C02 | Raw milk: risks, opportunities, and future prospects

L. Vallone¹, S. Fiorani². | ¹Dip. DIVAS, Università degli Studi, Milano; ²Libero professionista.

Purpose. The consumption of raw milk and raw milk cheeses is a topic of growing interest to the scientific community, the production sector, and institutions. While these products are appreciated for their sensory and nutritional characteristics, linked to the use of unpasteurized raw materials, there are still significant risks to public health, especially for the most vulnerable consumer groups. It is estimated that in Europe, approximately 1–2 out of 100 raw milk cheeses may contain Shiga toxin-producing Escherichia coli (STEC). In the Italian context (estimated mortality rate between 5% and 10%), out of a hypothetical cohort of 100,000 annual consumers, an average of about 3 confirmed cases of STEC are expected, of which between 2% and 7% could develop into hemolytic-uremic syndrome (HUS). This study aims to analyze the current context in terms of food safety, regulatory framework, and response of the production sector, with particular attention to the risks associated with the presence of STEC. Methods. A critical review of national and international scientific literature was conducted, supplemented by an analysis of institutional documents and the most recent Italian legislative initiatives on the subject. To this end, a bibliographic search (last search: May 30, 2025) was carried out using the PubMed and Scopus databases, with the use of keywords such as “raw milk,” “raw milk cheeses,” “Shiga-toxin producing Escherichia coli” (STEC), and “hemolytic-uremic syndrome.” Epidemiological data for Italy were obtained from reports by the Istituto Superiore di Sanità (ISS), while data for Europe were obtained from a joint EFSA/ECDC One Health review. The positions expressed by scientific bodies, trade associations, and producers were also examined, with the aim of highlighting points of convergence and critical issues. Results. The analysis shows that, despite current prevention measures based on good hygiene practices and self-monitoring significantly reducing microbiological risks, there continue to be cases of infection related to the consumption of raw milk and raw milk cheeses. Following a number of significant cases, in January 2025 a technical committee was set up, composed of experts from the Ministry of Health and MASAF, the ISS, the Zooprophylactic Institutes and trade associations, to assess the effectiveness of the measures in place for the prevention of E. coli STEC infections. At the same time, a bill was proposed to make it mandatory to indicate on the label the potential health risks associated with the consumption of fresh or medium-aged cheeses made from raw milk, especially for children under the age of 10. Conclusions. The issue of raw milk and dairy products lies at the intersection between promoting traditional production methods and ensuring food safety. Recent legislative attention reflects the need to strengthen risk communication to consumers, particularly for vulnerable groups. The ongoing dialogue between institutions, the scientific community, and producers will be crucial to achieving a sustainable balance between protecting public health and preserving traditional production methods.