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Lilia Villegas
Dr. Dawn Anderson
23 October 2014
How Safe are Unpasteurized Food Products?
To make certain that food is safe for consumption, it is put through a process called
pasteurization. This process uses high heat to destroy harmful pathogens that exist in food. A
lesser method that has the same effect on pathogens as pasteurization, but uses lower heat
temperature, is called thermization.1 Both of these methods are acceptable methods for
destroying harmful pathogens. Even though these processes exist to make food safe, there are
still some food products left untreated, and most commonly these products are dairy products,
such as milk and cheese. These products would be classified as unpasteurized products that have
not been treated with high heat in order to destroy pathogens; therefore, the harmful pathogens
continue to thrive in the unpasteurized food product. Even though unpasteurized products may be
harmful to ones health, there is still a small population of individuals who choose to consume
unpasteurized products due to beliefs that unpasteurized food products have better health
benefits, such as having a higher percentage of vitamin A and riboflavin than pasteurized ones,
or that they simply have better taste.2,3 Are these individuals putting their health at risk, and how
much of a greater risk is it to consume unpasteurized products over pasteurized ones?
The pathogens that usually are found in unpasteurized food are bacteria, and these
bacteria include Campylobacter jejuni and Campylobacter coli, Streptococcus equi
zooepidemcus, Salmonella, Listeria monocytogenes, and Bacillus cereus. Campylobacter jejuni
and Campylobacter coli are bacteria that are mostly found in poultry, but studies have found
them in raw milk products as well.3,4 If an individual is infected with Campylobacter jejuni
and/or Campylobacter coli, they may experience diarrhea, abdominal cramps, fever, vomiting,
and headaches. These similar symptoms may also be experienced by a person who has been
infected with Salmonella. It is important to note that eating just a small amount of a food
contaminated with Salmonella causes illness to the individual.5 Streptococcus equi
zooepidemicus is a bacteria that rarely infects humans, but it has been found in unpasteurized
milk products.6 In humans, Streptococcus equi zooepidemicus may cause glomerulonephritis,
rheumatic fever, meningitis, and arthritis.7 Finally, Listeria monocytogenes and Bacillus cereus
are the bacteria that are more commonly associated with unpasteurized milk/dairy products.

Listeria monocytogenes may cause pregnant women to miscarry, and newborns may develop
sepsis, pneumonia, and/or meningitis. On the other hand, Bacillus cereus creates two different
toxins that cause two different illnesses. These two illnesses are the vomiting illness and the
diarrhea illness. With the diarrhea illness, an individual will experience watery diarrhea with no
vomiting.5 With the vomiting diarrhea, an individual will experience vomiting and nausea.5 The
bacteria mentioned above are usually the most common bacteria to cause illness in humans due
to unpasteurized food consumption, but it is important to keep in mind that less common bacteria
may also be in unpasteurized food and, therefore, cause illness.
In a study performed by Russell et al4, they concluded that cross contamination between
bovine feces and unpasteurized milk caused an outbreak of Campylobacter jejuni. They came to
this conclusion by collecting bovine feces, milk samples, and flush alley water from two
different dairy farms that were suspected of being the source of the Campylobacter jejuni
outbreak in California. Even though they were not able to obtain Campylobacter jejuni isolates
from the milk samples because the bacteria died before the outbreak was recognized, they did
obtain strains of the bacteria in the bovine feces and in the flush valley water. They determined
that the Campylobacter jejuni strain was predominant in one of the dairy farms due to it still
being in the flush alley water for three months after the outbreaks. In another study, Eldin et al1
found that products made from unpasteurized milk had higher concentrations of bacteria than
products made from pasteurized milk. The bacterium they specifically were investigating was
Coxiella burnetii. They did note that the bacteria was also found in pasteurized and thermized
dairy products but at a much lesser concentration. Paenibacillus spp is considered a spoilage
bacteria. It is rarely known to cause illness, but since it is found in unpasteurized and pasteurized
milk, it is important to know about it. In a research study performed by Ranieri et al8, their
results confirmed the fact that Paenbacillus spp is found in low concentrations in unpasteurized
milk and continues to be present after pasteurization. Even though it is present in pasteurized
milk, the concentration is quite low for it to cause an individual illness. As it can be seen, even
though strains of bacteria are also found in pasteurized food products, it is in very low
concentrations. On the other hand, unpasteurized food products have higher bacteria
concentrations; therefore, they are most likely to cause illness.
According to Robinson et al3, in the United Stated alone, the reported number of
outbreaks due to the consumption of unpasteurized dairy products is approximately 150 times

