“Milk has been demonstrated to be the transmission agent for brucellosis, tuberculosis, diphtheria, streptococci, Salmonella, Shigella, Campylobacter, Yersinia, Listeria, and staphylococcal enterotoxin,” he added.
“The degree of risk for any of these infections is related to the care and screening of the cows from whom the milk is taken and the care in holding of the milk until it is sold.
“I would not drink raw milk or recommend it to my patients,” he emphasized.
However, fear of rabies transmission generally is not among the reasons physicians advise against drinking raw milk, Dr. Baltimore said.
Nonetheless, he noted that a 1999 report from the CDC found that “because of the nearly 100% case-fatality ratio of human rabies and the virtually complete effectiveness of PEP, many mass exposure incidents prompt administration of rabies immune globulin and vaccine, even if the circumstances do not meet the criteria for exposure. However, because rabies virus is inactivated by temperatures below those used for cooking and pasteurization, eating cooked meat or drinking pasteurized milk from a rabid animal is not an indication for PEP. … Transmission of rabies virus in unpasteurized milk is theoretically possible” (MMWR 1999;48:228–9).
Although the federal government regulates interstate sales of all milk, intrastate sales are regulated by the states only, which vary in their restrictions. (See chart.)
ELSEVIER GLOBAL MEDICAL NEWS