Which States Have the Most Illnesses from Raw Milk? Hint: This Is Not a Trick Question
Monday, February 23, 2009 at 10:54PM 
Imagine for a moment that sales of luncheon meats like salami, bologna and hot dogs were prohibited in half the states beginning in 1993, because such products cause more than 6,000 illnesses each year (see page 13 of the publication, which is actually about illnesses in a different year--this is hypothetical, remember).
Now imagine, 15 years later, you are studying data from 1993 to 2006 on the number of illnesses from luncheon meats in all 50 states.
In which states would you expect to have the most cases of foodborne illness caused by luncheon meats—the ones in which sales were illegal, or the ones in which sales were permitted?
This is not supposed to be a trick question. At least I haven’t been able to determine the trick, because I’ve been thinking about it for the last six days, since that raw milk symposium outside Washington last Tuesday, sponsored by the International Association for Food Protection, and couldn’t find anything overtly tricky.
My answer is always the same: the states that prohibit luncheon meats would have fewer outbreaks of illness because, well, there’d be less bologna, salami, and hot dogs available for sale than in the states where it was legal. And then I wonder, once again, am I missing something here?
The reason I’ve been agonizing so much about this question is that there was a lengthy presentation about a recently concluded (and as-yet unpublished) study from a highly regarded scientist from the U.S. Centers for Disease Control. The title of the presentation was this: “Do State Raw Milk Sales Restrictions Reduce Raw Milk Outbreaks: A Policy Analysis”.
The scientist, Adam J. Langer, analyzed data on foodborne illness from states where raw milk is illegal, and compared it to states where it is legal. As you can see from his PowerPoint presentation, his slides are very colorful, and he’s got assessments of illnesses per “billion person-years” and “incident density ratios.” He did a lot of work on this baby.
And guess what? According to Langer, “If you live in a state that permits raw milk sales, you have two to three times the risk of having an outbreak” than if you live in a state where it’s prohibited. Of course, that then becomes fodder to trash raw milk, to warn of "an increased risk throughout the country" if Rep. Ron Paul's legislative attempt to lift the federal ban on interstate sales of raw milk were to succeed.
Just another CDC scientific breakthrough, I guess. Doing the hard work and digging that needs doing to help us better understand the dangers of raw milk. Or is it a trick question?
Reader Comments (37)
There is an assumption here that raw milk sales restrictions do restrict raw milk consumption.What raw milk sales restrictions do is restrict the consumption of raw milk to those people who are willing to go out of their way to get it.What really restricts the consumption of raw milk is the shortage of farms willing to produce it.This seems to be a problem in states where retail sales are legal as well as in those where sales are prohibited.
USDA BETS THE FARM ON ANIMAL ID PROGRAM
By William Pentland and DAVID E GUMPERT
http://naissucks.com/index.php?con=usda_bets_farm
“If you live in a state that permits raw milk sales, you have two to three times the risk of having an outbreak”
It implies that you, the average joe who may or may not drink raw milk, are at risk of an outbreak simply because of where you live. A statement like that doesn't even BEGIN to address causality.
When I moved in with my boyfriend (who is now my husband) before we were married, my mother told me that since we were living together we'd be much more likely to get divorced. It was heavily implied that the mere act of sharing quarters with one another before the marraige ritual would be enough to doom us to a life of unhappiness and eventually divorce. It does not count for individual cases like maturity, crisis coping skills, adaptability, willingness to compromise, or even basic compatibility.
Would it not be more effective to say that people who co-habitate might be more prone to quick decisions? Lacking in patience and foresight? In other words, it's not the fact that they live together that dooms them, it's some other factor that's common in these people of which a 'symptom' is pre-marital co-habitation.
Same with Raw Milk. If you don't drink Raw Milk then you aren't going to get sick from it. If you don't eat salami then you won't fall ill. Simply saying that you're more likely to become ill from raw milk because you live in an area that allows its production and sale is ludicrous.
Far more beneficial would be statistics that polled raw milk and pasteurized-milk drinkers separately, and separated between places that authorized raw milk sales and places where it was illegal.
I'd be interested to see the percentage of raw milk drinkers who got sick in states that allow the sale of raw milk to the percentage of raw milk drinkers who got sick in states where the sale of such is illegal. Pasteurized-milk only drinking people are your control group.
It doesn't matter how much care he's taken with his report, making blanket statements like that with no attempt to determine causality is just bad science.
What is the definition of an outbreak?
What is an illness?
What does it mean?
Rookies look at the statistics....Real Pros look at the underlying assumptions behind the numbers.
Does being hospitalized and really sick verses just having been to your doctor for a case of the "two step" and that doctor reporting the incident to the state ( as required when lab tests show a pathogen present ) mean anything.