greater than outbreaks due to pasteurized dairy products. The following are cases of outbreaks
that have occurred due to unpasteurized and pasteurized food products. The following case that
occurred in May 2006 highlights the fact that pasteurized food may also cause illness.4 Due to
the consumption of pasteurized milk by prison inmates in a California prison, around 1,644 of
them became ill with Campylobacter jejuni. According to Russell et al4, even though the bacteria
was not recovered from the milk, the milk did have high aerobic standard plate and coliform
counts. By law, the aerobic standard plate counts should be <1.6 x 104 CFU/ml while coliform
counts should be <10 CFU/ml; but in the milk that caused the prison outbreak, the CFU/ml were
9.8 x 107 to 1.4 x 108 and 350 to >1.6 x 105. This was a significant difference that definitely
posed a great health risk to humans. A second outbreak that also took place in California in the
year 2007 was caused by raw milk and raw chocolate.4 The individuals in the outbreak were
suspected of having Campylobacter jejuni. As in the previous case, the bacteria was not able to
be found in the raw products, but the aerobic standard plate counts were determined to be too
high at >250,000 CFU/ml, way above the regulated standard. Another outbreak due to the
consumption of unpasteurized goat cheese occurred in Finland in October 2003.6 The bacteria
that caused the illness was Streptococcus equi zooepidemicus. The suspected manufacturer of the
cheese was a small local dairy farm, and when the cheese was taken for analysis, strains of
Streptococcus equi zooepidemicus were found. Fortunately, in this case, all seven individuals
infected recovered. However this is not always the case. For example, in an outbreak caused by
unpasteurized milk in England in the year 1984, seven out of eleven individuals died9 and in
New Mexico in 1983, two of sixteen people died due to unpasteurized cheese.10
With that said, all the research studies and outbreaks have determined that consumption
of unpasteurized food products may implicate greater health risks. Even if this is the case, there
will always be a small population who prefer unpasteurized food products over pasteurized ones
due to certain beliefs. For those individuals who prefer to consume unpasteurized food products,
they should be knowledgeable of the health risks this preference implicates and determine
whether the source they get their unpasteurized food products from is a safe and reliable one.

References
1. Eldin C, Angelakis E, Renvois A, Raoult D. Coxiella burnetti DNA, but not viable
bacteria, in dairy products in France. Am. J Trop Med. Hyg. 2013;88(4):765-769.
2. Perkin M. Unpasteurized milk: health or hazard?. Clin Exp Allergy. 2007;37:627-630.
3. Robinson T, Scheftel J, Smith K. Raw milk consumption among patients with nonoutbreak-related enteric infections, Minnesota, USA, 2001-2010. Emerg Infect Dis. 2014
Jan;20(1):38-43.
4. Russell M, Mandrell R, Yuan J, Bates A, Manalac R, Mohle-Boetani J, Kimura A,
Lidgard J, Miller W. Using major outer membrane protein typing as an epidemiological
tool to investigate outbreaks caused by milk-borne Campylobacter jejuni isolates in
California. J Clin Microbiol. 2013 Jan;51(1):195-201.
5. Educational Foundation of the National Restaurant Association. Servsafe Coursebook. 6th
Edition. Chicago, Illinois: National Restaurant Association; 2012;6:2-9-2-15.
6. Kuusi M, Lahti E, Virolainen A, Hatakka M, Vuento M, Rantala L, Vuopio-Varkila J,
Seuna E, Karppelin M, Hakkinen M, Takkinen J, Gindonis V, Siponen K, Huotari K, An
outbreak of Streptococcus equi subspecies zooepidemicus associated with consumption
of fresh goat cheese. BMC Infect Dis. 2006 Feb 27;6(36).
7. Pelkonen S, Lindahl S, Suomala P, Karhukorpi J, Vuorinen S, Kiovula I, Visnen T,
Pentikinen J, Autio T, Tauuminen T. Transmission of Streptococcus equi Subspecies
zooepidemicus infection from humans. Emerg Infect Dis. 2013 July;19(17):1041-1048.
8. Ranieri M, Ivy R, Mitchell W, Call E, Masiello S, Wiedmann M, Boor K. Real-time PCR
detection of Paenibacillus spp. in raw milk to predict shelf life performance of
pasteurized fluid milk products. J Appl Environ Microbiol. 2012 Aug;78(16):5855-5863.
9. Edwards A, Roulson M, Ironside M. A milk-borne outbreak of serious infection due to
Streptococcus zooepidemicus (Lancefield Group C). Epidemiol Infect. 1988; 101(1): 43
51.
10. Group C streptococcal infections associated with eating homemade cheese--New
Mexico. MMWR Morb Mortal Wkly Rep. 1983; 32:515-516.