User:Jane Sawyer/sandbox

Epidemiology
In order to see the public health effects of consuming raw milk it is important to look into the past before pasteurization was a common practice. Before purified milk was adopted in the US, public health officials were concerned with cow milk transmission of bovine tuberculosis to humans with an estimated 10 % of all tuberculosis cases in humans being attributed to milk consumption. Along with specific diseases, officials continue to be concerned about outbreaks. With the use of modern pasteurization and sanitation practices milk accounts for less than 1% of reported outbreaks from food and water consumption. As comparison, raw milk was associated with 25% of all disease outbreaks from food/water during the time before World War II in the U.S. From a public health stand point pasteurization has decreased the percentage of milk associated food/water borne outbreaks.

Outbreaks have occurred in the past from consuming food products made with raw milk. One of the potential pathogens in raw milk, Listeria monocytogenes, can survive the pasteurization process and contaminate post-pasteurization environments. Milk and dairy products made with that milk then become recontaminated. Consistent contamination persists by bacteria survival in bio-films within the processing systems. One food item that has commonly used raw milk in its production in the past is cheese. Several different types of cheeses made with raw milk are consumed by a large portion of the United States population including soft cheeses. Since Gouda cheese has a 60-day aging period prior to its consumption, it has previously been hypothesized that no bacteria would persist through that time. A review study published in the Journal of Food Protection showed that E. coli 0157:H7 has the ability to persist through the aging period of Gouda cheese. The study's evidence included three different outbreaks prior to 2013 associated with this specific strain of E. coli in Gouda cheese.

Between 2007 and 2016 there was a burden of 144 outbreaks connected to raw milk consumption in the United States. Because raw milk production skips the pasteurization process, the germs that are normally removed remain in the milk product. Exposure to raw milk containing harmful germs poses a threat of infection, including Camplyobacter, Cryptosporidium, E.coli, Listeria, and Salmonella. Additionally, depending on the severity of infection, there may be further threat to human health. Infection has the potential to induce serious illness such as Guillain-Barré syndrome and Hemolytic Uremic Syndrome (HUS). Because of the vulnerability of developing and degrading immune systems, children, pregnant women, the elderly, and those who are immunocompromised are at a heightened risk of experiencing infection from raw milk consumption.

When choosing a proper study to examine there are ethical reasons that humans are not evaluated for case control studies. Ethics must be examined when placing humans in situations where serious health conditions have the potential to occur. In the instance of examining raw milk and pasteurized milks nutritional value it is important to use subjects similar to humans. The mouse is the most common model for preclinical studies. Their genome is similar to humans. Therefore, rodent models have been developed to stimulate human pathologies. A mouse study aimed at evaluating the difference in nutritional values between raw and pasteurized milk. Mice were separated into two groups a pasteurized milk group and a raw milk group. Each group consisted of breeding pairs. The conclusion of the study measured no significant difference in weights of pasteurized to raw milk consuming mice. Birth Weights were measured from each group and showed no significant difference in the mouse group. Overall the study showed no measurable significant difference in nutritional value in growth and fertility of mice.