CASE REPORT. Hygienic characteristics and microbiological hazard identification in horse and donkey raw milk

Transcription

1 CASE REPORT Hygienic chrcteristics nd microbiologicl hzrd identifiction in horse nd donkey rw milk Gimpolo Colvit 1*, Crmel Amdoro 1, Frnc Rossi 1, Frncesco Fntuz 3 & Elisbett Slimei 2 1 Diprtimento di Medicin e Scienze per l Slute, Università degli Studi del Molise, Vi de Snctis SNC, Cmpobsso, Itly. 2 Diprtimento di Agricoltur, Ambiente ed Alimenti, Università degli Studi del Molise, Vi de Snctis SNC, Cmpobsso, Itly. 3 Diprtimento di Bioscienze e Medicin Veterinri, Vi Gentile III d Vrno, Cmerino (MC), Itly. * Corresponding uthor t: Università degli Studi del Molise, Diprtimento di Medicin e Scienze dell Slute, Vi De Snctis SNC, Cmpobsso, Itly. Tel.: , Fx: , e mil: colvit@unimol.it. Accepted: Avilble on line: Keywords Hzrds, Helth, Horse nd donkey milk, Hygiene, Pthogens, Risk ssessment. Summry Tody the interest towrd horse (Equus cbllus) nd donkey (Equus sinus) milk for humn consumption is receiving renewed ttention becuse of its prticulr composition, hypollergenicity, nd nutrceuticl properties. The relistic perspective of globl use of this liment in blnced diets, especilly for infncy nd geritrics, poses the need for more in depth knowledge on milk hygiene nd on the helth sttus of diry nimls, s prerequisite of consumers sfety. The im of this pper ws to review the vilble literture on the helth nd hygiene prmeters s well s on the potentil microbiologicl hzrds in horse nd donkey milk nd the risks relted to their consumption. Both microbil contmintion nd somtic cell count re resonbly low in equine milk nd lso the presence of pthogens, like Escherichi coli O157, Slmonell spp., Cmpylobcter spp., Yersini enterocolitic, Brucell spp., Mycobcterium spp., Bcillus cereus, Cronobcter skzkii, Streptococcus equi subsp. zooepidemicus, Rhodococcus equi, Streptococcus dysglctie subsp. equisimilis, Clostridium difficile nd Burkholderi mllei is low. However, in those regions of the world where the prevlence of Brucell spp. nd Rhodococcus equi is high, the limentry risks could increse. Similrly, in res with higher incidence of immunocompromised people, the incresed risks should be wrned not only for pthogens but lso for opportunistic microbiot. Crtteristiche igienico snitrie ed identificzione dei rischi microbiologici nel ltte di cvll e di sin Prole chive Igiene, Ltte equino e sinino, Ptogeni, Pericoli, Slute, Vlutzione del rischio. Rissunto In questi ultimi nni il ltte di cvll (Equus cbllus) e il ltte di sin (Equus sinus) hnno ftto registrre un rinnovto interesse si per l loro prticolre composizione si per le proprietà ipollergeniche e nutrceutiche. L rele prospettiv per un diffusione globle di questo limento innovtivo, specilmente nell mbito dell limentzione per i lttnti e gli nzini, richiede un più pprofondit conoscenz dei pre requisiti di sicurezz. Lo scopo di quest review è stto quello di esminre i dti disponibili in lettertur circ i prmetri igienico snitri e i potenzili pericoli microbiologici che possono riscontrrsi nel ltte di cvll e di sin e dei rischi connessi l consumo. Di dti disponibili risult che l contminzione microbic e il numero delle cellule somtiche del ltte sono rgionevolmente bssi e così pure l presenz di microrgnismi ptogeni, in prticolre Escherichi coli O157, Slmonell spp., Cmpylobcter spp., Yersini enterocolitic, Brucell spp., Mycobcterium spp., Bcillus cereus, Cronobcter skzkii, Streptococcus equi subsp. zooepidemicus, Rhodococcus equi, Streptococcus dysglctie subsp. equisimilis, Clostridium difficile e Burkholderi mllei. Tuttvi, il livello di rischio limentre potrebbe essere elevto in quelle regioni dove l prevlenz di Brucell spp. e di Rhodococcus equi è elevt. Inoltre, nelle ree con più lt presenz di persone immunocompromesse, un mggior livello di rischio è riconducibile non solo gli genti ptogeni, m nche quelli opportunisti. 21

