Has there been a serious jump in illnesses from raw-milk cheese recently? You might think so if you’ve read recent major pieces in The New York Times and The Washington Post — or the study put together by product liability law firm Marler Clark, which documented 54 illnesses attributed to raw milk cheese in 2010.
The FDA is certainly concerned. It has been considering significantly tightening the rule that allows producers to sell unpasteurized cheeses to the public, so long as they have been aged 60 days. Major changes to the 60-day rule could severely damage the growing artisanal cheese industry, some of whose products command $20 to $25 a pound.
What none of these sources discussed is how the illnesses attributed to raw milk cheese last year compared to other years. The 60-day aging rule for raw milk cheese has been in effect since 1949, partially in response to outbreaks of typhoid attributed to raw milk cheese. All of which prompts this question: Have illnesses from raw milk cheeses been a serious public health problem since then?
Since none of the articles or the Marler Clark study addressed that question, I decided to do some searching through the data. I examined the data from the U.S. Centers for Disease Control (CDC) from 1973 throgh 2008 — a period of 36 years. For data covering 1998-2008, I used the online CDC database on foodborne illnesses, and scrolled through all the reported illnesses year by year, beginning in 1998 (the first year covered) looking for those attributed to unpasteurized and pasteurized milk cheeses. I didn’t count those attributed to queso fresca, a soft cheese that isn’t aged and thus isn’t legal under FDA regulations.
For data going back to 1973, the CDC provided a table [PDF] on illnesses from raw milk and associated products in response to a Freedom of Information Act request by the Farm-to-Consumer Legal Defense Fund in 2007.
Here’s what I found:
- Remarkably, from 1973 to 1999, a period of 26 years, there’s not a single report of illness from either raw milk or pasteurized milk cheeses.
- It’s only in 2000 that we see the first illnesses from raw milk cheese — one outbreak in 2000 that sickened 18, then two outbreaks in 2001 leading to 31 illnesses, and one outbreak sickening 18 in 2003.
- Thereafter, the pace of illnesses picks up, though sporadically. After no illnesses were reported in 2004 and 2005, the data in 2006 show 121 illnesses from raw milk cheese, and in 2007, the number has increased to 162. Then, there were no reported illnesses in 2008.
- Interestingly, illnesses from pasteurized milk cheese begin showing up in recent years as well. In 2006, there were 41 illnesses from pasteurized milk cheese, and 161 in 2007. In 2008, when there were no illnesses from raw milk cheese, there were 45 from pasteurized milk cheese.
Pulling it all together, the CDC data show 350 illnesses from raw milk cheese over the nine years from 2000-2009, or an average of 39 per year. (If you average the number out over the entire 36-year period, the average goes down to nine per year.) While there were fewer illnesses from pasteurized milk cheeses during that same nine-year period — 247 — there was one death.
What does it all mean? A piece this week on National Public Radio termed the increase in illnesses from raw milk cheeses “a wake-up call.” Certainly the growing popularity of raw milk cheeses must have some bearing on the situation. The American Cheese Society, which was only started in 1983 and has since grown to more than 1,400 members, figures more than half of its 300 cheese producer members specialize in raw milk cheeses. (I reported on Grist last December about its survey of members being inspected by the FDA in connection with the agency’s assessment of the cheese rule.)
With fast growth can come pressure to rapidly increase production. Bill Marler of Marler Clark, which did the study of illnesses in 2010, says the 60-day aging requirement likely has little relationship to whether there are illnesses or not. “From what I have read, it is far more about how the raw milk cheese is made and the care that is taken in its manufacture.”
Similarly, Bill Anderson, a Wisconsin cheese expert and proponent of raw milk cheese, says, “Most outbreaks associated with cheese occur because of post-production contamination.”
That helps explain why the American Cheese Society is offering online safety classes for its members, along with instruction on putting together HACCP plans (Hazard Analysis Critical Control Points).
The problem here may be over what the FDA substitutes for the long-standing 60-day aging rule for cheese. If it extends the aging period to, say, 90 or 120 days, it will make illegal many of the soft raw milk cheeses that many consumers most highly value.
While the FDA could require cheese producers to conform with certain testing and sanitary standards — much like occurs in Europe — that seems unlikely given the agency’s long-standing hostility to raw milk in general. More likely, the FDA will use the data suggesting an increase in illnesses from raw milk cheese in recent years to simply eliminate production altogether. It has explicitly stated on any number of occasions — most recently last month while opposing the legalization of raw milk sales in California’s Humboldt County — that “raw milk is inherently dangerous.”
Even though an average of 39 reported annual illnesses is not indicative of a serious public health problem by any stretch of the imagination, the FDA can use the trend line of an increase in recent years to justify its preconceived bias against raw milk cheeses. That would be unfortunate, since it would deprive consumers of an enjoyable and nutritious food, plus it would likely put out of business a significant number of small artisanal producers. That’s not a favorable outcome at a time when jobs are at a premium and the general business climate is ever more uncertain.