Memo to raw-milk advocates: Improve information, or get sued

Fifty veterinarians and others concerned with food safety gathered at a raw milk symposium last Sunday in Seattle. Sponsored by the American Veterinarian Medical Association (AVMA), “The Raw Milk Conundrum” featured speakers from nearly every regulatory agency in this country,  food safety academics, and food-related injury attorney William Marler. In an unusual move, the panel also included two raw-milk advocates: David Gumpert, author of The Complete Patient blog and the forthcoming book "The Raw Milk Revolution," and me. I was there to present a survey that described the views of people who choose to drink unpasteurized milk; for more about it, see  this post on my blog. Basically, I argued that consumers should have access to raw milk but that they should also be accurately informed of its risks.

The role and responsibility of raw-milk information for consumers turned out to be a running theme at the symposium.

realmilkWAPF warning shot

Two days before  the meeting, Marler dropped a bombshell on the raw milk community with a PowerPoint slideshow on his site implying that he was considering suing the Weston A. Price Foundation, the most active raw milk consumer advocacy group in this country, on behalf of his clients injured by unpasteurized milk.

Marler has sued several parties for raw milk injuries to date, including the raw milk producer and two health food stores implicated in the 2006 E. coli 0157:H7 outbreak in California that was tied to raw milk. He is arguing that the WAPF may also be liable for injury under enterprise liability law, in which trade associations have been successfully sued for providing safety information they knew to be incorrect. Marler pointed to a case of a child injured by diving off the diving board into a swimming pool. Twenty years before the injury, the National Pool and Spa Institute (NSPI) — an organization that had taken it upon itself to provide members with safety information — had conducted a study that suggested the diving board in question was unsafe but failed to inform manufacturers and consumers.

A key element of that case, in which the NSPI and diving board manufacturer shared liability, was that the NSPI had volunteered itself as the expert on pool safety; consumers and retailers heeded its advice. The comparison to the WAPF is fairly strong: there is no other group more prominent in promoting raw milk, and much of the promotion is based on its claims of raw milk safety. If those claims are incorrect, and if WAPF knows that the information is incorrect, it could be liable for consumer injury.

"If you are a leader in the movement and your misinformation causes a child to lose his kidneys, you are in my crosshairs," said Marler.

The good bacteria vs. bad bacteria myth

One possible area of misinformation brought up by a number of symposium speakers (including me) was the idea that the beneficial properties of raw milk can kill pathogens. Raw milk does contain enzymes that are known to compete with pathogens, but the key question for consumers is whether this process of "competitive exclusion," as microbiologists call it, ensures raw milk safety.

Survival of E. coli 0157:H7 in raw milk is an informational website about unpasteurized milk created and maintained by WAPF; it also has links to raw milk producers. On it, a dairyman describes a private lab test he funded in which he had pathogens introduced into his own milk and colostrum. Referring to the counts of E. coli 0157:H7, he says the E. coli "did not grow and declined substantially over time." The lab report, which is available on the Internet, tells a different story. In the graph to the right, I present the data for E. coli 0157:H7 in the two milk and colostrum samples. Microbiologists would transform the bacteria counts and express them on a log scale, but for our purposes we can see that the number of pathogenic cells declines by Day 4 of the test and then largely recovers by Day 7.  As it may take fewer than 50 cells of this bacteria to make a person sick, complete reduction of the pathogen is necessary to ensure safety of the final product. We certainly see no evidence in this study of complete destruction of the disease-causing organism.

In a review of the research on competitive exclusion, symposium speaker Michele Jay Russell, D.V.M., showed that there is no clear evidence that raw milk is self-protective against pathogens. She presented some preliminary evidence in a U.C. Davis study on competitive exclusion in raw milk produced for human consumption. Researchers purchased fresh raw milk at the grocery store and inoculated it with Salmonella to examine the change in numbers over time. At refrigerated temperatures, the Salmonella did not tend to grow, but they also did not die off. In the milk stored at room temperature, the Salmonella grew from hundreds of cells to hundreds of thousands of cells in just two days.

The evidence that raw milk can kill pathogens is at best far more complex than is suggested in the WAPF literature about raw milk safety.

