美国儿科学会更新生奶指南：近半数生奶相关患病者不满20岁，呼吁禁售生奶及生奶制品
美国儿科学会（AAP）在11月刊出的《儿科》期刊上发表更新版政策声明，重申其长期立场：应禁止销售与分发生牛奶及生奶制品，包括生奶奶酪，孕妇与儿童尤其不应食用未经巴氏杀菌的奶制品。这份声明已于10月5日先行在线发表，属于面向家长与儿科医生的服务型指南，并非当日新发事件。
声明列举了生奶可能携带的病原体：弯曲杆菌、沙门氏菌、产志贺毒素大肠杆菌、隐孢子虫与单核细胞增生李斯特菌等，其中产志贺毒素大肠杆菌 O157:H7 可引发溶血性尿毒综合征，患者多为幼儿。声明援引的数据显示，2013年至2018年，美国共报告75起与生奶有关的疫情、675例患病、98例住院与2例死亡；生奶相关患病者中48%不满20岁，14%不满5岁。
更新版声明新增了高致病性禽流感的内容：2024年奶牛疫情期间，受影响地区约四分之一的生奶样本中检出有传染性的 H5N1 病毒；不过截至目前，尚未有因饮用生奶而感染该病毒的确诊人间病例。声明第一作者、纽约大学格罗斯曼医学院儿科副教授 Adam J. Ratner 表示，近半数生奶相关患病者是20岁以下人群，其中许多是尚不能为自己做饮食决定的低龄儿童。
按美国食品药品管理局（FDA）的规定，生奶不得跨州销售，陈化至少60天的生奶奶酪为例外；目前至少27个州允许某种形式的生奶销售。声明共同作者 Mark R. Corkins 表示，巴氏杀菌奶制品能提供同样的营养而没有这些风险；对网上流传的生奶保健说法，声明指出并无证据支持。家长为孩子选购奶制品时，可认准包装上的巴氏杀菌标识。
AAP Updates Raw Milk Guidance: Nearly Half of Raw-Dairy Illnesses Strike People Under 20; Academy Urges a Sales Ban
The American Academy of Pediatrics (AAP) has published an updated policy statement in the November issue of Pediatrics, renewing its long-standing position that the sale and distribution of unpasteurized (raw) milk and raw dairy products, including raw cheese, should be banned, and that pregnant people and children in particular should not consume them. The statement was first published online on October 5; it is service guidance for parents and pediatricians rather than a breaking event.
The statement lists pathogens that raw milk can carry: Campylobacter, Salmonella, Shiga toxin-producing E. coli, Cryptosporidium, and Listeria monocytogenes, among others. Shiga toxin-producing E. coli O157:H7 can cause hemolytic-uremic syndrome, which occurs mostly in young children. Citing federal data, the statement notes that from 2013 to 2018 the United States recorded 75 raw-milk outbreaks, 675 illnesses, 98 hospitalizations, and 2 deaths; 48 percent of raw-dairy illnesses occurred in people younger than 20, and 14 percent in children younger than 5.
The updated statement adds new material on highly pathogenic avian influenza: during the 2024 dairy cattle outbreak, infectious H5N1 virus was found in roughly a quarter of raw milk samples in affected areas, though to date there have been no confirmed human cases from drinking raw milk. Lead author Adam J. Ratner, an associate professor of pediatrics at NYU Grossman School of Medicine, noted that nearly half of raw-dairy illnesses strike people under 20, many of them young children who cannot make their own food decisions.
Under U.S. Food and Drug Administration rules, raw milk may not be shipped across state lines, with an exception for raw cheese aged at least 60 days; at least 27 states allow some form of raw milk sales. Co-author Mark R. Corkins said pasteurized products provide the same nutrients without the risk, and the statement notes that claimed health benefits of raw milk are not supported by evidence. Parents can look for the pasteurization label when choosing dairy products for their children.
来源：美国儿科学会
发布：GSM·美国（发布链接）
图片来源：奶牛场挤奶场景（资料图），CC BY 2.0，经 Wikimedia Commons
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