On Fri, 28 Jan 2000 Loren Muldowney and Donna Fetzler wrote:
> MICRO-ORGANISMS IN MILK CAUSE CROHN'S DISEASE
LM:
>I decided to go read that article in full. It said that the
>mycobacterium was present EVEN IN PASTEURIZED MILK. It then follows
>with the remarkable "conclusion" that therefore it is a bad idea to
>allow the sale of unpasteurized milk, due to the risk of spreading
>Crohn's disease! Did I misunderstand what it said, or is there indeed
>some dicontinuity of reason here?
No discontinuity at all. This is the whole basis of vaccines. You can
have live critters, attenuated critters, and killed critters as the
microbial base of the vaccine. It has happened (more than once) that a
vaccine didn't get killed *enough,* and people got the very disease
they were trying to prevent. Ditto for attenuated (cook 'em enough to
slow 'em down but not kill 'em) vaccines that didn't get attenuated
*enough.* In one case the strain got more virulent so the old heating
level was no longer sufficient to de-activiate the microbe.
It also relates to numbers. Many GI problems are directly related to
the *number* of viable critters ingested. Pasteurisation may not kill
*all* the Crohn's, and might not even attenuate all of it, but it will
sure reduce the numbers compared to raw milk.
DF:
> The truth is closer to this: the weakened immune system and the altered
> biochemistry of the gut of people with Crohn's disease provides a perfect
> environment for the growth of the mycobacterium. Presence does not connote
> pathogenicity.
The first statement here implies that the Crohn's article misses the
truth, yet as I read things the question of immune systems and gut
chemistry actually *reinforces* the general approach of the article. Of
course immuno-compromised people are going to be susceptible to all
sorts of things. Of course gut chemistry matters. That's why you use
immuno-supportive techniques, and it is the basis for probiotics in
both man and beast.
A pathogen is a pathogen. When it is present it is *still* a pathogen,
whether active or not. BASIC PATHOLOGY: You need three components to
have disease --- the pathogen, the host, and the right environment.
Immunity, gut chemistry, and all that, are elements of the environment
that can impede the development of a given pathogen. That doesn't
change the pathogenicity of the critter.
An overwhelming percentage of the reduction in disease over the last
century is due to *prevention,* not cure. Chicago used to be a hot spot
for malaria and cholera. Vaccines, chlorination of water supplies,
pasteurisation of milk, more sanitary food handling, and good old
hand-washing have greatly reduced the incidence of disease,
particularly in children. Most of the rise in life expectency over the
last century is due to a reduction of child mortality rates, and most
of *that* is due to prevention, not cure.
Prevention, not treatment is the philosophical basis of sustainable
agriculture, is it not? Instead of pumping pasty-tailed calves full of
anti-biotics, you give the cows a clean, dry area in which to calve,
and you bed them up to their butts in the best straw you have. Maybe
you immunize with maternal challenge (E. coli, rota, and corona virus)
via the colostrum.
In the case of the Crohn's mycobacterium, one part of prevention is to
maintain a healthy immune system and a healthy gut. *Another* part of
prevention is pasteurisation. Since we're the host, prevention can only
focus on reducing the number of pathogens ingested (pasteurisation) and
on making the environment unfavourable to those MAP critters who do
make it in (probiotics). One form of prevention does not eliminate the
need for the other.
If there is a discontinuity of reason, it most likely arises in our
failure to apply the very sound logic of sustainable agriculture to
other aspects of our day to day lives. If you've got a damping off
problem in the greenhouse, you pasteurise your mix *and* you pay
attention to how and when you water. If there are problems with TB,
brucella, MAP, and other pathogens in the milk supply, you pasteurise
you milk *and* you pay attention to the health of immune systems and
gut chemistry.
Three of the sorriest examples of our failure to focus on prevention
(instead of cure) are lung cancer, obesity, and STDs. Effective
prevention of each of these is simple: don't smoke, don't eat too much,
and keep sex in a monogamous marriage. I said simple, not easy.
As much as I like raw milk (and I do drink it if I know the operation
very well), nobody has demonstrated that the (arguable) benefits
associated with raw milk come anywhere near outweighing the
considerable risks. Even without the discussion of Crohn's (because I
don't know what percentage of the population it affects), the
risk/benefit analysis of milk in commerce would seem overwhelmingly to
favour pasteurisation.
I would sure rather have pasteurised milk than have the kind of
intrusive and overbearing on-farm inspection regime that would be
required to accomplish (at vastly greater cost) the same thing.
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