Abstract
Campylobacteriosis is the most common notifiable disease in New Zealand. While the risk of campylobacteriosis has been found to be strongly associated with the consumption of undercooked poultry, other risk factors include rainwater-sourced drinking water, contact with animals and consumption of raw dairy products. Despite this, there has been little investigation of raw milk as a risk factor for campylobacteriosis. Recent increases in demand for untreated or 'raw' milk have also raised concerns that this exposure may become a more important source of disease in the future. This study describes the cases of notified campylobacteriosis from a sentinel surveillance site. Previously collected data from notified cases of raw milk-associated campylobacteriosis were examined and compared with campylobacteriosis cases who did not report raw milk consumption. Raw milk campylobacteriosis cases differed from non-raw milk cases on comparison of age and occupation demographics, with raw milk cases more likely to be younger and categorised as children or students for occupation. Raw milk cases were more likely to be associated with outbreaks than non-raw milk cases. Study-suggested motivations for raw milk consumption (health reasons, natural product, produced on farm, inexpensive or to support locals) were not strongly supported by cases. More information about the raw milk consumption habits of New Zealanders would be helpful to better understand the risks of this disease, especially with respect to increased disease risk observed in younger people. Further discussion with raw milk consumers around their motivations may also be useful to find common ground between public health concerns and consumer preferences as efforts continue to manage this ongoing public health issue.
Highlights
The milk of healthy cows usually contains few bacteria at the source, it can become contaminated during collection via contact with pathogenic bacteria from the skin and teats of the cow, the interior surfaces of the milking machine and the hands of those associated with the milking process [1]
Designation of cases The number of notified cases of campylobacteriosis that were reported in the MidCentral District Health Board (DHB) area between 2012 and 2017 was 1408
Campylobacter sequence typing did not support a diagnosis of campylobacteriosis in eight cases and these were excluded from the analysis
Summary
The milk of healthy cows usually contains few bacteria at the source, it can become contaminated during collection via contact with pathogenic bacteria from the skin and teats of the cow, the interior surfaces of the milking machine and the hands of those associated with the milking process [1]. Campylobacter spp. are the most common pathogens reported in association with raw milkrelated disease outbreaks in New Zealand, a pattern that is seen internationally [5,6]. In New Zealand, raw milk can be legally purchased directly from registered farms and is commonly consumed by farm residents and employees [5]. A survey of New Zealand dairy farmers found that 65% reported consuming raw milk [7]. Demand for raw milk in New Zealand has increased in recent years, in line with a rise in interest in natural and locally produced food products [8]. In the USA, the number of notified raw milk-associated disease outbreaks has likewise increased, with nearly twice the number of outbreaks reported in 2007–2012 compared to 1993–2006 [6,9,10]
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