>>Unpasteurized milk and milk products are the source of preventable, life-threatening infections in both healthy people and those with compromised immune systems, warns the American Academy of Pediatrics (AAP) in an updated policy statement published this week in Pediatrics. Unpasteurized dairy poses particular dangers to children, pregnant women, and those who are breastfeeding, continues the statement. 

The statement also highlights H5N1 avian flu as an emerging concern. 

Claims that unpasteurized (raw) dairy products offer superior health benefits lack scientific support, write the authors. “These purported benefits have no evidence base and do not outweigh the risks of unpasteurized milk consumption,” notes the statement. “Substantial data suggest that pasteurized milk confers equivalent health benefits compared with unpasteurized milk, without the additional risk of infection.”

The sale of unpasteurized dairy products remains legal in at least 27 states. The AAP statement renews its call for a nationwide ban on unpasteurized dairy.

Children account for nearly half of raw milk illnesses

Raw milk can contain several virulent pathogens, including Listeria, Campylobacter, Salmonella, Brucella, and Escherichia coli. 

In 2019, Campylobacter species, Clostridium perfringens, Listeria monocytogenes, norovirus, nontyphoidal Salmonella species, and Shiga toxin–producing E coli (STEC) caused an estimated 9.9 million foodborne illnesses in the United States and led to roughly 53,000 hospitalizations and nearly 900 deaths. 

From 2013 to 2018, there were 75 known outbreaks linked specifically to consumption of unpasteurized milk products, which resulted in 675 illnesses, 98 hospitalizations, and two deaths. Campylobacter was responsible for the most outbreaks (49%), followed by Salmonella (17%) and STEC (15%). 

One-hundred percent of people sickened by Listeria were hospitalized, as were 42% of those sickened by STEC and 16% of those infected with Salmonella. Roughly half of those who became ill were younger than 20 years, and 14% were under 5 years. 

“These illnesses can be severe and lead to life-threatening complications. Pasteurization—a safe, effective process of heating and cooling milk before consumption that has been used for more than a century—dramatically reduces the risks without taking away the nutritional value families rely on,” said lead author Adam J. Ratner, MD, MPH, in an AAP news release. 

Pregnant women face additional risks. The authors estimate that listeriosis occurs 12 to 14 times more frequently in pregnant women than in the general population. Listeria infection can cause miscarriage, stillbirth, premature delivery, and severe neonatal infections. 

H5N1 found in quarter of raw milk samples in 2024 outbreak

Passed from wild birds to dairy cows, H5N1 avian flu was found in nearly one-quarter of unpasteurized milk samples in states affected by the 2024 dairy cattle outbreak. The virus can persist in refrigerated raw milk for up to five weeks. 

While no human H5N1 cases attributable to raw milk consumption have been identified, infected milk has caused systemic illness and death in animals that consumed it. Pasteurization effectively inactivates the virus, the authors note.

Nearly all national and international food advisory agencies strongly recommend drinking only pasteurized milk and milk products. These include the American Medical Association, the American Veterinary Medical Association, the US Food and Drug Administration, the American College of Obstetrics and Gynecologists, and the World Health Organization.

"Parents may choose raw milk because they have heard it is healthier or more natural, but the scientific evidence tells a different story."

The AAP recommends that families choose only pasteurized dairy products. The organization also endorses a ban on the sale or distribution of raw milk and milk products, including unpasteurized milk cheeses. 

"Parents may choose raw milk because they have heard it is healthier or more natural, but the scientific evidence tells a different story," says coauthor Mark R. Corkins, MD, in the news release. "Pasteurized dairy products provide the same essential nutrients without exposing children and families to preventable infections from dangerous bacteria and viruses."

clip >>“The cat was expected, but the rat is the surprise,” said Wang, who also is a professor of veterinary clinical medicine at the U. of I. “Since rats live on nearly every farm despite biosecurity, they may be an overlooked link between wild birds, poultry and other mammals. Rodents live close to people, livestock and feed, so infected, shedding rodents could contaminate the farm environment and create new exposure routes.”

The labs then sequenced the viral genomes from all three animal sources: chicken, cat and rat. They found that the sequences were nearly identical, indicating a shared source— likely spillover from the poultry to the cat and the rat, Wang said. Crucially, all three had a certain mutation that makes the avian virus more adapted to mammals, which raised a red flag for Wang.

“Because the mammalian-adaptation marker was already present in the bird virus, crossing into mammals may not require new mutations,” Wang said. “Shared changes arising in two mammalian species are exactly the kind of adaptation signal worth watching.”

The researchers reported their findings in the journal Emerging Infectious Diseases, a publication of the U.S. Centers for Disease Control and Prevention.

In light of the findings, particularly the mammalian adaptation and the presence of viral RNA in the rat’s urine, Wang cautions farmers, backyard coop owners and veterinarians to be vigilant.<< more at link