2 Hzrd nd chrcteristics of horse nd donkey milk Colvit et l. Introduction During the pst few yers the Europen scientific community hs incresingly devoted more ttention to the nlysis of horse (Equus cbllus) nd donkey (Equus sinus) milk, minly owing to both pltbility nd ttrctive nutrient nd functionl components tht mke it suitble to be used s n lterntive food in the diet of infnts with Ig E medited cow s milk protein llergy (Businco et l. 2000, Monti et l. 2007). Moreover, donkey milk cn be considered n vluble food lso for elderly consumers, due to its immunonutrient components (Slimei & Fntuz 2012). Equine milk is rich in lctose ( g/kg milk), ω 3 ( % totl ftty cids), nd ω 6 polyunsturted ftty cids ( % totl ftty cids) (Pvlik et l. 2004). The mcro minerl (clcium, potssium, phosphorus, mgnesium) content is reported to be higher thn in humn milk, but lower thn in ruminnt milk; while sodium s well s zinc nd mngnese contents, re reported to be similr to humn milk (Fntuz et l. 2012, Fntuz et l. 2013). Lysozyme content in horse nd donkey milk results to be high (men vlue 600 4,000 mg/l) if compred to bovine (trces), cprine (trces), nd humn milk (Slimei et l. 2004, Guo et l. 2007, Unicke Lowe et l. 2010). Lysozyme, together with other fctors, including immunoglobulins, lctoferrin, nd lctoperoxidse, my function in the infnt s digestive trct by reducing the incidence of gstro intestinl infections nd promoting proper helthy growth (Monti et l. 2007). The high lysozyme content, s reveled by previous studies, my contribute to the low bcteril concentrtion of properly milked equine milk (Slimei & Fntuz 2012). Also lctoferrin (verge content g/kg milk) is reported to hve ntimicrobil ctivity, mong its possible functions, consistent with its digestibility (Unicke Lowe et l. 2010, Tidon et l. 2011). It is worth noting tht worldwide equine popultions ccount for bout 112 million heds, including 9% of mules. Horse nd donkey popultions re differently distributed mong continents, rnging from 25 39% reported in Afric, Asi, nd Americs to 6.3% in Europe nd 0.4% Oceni (FAOSTAT ). Donkey world popultion is estimted to be of 44 million, of which 40 million (96.4%) in the developing countries. Donkeys represent bout 73% of Afric s totl equine popultion, while they ccount for 49.0%, 15.2%, 8.2%, 2.2% in Asi, Americs, Europe, nd Oceni, respectively (FAOSTAT 2013). Equine milk nd met re trditionlly consumed in mny res of the World s dietry source of vluble proteins (Blench 2000, Benítez 2011), lthough culturl nd technologicl constrins my limit their use. In Europe, the diry donkey enterprise is developing in reltively few frms. One of the lrgest herds of diry donkeys is locted in Centrl Itly, with bout 700 heds in single frm. It is well known tht milk for humn consumption needs to be chrcterised by low microbil contmintion nd by low somtic cell count. Milk my in fct represent microbiologicl risk especilly when consumed rw. On this regrd, the recent literture highlights cses of infections in humns s relted to the consumption of rw milk from ruminnts nd cused by Escherichi coli O157, Cmpylobcter spp., Slmonell spp., nd other pthogens or potentil pthogen microorgnisms (Cleys et l. 2013). The im of this rticle is to review the vilble literture on hygienic nd sfety chrcteristics of equine milk. A descriptive nlysis of the min nd potentil microbiologicl hzrds nd their risk is therefore