In the old days when I was a paramedic we called this "waste-basket stats" it really means nothing unless the assumptions are understood and published along side the data. This data amounts to inflamatory meaningless "spin science". We used to look at ACLS and CPR survival data. Glorious paramedic work was all expensive money spent...unless it worked to actually save lives that were lived out meaningfully and productively. For a while, all CPR did was fill ICU's with brain dead people. Those were all considered saves.
When we figuered out what we were actually doing... CPR and "real saves" were redefined and we stopped filling ICU's with the brain dead and we started saving money and real lives.
Now... a "save" is a person with a brain and a real life that actually goes to work and functions well.
I do not think that the CDC or the FDA has gotten to that level yet. They are still at the brain dead level and do not consider the nuances of real data or analysis or real outcomes. To the FDA and the CDC is not important to know or publish real data and explain it. So it is just quotable commingled garbage.
Just blame every little two step or cramp all on raw milk...what the hell.
Can not wait to ask John Sheehan these and other questions.
By the way.....I just figuered it out...."Concerned Person" is an Eskimo. Eskimos never drank raw milk but found their raw fats, probiotic bacteria and enzymes from fermented fish and other raw fermented foods. The rest of us just drink a some raw milk every day to get the same nutrients.
CP....Weston A Price would be very proud of you.
Mark McAfee
"Garden centre water-features may harbour deadly bugs"
http://www.telegraph.co.uk/health/4797686/Garden-centre-water-features-may-harbour-deadly-bugs.html
Jenny
“I do think that herdshare members are better informed and more connected to the source of their milk. They have to take more responsibility in order to get the milk. Maybe they are more serious about their health in general and so are more likely to avoid all types of food poisoning.”
That is very true, and one wonders why the government would desire so much to interfere with them.
It has been an accepted fact of microbiology for a hundred years that host state is a factor in determining illness. Certain hosts carry this or that microbe and become ill, others carry the same microbe and do not become ill. Yet we persist in classifying certain microbes as “pathogens” even though they do not cause disease in every host. Why? Our medical practitioners, along with government and their corporate allies, chase down “pathogens” as if there is no understanding whatsoever about host-carrier interplay. Why?
Just today a nurse in my hospital (who is often sick) complained to me about suffering from yet another viral infection with the words, “This bug is really bad.” She has been completely indoctrinated into the false idea that she is sick because she was in the wrong place at the wrong time and imbibed the wrong microbe. She is, of course, doomed to be intermittently sick as long as she holds on to that notion.
Lykke says:
“One thing that amazes me with all the exchanges at this blog, in particular, is how some of us can read the same thing and have such different interpretations.”
We are merely accepting the reality that host state is a significant factor in determining host-microbe interactions. We are, as miguel says, serious about our health. We are fixing ourselves up so that we can live in harmony with so-called pathogens.
Those who wish to live their lives according to Koch's postulates may do so, to their great peril. But why should I, or anyone else, be required to do that? Because, apparently, our medical establishment has not been able to escape the Koch's chains.
(I wish that our doctors would follow Koch himself, who did abandon certain of his ideas when he saw that there was such a thing as asymptomatic carriers.)
Somewhat related to garden center water features....public water displays/recreational areas linked to outbreaks:
An outbreak of Escherichia coli O157:H7 associated with a children's water spray park
http://tinyurl.com/aqq4fb
This is the first known report of an outbreak linked to a children's water spray park in Canada. Outbreaks of enteric infections related to spray parks or fountains have previously been reported in the US. Pathogens identified include Cryptosporidium, Shigella, and Norovirus. All outbreaks occurred in spray parks or fountains with recirculating water systems, and in all reports the contributing factor identified was a lack of or inadequate filtration and disinfection.
E. coli tragedy in 1998 changed water park safety
http://tinyurl.com/bqh6yv
Twenty-six children were stricken in 1998 by an E. coli outbreak in a kiddie pool at the White Water swim park in Cobb County, metro Atlanta's best-known water park. Seven children were hospitalized and one died. The legacy of the outbreak has led to sweeping changes in how water parks monitor and treat their water. In some cases, the kiddie pools have been scrapped in favor of fountain-type areas that have no standing water.
Outbreak of cryptosporidiosis associated with a water sprinkler fountain - Minnesota, 1997. CCDR 1999;25(2):13-5.
Outbreak of gastroenteritis associated with an interactive water fountain at a beachside park - Florida, 1999. MMWR 2000;49(25):565-8.
Hoebe CJ, Vennema H, Roda Husman AM et al. Norovirus outbreak among primary schoolchildren who had played in a recreational water fountain. J Infect Dis 2004;189(4):699-705.
Fleming CA, Caron D, Gunn JE et al. An outbreak of associated with a recreational spray fountain. Am J Public Health 2000;90(10):1641-2.
