The Complete Patient

I’m not through with my “Illusionist”-driven effort to re-visit milk data. (Don, afraid I’m a little slow on the uptake, so I didn’t figure the ending out till…the end.)

Last month, when I first inquired about the case of Dawn Sharts, New York’s Department of Agriculture and Markets forwarded me a dairy study as “background” . It has the fascinating title, “Prevalence of Salmonellae, Listeria monocytogenes, and Fecal Coliforms in Bulk Tank Milk on US Dairies”, published by the American Dairy Science Association in 2004.

Unfortunately, I only glanced briefly at it when I wrote the BusinessWeek.com article, but in light of the new case involving Lori McGrath, the comments about listeria monocytogenes on this blog, and my re-review of the CDC data yesterday, I decided to read the US Dairies study more carefully. My first reaction was “Yuck!”—from learning that “fecal coliforms” were detected in 818 of 860 bulk tank milk samples, or an astounding 95%. I can’t believe the raw milk currently being consumed around the country would have the same result, without lots of people becoming ill…or perhaps raw milk drinkers have built up amazing immunity?

In any event, there’s lots of pasteurized milk being consumed every day that is, literally, full of poop (even if it’s zapped poop).

More interesting from the perspective of the discussion about listeria monocytogenes were several points in the study. Listeria m was found in 6.5% of the samples, prompting the authors to conclude that “although the prevalence…was low, these pathogens represent a potential risk to consumers of raw milk and raw milk products.”

Obviously, the authors didn’t review the CDC data I reviewed yesterday, showing zero cases of illness from listeria m in raw milk over a period of 32 years. Or, maybe they did, but still felt compelled—perhaps based on not wanting to upset their audience--to talk about “potential risk.”

That little slipup by the authors is enough to call their credibility into question. But there is more to wonder about in the study. The authors mention that in 38 samples showing listeria m, the amount “was below our direct detection limit…” Was there a direct detection limit for listeria m on the New York dairies penalized for having the pathogen? The lab results sent to me for two farms don’t say.

Finally, there’s another statement in the study suggesting the authors’ bias: “Dairy products account for a small percentage of foodborne illness in the U.S., and many of these outbreaks are due to the consumption of raw milk and raw milk products.” Once again, if they had read the CDC data, they’d know raw milk accounted for less than 10% of the total dairy-related outbreaks between 1973 and 2005.

Here’s one statement I can agree with them on: “Public perception of food quality is critical in the marketing of any product.” Thus, if you continually smear one product, public perception should suffer...except if consumers realize who is doing the smearing.

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Note to farmer ed:

If you know more about the situation in Georgia, please let me know (david@davidgumpert.com). There have been recent stirrings in Georgia, including an article in the Atlanta Constitution saying three people got sick from raw milk, and a press release from the state's director of agriculture warning about the dangers of raw milk.

I saw a very clever movie this weekend, “The Illusionist”. That movie, together with comments on my previous posting—citing evidence suggesting that potential dangers from listeria monocytogenes may be overstated—got me thinking. Since last December, New York state has branded as dangerous five of its farms for selling raw milk contaminated with listeria monocytogenes,. Yet, curiously, no one has become ill.

So I decided to re-review the data Pete Kennedy of the Weston A. Price Foundation obtained recently from the Centers for Disease Control about outbreaks of foodborne illness from milk between 1973 and 2005 (which I discussed in a previous post, and I have now posted separately; sorry about the sideways statistical pages).

Want to guess the number of raw-milk illnesses from listeria monocytogenes? After you deduct the 36 illnesses from queso fresco, the Mexican cheese sprinkled on tortillas, it is zero. That’s right, no illnesses from actual raw milk between 1973 and 2005. The vast majority are from campylobacter, with salmonella and E.coli 0157:H7 as way-distant followons.

The number of pasteurized-milk illnesses from listeria monocytogenes? There were 69 cases in 1983 and 69 more in 1994 (from chocolate milk), for a total of 138. Not a serious problem in the entire scheme of things, but a great deal more serious a problem than for raw milk.

Remember, we are dealing here with government-supplied statistics, certified under penalty of perjury to be “true and correct.”

So here’s New York’s Department of Agriculture and Markets shuttering and slandering small farms in the name of protecting citizens from…what? Nothing, as far as I can see. If they want to be searching out listeria monocytogenes, seems they’d have a better chance of protecting citizens by searching out problems in pasteurized milk.

