Abstract
The growing popularity of unpasteurized milk in the United States raises public health concerns. We estimated outbreak-related illnesses and hospitalizations caused by the consumption of cow’s milk and cheese contaminated with Shiga toxin–producing Escherichia coli, Salmonella spp., Listeria monocytogenes, and Campylobacter spp. using a model relying on publicly available outbreak data. In the United States, outbreaks associated with dairy consumption cause, on average, 760 illnesses/year and 22 hospitalizations/year, mostly from Salmonella spp. and Campylobacter spp. Unpasteurized milk, consumed by only 3.2% of the population, and cheese, consumed by only 1.6% of the population, caused 96% of illnesses caused by contaminated dairy products. Unpasteurized dairy products thus cause 840 (95% CrI 611–1,158) times more illnesses and 45 (95% CrI 34–59) times more hospitalizations than pasteurized products. As consumption of unpasteurized dairy products grows, illnesses will increase steadily; a doubling in the consumption of unpasteurized milk or cheese could increase outbreak-related illnesses by 96%.
Highlights
Facilitated greater access of consumers to unpasteurized milk
The incidence rates of Shiga toxin–producing Escherichia coli (STEC), Salmonella spp., and Campylobacter spp. illnesses and hospitalizations per 1 billion servings were higher for unpasteurized dairy product consumers than for pasteurized dairy product consumers
Unpasteurized dairy products are responsible for almost all of the 761 illnesses and 22 hospitalizations in the United States that occur annually because of dairy-related outbreaks caused by STEC, Salmonella spp., L. monocytogenes, and Campylobacter spp
Summary
Facilitated greater access of consumers to unpasteurized milk (e.g., through farm sales or cow share programs). The number of states where the sale of unpasteurized milk is prohibited decreased to 20 in 2011 from 29 in 2004 (8–10). This trend toward increased availability of unpasteurized dairy products raises public health concerns, especially because raw milk consumers include children (2,4,6). Our study aimed at estimating the outbreak-related disease burden associated with the consumption of fluid cow’s milk and cheese made from cow’s milk ( referred to as milk and cheese or dairy products) that are unpasteurized and contaminated with Campylobacter spp., Salmonella spp., Shiga toxin–producing Escherichia coli (STEC), and Listeria monocytogenes. We assessed how hypothetical increases in unpasteurized dairy consumption would affect this outbreak-related disease burden
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