Adetunji Shakirat A, Ramirez Gilbert, Ficht Allison R, Perez Ligia, Foster Margaret J, Arenas-Gamboa Angela M
Department of Veterinary Pathobiology, Texas A&M University, College Station, TX, United States.
School of Public Health, Texas A&M University, College Station, TX, United States.
Front Public Health. 2020 Mar 13;8:76. doi: 10.3389/fpubh.2020.00076. eCollection 2020.
The scientific evidence of the health risks associated with the consumption of raw milk has been known for a long time. However, less clear is the impact of acquiring infectious diseases from raw milk consumption in the United States (US) due to incomplete reporting of cases and the complex factors associated with the sale and consumption of raw milk. Investigations of this current study focused on human brucellosis, one of the infectious diseases commonly acquired through the consumption of raw milk and milk products, and which continues to be a public health threat worldwide. A qualitative systematic review of the sources of opinions that contribute to the increased trend of raw milk sales and consumption in the US was conducted. Interestingly, opinions about the sale of raw milk and/or the benefits arising from its consumption varied by US region, with the proportion of messages supporting raw milk consumption being highest in the Northeast compared to other US regions. Several evidence gaps and factors that possibly contribute to the increased prevalence of raw milk-acquired brucellosis were identified including inadequate monitoring of the raw milk sales process and lack of approved diagnostic methods for validating the safety of raw milk for human consumption. The unavailability of data specifying brucellosis cases acquired from raw milk consumption have precluded the direct association between raw milk and increased brucellosis prevalence in the United States. Nevertheless, the evidence gaps identified in this study demonstrate the need for intensified surveillance of raw-milk acquired infectious diseases including human brucellosis; establishment of safety and quality control measures for the process of selling raw milk; and design of an effective strategy for the prevention of raw milk-acquired infectious diseases including brucellosis. Overall, for the first time, this study has not only shown the gaps in evidence that require future investigations, but also, variations in the perception of raw milk consumption that may impact disease acquisition in different US regions.
与饮用生牛奶相关的健康风险的科学证据早已为人所知。然而，由于病例报告不完整以及与生牛奶销售和消费相关的复杂因素，在美国因饮用生牛奶而感染传染病的影响尚不清楚。本研究的调查重点是人类布鲁氏菌病，这是一种常见的通过饮用生牛奶和奶制品感染的传染病，并且在全球范围内仍然是一种公共卫生威胁。对导致美国生牛奶销售和消费增加趋势的观点来源进行了定性系统综述。有趣的是，关于生牛奶销售和/或饮用生牛奶所带来益处的观点因美国地区而异，与美国其他地区相比，支持饮用生牛奶的信息比例在东北部最高。确定了几个可能导致生牛奶引发的布鲁氏菌病患病率增加的证据空白和因素，包括对生牛奶销售过程的监测不足以及缺乏用于验证供人类消费的生牛奶安全性的经批准的诊断方法。缺乏明确从饮用生牛奶感染布鲁氏菌病病例的数据，使得无法在美国直接关联生牛奶与布鲁氏菌病患病率上升之间的关系。尽管如此，本研究中确定的证据空白表明，需要加强对包括人类布鲁氏菌病在内的生牛奶引发的传染病的监测；为生牛奶销售过程制定安全和质量控制措施；以及设计预防包括布鲁氏菌病在内的生牛奶引发的传染病的有效策略。总体而言，本研究首次不仅揭示了需要未来调查的证据空白，还揭示了不同美国地区对饮用生牛奶的认知差异，这些差异可能会影响疾病感染情况。