If you haven’t seen “The Illusionist”, I highly recommend it, as a very entertaining illustration of the truism that what you see isn’t always what you think you’re seeing. I wonder if the New York agriculture authorities are taking a few lessons from it.

The press release about listeria contamination of the farm’s raw milk has been posted online and sent to local newspapers. The calls have gone out to the three customers who purchased the milk, warning them to dispose of it. The farm has “voluntarily suspended” raw milk sales. Within a few weeks, New York’s Department of Agriculture & Markets can be expected to impose a $300 fine on the farmer.

But this, the fourth New York state raw milk dairy to test positive for listeria monocytogenes in the last eight months (a fifth was cited for camphylobacter), vows not to just be another statistic.

“We have no intention of paying the penalty,” says Lori McGrath, owner with her husband, Darren, of Autumn Valley Farm in Worcester, NY. (A few of the farm's 44 cows are pictured grazing above.)

“I don’t intend on letting them bully us,” she adds. If her farm loses its raw milk license as a result of its refusal to pay the fine, she and her husband will consider organizing cow share arrangements, which are used in many other states to distribute raw milk. “There are no regulations (in New York) about cow shares. They’re going to end up spiting themselves.”

In the meantime, says Lori, the three customers who purchased the milk are as upset as she is. Not only have none of them gotten sick, but, “They said they would come back tomorrow and buy more milk from us…We have an immaculate farm.”

Like Dawn Sharts, the New York farmer whose upset with the authorities I described in a recent BusinessWeek.com article, Lori is convinced there is no danger from her milk. “I have no concerns at all about the milk being contaminated.”

Lori and her husband have operated the 160-acre dairy for six years, and have had their raw milk license for eight months. “We gave up our entire (professional) lives six years ago to be farmers…We worked too hard to let them take this away.”

Like many raw-milk producers and consumers alike, Laurie wonders why no one has become ill from the supposed pathogens. She also wonders why the state isn’t investigating the problem further. “You’d think they’d wonder if there’s an epidemic,” since so many cows are turning out milk with listeria monocytogenes.

Lori feels the state is simply trying to sow fear, based on its own fears. “The raw milk demand is exploding, and they don’t know what to do about it.”

New York’s raw milk dairy farmers are clearly becoming tired of what they consider to be government harassment. If Lori McGrath is any indication, not only are they becoming tired, they’re not going to take it any more.

Something about the comment from Jenny @ Sagehill about colostrum (following my previous post) touched me. For a good while, I couldn’t figure it out, but then I realized I was awestruck with the reality that the high-colostrum milk I have been consuming is produced by a particular cow as part of the birthing process. The idea that I am consuming milk intended to provide sustenance for that animal’s offspring, well, it’s a lot to take in.

In fact, the entire discussion about raw milk standards has reinforced the sense that there is a connection with particular animals when we consume raw milk—it’s direct from one or a few cows, unprocessed. For a city slicker like me, that idea represents a total departure from a lifetime of anonymity associated with milk and meat consumption.

Trying to introduce the subject of standards into products that inspire such a deep connection is difficult. In any event, Dave Milano and Steve Bemis are correct in suggesting (following my previous posting) that I was using the term a bit loosely. So I’ll try to clarify, especially in light of an additional comment provided by Mark McAfee of Organic Pastures, in response to my original posting on raw milk standards.

Standards are usually applied on two levels. First there are government/industry standards that allow, for instance, for categorizing dairy products as cream, whole milk, and skim, or meat as prime, choice, select, etc., or that designate how DVDs should be produced so they all work on the players made by different manufacturers. 

But then, particular milk and meat companies institute their own individual quality standards regarding things like freshness of their milk or the tenderness of their beef.

When it comes to raw milk, states that permit raw milk distribution have standards in effect—primarily for plate counts and pathogens like E.coli 0157:H7 and listeria. Organic Pastures publishes key standards that apply in California, and how it measures up.

The Organic Pastures summary doesn’t cover everything, such as the particulars of testing for specific pathogens; I agree with Steve it would be useful to provide such requirements from around the country; I’d be glad to provide on this site if I could get some help in assembling them.

Getting back to the second type of standards, what Mark McAfee has been talking about are individual producer standards—in effect, quality control.

This is an issue all business people are faced with at one time or another. How much risk can we take with our product or service before we put others in danger? How many risks with regard to non-life-threatening issues before we damage our brand and credibility with customers? For example, I’ve mentioned that my daughter, Laura, purchases raw milk in Philadelphia. But lately, she’s noticed that probably half the time, her milk goes sour within two or three days of her purchasing it, suggesting that producers or retailers are letting it sit longer than they should. It gets her wondering, if the producers and/or distributors are slackening on delivery times, what other corners are they cutting?