reported. Hygiene nd helth prmeters of horse nd donkey milk The limited dt vilble in literture on horse nd donkey milk show firly vrible levels of totl microbil count (TMC) ( log CFU/ml) (Figure 1). According to Šrić nd collegues (Šrić et l. 2012), breed nd other niml fctors, s well s interctivity of lysozyme nd lctoferrin, my ffect the ntimicrobil properties of equine rw milk but more in depth detils re lcking t the moment. Studies crried out in Sicily (Itly) reported vlues of TMC between 4.15 nd 5.63 log CFU/ml. Moreover, Enterobctericee ( log CFU/ml) nd pthogens, or potentilly pthogenic microorgnisms such s Stphylococcus ureus, Stphylococcus intermedius, Stphylococcus epidermidis, Streptococcus dysglctie nd Cronobcter skzkii (formerly Authors Srno et l. (2012) Colvit et l. (2010) Slimei & Fntuz (2012) Dnków et l. (2006) Mrkiewicz-Keszyck et l. (2013) 0 Log CFU/ml b b 1 FAOSTAT, FAO Sttistic Division. Avilble t Figure 1. Totl Microbil Count of donkey milk ccording to literture (men vlues). = Horse milk; b = Donkey milk. 22

3 Colvit et l. Hzrd nd chrcteristics of horse nd donkey milk Enterobcter skzkii), hve been isolted in rw donkey milk (Conte et l. 2007). During 2 yer study, 39 smples of bulk milk produced by 10 Mrtin Frnc donkeys were evluted for hygiene nd helth prmeters. The vlue of the TMC t 30 C ws 4.7 (± 0.73 s.d.) log CFU/ ml nd Escherichi coli ws isolted in only 2 smples (2 log CFU/ml), while totl coliforms showed counts rnging between less thn 1.00 nd 6.57 log CFU/ ml. These dt were strongly influenced by the vlues of 2 smples collected from refrigerted tnk, which hd not been clened nd snitized properly, s verified lter. This cse underlined tht, when hygiene is neglected, the level of microbil contmintion cn rech very high vlues in donkey milk. Pthogens, such s Listeri monocytogenes nd Slmonell spp., hve never been detected, yet; Listeri spp. were detected by polymerse chin rection (PCR). This highlighted the importnce of hygiene of both equipments nd environment (Colvit et l. 2010). The wholesomeness of milk strictly depends on the mmmry glnd helth. The vlues of Somtic Count Cells (SCC) rnged from 3.86 to 4.66 log/ml in one study (Conte et l. 2007), nd 4.37 (± 0.32 s.d.) log/ ml in nother study (Colvit et l. 2010) (Figure 2). In study on milk prmeters over n entire lcttion of jennies rised s compnion nimls, Pill et collegues (Pill et l. 2010) noted SCC content consistent with vlues observed in diry jennies (Beghelli et l. 2009, Colvit et l. 2010, b). However, the number of SCC cn be influenced by the milking intervls, s it remins lmost unchnged for milking intervls of 3 nd 5 hours but it increses t longer intervl (D Alessndro et l. 2009). It is importnt to note tht horse nd donkey need to be seprted from the fol t lest 3 hours before mechnicl or mnul milking. For this reson, dt on donkey milk production re frequently expressed per milking session, i.e. from fol seprtion until donkeys leve the milking prlour (Slimei nd Fntuz 2012). The low levels of SCC indicte n Authors Srno et l. (2012) Colvit et l. (2010) Slimei & Fntuz (2012) Dnków et l. (2006) Mrkiewicz-Keszyck et l. (2013) Log SCC/ml Figure 2. Somtic cell counts (SCC) of donkey milk (men vlues) reported in literture. = Horse milk; b = Donkey milk. b b overll helthy sttus of mmmry glnd in the diry equine where mstitis is less frequent thn in the diry cow (Svendsen 1997). This phenomenon is prtly due to both the smll volume of the mmmry glnd (mx l) nd its protected position so tht tets re less exposed to trums nd infections. In ddition, the mmmry glnd cistern hs limited cpcity so tht its emptying is gurnteed by fol suckling, when dms re not