Isn't it clear yet that everything will eventually become a threat to those who have destroyed the community of bacteria that protect them from opportunistic bacteria?
"The legacy of the outbreak has led to sweeping changes in how water parks monitor and treat their water."
When will people see that the waterpark,the petting zoo, the shopping kart handle and unsterilized food are not what needs to be changed?It is impossible to make the world safe for people who do not have a functioning immune system.Being in contact with manure on the farm does not make us sick,but now we will be required to post a warning to all visitors that they enter our farm at their own risk because we cannot possibly eliminate all of the "pathogens" that will surely kill someone without a functioning immune system.
Beautifully said.....
"When will people see that the waterpark,the petting zoo, the shopping kart handle and unsterilized food are not what needs to be changed?It is impossible to make the world safe for people who do not have a functioning immune system.Being in contact with manure on the farm does not make us sick,but now we will be required to post a warning to all visitors that they enter our farm at their own risk because we cannot possibly eliminate all of the "pathogens" that will surely kill someone without a functioning immune system."
This type of statement needs to get before congress in hearings. When this type of statement was made before the Senate in CA during SB 201 hearings...people listened and there was real progress made.
It is not the food... it is the mismatching, unfamiliarity and disassociation of the external ecosystem with our suffering and weak internal immune ecosystems. Add, antibiotics super bugs and sterilization of foods and the problems exponentially multiply.
Shazaam....America 2009....
Add good raw milk, whole food nutrition, economically successfull smaller consumer connected local dairies and farms and you get the beginnings of healthy America 2020.
Please hear us Mr. President...the raw roots are the grass roots of our prevention based medical revolution and the source of national economic stability and nutrition for a future better America.
Invite us to DC and we can explain!!!
Mark McAfee
Don W,
The Kendall Komparison: Kefir, Yogurt, and Filmjolk
Kefir grains are a Symbiotic Culture Of Bacteria and Yeast (SCOBY) and have probiotic yeasts in addition to their many strains of lacto bacilli – good if a person needs a boost in beneficial yeasts. Filmjolk & yogurt cultures have no yeasts in them.
People who are extremely lactose intolerant consume kefir that is well-fermented (48 hrs). It is very sour, but virtually all the lactose has been converted into lactic acid and CO2. I don’t know if this is also true for filmjolk and yogurt.
Temperature: Kefir and filmjolk culture well through a wider range of temperatures than yogurt. Yogurt cultures are thermophilic and require a temperature range close to 110 degrees.
Procedure: Filmjolk – simply dump a quarter to a half cup of starter into a clean quart jar, fill the jar with fresh milk, and shake it up. Let it sit for 24 hours at room temperature. No real cleanup. Yogurt – is fussy and requires a temperature controlled setup. More cleanup. Kefir requires straining the liquid from the grains after each batch. Even more cleanup time.
Taste: When fermented within a palatable range, I think filmjolk has the most pleasing taste.
Dairy starter cultures (including filmjolk) can be purchased from GEM Cultures Lakewood WA. http://www.gemcultures.com.
cp’s comment, quoted from GEM’s website, “We do not recommend the use of Raw Milks as they can carry a heavy bacterial load that can compete with these Dairy Cultures, alter the taste and can cause illness to the user.”
Our dairy ferments are made from raw milk. We use Miguel’s teat test: if the finished product has a funny smell or taste, we throw it out because it has likely been compromised. Share your filmjolk culture around. If yours becomes contaminated, your friends will be able to give you some from their most recent batch for your new starter.
I may have a more local source of culture starter for you. You can email me at
daveshanken@juno .com.
Dear Friends and Colleagues,
This is a landmark week for transforming our health care system.
The Senate is having hearings on transforming health care and integrative and Functional medicine and the National Academy of Sciences is hosting an Institute of Medicine Summit on Integrative Medicine and the Health of the Public http://www.iom.edu/integrativemedicine.
I am also honored to let you know that on Thursday, February 26th between 10 am and 12 pm, I will be testifying on how Functional medicine can help solve our health care crisis before the Senate Committee on Health, Education, Labor and Pensions at the invitation of Senators Kennedy, Harkin and Mikulski.
You can view this testimony, along with that of Drs. Oz, Ornish and Weil online at:
http://help.senate.gov/Hearings/2009_02_26/2009_02_26.html
I am not clear on whether the hearing will be streamed live or available for viewing afterward, so please check back for the recorded version if it's not streamed live.
Here is some of what I will be sharing with them.
• The current medical and scientific paradigm of acute care medicine has been unable to effectively address the epidemic of chronic disease and its associated costs.
• There is a new paradigm which addresses the fundamental underlying causes of chronic disease, and can form the basis for a more effective model of medical education, practice, and research that over time will generate dramatic cost savings and improved health outcomes.
