At the beginning of August the news arrived of the death of Mattia Maestri, a boy who in 2017, at just four years old, had eaten a raw milk cheese contaminated by Escherichia coli and who since then, due to the haemolytic-uremic syndrome triggered by the infection, had been living in a permanent vegetative state: it was his father who announced his passing, after nine years in which the family never stopped caring for him. A story that dramatically brings an often underestimated risk back to current events, and which comes just as the Ministry of Health has released guidelines on the control of STEC, the Shiga-toxin-producing Escherichia coli, in unpasteurized milk and its derivatives. The document, developed together with MASAF, the National Institute of Health and Zooprophylactic Institutes, does not aim to demonize a category of products that includes many traditional Italian dairy products, but to make prevention more solid along the entire supply chain, from breeding to the table.
What are STEC and why do they worry especially the little ones
STEC are strains of Escherichia coli capable of producing toxins which, while not making the ruminants that host them in the intestine ill, can accidentally contaminate milk during milking. In humans, the infection ranges from a mild course, with cramps and diarrhea, to more severe forms that can result in hemolytic-uremic syndrome, a complication capable of affecting the kidneys and nervous system and which is particularly feared in pediatric age. The data from the Italian HUS Registry relating to 2025 speak of just over forty reported cases, almost all attributable to a STEC infection and concentrated in patients up to fifteen years of age, although it should be remembered that these bacteria can also arrive from other foods, from water or from contact with animals, and not just from dairy products.
Raw milk and unpasteurized milk are not synonymous
The guidelines introduce a distinction that often escapes the consumer: according to European legislation, raw milk is milk that has never been heated above forty degrees, while there are intermediate heat treatments, such as thermisation, which do not guarantee the same level of microbiological safety as actual pasteurization. For this reason, the ministerial document thinks in broader terms about unpasteurized milk, shifting attention from a generic label to the question that really matters, i.e. whether the treatment undergone by the product was sufficient to inactivate the pathogens.
What changes for breeders and dairies
The guiding principle is that safety cannot depend only on the analysis of the finished product, but must be built step by step along the entire supply chain, from milking to processing up to conservation and communication to those who purchase. Companies are asked to strengthen self-control and conduct a specific STEC risk assessment when processing unpasteurized milk, while local health authorities and other health authorities have the task of making supervision more uniform across the territory.
The rule of thumb for those who buy raw milk from the distributor
For consumers, the message remains rather simple: raw milk sold for direct consumption should only be drunk after boiling, an indication that must appear on the label and in points of sale and which also applies when the product is served on a farm. It is a precaution that takes a few minutes but which, the guidelines explain, substantially reduces the risk of infection.
Children, pregnant women and fragile people deserve extra attention
The overall risk remains limited, but grows significantly in the most vulnerable subjects, among whom the Ministry explicitly includes children, the elderly, pregnant women and people with compromised immune defenses. Several paediatricians, consulted in the past about news cases linked to haemolytic-uremic syndrome, have advised parents to avoid cheeses made from raw milk that have not undergone long maturation, indicatively at least nine-twelve months, precisely because prolonged maturation reduces the bacterial load more effectively than short storage. For cheeses, however, the mere wording raw milk is not enough to define the level of risk, since the production process and the control measures adopted by the individual dairy also count.
Does pasteurizing really cause you to lose nutrients?
One of the most widespread beliefs is that raw milk is significantly more nutritious than pasteurized milk: the ministerial FAQs revise this idea, clarifying that heat treatment involves at most a slight reduction in some vitamins, a minimal cost when compared with the benefit obtained in terms of microbiological safety. The final message, rather than a ban, is therefore an invitation to conscious risk management: traditional productions can continue to exist alongside food safety, as long as the supply chain remains under control and that those who purchase have clear information available, starting from the habit, which is anything but obvious, of boiling raw milk before drinking it.