milked. Nonetheless, mngement of milking cn ffect the udder helth. Clinicl forms re often the result of trumtic lesions of tets cused by suckling or milking. The prevlence of mstitis in donkeys is not known, with vilble dt referring to mres: out of 100 lctting horses exmined by Brtmnn nd collegues (Brtmnn et l. 1996), mstitis ws dignosed in 21 subjects. Although there re no dt on the incidence of subclinicl mstitis, these re considered more common thn clinicl mstitis. Perkins nd Threlfll (Perkins nd Threlfll 2002) reported Streptococcus equi subsp. zooepidemicus (32%), Stphylococcus spp. (15%), nd Actinobcillus spp. (8.1%) s the min gents of mstitis in horses. Cses of purulent mstitis cused primrily by streptococci nd stphylococci hve been reported in mres, glnders mstitis hs rrely been reported, s well s mstites cused by Mycobcterium vium (Pvlik et l. 2004, Ryhner et l. 2009). In generl, vlues of SCC/ml milk greter thn 100,000 re considered pthologicl nd index of mstitis. It is frequently possible to isolte Streptococcus equi subsp. zooepidemicus from mre udders, but pthogens my lso be present in milk from helthy udders (Bohem et l. 2009). As Kocbiyik nd collegues (Kocbiyik et l. 2008) reported, out of 28 mres ffected by mstitis, S. equi subsp. zooepidemicus ws isolted in 37% of cses. Anlysis of microbiologicl hzrds in horse nd donkey milk Since the dt re currently scrce nd frgmentry, it is not possible to pproch properly the ssessment of microbiologicl hzrds ssocited with the consumption of equine milk. For this reson, in this context only descriptive nlysis of the ctul nd potentil microbiologicl hzrds nd their risk is provided by considering both common risks with rw cow milk nd specific ones for equids. Escherichi coli O157 group nd Slmonell spp. With regrd to microorgnisms of the E. coli O157 group, the cow is considered the min reservoir, while 23

4 Hzrd nd chrcteristics of horse nd donkey milk Colvit et l. other species my serve s secondry reservoir to humns, especilly fter contct with ruminnts. The few dt vilble in literture show tht the prevlence of E. coli O157 in horses is low. During study conducted on 242 fecl smples of horses, the germ ws isolted only in 1 subject (0.4%), which ws frmed in promiscuity with cttle (Lengcher et l. 2010). In some epidemiologicl cses, mixed frming cn represent risk fctor, s evidenced by survey in Englnd nd Wles, in which E. coli O157 ws sought in the feces of nimls in some free stlls. The germ ws found in 29% of the feces smples of 365 cttle, in the 24% of the feces smples from 426 sheep, in the 14.6% nd 12.3% of the feces smples of 26 donkeys nd 85 horses, respectively (Pritchrd et l. 2009). In Germny, out of 400 smples of horse feces, only in 1 cse strin of E. coli STEC belonging to serotype O113:H21 ws identified by PCR, wheres ll smples were negtive for Slmonell enteric (Pichner et l. 2005). Like other enteric pthogens, Slmonell spp. my contminte the milk from fecl mteril during nd fter milking, lthough there re no reported cses of slmonellosis from consumption of equine rw milk so fr (de Jger 2009). In studies crried out t slughter on smples of feces from horses coming from different Europen countries, Slmonell spp. ws isolted in only 1.43% cses. However, this result my be misrepresented by the intermittent elimintion of germs in the feces (Colvit et l. 2010b). Cmpylobcter spp. nd Yersini enterocolitic Cmpylobcter spp. nd Yersini enterocolitic were found with low frequency in horse feces (Browning et l. 1991). However, out of 100 smples of horse muscles from nimls slughtered in Piedmont (Itly), thermo tolernt Cmpylobcter spp. were isolted in 3% cses. Outbreks