With raw milk returning to public conversation, it’s important to understand the science, public health data, and concerns surrounding its consumption. While raw milk—milk that has not been pasteurized—has its advocates, the overwhelming consensus from health and regulatory experts is clear: raw milk poses a significant risk to public health, especially for vulnerable populations such as children, pregnant individuals, older adults, and those with compromised immune systems.
Commissioner Troxler Speaks Out
North Carolina Agriculture Commissioner Steve Troxler has been vocal in his support of legislation that limits access to raw milk in North Carolina. “Raw milk presents a significant public health risk as there is absolutely no way to ensure its safety,” Troxler stated. “Science says raw milk is not safe. Study after study has shown that.” He noted that raw milk is 150 times more likely to cause a disease outbreak than pasteurized milk, and nearly half of illnesses involve individuals aged 0–19—many of whom are not the purchasers of the product.
What Is Pasteurization and Why Does It Matter?
Pasteurization, developed in the 19th century by Louis Pasteur, is a process of heating milk to kill harmful bacteria. The FDA banned the interstate sale of raw milk in 1987, and today, pasteurization remains a cornerstone of public health policy. While raw milk makes up only 1–2% of milk consumption in the U.S., it is responsible for a disproportionate number of foodborne illness outbreaks.According to the CDC, from 1998 to 2018, raw milk was linked to 202 outbreaks, causing 2,645 illnesses and 228 hospitalizations. In a five-year span from 2013 to 2018, 75 outbreaks linked to raw milk led to 675 illnesses—nearly half in individuals under 20 years old, and 93 in children under five.
Common Pathogens and Health Outcomes
Raw milk can harbor harmful bacteria such as
E. coli O157:H7,
Listeria monocytogenes,
Salmonella,
Campylobacter,
Brucella, and others. These bacteria can cause severe and sometimes fatal illnesses, including:
- Hemolytic Uremic Syndrome (HUS): Kidney failure often caused by E. coli.
- Reactive Arthritis and Guillain–Barré Syndrome: Linked to infections from raw milk bacteria.
- Stillbirths and Miscarriages: Resulting from Listeria infections in pregnant individuals.
A recent outbreak of highly pathogenic avian influenza (H5N1) has raised additional concerns. A 2025 study published in the
New England Journal of Medicine linked human H5N1 cases to raw milk exposure, with 84% of cases involving contact with both infected dairy cattle and raw milk.
The Situation in North Carolina
North Carolina is home to 91 Grade A dairy farms, which operate under strict standards outlined in the Pasteurized Milk Ordinance. These farms work tirelessly to produce safe, high-quality milk. However, one outbreak attributed to raw milk can undermine public trust in all milk products—pasteurized or not—jeopardizing the state’s dairy industry.The NC Department of Agriculture and Consumer Services (NCDA&CS) enforces food safety laws that define adulterated food as anything unfit for consumption or produced under unsanitary conditions. For milk, this includes viable pathogens. Both NC and FDA require laboratory confirmation before deeming milk adulterated.
Risks to Animals and Pets
Raw milk is also unsafe for pets. Cats and dogs can contract diseases such as
Salmonella,
Campylobacter, and even avian flu (H5N1) from contaminated milk. The American Veterinary Medical Association opposes the sale of raw milk and advocates for mandatory pasteurization to protect both humans and animals.
National Insights and Studies
A 2012 CDC study showed that states where raw milk sales are legal had twice the rate of outbreaks as those where it was illegal. Furthermore, 60% of raw milk-related outbreak patients were under the age of 20, and 13% of them were hospitalized—compared to just 1% from pasteurized milk outbreaks.From 1993–2006, the incidence of illness from raw milk was 150 times higher per pound consumed than from pasteurized milk. Increased legal access correlates strongly with increased illness. Data consistently shows that even stringent cleanliness on farms cannot guarantee raw milk safety.
Key Takeaways
- Raw milk carries significant health risks, particularly for children, the elderly, pregnant individuals, and those with weakened immune systems.
- Pasteurization is a proven, effective public health tool that eliminates dangerous pathogens without diminishing milk’s nutritional value.
- North Carolina's dairy producers operate under rigorous standards to protect public health, and broad access to raw milk undermines those efforts.
- Regulators, legislators, and consumers must remain vigilant in supporting science-based food safety policies that protect both individuals and the agricultural industry.
For more information and to view the referenced studies, visit:
