Pasteurization Without Representation

Corby Kummer

Raw milk is one of those issues that riles people (and inspires puns, "raw deal," "raw nerves" and the like). This week Massachusetts farmers and fans of raw milk were sufficiently agitated to bring a cow to Boston Common, in view of the State House, to demonstrate their anger at state laws banning the sale of raw milk anywhere but directly from farms certified to sell it.

That Massachusetts allows the sale of raw milk at all makes it unusual—only 28 states do, and laws addressing how and where it can be sold vary by state. The reason: raw milk can be deadly, and can cause severe illness with what Barry Estabrook, in a post defending raw milk, recently called a "rogue's gallery of bugs" (and he named quite a number). The Centers for Disease Control says that even if only 1 to 3 percent of the U.S. population consumes raw milk or raw milk products, 68 percent of disease outbreaks related to dairy products involve raw milk or raw milk products.[Update below.] Here's a FAQ page from the CDC with claims that would make raw-milk proponents mad: for instance, that there's no evidence that drinking raw milk can protect against illnesses like asthma and allergies, nor evidence that raw milk is any more nutritious than pasteurized milk.

Don't tell people who want their milk raw! They'll gladly give you a long list of its disease-preventing qualities, and trump everything by calling it REAL MILK, milk that has been spared the depredations of industry that "feeds swill" to cows, "tampers with and harms" milk by mixing hundreds of batches together and homogenizing it "so you can't tell the cream from the fat from the milk," and wants to "be sure people have no idea where milk comes from."

All this was from a woman helping staff the table I found on the Common, where a farmer was pouring passersby tastes of raw milk. She had a shock of long, wavy, cream-white hair and looked like she'd spent most of her life on the farm. In fact I recognized her right away as the prominent local food activist Abby Rockefeller, who divides her time between Cambridge, across the river, and a farm in New Hampshire. We've met at Slow Food activities, and as always she was wonderfully outspoken. (Here's a paper she wrote on sludge; she's a strong supporter of composting toilets, and in the 1970s founded a company to sell them.)

Outraged, in fact. Rockefeller is one of the people who have banded together in buyer's clubs that, in essence, carpool milk by making a pickup for numerous customers at a certified farm and then deliver it. Because of direct-sale laws, anyone in and around Boston who wants raw milk has to drive at least 45 minutes each way to get it. Old-fashioned milk delivery isn't allowed. Rare as they are (I treasure the metal milk boxes on front porches in my neighborhood, awaiting deliveries in glass bottles from Thatcher Farms), existing residential milk-delivery services could help remedy the main objection the state Department of Public Health (disclosure, headed by my spouse, John Auerbach) has to selling raw milk off the farm: the risk of improper refrigeration. All milk is subject to deterioration and rapid bacterial growth the higher the temperature, but with raw milk the deterioration is rapid and dangerous, because of its much higher bacterial count before pasteurization. [UPDATE: The Boston Globe ran a lead editorial supporting the state. They must've read Barry, because they refer to the "rogue's gallery" of germs. Their conclusion: "By restricting raw-milk sales to licensed farms, the state can at least isolate the source of any outbreak. Creating a new licensing and inspection system to keep track of such milk and ensure its safety once it leaves the dairy is a burden the state should be spared."]

That high bacterial count is just what makes raw milk desirable and good, of course: those bacteria give milk and, particularly, cheese and yogurt their flavor. I wrote about my own advocacy of raw milk and inherent trust of it 10 years ago in a piece advocating raw-milk cheese in America and, unsurprisingly, Vermont, whose cheese has only gotten better and better in the years since. Then and now, it wasn't easy to get people to try drinking raw milk:

It's hard to engage non-food people in urgent talk about raw milk, which seems like a dangerous relic of the pre-Pasteur past. It's even harder to get people to try a sip, as I discovered on a visit to Martha's Vineyard last summer, which began with stops at local farms to collect ingredients for a reunion lunch. One of the farms was a state-certified raw-milk dairy, and after lunch I proudly passed around a creamer full of raw whole milk to go with coffee. My friends, who I knew loved milk, suddenly decided that they'd really always preferred their coffee black.

I couldn't blame them. But I happen to trust raw milk instinctively, having grown up in a dairy-farming town, and I remember as one of the greatest treats imaginable the tea a family friend served with milk warm from the cow.

On the Common the other day, a young man hesitated before taking a proffered paper cup of milk, closed his eyes with a what-the-hell expression, and after he swallowed opened them and said to no one in particular, "It's actually kinda good! It tastes like half-and-half." (If he'd read Barry's post, he would surely have agreed that "You've never tasted real milk in all of its rich, creamy, complex glory until you've tasted raw milk.")

In Massachusetts, it's being framed as a libertarian issue. As a farmer from Eastleigh Farms, in Framingham, 25 miles from Boston, said as he led the cow, Suzanne, back into his truck, "DPH should stay the hell out of this. It's none of their affair. Corporate milk is doing this." (The farm's website has a summary of coverage of the rally.) The Northeast Organic Farming Association Raw Milk Network is an active supporter of raw milk, and helped organize the rally; it lists the state's raw-milk dairies and provides updates on campaigners' efforts to keep buyer's clubs alive, urging state residents to "Please continue to buy milk from Massachusetts raw milk dairies, spread the word about this wonderful food, and keep speaking out about the importance of preserving food freedom."

