The Italian Ministry of Health (Ministero della Salute) has issued a guidance document covering the control of Shiga toxin-producing E. coli (STEC) in raw milk and raw milk products.
The document was sent to Italian regions, the provinces of Trento and Bolzano, and major trade associations. It is the result of work by a technical committee, which featured experts from the Ministry of Health, Istituto Superiore di Sanità (ISS), and trade associations.
The aim is to define more stringent measures to ensure food safety and reduce the risk of serious E. coli infections associated with the consumption of unpasteurized, raw milk and dairy products. STEC infections can be mild but can sometimes lead to hemolytic uremic syndrome (HUS). HUS is a clinical syndrome related to E. coli, which can lead to kidney failure and death.
Data from the Italian Hemolytic Uremic Syndrome Registry, operated by the Italian Society of Pediatric Nephrology and ISS, shows there were 57 HUS cases in 2024.
The guidance document provides practical support for supply chain operators during self-monitoring, and for local health authorities involved in surveillance and official controls, to ensure effective management of STEC risk.
At the primary production level, the guide suggests fortnightly or monthly monitoring for the presence of STEC on the farm through milk analysis, in-depth training on milking hygiene, and maintaining the cold chain for fresh milk to prevent microbial growth.
At production and distribution level, the guide recommends labeling and consumer information, so people are aware of the nature and risk associated with the product they are buying. It also covers testing and management of non-compliant products.
“These guidelines are a fundamental technical and scientific tool for strengthening the prevention of STEC infections. We offer the regions an updated, shared, and operational document, with the aim of protecting especially the most vulnerable: children, the elderly, and immuno-compromised individuals,” said Marcello Gemmato.
Negative reaction
Carlo Petrini, founder of Slow Food, said: “It would be truly paradoxical if, while today American cheesemakers — thanks in part to Slow Food’s awareness-raising efforts — can produce raw milk cheeses, we apply new guidelines that effectively prevent the production of our dairy gems. The risk is that foreign raw milk cheeses would arrive on our markets, leaving us left behind, damaging our economy. We must learn from the French in this regard. They would never allow their raw milk cheeses to be put at risk.”
In September 2025, Cheese, organized by Slow Food and the city of Bra with the support of the Piedmont region, will continue to discuss protecting producers while ensuring public health. The event will include the opportunity to learn about and taste thousands of raw milk cheeses over four days.
The Italian Rural Association (Associazione Rurale Italiana) said if the guidelines were implemented in practice, it would spell the end of raw milk production and the closure of hundreds of artisanal and farmer-based dairies.
The group said the document reiterates already generally established practices but also imposes costly analyses and control practices that are unsustainable for small dairies. Overall, it leads to the forced obligation to pasteurize milk to avoid any health risks, according to the group.
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