Ready-to-bake cookie dough not ready-to-eat, study of E. coli outbreak finds

December 09, 2011

[EMBARGOED FOR DEC. 9, 2011] The investigation of a 2009 multistate outbreak of Shiga toxin-producing Escherichia coli (STEC), an important cause of bacterial gastrointestinal illness, led to a new culprit: ready-to-bake commercial prepackaged cookie dough. Published in Clinical Infectious Diseases and available online, a new report describing the outbreak offers recommendations for prevention, including a stronger message for consumers: Don't eat prepackaged cookie dough before it's baked.

The report's authors, led by Karen Neil, MD, MSPH, and colleagues at the Centers for Disease Control and Prevention and at state health departments, reached two key conclusions: 1) manufacturers of cookie dough should consider reformulating their product to make it as safe as a ready-to-eat product and 2) more effective consumer education about the risks of consuming unbaked goods is needed. During the 2009 outbreak, 77 patients with illnesses were identified in 30 states, and 35 people were hospitalized.

Previous E. coli-related food-borne illnesses have been associated with ground beef, leafy green vegetables, sprouts, melons, salami, and unpasteurized apple cider. The 2009 investigation, which involved extensive traceback, laboratory, and environmental analysis, led to a recall of 3.6 million packages of the cookie dough. However, no single source, vehicle, or production process associated with the dough could be identified for certain to have contributed to the contamination.

Dr. Neil and colleagues suspected that one of the ingredients used to produce the dough was contaminated. Their investigation didn't conclusively implicate flour, but it remains the prime suspect. They pointed out that a single purchase of contaminated flour might have been used to manufacture multiple lots and varieties of dough over a period of time as suggested by the use-by dates on the contaminated product.

Flour does not ordinarily undergo a "kill step" to kill pathogens that may be present, unlike the other ingredients in the cookie dough like the pasteurized eggs, molasses, sugar, baking soda, and margarine. Chocolate was also not implicated in this outbreak since eating chocolate chip cookie dough was less strongly associated with these illnesses when compared with consuming other flavors of cookie dough, according to Dr. Neil.

The study authors conclude that "foods containing raw flour should be considered as possible vehicles of infection of future outbreaks of STEC." Manufacturers should consider using heat-treated or pasteurized flour, in ready-to-cook or ready-to-bake foods that may be consumed without cooking or baking, despite label statements about the danger of such risky eating practices, the authors conclude. In addition, manufacturers should consider formulating ready-to-bake prepackaged cookie dough to be as safe as a ready-to-eat food item.

Eating uncooked cookie dough appears to be a popular practice, especially among adolescent girls, the study authors note, with several patients reporting that they bought the product with no intention of actually baking cookies. Since educating consumers about the health risks may not completely halt the habit of snacking on cookie dough, making the snacks safer may be the best outcome possible.
-end-
NOTE: The study is available online. It is embargoed until 12:01 a.m. EST on Friday, Dec. 9, 2011.

A Novel Vehicle for Transmission of Escherichia coli O157:H7 to Humans: Multistate Outbreak of E. coli O157:H7 Infections Associated With Consumption of Ready-to-Bake Commercial Prepackaged Cookie Dough--United States, 2009
http://www.oxfordjournals.org//our_journals/cid/prpaper.pdf

Clinical Infectious Diseases is a leading journal in the field of infectious disease with a broad international readership. The journal publishes articles on a variety of subjects of interest to practitioners and researchers. Topics range from clinical descriptions of infections, public health, microbiology, and immunology to the prevention of infection, the evaluation of current and novel treatments, and the promotion of optimal practices for diagnosis and treatment. The journal publishes original research, editorial commentaries, review articles, and practice guidelines and is among the most highly cited journals in the field of infectious diseases. Clinical Infectious Diseases is an official publication of the Infectious Diseases Society of America (IDSA). Based in Arlington, Va., IDSA is a professional society representing more than 9,000 physicians and scientists who specialize in infectious diseases. For more information, visit www.idsociety.org.

Infectious Diseases Society of America

Related Outbreak Articles from Brightsurf:

What San Diego's Hepatitis A outbreak can teach us during COVID-19
The disconnect between the public and government agencies, and how information is communicated on social media during an outbreak was the focus of a study by San Diego State University researchers.

Pregnant women's psychological health during the COVID-19 outbreak
A recent study that examined the psychological health of pregnant women during the COVID-19 outbreak uncovered fear and depression in many participants.

Operation Outbreak simulation teaches students how pandemics spread
In 2015, a team of specialists in modeling disease outbreaks got together with educators to create Operation Outbreak, an educational platform and simulation intended to teach high school and college students the fundamentals of responses to pandemics.

Is the coronavirus outbreak of unnatural origins?
Did coronavirus mutate from a virus already prevalent in humans or animals or did it originate in a laboratory?

'Stealth transmission' fuels fast spread of coronavirus outbreak
Undetected cases, many of which were likely not severely symptomatic, were largely responsible for the rapid spread of the COVID-19 outbreak in China, according to new research by scientists at Columbia University Mailman School of Public Health.

'Quit vaping searches increased during lung-disease outbreak
Researchers found that searches on such terms as ''quit vaping'' increased as much as 3.7-fold during the vaping-related illness outbreak.

Researchers trace Coronavirus outbreak in China to snakes
Emerging viral infections -- from bird flu to Ebola to Zika infections -- pose major threats to global public health, and understanding their origins can help investigators design defensive strategies against future outbreaks.

Outbreak science: Infectious disease research leads to outbreak predictions
Infectious diseases have a substantially growing impact on the health of communities around the world and pressure to both predict and prevent such diseases is ever-growing.

Researchers carry out simulation of a hospital outbreak
Researchers carried out a simulation of a hospital outbreak investigation using advanced genomic analysis technologies.

Yale researchers detect unreported Zika outbreak
Researchers at the Yale School of Public Health (YSPH) have detected a large unreported Zika outbreak that occurred in Cuba during 2017, a year after Zika outbreaks peaked throughout the Americas.

Read More: Outbreak News and Outbreak Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.