been more recent, high-profile cases. Pathogens were found in 13 percent of bulk tank raw milk samples by a survey of Pennsylvania dairy farms in 2006. In California, 2008, new regulations set a limit of 10 coliforms per millilitre of raw milk. Raw milk suppliers maintain that the regulation will put them out of business, which suggests to me that they feel unable to meet this specification. But it's the same standard used for pasteurized milk. <For an explanation of the use of coliforms, see "Is hamburger a greater risk for E. coli" this blog, posted 3rd May 2008>.

Farmers who are selling raw milk are able to charge a significant premium for their product and understandably wish to continue supply. However, nothing comes without a price, and the right to sell a particular food product imposes certain responsibilities. Some American consumers have contracted serious disease from drinking raw milk. Unfortunately, children have no choice in the source of their milk and several have suffered haemolytic uremic syndrome (which has a 90% mortality rate without treament) and a number have required kidney transplants. The suppliers are now being sued.

In New Zealand, NZFSA has recently renewed its warning to consumers about raw milk cheeses, which have recently been approved for sale here. People with compromised immune systems, the elderly or pregnant women are urged to avoid these products.