My husband and I recently moved back from 2+ years living in Belgium.  My mom was absolutely convinced we would have babies over there, but my response – “no way, I like non-pasteurized cheese FAR too much”.  I just wasn’t quite ready to sacrifice the amazing experience of driving up to a random cheese farm in France and tasting their fare.

I certainly love my gooey, stinky, moldy cheese.

And this was, of course, another big concern when I got pregnant – none of my favorite cheeses for 9 months?

Here is what we are afraid of lurking soft cheeses:  a little bacteria called Listeria monocytogenes that causes listeriosis. And I am going to start this post by saying – listeriosis is a serious, SCARY infection to expose a developing fetus to.  A paper titled “Do We Really Need to Worry about Listeria in Newborn Infants?” by Oikike, Lamont, and Heath in The Pediatric Infectious Disease Journal  concluded with a strong yes.  Fatality risk is high and for babies that survive there is some evidence for long term disabilities.  So, yes, there is absolutely cause for concern.

But, back to the cheese.
Really, what are these odds that this nightmare bug is hanging out in the wheel of brie you just picked up from Whole Foods?

First of all, check the label.  It was probably pasteurized.  Pasteurization was designed to kill bugs and it does this very effectively.  So unless the cheese maker or the guy behind the cheese counter took a perfectly good piece of pasteurized cheese and slathered in in Listeria infected dirt, it is probably safe from bacteria.

To be safe – Stay away from unpasteurized cheese.  I know, this is not new. Every pregnant lady, her friends, acquaintances, and every other person who likes to offer pregnant women unsolicited health advice knows this tidbit.

But why the scare about ALL soft cheeses and blue cheeses and moldy rinded cheeses in the name of just-to-be-safe?

New scenario – a friend is hosting brunch and serving fresh goat cheese on a baguette with a dribble of honey.  It looks delicious.  Do you have to decline just-to-be-safe?

Let’s consider the odds that this cheese is actually carrying Listeria.

In the US, sale of raw milk and its products is pretty widely against the law.  California, along with 10 other states, does appear to allow retail of raw milk products but judging from the cheese available at my favorite cheese shop, even this legal status is limited. Check in on your state here: http://www.farmtoconsumer.org/raw_milk_map.htm#.

Ok, so I’m in California, land of limited cheese governance, do I have to be concerned?

In that previously mentioned article by Oikike et al., the authors openly admit that neonatal listeriosis is rare:  1.3/100,000 in the Netherlands, 5/100,000 in the UK, and 8.6/100,000 in the US.   See something strange, though?  The US, land of pasteurized cheese, has the highest low rate of infection where the Netherlands, a country that has absolutely no problem selling non-pasteurized cheese, is far behind.

Let’s focus on France, where it can be illegal to pasteurize cheese (as in the case of Roquefort) and the citizens and fromagers generally think Americans are silly when it comes to our fear of raw milk cheese.  In a 2012 paper, published in Clinical Infectious Diseases, Goulet and colleagues surveyed the incidence of neonatal listeriosis from 2001-2008 in France.   During this time, the rate of infection in pregnant women was 5.6/100,000 (still behind the US!).  Yes, the authors note that pregnant women should avoid “specific at-risk foods” but they mostly point fingers at prepared foods, smoked fish, etc.; absolutely no mention of non-pasteurized cheese.  Again, this is in France.

Focusing on the US, a 2012 paper by Langer and colleagues in Emerging Infectious Diseases titled “Nonpasteurized Dairy Product, Disease Outbreaks, and State Laws – United States, 1993-2006”, mined 13 years of CDC outbreak data.  Their goal: to demonstrate that non-pasteurized dairy products are dangerous to our health. From this 13 year data set, a whopping total of 73 disease outbreaks were directly attributed to non-pasteurized milk products.  Of these, 3, yes, 3, were from Listeria.  And this number is not cheese specific.

Quick mental math:  it appears that the risk of neonatal listeriosis is insanely low.
And those 8.6/100,000 cases of neonatal listeriosis in the US?  most likely, not cheese related.

That goat cheese at brunch?  Safer than leaving your house in the morning to get to brunch.

Advice to myself, I am going to continue to pass on the bologna and smoked salmon, but I will not hesitate to dig into a gooey, stinky block of slightly aged goat cheese that I love so much.

My recommendation?  Try to find yourself some Bonne Bouche from Vermont Creamery…

 don’t worry, its pasteurized.