Nonpasteurized Dairy Products, Disease Outbreaks, and State Laws—United States, 1993–2006

TLDR

Although pasteurization eliminates pathogens and consumption of nonpasteurized dairy products is uncommon, dairy‑associated disease outbreaks continue to occur. To determine the association of outbreaks caused by nonpasteurized dairy products with state laws regarding sale of these products, we reviewed dairy‑associated outbreaks during 1993‑2006. Among 121 outbreaks with known pasteurization status, 73 (60%) involved nonpasteurized products, causing 1,571 cases, 202 hospitalizations, and 2 deaths, and 55 (75%) of these occurred in 21 states permitting sale where incidence was higher, and nonpasteurized products were responsible for ≈150× more outbreaks and illnesses per unit consumed, disproportionately affecting those under 20, while states with restrictions experienced fewer outbreaks and illnesses, suggesting stronger enforcement could reduce risk.

Abstract

Although pasteurization eliminates pathogens and consumption of nonpasteurized dairy products is uncommon, dairy-associated disease outbreaks continue to occur. To determine the association of outbreaks caused by nonpasteurized dairy products with state laws regarding sale of these products, we reviewed dairy-associated outbreaks during 1993-2006. We found 121 outbreaks for which the product's pasteurization status was known; among these, 73 (60%) involved nonpasteurized products and resulted in 1,571 cases, 202 hospitalizations, and 2 deaths. A total of 55 (75%) outbreaks occurred in 21 states that permitted sale of nonpasteurized products; incidence of nonpasteurized product-associated outbreaks was higher in these states. Nonpasteurized products caused a disproportionate number (≈150× greater/unit of product consumed) of outbreaks and outbreak-associated illnesses and also disproportionately affected persons <20 years of age. States that restricted sale of nonpasteurized products had fewer outbreaks and illnesses; stronger restrictions and enforcement should be considered.