of cmpylobcteriosis cused by diry products re most commonly ssocited with drinking unpsteurized milk. The infective dose of these bcteri is generlly low. In Europen Union, the occurrence of Cmpylobcter rnges between 0% nd 2.7% in rw milk nd from 2.4% to 4.1% in cheese (EFSA 2012). Moreover, Yersini enterocolitic serotype O:5 ws isolted in 9% of cses (Ercolini et l. 1997). Regrding the presence of these pthogens in milk, only dt on cow s milk re vilble. In the sme region of Itly on 30 smples of rw cow s milk, Y. enterocolitic ws isolted in 4 cses (Frnzin et l. 1984), while in Sicily it ws detected in 8 smples of rw cow's milk out of 316 tested (Aiello et l. 1985). Yersini enterocolitic ws found in 5% smples of bovine rw milk on 111 collected smples in Argentin (Mercdo nd Ibñez 1986). It is estimted tht Y. enterocolitic is responsible for 2% of ll infectious enteritis ffecting children (Bottone 1999). Brucellosis In Europe, equine brucellosis is rre. Although there hve been cses of infections by Brucell suis nd Brucell bortus with rre episodes of bortion in the mre, nd 2 cses of equine brucellosis cused by B. suis biovr 3 hve been recently reported (Cvetnic et l. 2005). The infection cn cuse minly suppurtive spinous bursitis nd fistulizing. Brucellosis in horses hs prevlence of 5.8% in Egypt (donkey 7.3%), of 12.8% in Indi, nd of 5.8% in Pkistn (Gul nd Khn 2007). On popultion of 346 horses nd 28 donkeys, exmined in Afric, 4.9% horses (17 subjects) nd 3.6% donkeys (1 niml) were positive for brucellosis (Mus 2004). Moreover, on bout 412 donkeys exmined with seropositivity, prevlence of 2.1%. B. bortus ws reported (Elslm Abdll et l. 2010). Another sero epidemiologicl survey crried out in Middle Est reported tht sero prevlence for Brucell spp. ws of 1% nd 8.5% in horses nd donkeys, respectively (Abo Shehd 2009). Mycobcteriosis Tuberculosis in horses is extremely rre, but when it occurs it is often cused by Mycobcterium vium subsp. vium (gent of vin tuberculosis). Very spordiclly both Mycobcterium tuberculosis nd Mycobcterium bovis re the etiologicl cuse of equine tuberculosis (Keck et l. 2010, Monrel et l. 2011). As lso observed for Rhodococcus equi, the risk of trnsmission of tuberculosis infection from horses to humns cn be considered very low, except for immunocompromised ptients who re prticulrly susceptible to mycobcteril infection (Pvlik et l. 2004). Bcillus cereus Bcillus cereus cuses 2 types of gstrointestinl disorders (dirrheic nd emetic). The orgnism is ubiquitous in nture, nd s consequence, it is present in feedstuffs nd contmintes rw milk from feces, soil, nd during processing. Its het stble spores survive to the psteuriztion process. Severl reports hve shown tht it cn proliferte rpidly in milk, depending on storge temperture, nd some uthors indicted the relese of enterotoxin in milk (Notermns et l. 2009). The contmintion 24

5 Colvit et l. Hzrd nd chrcteristics of horse nd donkey milk of bovine milk by B. cereus is very common. Sctss nd collegues (Sctss et l. 2009) hve isolted B. cereus t 3 log CFU/ml in smples of donkey milk. In the Netherlnds, de Jger (de Jger 2009) nlysed milk from 12 horse frms nd found the orgnism in 2 smples, with counts rnging from 40 to 120 CFU/ml. Cronobcter skzkii About neontl Cronobcter infections hve been described s frequently ssocited with immunodeficiency syndrome in bbies minly fed with contminted infnt formul milk. Moreover, FAO/WHO cited cses of colonistion nd infection with Cronobcter spp. in the elderly popultion. Microbiologicl criteri for food nd process hygiene, relevnt for the Europen Union, consider Cronobcter spp. s possible risk fctor in powdered infnt