• There are specific initiatives and strategies based on this new paradigm that can help quickly transform our sick care system into a health care system.
Even if we get everything else right in health care reform, it won't matter unless we address the underlying causes of illness that drive both costs and the development of chronic disease. This innovative approach to chronic disease cannot only prevent but also more effectively TREAT chronic disease.
We must change not only the WAY we do medicine, but also the medicine we DO.
We must improve not only financing and delivery of health care, but also our fundamental scientific approach to chronic disease-an epidemic that now affects 133 million Americans and accounts for 78% of health care costs.
This way of doing medicine, or Functional medicine, is a system of personalized, patient centered care based on how our environment and lifestyle choices act on our genes to create imbalances in our core biologic systems. Those imbalances show up as the signs and symptoms we call disease.
It is best solution for our health care crisis. The solution is not our current acute care model, which though extremely effective for acute disease, leads to worse outcomes and higher costs when applied to chronic disease because it doesn't address WHY people are sick.
This new paradigm is personalized, preventive, participatory, predictive, prospective, and patient centered.
It is proactive rather than reactive.
It is based on addressing the causes of disease and optimizing biologic function in the body's core physiologic systems, not only treating the symptoms.
It based on systems biology or medicine.
That model exists today, and is called Functional Medicine.
****Key Avenues for Change: Recommendations ****
1. Re-tooling medical education and research to match the science of systems medicine. I recommend the establishment of a sustainably funded Institute for Lifestyle and Systems Medicine/Functional Medicine.
2. Creation of Functional medicine demonstration projects in federally funded community health centers, with integrated health care teams focusing on treating chronic disease and providing education about lifestyle and wellness
3. The establishment of a White House and/or Congressional Office for Health and Wellness to coordinate all efforts in this area.
Thanks for all your support and encouragement in this critical time.
If you want to help, please contact your congressman, Senators and the White House to advocate for this type of change and share your stories of how this has impacted you.
We all can change our health care system together!
To your good health,
Mark Hyman, MD
He practices functional medicine. It's the belief that with the correct food, nutrients, and detoxing the body can heal itself.
http://www.drhyman.com/
cp
Somewhat OT - the following link is to a long article about the recent "Camembert War" in France, where a large industrial cheese processor (80% of the Camembert market) in the Spring of 2007 abandoned raw milk Camembert in favor of pasteurized milk cheese and finally capitulated back to raw milk. In the course of the "war," it was clear that their reason for abandoning raw milk Camembert was economic, but as the fight dragged on they resorted to fear tactics and arguments about the dangers of raw milk. The French public did not buy it (the pasteurized cheese, as well as the company's other products) and they finally capitulated back to raw milk Camembert. This suggests, as does Dr. Ted Beals, that pasteurization is primarily an economic issue since it fosters longer shelf life and fits the industrial food management paradigm more perfectly than does raw milk: http://www.spiegel.de/international/europe/0,1518,609046,00.html
What is a "functioning immune system?"
A diversity of people go to water parks/gardens - many are low income. They cannot afford raw milk. And, most do not have the ways and means to seek on the Internet cultures to ferment milk and vegetables, then create a breakfast for their kids of sauerkraut and swedish sour milk. Sounds great for a small number of people that want to pursue this path...
But, public health looks at a problem in a bigger way. For example with the water fountains - make the water clean since the kids are sucking it up while they play. How is this bad? What is the alternative? Signs to the public saying: improve your immune system: feed your kids more sauerkraut?
Seriously, how would you "educate" the public with this "improve your immunity message." Especially in the context that many here agree that people with bad immunity are susceptible to pathogens in raw milk, and should not just "take the leap" into drinking it - they need "strong" immune systems to start drinking raw milk to make their immune systems "strong."
The discussion is fascinating, but running my mind in circles - any clarification on the "immune system" component would be appreciated.
RE the Camembert Wars.
I enjoyed the article. Good support for the notion that high quality dairy products are made with raw milk – and with the blessing and support of the national government. Also, a little insight into how the dominant corporations think and act.
Intelligently written and spiced with humor. Nice find.
Since naming water fountains and shopping cart handles as a source of infections, while true, is a little over the top, I would hope that “public health” will find more important things to focus on – like educating “the public with this improve your immunity message." How would YOU go about doing that – assuming that you believe it is a worthwhile goal?
As a thoughtful, concerned person and in light of the conversation here, surely you see that *pathogens as causers of disease* is becoming *Old Think*, and that it is slowly being replaced by *immunity-building* as the best way to obtain and keep good health.
BTW, are you putting down homemade sauerkraut and Swedish sour milk made from pasteurized milk as wholesome, health- inducing foods? I hope not. They are not chi-chi foods. They are available to anyone who seeks them – and they are CHEAP.