Another example of problematic content on the WAPF sites is an article "Is Raw Milk Safe for Babies?" that lists contaminated milk outbreaks in California from 1982 to 1996. According to the WAPF article, no sicknesses from raw milk occurred in that time, yet multiple outbreaks were linked to pasteurized milk and other foods. Many Californians however may remember that there were a series of outbreaks linked to raw milk in that timeframe, for example this one, cited in a published article on outbreaks in the early 1980s. I checked the outbreak data provided by the CDC, which lists outbreaks by year. I selected 1995 randomly, scrolled down to a "raw milk" outbreak, and discovered it was in California. So, there have been raw milk outbreaks in California, and they have been fairly widely covered. While some might quibble with the evidence linking these incidents to raw milk, it does consumers no service to pretend there never was an outbreak in the first place. I contacted the president of the WAPF about 18 months ago with this concern. She responded that the outbreak table in question was developed by another raw-milk advocate — Aajonus Vonderplanitz — not WAPF; she did not seem concerned with its content.

Advocacy groups make claims all the time that are not based in solid research. For example, groups opposed to genetically modified organisms in food production make many health-related claims that industry disputes. One claim is that the genetically engineered growth hormone used in dairy cows, recombinant bovine somatotropin (rBST), is linked to breast cancer in humans; another claim is that genetically modified corn causes fertility problems. Like many claims that advocates make every day, the health effects of genetically modified foods are not well documented — partly because, as we have written here and many others have elsewhere, there is an absence of much long-term, independent research.

rawmilk2But while it's the lack of solid research on the long-term impact on human health and the environment that keeps GM foods off most Ethicureans' menu, raw milk claims play a different role, because the recommendations are to drink it, not avoid it. We may choose a life of rBST-free milk and never suffer physical injury as a result, but we can't ignore that even raw milk produced with great care has the potential to harm us. Raw milk can harbor disease-causing pathogens. If  you are a raw-milk consumer and that fact surprises you, you may just end up as a witness in a Marler-Clark lawsuit.

Drowning in a teacup?

At last week's symposium, speaker David Gumpert argued that so few outbreaks are linked to raw milk that regulators are making more out of the issue than it merits. “I kind of agree with that guy,” said William Keene of Oregon Public Health Services, later adding “We have won the war.” He described that the vast majority of consumers are not even aware of raw milk. He questioned the resources put into regulating raw milk, implying that there were more productive avenues for funding.

In the final minutes of the 10-hour-long symposium, Keene’s no-nonsense “Why are we making such a big fuss of all of this?” attitude appeared to win the day. Others had countered that food safety professionals have an obligation to keep the public informed, especially as more people seek unprocessed food, including raw milk.

A slender blonde woman then waved her arm and said, “I am ready to speak now.” I had a good idea about what she was about to say, since I had met her the evening before. Mary McGonigle-Martin is the mother of Chris Martin, a child who spent two months in a California hospital after the 2006 E. coli outbreak linked to a raw dairy in California. As she began to speak, I turned away and stared at my lap so that I would not cry in the middle of the Seattle Convention Center.

"I believed the claims," she said. "I believed that the milk was tested regularly. I didn’t know that there was no approved on-farm test for E. coli. I thought if you tested the milk for it, it would guarantee its safety. I didn’t know that you really can never test all of the milk. I believed what I read on the Internet and felt safe in feeding raw milk to my son. He drank it for two weeks before he ended up in the hospital fighting for his life. I don’t want any other mother to go through this.

When Martin was finished and I felt composed, I turned and caught sight of a California food safety expert still staring at his lap. What I did learn about the food safety crowd this week is that they have a great deal of compassion for consumers. Their job is to keep the public safe from high-risk foods. When they hear stories like Martin’s, it is likely difficult for them to think about ignoring regulation of raw milk.

Later in my Seattle stay, I met up with a friend who, like me, grew up in California’s dairy country. When I mentioned the symposium, he said: “Raw milk is great. I used to get it straight from a friend’s small dairy. You just have to know that every five or six years, you are going to puke your guts out. Besides that — it’s great.”

I responded: “If you were in charge of raw milk consumer information, I doubt there would have been a symposium this week.”

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Photo of raw milk from local farm by Ethicurean editor Bonnie Powell

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