What Happens When You Eat Raw Cookie Dough

Federal report focuses on ongoing pathogen threat from raw flour

FOOD SAFETY NEWS – Warnings are now appearing on the flaps of flour packages. “Cook before sneaking a taste,” says one. Another says “Flour is raw. Please cook fully before enjoying.”

And the April 23 edition of Morbidity and Mortality Weekly Report (MMWR) turned its “Note from the Field” section to a closer look at outbreaks involving flour.

“Multistate Outbreak of Escherichia coli O26 infections linked to Raw Flour — the United States, 2019” examines one such instance.

Here’s how it came down, according to the MMWR authors:

PulseNet, the molecular subtyping network for foodborne disease surveillance, on Feb. 20, 2019, identified six Shiga toxin–producing Escherichia coli (STEC) O26:H11 infections with the same pulsed-field gel electrophoresis (PFGE) pattern combination.

...article continued below
- Advertisement -

The PFGE pattern combination matched that of infections from a July 2018 outbreak associated with ground beef. In response, CDC initiated an investigation with federal, state, and local partners to identify the outbreak source and implement prevention measures.

The CDC defined the case as STEC O26 infection with an isolate matching the outbreak strain by PFGE or related by core genome multilocus sequence typing scheme (cgMLST), with dates of illness onset from Dec. 11, 2018 – May 21, 2019.

Investigators initially hypothesized that ground beef was the outbreak cause because of the PFGE match to the July 2018 outbreak and because in early interviews, patients commonly reported eating ground beef and leafy greens.

Investigators used cgMLST to compare the genetic sequences of isolates from both outbreaks and determined that they fell into separate genetic clades, or groups, differing by 6–11 alleles, suggesting that something other than ground beef caused the illnesses in 2019.

The CDC noted that one patient consumed raw cookie dough and that most patients were young adult females, similar to demographic distributions of past flour-associated STEC outbreaks. Investigators developed a supplemental questionnaire focusing on beef, leafy greens and flour exposures.

...article continued below
- Advertisement -

Twenty-one cases were reported from nine states. The median age of patients was 24 years with a range of 7 to 86 years; 71 percent were female. Three patients were hospitalized, and none died.

Among 13 patients asked about flour exposures, six reported eating, licking, or tasting raw homemade dough or batter during the week before illness onset. Three patients reported eating raw dough or batter made with the same grocery store brand of all-purpose flour, including a patient who reported eating raw dough at a bakery in Rhode Island. Overall, of 18 patients with store information, 11 reported shopping at this same grocery store chain.

The Rhode Island Department of Health visited the bakery reported by the patient and collected flour for testing. On May 21, 2019, testing identified STEC O26 from an intact bag of all-purpose flour, which was the same grocery store brand reported by other patients.

PulseNet confirmed that the STEC O26 isolated from the flour was highly related to clinical isolates using cgMLST (0–1 alleles). Product distribution records collected by the Food and Drug Administration found six patients in three states purchased flour from a single milling facility in Buffalo, New York.

The flour brand was recalled from retail outlets in 11 states.

The milling company also recalled all lots of this product and several other lots of flour produced in that facility, resulting in the recall of additional brands and products distributed to multiple states.

The MMWR authors say flour is recognized as a cause of STEC outbreaks (1–5). Raw flour is not a ready-to-eat product, and this outbreak highlights the continuing risk for illness associated with the consumption of flour and raw dough or batter.

FIGURE. Number of patients* (N = 21) infected with the outbreak strain of Escherichia coli O26, by state of residence — United States, December 2018–May 2019
The figure is a map of the United States showing the states in which 21 patients who were infected with the outbreak strain of Escherichia coli O26 lived during December 2018–May 2019.

* California, one; Connecticut, one; Massachusetts, two; Missouri, one; New Jersey, one; New York, seven; Ohio, five; Pennsylvania, two; Rhode Island, one.

The authors: Vasser M, Barkley J, Miller A, et al. “Notes from the Field: Multistate Outbreak of Escherichia coliO26 Infections Linked to Raw Flour — the United States, 2019.” MMWR 2021;70:600–601. DOI: http://dx.doi.org/10.15585/mmwr.mm7016a4external icon.

(To sign up for a free subscription to Food Safety News, click here.)

- Advertisement -


Biden Admin. Awards $150K To Florida District That Resisted DeSantis

WASHINGTON — The Biden administration said on Thursday that it was reimbursing a Florida school district that lost state money for imposing a mask...

Ivermectin: What The Evidence Says

Daily Briefing, September 21, 2021 ADVISORY BOARD – Ivermectin is an anti-parasite drug discovered in 1975. It was initially introduced as a drug for livestock,...

CDC Backs COVID Booster For Millions

AP – The Centers for Disease Control and Prevention on Thursday endorsed booster shots for millions of older or otherwise vulnerable Americans, opening a...

Doctors Charged In Massive Fraud Including False Covid Claims

NBC NEWS – The Department of Justice has announced criminal charges against 42 medical professionals, including 23 doctors, and nearly 100 other people for...

Middle-School Mom Rips School Board Over Anal Sex Reference

FOX NEWS – A Texas school district has removed a book from schools after an irate mother read aloud an excerpt about anal sex...

State Cops Sue Governor To Block Vaccine Mandate

FOX NEWS – The union that represents about 1,800 Massachusetts State Police troopers went before a judge Wednesday asking for a delay in the...

Vaccine Effectiveness “Appears To Wane Over Time”

(CNN) The protection provided by Covid-19 vaccines appears to wane over time, especially for people 65 and older, a US Centers for Disease Control...

Frozen Shrimp From India? Throw It Back [Check Labels Now]

FOOD SAFETY NEWS – Officials say a Salmonella Weltevreden outbreak linked to imported, cooked, frozen shrimp is over, but they are concerned some consumers...

“Biden’s Failure During A National Health Crisis” – Kaiser

KAISER HEALTH NEWS – President Joe Biden’s failure to name someone to lead the Food and Drug Administration, more than 10 months after the...

Rising Covid Death Count “A Real Failure Of Society”

For health workers, the deaths, combined with misinformation and disbelief about the virus, have been "heart-wrenching, soul-crushing."
- Advertisement -