By Emily Vespa
Raw milk sales are on the rise. Even as its consumption has rocketed into a social media sensation, experts continue to warn of dangerous illnesses linked with drinking it.
Some social media influencers have touted raw milk as a more nutritious alternative to pasteurized milk, and internet searches for it have steadily risen in the U.S. in the past five years, Google Trends data shows.
Ben Chapman, a professor and department head of Agricultural and Human Sciences at N.C. State University, said the issue never sours, despite a wealth of scientific evidence about the risks of drinking raw milk.
“I think 20 years from now, as I’m finishing my career, we’ll be talking about raw milk,” Chapman said. “It’s not going away, it’s not new, it’s just a thing that’s kind of always there, bubbling in the background.”
A recent survey of U.S. adults conducted by the Annenberg Center for Public Policy found that fewer than half knew that drinking raw milk was less safe than pasteurized milk.
The same survey found that a quarter of the adults surveyed doubted pasteurization’s effectiveness at killing bacteria and viruses in milk, even as research from the Centers for Disease Control and Prevention shows that consuming raw milk causes 840 times more illness for consumers and increases the risk of hospitalization by 45 times over drinking pasteurized products.
“I’ve always said we’ve got pasteurization because we had problems before we had pasteurization with raw milk,” N.C. Agriculture Commissioner Steve Troxler said at a recent panel on the national avian influenza outbreak. He recounted an outbreak of listeria caused by contamination in milk that led to five stillbirths, three early deliveries and two infected infants in 10 pregnant women who consumed it. “This is even borne out more when I think about, you know, what could happen by the consumption of unpasteurized milk, especially during a time like this.”
What is pasteurization?
There’s a variety of bacteria that naturally occur in animals but are dangerous when passed to people, like E. coli or Salmonella, both of which are present in animal feces.
“Where cows defecate is pretty close to where we also get milk from,” Chapman said. “And so there is an opportunity for pathogens.”
Pasteurization is the process of heating milk to certain time and temperature requirements to kill those pathogens. It’s been used to make dairy products safer for more than a century, said Carl Williams, the state public health veterinarian.
“We always tell people, ‘Cook your ground beef, because if you don’t, you’re at risk for [Shiga toxin-producing E. coli] and salmonella, and you can prevent those,’” Williams said. “It’s just that the control step for ground beef is in your kitchen; the control step for milk is at the production facility.”
Drinking contaminated raw milk can have serious consequences — especially, Chapman said, for children, who are at the highest risk of foodborne illness. Many pathogens associated with raw milk can cause other health complications or death, he said. A strain of E. coli sometimes found in raw milk known as E. coli O157:H7 can lead to rare complications that can cause kidney failure.
It’s the same type of bacteria that caused a massive outbreak among children from the petting zoo at the Cleveland County Fair in 2012 and resulted in the death of a 2-year-old boy.
“So it’s not kind of, ‘Hey, a little bit of vomit, diarrhea, 24 hours, 48 hours, then get over it.’” Chapman said. “It’s a really, really, really serious pathogen.”
Science doesn’t support claims that there are significant health benefits to drinking raw milk, Chapman said. While it’s true that pasteurization affects the availability of some nutrients like vitamin C, he said raw milk isn’t a great source of vitamin C to begin with.
“Just using a lime in a drink gives you way more vitamin C than 32 ounces of raw milk,” Chapman said.
Often, foodborne illnesses go unreported to the health department, Williams said, so it’s likely that illnesses linked to raw milk are undercounted. A 2011 CDC report estimated that 48 million people in the U.S. contract foodborne illnesses annually, but between 2010 and 2011, only 1,527 outbreaks were reported.
“When a condition is recorded to the health department, certain things have to align,” Williams said. “You have to have a person who’s sick, sick enough to go to the doctor, get a specimen collected, a pathogen is identified.”
Some skirt the state ban
The federal Food and Drug Administration bans the sale of raw milk across state lines, but 30 states permit its sale within their borders.
Though it’s technically illegal to sell raw milk for human consumption in North Carolina, consumers get around it by purchasing milk labeled “Not for human consumption” and sold as animal feed.
All raw milk sold as animal feed must be registered annually with the North Carolina Department of Agriculture and Consumer Services.
There have been 75 raw milk products registered as animal feed in the past five years, according to data from an agency spokesperson. In that time, the department has received five complaints alleging the illegal sale of raw milk.
Most recently, in January, after the agency investigated a Lincoln County butcher shop in response to a complaint, it embargoed the sale of six containers of ricotta cheese and 50 containers of yogurt made from raw milk, public records show.
In 2022, the NCDACS cracked down on a shop for insufficiently labeling raw milk products. Though there was a small note with “not for human consumption,” rubber banded onto the yogurt, milk and light cream containers, the department requires that the disclaimer be placed on the container label.
Some circumvent the state ban through a provision the General Assembly slipped into the Farm Act of 2018 that lifted a 14-year ban on herd shares. That’s a mechanism used to allow people to become partial owners of a herd and legally receive raw milk produced by those animals. Consumers with a “share” in a herd pay a membership fee to cover a portion of its care in exchange for raw milk products.
Others make the trip to South Carolina, where it’s legal to sell raw milk for human consumption.
“I just spent a whopping five minutes crossing the border into South Carolina to pick up these,” said one person on TikTok, holding two gallons labeled “RAW MILK” from Milky Way Farm based in Starr, South Carolina. “Cheers!”
Though South Carolina regulates raw milk to reduce the risk of contamination, it’s still possible to get sick. In 2011, eight North Carolina residents were sickened by a diarrhea-causing bacteria in an outbreak linked to raw milk they purchased in South Carolina. One was hospitalized.
California, where raw milk is sold under regulations similar to South Carolina’s, in July reported the largest U.S. salmonella outbreak in more than two decades linked to raw milk. There’s more incidence of disease outbreaks caused by raw dairy products in states where the sale is legal, research shows.
That’s the crux of the issue, Chapman said: Even with oversight, it’s hard to be certain raw milk is safe.
“We don’t have a technology that is better than, or even is equal to, pasteurization to reduce pathogens,” Chapman said.
Troxler, the agriculture commissioner, warned that it’s not worth the risk.
“It’s playing Russian roulette in my book,” Troxler said.
Rose Hoban contributed reporting.
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