Why a blue state embraced raw milk, despite bird flu and other health risks

DOVER, Del. – The mood in the Delaware General Assembly chamber was jovial last Thursday night as lawmakers considered legislation to legalize the sale of raw milk. There were udder puns and moo sounds. A Democratic member took the floor to ask whether the Ol’ Dirty Bastard lyrics “Ooh, baby, I like it raw” were written about the bill. And there was a standing ovation when, after eight minutes of debate, it passed 39-2.

You wouldn’t have known that raw, unpasteurized milk has exposed people to dangerous salmonella, listeria and E.coli bacteria — or that scientists are increasingly concerned that the H5N1 bird flu virus could be transmitted to humans through the product. It never came up.

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Bird flu from raw milk is “not a concern at all,” Republican Rep. Michael Smith, the lead sponsor of the bill, told STAT before the vote.

While there have not been confirmed human cases of bird flu transmission as a result of raw milk consumption, studies have shown that animals that drank unpasteurized milk infected with the bird flu virus become gravely ill. Last month, the Food and Drug Administration urged state health officials to “use regulatory authorities or implement other measures, as appropriate, to stop the sale of raw milk that may present a risk to consumers.”

“You would think that [the bird flu outbreak] might slow things down a little bit and maybe at least encourage legislatures to wait and see what happens with H5N1,” said Marcus Plescia, the chief medical officer of the Association of State and Territorial Health Officials.

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Delaware’s embrace of raw milk reflects a broader nationwide skepticism of public health warnings about its risks. Since particles of H5N1 were identified in milk earlier this year, the Louisiana legislature has also voted to legalize the drink. On-farm or retail sales are now legal in more than half the country. Raw milk sales are reportedly spiking. Presidential candidate Robert F. Kennedy Jr. and his vice presidential nominee have also begun publicly boosting raw milk in recent weeks.

In Delaware, that skepticism came from the highest ranks of government. While the secretary of agriculture in Louisiana raised concerns about the health risks of raw milk during that states’ recent legislative debate, Delaware Secretary of Agriculture Michael Scuse, who was present in the chamber Thursday, vocally supported the bill.

Scuse, a former U.S. Department of Agriculture official in the Obama White House, downplayed the risks of raw milk in a short interview.

“I drank raw milk from the time I was born till I was 11 years old, and our farms are a lot better prepared today — they’re doing a much better job of milking the cattles, providing sanitary conditions — than they were 50, 60 years ago when I was a kid,” Scuse said.

Asked about the potential for H5N1 transmission through raw milk, he said “there is no proof that raw milk can pass on any type of avian virus to anyone who is consuming it at this time.” He cited a recent letter from the FDA to states to support his claim. In reality, the letter said that regulators “do not know at this time if the HPAI H5N1 virus can be transmitted to humans through consumption of raw milk and products made from raw milk from infected cows.” Scuse added, however, that if H5N1 was found in a Delaware dairy farm “we would stop the sale of that milk.”

The General Assembly’s passage of the bill followed the Senate’s passage in late May. The bill will now head to the governor’s desk for final approval.

Delaware seems, at first glance, like the last place raw milk mania would take hold.

Legalization of raw milk has been branded as a conservative issue, and Delaware hasn’t been represented by a Republican in Washington since 2011. Democrats outnumber Republicans in the state legislature by nearly 2-1. The state hasn’t voted for a Republican presidential candidate since 1988 — it’s the home of Joe Biden, after all.

But a confluence of economic and geopolitical factors gave raw milk a foothold in the traditionally blue state.

There are just 12 dairy farms left in Delaware, according to the state Department of Agriculture. Farms in the nation’s second smallest state can’t compete with megafarms that have popped up in larger states like California and Texas, which now dominate dairy production.

Raw milk, rightfully or not, is seen as a solution to that problem. While a small percentage of the population drinks raw milk — an estimated 4% tried it in one recent year — those who do are willing to pay a premium. A gallon of raw milk can fetch upwards of $10 and $12, while a pasteurized gallon sells for around $4.

“It has the power to save dairy,” said Stephanie Knutson, a dairy farmer in the state who has advocated for the bill. “It has given us the opportunity to dream about a future in dairy for our children.”

Raw milk is also stocked on store shelves in neighboring Pennsylvania, and supporters of the bill argued that legalizing it will allow Delaware to protect consumers.

“We have a percentage of people in this state that we know for a fact are consuming raw milk but it’s coming from other states, not Delaware, and we don’t know the precautions that those states have put in place,” said Scuse. “Let’s let Delaware manage it to make sure that it’s as safe as it possibly can be.”

Scuse and sponsors of the bill have indicated that they will require daily on-farm testing of milk for contaminants, although the bill itself — a mere four pages — does not spell out those requirements.

Several food safety experts told STAT that no barrage of tests will protect consumers from potentially unsafe milk — or justify the bill’s passage.

“There’s nothing in this bill that speaks to public health, safety, and science,” said Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “In fact it’s just the opposite.”

Nicole Martin, an assistant research professor in dairy foods microbiology at Cornell University, said many tests that could be used often take several days to report results, which could limit their utility for daily testing.

“They’re not meant to be necessarily a pass-fail,” Martin said. “They’re more of a monitoring tool to detect gross contamination.”

She noted, too, that testing of milk for pathogens typically relies on a small sample of milk, which means that it cannot guarantee that the milk making it into consumers’ fridges is actually free of contaminants.

That type of guarantee of safety, according to Susan Mayne, former head of the FDA’s Center for Food Safety and Applied Nutrition, can only be achieved by the bogeyman in this whole debate: pasteurization.

“The beauty of pasteurization is that it can reduce/eliminate numerous pathogens simultaneously,” Mayne wrote to STAT. “You cannot test your way to safe food.”

With poll after poll showing that trust for public health professionals nationally is at a low, such messages are falling flat. While supporters of raw milk in Delaware say that they’re listening to public health officials, they contend they can sell the product safely and point to another set of numbers: The number of people who have reported getting sick from raw milk is quite low — and the number of deaths is even smaller. There have been just 228 hospitalizations blamed on raw milk from 1998 to 2018.

“When I pored over the CDC database … and looked at the numbers, it doesn’t support the stigma that’s still there,” said Knutson, the farmer.

Those statistics are almost certainly an undercount of the actual number of people who would become sick if raw milk was widely available nationally, given it is currently consumed by such a small percentage of the population and it is still illegal in many states, said Marie Helweg-Larsen, a professor at Dickinson College who is an expert on people’s perceptions of risk.

“Those numbers seem to be kind of irrelevant,” she said. “Isn’t that the same thing as saying very few people died on spaceships? We haven’t really been on that many spaceships.”

Still, warnings about bird flu and raw milk are seen as hypothetical by many. While the science seems to suggest bird flu can be transmitted by raw milk, no cases have been documented.

Don Clifton, executive director of the Delaware Farm Bureau, which supported the bill, was quick to note that the smattering of human cases of H5N1 tied to the dairy cattle outbreak have been in workers in contact with sick animals, not consumers of raw milk.

“I think it’s a red herring,” said Clifton. “But I’m certainly not an expert.”