A vivid example of varying company quality control standards can be seen in the automobile industry. Japanese auto companies have over the years been more attentive to the fine points than American manufacturers, and the differences are clear to see in the annual Consumer Reports auto quality ratings.

What Mark is saying essentially—and it’s the first time I’ve heard anyone say it quite this way—is that producing raw milk isn’t much different from producing automobiles.

“As you start to use (the standards) there will be areas that may need to be changed a little for each farmer and his special set of conditions. The farmer then must realize that safety is then going to be moving that much against him, however so slight. Adding grain  is not a problem but as you add more expect different bacteria in her manure and this goes against raw milk safety. Same goes for antibiotics. As these factors add up...so do your odds of a pathogen being found in your raw milk…In the past raw milk has had a black eye during some time periods in our American history. Study these periods and you begin to realize the factors that cause raw milk safety issues… There’s a complex production process, and each time you deviate from the optimum practices, you increase the risks of a problem, minor or major. A farmer needs to use the best possible practices every step of the way. It’s easy to screw up.”

While an auto manufacturers and even food producers are given the benefit of the doubt and allowed a few serious screwups, that’s not the case with producers of raw milk. All that has to happen is someone gets even mildly ill, and governmental authorities are just sitting around waiting to pounce and put you out of business.

It’s difficult to let go of the emotional overlay that comes with raw milk. It is a fragile product in more ways than one.

The discussion about raw milk standards, following my post of July 19, besides being extremely informative, brings to mind a couple of recent conversations I had with dairy farmers who produce raw milk.

One of the farmers produces raw milk in New York state, and among his customers is a group of orthodox Jews, who insist that their milk be kosher. For it to be considered kosher, the milk must either come from a farm owned by Jews or, if not, the milking must be observed by a designated orthodox Jew to ensure the milk isn’t mixed with milk or meat from non-kosher animals.

The farmer told me a second group of orthodox Jews approached him recently about buying milk, but when they inspected his barn and milk house, had some concerns because the group's inspector couldn’t simultaneously observe the milking take place and see the milk flow to the bulk tank, since there were some obstructions. Last this farmer heard, the group was discussing among themselves whether his milk would be acceptable, or whether to seek their raw milk elsewhere.

So milk that was kosher for one group possibly wasn’t kosher for another. This situation among Jews who keep kosher isn’t unusual. Some Jews who keep kosher won’t eat any food that isn’t known to be kosher and prepared in a kosher kitchen, while others who eat only kosher food at home will eat at non-kosher restaurants, but limit themselves to fish and/or vegetable dishes. The Torah is certainly open to varying interpretations.

Another situation that came up recently with the New Hampshire farmer who supplies me with raw milk concerned the matter of when the milk of a newly milking cow was appropriate for sale. Kathy, the farmer, told me that the cow’s milk the first week or ten days was watery, and so she didn’t think it was appropriate to sell. She decided it was appropriate for sale about two weeks after the cow started milking, and even then she mixed it with the milk from another cow. But the taste was different than what I was accustomed to—much less sweet than the usual milk. I wonder if that was because it contained more colostrum than the usual milk.

As in the situation with the antibiotics, the decision on what to do was left to me. In the end, I essentially decided to trust Kathy. If she felt comfortable selling me the milk, then I was comfortable buying it. The last thing she wants is for me to become ill.

So I can appreciate Elizabeth McInerney’s upset at the consumers who arbitrarily set their own standards about how long the cows producing their milk should be “clean” of antibiotics. These individuals have no idea how much antibiotics they consume in the meat of a restaurant chicken or the cheese of a party host. Yet they insist that a farmer who has been completely transparent in disclosing information comply with a very difficult standard.

At the same time, I don’t deny these individuals the right to make the decisions they feel comfortable with—that is part of the reason they are buying milk directly from a farmer.

In California, Mark McAfee, who sells about 95% of the milk consumed in the state, is entrusted with setting the state's standards, by default. But everywhere else, it's a free-for-all.

Until marketplace standards are agreed to, we are on our own, and have to arrive at standards in consultation with the farmers who sell us milk. And those standards may well vary from farmer to farmer, and consumer to consumer. It’s part of the price for seeking a product the government would just as soon we not have.