Raw Sprouts, Raw Milk and Undercooked Foods: Risks for Higher-Risk Groups

Who the warnings are for

Most healthy adults recover from food poisoning within days. The FDA says children, older adults, pregnant women and people with weakened immune systems, such as transplant patients and people with HIV/AIDS, cancer or diabetes, can be especially vulnerable to foodborne illness. [1] The foods below are the ones US and UK health bodies single out. This page gives their warnings, not a recipe for making these foods safer at home. See pasteurized vs unpasteurized foods and food storage and leftovers for everyday food safety.

If you are pregnant, or someone in your household is, and you feel unwell after eating one of these foods, contact a healthcare professional. The FDA says to see one immediately if you think you may have eaten contaminated raw milk or cheese in pregnancy. [2]

Raw sprouts

The FDA explains that sprouts such as alfalfa or mung bean are grown from seeds and beans in warm, humid conditions that are also ideal for Salmonella, Listeria and E. coli. If a few bacteria are on the seed, they can reach high levels during sprouting, even when sprouts are grown at home under clean conditions. [1] Its advice: people who are more vulnerable should avoid raw or lightly cooked sprouts of any kind, including onion, alfalfa, clover, radish and mung bean sprouts. [1] The FDA also says cooking produce thoroughly kills harmful bacteria. [1] Sprouts are not grouped here with other vegetables: the concern is how they are grown, not the nutrients.

Raw milk and raw-milk products

Raw milk is milk from cows, sheep, goats or other animals that has not been pasteurized to kill harmful germs. The FDA says it can carry Salmonella, E. coli, Listeria and Campylobacter. [2] It cites CDC data of 202 outbreaks linked to raw milk from 1998 through 2018, with 2,645 illnesses and 228 hospitalizations. [2] The FDA states that raw milk marketed for pets is not safe for people, and that pasteurization does not reduce milk's nutritional value. [2] It lists unpasteurized soft and hard cheeses, queso fresco-type cheeses, and yogurt, pudding and ice cream made from unpasteurized milk as high-risk choices. [2]

MedlinePlus says listeriosis is most likely to affect pregnant women and unborn babies, older adults and people with weak immune systems, and that Listeria can grow even at refrigerator temperatures. [3] The FDA adds that in pregnancy Listeria can cause miscarriage, illness or death of the newborn, even if the mother does not feel sick. [2] The NHS says listeriosis can cause miscarriage or stillbirth and advises avoiding unpasteurised milk, cream, yoghurt, butter and ice cream in pregnancy. [4]

The FDA page lists common beliefs about raw milk, such as that pasteurization harms milk or that raw milk is a safer, healthier alternative, and rebuts them. [2] Proper evidence not found, in the pages we read, for a health advantage of raw milk.

Untreated juice

Fresh-squeezed juice and cider can carry bacteria from the produce unless the produce or juice has been pasteurized or otherwise treated. The FDA says untreated packaged juice must carry a warning label, but juice sold by the glass, for example at juice bars or farmers' markets, does not need one. [5]

Undercooked eggs and meat

The FDA says homemade ice cream causes serious Salmonella outbreaks each year because of raw or undercooked eggs, and tells readers to cook eggs until the yolk and white are firm. [2] The NHS lists raw or undercooked meat, raw fish and shellfish, and some cured meats among foods to avoid or heat thoroughly in pregnancy because of toxoplasmosis, listeria or food poisoning risk. [4] Fermented foods are a separate topic: see fermented foods safety.

Summary table

What a reader can do

Check labels for the word "pasteurized," ask sellers, and talk with your doctor or midwife about your own situation. [2] Symptoms the FDA lists are vomiting, diarrhea, abdominal pain, and flu-like symptoms; illness can start within 20 minutes or up to 6 weeks later. [1]