Food Protection Trends - April 2009 - (Page 219) result, educators began conducting more workshops throughout the state. The success of the Abuela Project suggests that a public health campaign informing potential raw milk consumers and producers about the safety of raw milk products would be beneficial. Such campaigns may be accomplished in a variety of ways, including information sessions, community meetings, and dissemination of brochures. Public health measures to help improve the pasteurization process include the use of a recording thermometer and air space heater, pasteurization at appropriate temperatures and time intervals, and regular phosphatase and bacteriologic testing. Another alternative is to require warning labels on raw milk, thus allowing consumers to make informed choices. This would help reduce rates of infection, especially among the most vulnerable populations. Moreover, in the event that a disease outbreak occurs, the contaminated products could be traced easily to the source. The possible disadvantages of this approach include limited public health benefits and inaction among consumers after reading labels. Currently, 12 out of the 22 states where it is legal to sell raw milk for human consumption require warning labels (Fig. 4) (15). In Washington state, all retail raw milk products must bear the following label (11): “WARNING: This product has not been pasteurized and may contain harmful bacteria. Pregnant women, children, the elderly and persons with lowered resistance to disease have the highest risk of harm from use of this product.” States could use a warning such as this to properly inform all producers and potential consumers about hazards associated with raw milk and raw milk cheese consumption. A measure such as this is feasible and not without precedent. Given these considerations, providing education to dairy producers and consumers and implementing the use of warning labels on unpasteurized milk and soft cheeses are the most effective ways for state agricultural departments to decrease the consumption of these products, prevent illness, and thus ensure increased public safety. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. REFERENCES 1. Ackers, M. L., S. Schoenfeld, J. Markman, M. G. Smith, M.A. Nicholson,W. DeWitt, D. N. Cameron, P. M. Griffin, and L. Slutsker. 2000.An outbreak of Yersinia enterocolitica O:8 infections associated with pasteurized milk. J. Infect. Dis. 181:1834–7. Afshar, A. 1979. A review of nonbite transmission of rabies virus infection. Br.Vet. J. 135:142–148. Allerberger, F., A.W. Friedrich, K. Gri f, M. P. Die rich, H. J. Dornbusch, C. J. Mache, E. Nachbaur, M. Freilinger, P. Rieck, M. Wagner, A. Caprioli, H. Karch, and L. B. Zimmerhackl. 2003. Hemolytic-uremic syndrome associated with enterohemorrhagic Escherichia coli O126:H7 infection and consumption of unpasteurized cow’s milk. Int. J. Infect. Dis. 7:42–5. Anonymous. 1928. U.S. Public Health Service. Milk investigations: preparation of a standard milkcontrol code. Annual report of the Surgeon General of the Public Health Service of the United States, for the Fiscal Year 1928. Washington: U.S. Government Printing Office; p. 53. Anonymous. 1983. Group C streptococcal infections associated with eating homemade cheese – New Mexico. Morb. Mortal. Weekly Rep. 32:510, 515–6. Anonymous. 1983. Kiel. Milchw i r t s c h F o r s c h u n g s b e r. 35:345–356. Anonymous. 1994. Two clusters of haemolytic uraemic syndrome in France. Communicable Dis.Weekly Rep. 4:29. Anonymous. 1995. Brucellosis associated with unpasteurised milk products abroad. Communicable Dis. Weekly Rep. 5:151. Anonymous. 2000. Outbreak of Escherichia coli O157:H7 infection associated with eating fresh cheese curds—Wisconsin, June 1998. Morb. Mortal. Weekly Rep. 49:911–913. Anonymous. 2002. Joint FAO/ WHO Working Group report on drafting guidelines for the evaluation of probiotics in food. London, Ontario, Canada. Available at ftp:// ftp.fao.org/es/esn/food/wgreport2. pdf . Accessed 3 February 2009. Anonymous. 2006. Food Facts: U.S. Food and Drug Administration.The dangers of raw milk. Available at http://www.cfsan.fda.gov/~acrobat/ rawmilk.pdf. Accessed 3 February 2009. 12. Anonymous. 2006. Washington State Department of Agriculture Food Safety Program. The truth about raw milk sales. Available at http://agr.wa.gov/foodanimal/dairy/ docs/RawMilkTruth.pdf. Accessed 3 February 2009. 13. Anonymous. 2008. National Environmental Health Association. National Environmental Health Association Position Regarding Sale or Distribution of Raw Milk. Available at http://www.highbeam. com/doc/1G1-177028519.html. Accessed 3 February 2009. 14. Anonymous. 2008. United States Food and Drug Administration. Recall — State Press Release. Consumer Warning: Contaminated Cheese. Available at http://www. fda.gov/oc/po/firmrecalls/grassymeadows01_08.html. Accessed 3 February 2009. 15. Anonymous. 2008.Weston A. Price Foundation. Happening. Available at http://www.realmilk.com/happening.html. Accessed 3 February 2009. 16. Anonymous. 2008. Weston A. Price Foundation. Sheehan PowerPoint Response. Available at http:// www.realmilk.com/documents/ SheehanPowerPointResponse.pdf. Accessed 3 February 2009. 17. Arunachalam, K. D. 1999. Role of bifidobacteria in nutrition, medicine and technology. Nutr. Res. 19:1559–1597. 18. Bell, R. A., V. N. Hillers, and T. A.Thomas. 1999. The Abuela Project: safe cheese workshops to reduce the incidence of Salmonella Typhimurium from consumption of raw-milk fresh cheese. Am. J. Public Health. 89:1421–1424. 19. Bielaszewska, M., J. Janda, K. Bláhová, H. Minaríková, E. Jíková, M. A. Karmali, J. Laubová, J. Sikulová, M. A. Preston, R. Khakhria, H. Karch, H. Klazarová, and O. Nyc. 1997. Human Escherichia coli O157:H7 infection associated with the consumption of unpasteurized goat’s milk. Epidemiol. Infect. 119: 299–305. 20. Blaser, M. J., E. Sazie, and L. P. Williams, Jr. 1987. The influence of immunity on raw milk-associated Campylobacter infection. J.Am. Med. Assoc. 257:43–46. 21. Bowen, D. April 13, 2005. Cheese shop seeks better precautions. New York Times. Available at http:// APRIL 2009 | FOOD PROTECTION TRENDS 219 http://agr.wa.gov/foodanimal/dairy/docs/RawMilkTruth.pdf http://agr.wa.gov/foodanimal/dairy/docs/RawMilkTruth.pdf http://www.highbeam.com/doc/1G1-177028519.html http://www.highbeam.com/doc/1G1-177028519.html http://www.fda.gov/oc/po/firmrecalls/grassymeadows01_08.html http://www.fda.gov/oc/po/firmrecalls/grassymeadows01_08.html http://www.fda.gov/oc/po/firmrecalls/grassymeadows01_08.html http://www.realmilk.com/happening.html http://www.realmilk.com/happening.html http://www.realmilk.com/documents/SheehanPowerPointResponse.pdf http://www.realmilk.com/documents/SheehanPowerPointResponse.pdf http://www.realmilk.com/documents/SheehanPowerPointResponse.pdf ftp://ftp.fao.org/es/esn/food/wgreport2.pdf ftp://ftp.fao.org/es/esn/food/wgreport2.pdf ftp://ftp.fao.org/es/esn/food/wgreport2.pdf http://www.cfsan.fda.gov/~acrobat/rawmilk.pdf http://www.cfsan.fda.gov/~acrobat/rawmilk.pdf
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