title: Nonpasteurized dairy products, disease outbreaks, and state laws-United States, 1993-2006.
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.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. alanger@cdc.gov
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Langer
authors.forename: Tracy
authors.initials: T
authors.lastname: Ayers
authors.forename: Julian
authors.initials: J
authors.lastname: Grass
authors.forename: Michael
authors.initials: M
authors.lastname: Lynch
authors.forename: Frederick J
authors.initials: FJ
authors.lastname: Angulo
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Mahon
mesh_terms: D000293:Adolescent; D000328:Adult; D003611:Dairy Products / Q000506:poisoning*; D004196:Disease Outbreaks; D005260:Female; D005516:Food Microbiology; D005517:Foodborne Diseases / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D018673:Nutrition Policy / Q000331:legislation & jurisprudence*; D061352:Pasteurization / Q000331:legislation & jurisprudence*; D014481:United States / Q000453:epidemiology; D055815:Young Adult