Some argue we are losing the battle against bacteria with ever-more resistant bugs being able to beat whatever antibiotic we throw at them. There’s a name for that – evolution – but in reality the bugs have already won and we are but sophisticated social care systems for the 10-100x the number of microbial cells that live in and on us compared with the number of cells of us.

If you look at the public health landscape before clean water / sewerage, vaccines, antibiotics and what we’d now view as ‘good’ hygiene it’s difficult to argue we aren’t better off – with better general health and a longer life expectancy. Yes, diet etc plays a part but for all the Daily Mail says you’re still far more likely to die in a car crash than from MRSA in a hospital.

Look! No cow shit! Promise!

Look! No cow shit! Promise!

But some people still insist on giving bacteria every chance to redress that balance. The Food Standards Agency is finally starting its consultation on the sale of raw (i.e. unpasteurised) milk – already illegal in many jurisdictions including Scotland. The HPA is pretty good at evidence-based judgements so perhaps this report in Emerging Infectious Diseases might help the decision. It shows that in routine surveillance in Minnesota over the last decade 3.7% of patients with enteric infections had reported raw milk consumption during their exposure period – which is probably underreported. People are far more likely to take a child with an enteric disease to primary medical care – and in this survey, shockingly 76% of those under 5 years of age had been served raw milk from their own or a relative’s farm. One died.

The pasteurisation of milk has always been a controversial subject, not because the aetiology of TB was in doubt – it really hadn’t been since the early 1900s – but more likely because successive generations of politicians between 1900 and 1950 thought slaughtering 40% of the dairy herd was too high a cost. The risks were downplayed and most people believed the danger of catching tuberculosis from milk was insignificant. Consider that in 1926 only 1.5% of the UK milk supply was pasteurized and most retail milk was still unpasteurized in at the start of World War II. But during the 1950s pasteurised  pretty much replaced raw milk except in some rural areas. The BCG vaccination came in in 1953.

Now let’s look at death rates from TB over that period:

TB Deaths 1913-2012

Click on the graph to enlarge^^

I realise correlation is not necessarily causation but, seriously…

Why would anyone choose to consume raw milk? A brief trawl of the Interwebs reveals a veritable plague of people determined to win a Darwin Award for themselves or endow one on their poor offspring by drinking raw milk. They claim it is healthier than pasteurised, tastes better and cures bowel disorders, asthma, allergies, high cholesterol and – wow! – cancer. As well as just about everything else. Funny how many of the people making these claims tend to be the same people that sell the stuff.

It also ‘boosts your immune system‘. I will concede that one – if you challenge your immune system with Campylobacter, Salmonella, Brucella, Giardia, Listeria, Mycobacterium (TB), Shigella, Yersinia, – all of which have figured in outbreaks associated with raw milk – then one would hope one’s immune system would be up for the fight. Oh – and don’t forget E. coli. Lots and lots of E. coli, including the nasty strains like O157. Just like in Minnesota. How quickly we forget the pre-pasteurisation / immunisation landscape. And it’s not just the illness that could ruin your day – the immune response is prothrombotic so if the bug doesn’t get you the heart attack or stroke might. This is basic stuff.

More basics. Milk is a warm liquid filled with protein, fats and sugars. And bugs. This perfect bacterial growth medium comes out of a spout conveniently located pretty much directly below the cow’s bum. For anyone who’s not seen a cow in action they do not produce tidy No 2 on the Bristol Scale sort of effluent. It’s runny. And splashy. And udders are close to the ground.

I will concede that flash heating milk in the name of public health may well affect its flavour slightly but don’t care how clean and happy they tell me the cow is, would I lick its udder? No more than I’d lick its arse – and for precisely the same reason. While I’m all in favour of people doing dumb, life threatening things if they want (I’m a motorcyclist, I should know), parents who think that supplementing their children’s milk with cow shit is healthful I find a freedom too far.

Unpasteurised cheese or beer, however, is a different matter entirely….