formul nd dried dietry foods for specil medicl purposes for infnts of less thn 6 months of ge (Friedemnn 2009). The pthogen ws found in 2 smples of donkey milk (Conte 2007). However, the ingestion of low numbers of this micro orgnism by helthy infnts nd children does not led to illness (EFSA 2004). Streptococcus equi subsp. zooepidemicus Humn infection by Streptococcus equi subsp. zooepidemicus is known zoonosis, primrily in ptients who consume milk or rw milk products (Brnhm et l. 1989). There re numerous reported cses of illness, often severe (septicemi, meningitis, bscess, fever), from the consumption of cow or got rw milk. An episode cused by the consumption of unpsteurized cow's milk hs been described in Englnd, in which 11 people were ffected nd 7 died (Edwrds et l. 1998). A cse of streptococcl toxic shock syndrome (STSS) involving womn suffering from meningitis cused by S. equi subsp. zooepidemicus nd referble to the consumption of rw milk from mre hs been reported in Jpn (Hshikw et l. 2004). Rhodococcus equi Rhodococcus equi cuses pneumoni nd enteritis with high mortlity rte in fols of 1 3 months. Isolted for the first time in 1923, it ws nmed Corynebcterium equi. Rhodococcus equi is considered n importnt emerging pthogen in immunocompromised individuls, prticulrly if ffected by Acquired Immune Deficiency Syndrome (AIDS), in which it plys the role of opportunistic pthogen, with high mortlity rte. Erdiction is difficult since it is trnsmitted by inhltion, through skin nd tissues lesions s well s by food (Kedly et l. 2001). It lives nd prolifertes in soils rich in orgnic mtter nd it hs been isolted from feces of cttle, sheep, gots, pigs, nd wild birds but, most frequently, from horse feces (Tki et l. 1991). In fols it cn be found t 3 4 log CFU/g, wheres in dults the counts re much lower. Thus, the fols re the true responsible for the mintennce of contmintion t the frm level. In pigs nd cttle, R. equi cn cuse injury, prticulrly t the level of the submxillry lymph nodes, with some difficulty in the differentil dignosis with tuberculosis (Mrcto 2008). In other species, lbeit rrely, R. equi cn give pyometr, mstitis, nd purulent injuries (Cttbini 2003); R. equi ws lso isolted from mmmry qurters (13.7%) of diry buffloes (Bonini et l. 2007). The contmintion of milk my be cused by environmentl contmintion or during suckling of the fol. While being dnger frequently present in some epidemiologicl conditions, the risk should be considered higher for immunocompromised consumers. Streptococcus dysglctie subsp. equisimilis Streptococcus dysglctie subsp. equisimilis comprises β hemolytic streptococci belonging to the Lncefield group C. In humns, these colonize the phrynx, skin, gstrointestinl trct, nd femle genitourinry trct. This species cuses severe pneumoni, septicemi, endocrditis, nd toxic shock syndrome. In horses, S. equisimilis is generlly considered infrequent or opportunistic, but it hs recently been isolted from cses of strngles like disese from borted plcents nd bscessed lymph nodes, suggesting possible pthogenic role (Preziuso et l. 2010, Rntl et l. 2010). Clostridium difficile Clostridium difficile is spore forming Grm positive, it produces toxins A nd B, which cuse gstroenteritis in humns with severe complictions. It frequently develops resistnce to ntibiotics nd cuses outbreks of nosocomil nd community infections. It is ssumed tht liments re possible source of contmintion, even though dt re still inconsistent. Clostridium difficile hs been isolted from foods commonly mrketed in the United Sttes, Cnd, nd Europe. The strins were often indistinguishble from those in humns, so tht common source or zoonotic trnsmission is presumed. In 2005, C. difficile ws isolted in 20% of beef smples in Cnd nd in 42% of beef nd turkey 25