"Food Freedom": it's reminiscent of the motto on New Hampshire license plates, "Live Free Or Die." Rockefeller echoed this New Hampshire passion, talking about the "wonderful deal" farmers get from the buyer's club that brings raw milk to her Cambridge home: "We pay between $8 and $12 a gallon. They can afford to live, and to keep their cows healthy. Those farms do well, and it's fantastic that people are willing to pay that now—they're frantic to pay that. We need to be eating living food. I've drunk raw milk my whole life. My father's father supplied his family and workers with raw milk. Raw milk doesn't go bad, you know. Take a quart, let it turn, and let a quart of pasteurized and homogenized go bad at the same time—or ultrapasteurized, which will give you the most disgusting stink. Raw milk is interesting the whole way—and completely edible, starting with curds and whey and then when it's ready for cheese."

There's not an easy answer. Marion Nestle, ever my guide, told me in an email,

My position on raw milk has been that people have the right to consume it if they want to but they have to be responsible for the risk. I've argued that producers of raw milk MUST use HACCP plans, but experts on food safety assure me that HACCP, even with testing, is not protective enough. They say it's not possible to test enough samples to be sure. The cases are rare but they sure are nasty when they do occur. This is a tough one.

For further information she recommends the website of Bob Marler, a liability lawyer in Washington State who has taken many raw-milk cases and provides frequent updates on the issue nationally.

For now, the state's Department of Agricultural Resources, which held the hearings the protesters marched to, is considering testimony and letters, and the public health department's recommendation that the name of the agricultural department's raw-milk certificate be changed from "Certificate of Raw Milk for Retail Sale" to "Certificate of Raw Milk for Direct Sale." Every state has its own options—"strict and even Byzantine regulatory guidelines," as Barry calls them, "that typically limit the amount a farmer can sell, prohibit advertising, and require that customers purchase directly from the farm." He's encouraged by one middle course that comes, no surprise, from Vermont. Maybe Massachusetts can look across the non-Live Free Or Die border and take a cue. It could even get more people where Massachusetts currently makes all raw-milk lovers ((legal ones, that is) go—a dairy farm.

Last summer, Vermont, the state in which I live, adopted a middle course that requires farmers who sell raw milk to adhere to strict standards of sanitation and animal health. Milk samples must be taken each day and preserved. Sellers must maintain a contact list of all their customers and can sell only to end users, not middlemen. The containers in which raw milk is consumed must bear a label clearly warning of its potential dangers. And—here's my favorite—customers must be provided with the opportunity to tour the farm from which their milk comes.

UPDATE: I started looking for that 68 percent figure soon after posting this, but only found the citation today, which is from an article last fall in Morbidity and Mortality Weekly Report, summarizing food-borne illness outbreaks 2006; it was 71 percent, not 68, and the context is outbreaks that could be traced to a single-commodity food, like shellfish or meat. The most arresting fact in the report, though, was about baked good. What are those commercial bakeries doing?

Eleven multistate outbreaks, defined as outbreaks in which exposures occurred in more than one state, were detected; 10 of these were attributed to bacteria. One attributed to chemical agents was transmitted by baked goods contaminated by a floor sealant (11 cases). Four of the bacterial outbreaks were attributed to E. coli O157, of which three were transmitted by leafy vegetables (395 cases) and one was transmitted by beef (44 cases). Four were attributed to Salmonella, of which two were transmitted by tomatoes (307 cases), one by peanut butter (715 cases), and one by fruit salad (41 cases) (3). An outbreak of Vibrio parahaemolyticus infections was transmitted by oysters (177 cases). An outbreak attributed to C. botulinum toxin was transmitted by carrot juice (four cases) (4).

Public health officials identified a food vehicle in 528 (42%) FBDOs, of which 243 (46%) outbreaks with 6,395 (50%) cases were classified as having ingredients belonging to only one of the 17 commodities (Table 2). Among the 243 outbreaks attributed to a single commodity, the most outbreaks were attributed to fish (47 outbreaks), poultry (35 outbreaks), and beef (25 outbreaks), and the most cases were attributed to poultry (1,355 cases), leafy vegetables (1,081 cases), and fruits/nuts (1,021 cases). Pathogen-commodity pairs responsible for the most outbreak-related cases were Clostridium perfringens in poultry (902 cases), Salmonella in fruits/nuts (776 cases), norovirus in leafy vegetables (657 cases), STEC in leafy vegetables (398 cases), Salmonella in vine-stalk vegetables (331 cases), and V. parahaemolyticus in mollusks (223 cases).

Although the dairy commodity accounted for only 3% of single commodity outbreak-related cases (16 outbreaks and 193 cases), 71% of dairy outbreak cases were attributed to unpasteurized (raw) milk (10 outbreaks and 137 cases). A wide range of bacterial pathogens were associated with unpasteurized milk outbreaks, including Campylobacter (six outbreaks), STEC O157 (two outbreaks), Salmonella (one outbreak), and Listeria (one outbreak), resulting in 11 hospitalizations and one death.