The most dangerous thing you could drink right now
Key Takeaways
Some people drink raw milk for its purported health benefits, but the medical community is largely in agreement that risks associated with unpasteurized milk outweigh any benefit—especially given the increasing risk of bird flu in the US.
Raw milk contains higher levels of Listeria, Brucella, Campylobacter, Cryptosporidium, E. coli, and Salmonella than pasteurized milk, according to the CDC.
Despite what special interest groups claim, patients should be advised against drinking raw milk—especially if they are young, old, immunocompromised, or pregnant.
Raw milk—cow’s milk that hasn’t been pasteurized or homogenized—is a staple in the kitchens of some health-conscious consumers. These wellness enthusiasts believe raw milk is an immune-booster, claiming that it is non-allergenic, full of healthy bacteria, and easier to digest than its pasteurized counterpart, among other factors.[]
The medical community, however, largely agrees that the alleged benefits of drinking raw milk (which are not backed by scientific evidence) do not outweigh its health risks, which includes potential exposure to bacteria, parasites, and viruses, according to the CDC.[]
Urging your patients to avoid raw milk is even more important now, given the rising risk of bird flu and potentially contaminated milk, as pasteurization kills harmful bacteria and viruses that pose a risk to consumer health.[]
Raw milk advocates
Despite the health risks, there’s a contingent of stakeholders that continue to promote the benefits of raw milk. The Raw Milk Institute (RAWMI), for example, lists farmers who allegedly produce clean and safe raw milk in a hygienic environment.[]
RAWMI’s board consists of dairy farmers, scientists, and others who support the direct consumption of raw milk.
While corporate interests may be at play, RAWMI and organizations like them insist that drinking raw, unpasteurized milk has significant health benefits.
Generally, proponents suggest there are two types of raw milk.[] The first is raw milk that is intended for pasteurization, produced on farms where cows’ health is compromised and both antibiotic and hormone use is prevalent. The second type is raw milk intended for direct human consumption, produced by cows living in clean, free-roaming environments.
In a letter meant to convince doctors of its benefits, RAWMI claims the following of raw milk:[]
It is easier to digest
It is rich in “living” enzymes and probiotics
It is more nutritive than pasteurized milk, which contains denatured proteins and fats
It contains living bacteria that mediate the production of lactase enzymes, making it easier to consume for lactose intolerant individuals
It is linked to lower levels of asthma, allergies, eczema, fever, otitis, respiratory infections, and fever
RAWMI is a source that patients may find on the internet and discuss with their physicians. It should be noted that RAWMI does not support its claims with original studies, and physicians should be prepared to counter any factual claims made by special interest groups like RAWMI.
What the scientific establishment says
The US medical establishment does not promote the consumption of raw milk based on the research. In fact, in the US, 20 states prohibit intrastate raw milk sales.[] According to the CDC, raw milk can expose children and adults to Listeria, Brucella, Campylobacter, Cryptosporidium, E. coli, and Salmonella. The risk of infection is especially high in children under 5 years, adults aged more than 65 years, pregnant people, and those with weakened immune systems.[]
The dangers of drinking raw milk are evident in a number of historic outbreaks. According to 2023's Canada Communicable Disease Report, there were 26 outbreaks from 2000 to 2009 in North America related to raw milk consumption, resulting in 545 illnesses, 23 hospitalizations, and 7 infant deaths.[]
The true number of incidents, however, may be far higher, as many people don’t visit the hospital unless symptoms are severe.
Additionally, the Canadian authors found that the consumption of raw milk can result in the development of hemolytic uremic syndrome (HUS), with 83% of the cases in North America from 2007 to 2020 attributed to outbreaks from raw dairy consumption.
HUS is caused by enterohemorrhagic E. coli, which is a subtype of Shiga toxin-releasing E. coli, and leads to severe renal failure, anemia, and seizures or death.
H5N1 and pasteurization
More recently, investigators publishing in The New England Journal of Medicine found that mice fed raw milk samples from dairy cows infected with H5N1 influenza harbored high virus levels in respiratory organs and became severely ill.[] Moreover, routine testing of raw milk from infected cows also shows high levels of H5N1.
Erin Sorrell, PhD, MSc, senior scholar at the Johns Hopkins Center for Health Security, tells MDLinx that other farm animals have also been infected with H5N1 via raw milk, including feral cats who died following infection.
“From my knowledge there has not been a human case reported from ingestion of milk, but we have seen three confirmed cases of cow-to-dairy worker transmission,” she says. “There are links to ocular exposure to the milk or droplets getting into the eyes of dairy workers, and that is a potential route of exposure.”
Dr. Sorrell believes avoiding raw milk consumption is of the utmost importance right now. “We have proof the virus is in the raw milk, [so] I think it’s a very dangerous activity for people to participate in,” she says. She notes that consumer milk is pooled, meaning one cow can infect an entire supply chain, across distributors.
"Even if you have no H5 infected cows, milk is a fantastic nutrient for bacteria."
— Erin Sorrell, PhD, MSc
“Pasteurization effectively kills pathogens that exist in raw milk without any significant impact on the nutritional quality of the milk," Dr. Sorrell explains. "Pasteurization has drastically decreased the number of food–borne illnesses because it inactivates bacteria and H5."
Clinical interventions
Physicians play a key role in keeping their patients safe from the dangers of raw milk. When relevant, it’s important that physicians ask about purchases from farm gate sales or “herd shares” and counsel their patients about the risks of consuming raw milk (or raw milk products). Adults and children who consume raw milk should be warned about symptoms of related illnesses and advised to seek medical help when necessary.
Physicians should counsel patients about the safety of consuming pasteurized milk products. This is especially true in immuno-compromised patients, the old, the young, and pregnant people. All milk or milk products should be purchased from grocery stores with pasteurized dairy plant-supply chains.[]
What this means for you
It’s much safer to consume pasteurized vs raw milk, regardless of what some special interest groups may claim. Although many people love the taste of raw milk and tout its health benefits, there is little evidence supporting these claims. The young, elderly, pregnant, and immunocompromised are at the highest risk for infection secondary to raw milk.
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