6 Hzrd nd chrcteristics of horse nd donkey milk Colvit et l. smples in the United Sttes. In survey crried out in Europe, C. difficile ws isolted in 7.5% of smples of redy to et foods. These dt show tht the germ is common in food nd norml cooking of food will not idle the reltively rre spores. Although the issue is still controversil, some reserchers believe tht liments of niml origin, including milk, my ply role in the trnsmission of C. difficile in humns, so tht further studies re needed to design pproprite rrngements to control such trnsmission (Gould nd Limbgo 2010). In 10% of horses C. difficile lives in the gut. Its presence my rech 45% in fols nd in horses treted with ntibiotics, but this germ rrely cuses the disese, lthough in some cses colitis nd dirrhel my rise. While the infection in humns is more common in hospitls, in equines it is found more frequently in the herd (Båverud et l. 2003). Glnders Burkholderi mllei is the custive gent of this disese tht severely ffects horses, mules, donkeys, nd humns, with ulcerous lesions of the skin nd lung tht cn even led to deth. Formerly widespred, the disese hs been erdicted from mny countries. Eliminted in Western Europe, glnders remins endemic in severl countries in Asi, Afric, nd South Americ (Wittig et l. 2006). In the lst yers, glnders outbreks hve been reported in Irq, Irn, Indi, Pkistn, Turkey, nd United Arb Emirtes (Scholz et l. 2006). In Brzil, recent cses of glnders hve been reported in some donkeys in the stte of Pernmbuco. The milk my be contminted with mteril derived from pthologicl skin lesions (Mot et l. 2010). nd hypollergenic properties, is not yet ccompnied by sufficient dt on microbiologicl hygiene nd helth chrcteristics. If during milking the hygiene procedures re strictly observed, microbil contmintions of horse nd donkey milk re generlly low thnks to their ntomicl nd behviourl peculirities. Both horses nd donkeys exhibit high cpcity of dpttion to severe environmentl conditions: resistnce to mmmry glnd infections is ttested by the low somtic cell count of milk nd rre presence of mstitis gents compred to cow milk. According to the reviewed literture, hzrd exposure ssocited to the consumption of rw horse nd donkey milk hs to be considered lower thn for cow milk, especilly for microorgnisms like enterotoxigenic E. coli nd thermo tolernt Cmpylobcter. However, the hzrds relted to milk consumption vry depending on whether one considers risks for humn or domestic nimls helth. Even if the limentry risks ssocited to equine milk consumption is resonbly low in Europe compred to bovine milk, therml tretment before consumption is strongly recommended. The limentry risks increse in those regions of the world where horse, donkey, nd mules re still crucil components of micro economies nd prevlence of Brucell spp. nd R. equi is higher. For exmple, in those regions of the world where HIV/ AIDS represent serious helth problem, the high incidence of the immunocompromised popultion wrns on the incresed risk for pthogens s well s for opportunistic microbiot possibly present in horse nd donkey milk. Conclusions Domestic equines re considered diry species worldwide since ncient times, but the recent scientific interest towrd their possible role in humn nutrition, minly focused on nutritive, nutrceuticl, Acknowledgment Prt of the dt reported in this pper hve been published in Colvit G., Amdoro C & Slimei E Sicurezz limentre. Ltte d'sin: spetti igienico snitri e normtivi. Argomenti, 13,

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