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disease, better and more available laboratory facilities and more improved
reporting but there has also been a real increase related to changing patterns
of food production, processing, distribution and consumption" (30).
Salmonellosis does not appear to have been a common disease in England and Wales
in the 1930's - when much more unpasteurised milk was consumed than is now. Only
38 incidents were reported from all causes between 1936 and 1940 compared to
9461 in 1982 (30).
7
In the period 1950 - 1982 there were 172 outbreaks attributed to untreated milk
and 6 deaths (31, 33, 34), which is only a small proportion of the total numbers
over that period. In 1982 salmonellosis attributed to untreated milk affected
412 people (34), only 3.2% of the total number of 12,684 who were affected (36)
from all causes. During the period 1950 - 1980 this figure was only
approximately 1% (30). When considered in terms of 'incidents' of food
poisoning, less than 3% of the total for 1982 were conclusively linked to
untreated milk (see diagram).
Over the 31 years from 1951 - 1982 only 6 deaths were attributed to infections
from untreated milk (31, 33, 34). Yet in one year alone, 1982, there were 67
deaths from other types of bacterial food poisoning (31).
Infection from Pasteurised Milk
Contrary to popular belief, contamination with pathogens can occur in
pasteurised milk. For example, 3,350 people were affected in two outbreaks of
Campylobacter infection (31), and salmonella outbreaks attributed to pasteurised
milk, dried and tinned milks, have also occurred (31, 30, 37). Other types of
infection have been linked with pasteurised milk (38,39). For example, in 1982
in the United States there was a multi-state outbreak of a gastrointestinal
infection (Yersinia enterocolictica) transmitted by pasteurised milk (38).
Reported cases number 172 but estimates suggested approximately 800 individuals
may have been ill. This was despite the fact that "standards for adequate
pasteurisation had been met or exceeded throughout the period when contamination
had occurred" (38).
Who is to Blame ?
It must be accepted that illness derived from food may not necessarily be the
fault of the primary producer. Mishandling in the home can lead to bacterial
growth significant enough to cause infection (35), as can dumping of
contaminated sewage on the land. What too of the reduced capacity to resist
disease which can be engendered by an unhealthy lifestyle and reliance on
heavily processed, nutritionally inferior foods?
It has become evident that the risk of infection from untreated milk is very
small for most of the traditionally associated diseases. The apparent increased
danger from food poisoning is part of a general increase, which has been
exaggerated by a greater awareness of the problem, and against which
pasteurisation is not a complete safeguard.
8
THE WAY AHEAD
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