If flour is a source of dangerous E. coli, how is cross-contamination controlled in kitchen? Ready-to-bake cookie dough not ready-to-eat

 To all broken hearts: don’t eat prepackaged cookie dough before it’s baked.

That’s the message health-types conclude from a June 2009 outbreak of shiga-toxin producing E. coli (primarily O157:H7) in Nestle Toll House cookie dough that sickened at least 77 people in 30 states. Thirty-five people were hospitalized – from cookie dough.

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.

The researchers could not conclusively implicate flour as the E. coli source, 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.

The study authors conclude that "foods containing raw flour should be considered as possible vehicles of infection of future outbreaks of STEC."

During the investigation, three strains of STEC were discovered in one brand of cookie dough — although it wasn’t the same strain involved in the outbreak.

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.

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

Nestle Toll House cookie dough returns; Linda Rivera still hospitalized

In Room 519 of Kindred Hospital, Linda Rivera can no longer speak.

Her mute state, punctuated only by groans, is the latest downturn in the swift collapse of her health that began in May when she curled up on her living room couch and nonchalantly ate several spoonfuls of the Nestlé cookie dough her family had been consuming for years. Federal health officials believe she is among 80 people in 31 states sickened by cookie dough contaminated with a deadly bacteria, E. coli O157:H7.

The impact of the infection has been especially severe for Rivera and nine other victims who developed a life-threatening complication known as hemolytic uremic syndrome. One, a 4-year-old girl from South Carolina, had a stroke and is partially paralyzed.

But good news. Two weeks ago, Nestle announced, in breathless PR-speak,

After almost two months of being out of the U.S. marketplace, Nestle USA is pleased to announce that Nestle Toll House refrigerated cookie dough is returning to stores this week.

To make it easy for both retail partners and consumers to identify the new batch of cookie dough, a blue "New Batch" label will appear on all new production cookie dough items. Nestle Toll House shipping cases also are marked in blue (rather than the previous black) to denote new production and will contain the statement: "Do not consume raw cookie dough." The adoption of this distinct labeling is the result of helpful discussions between Food & Drug Administration (FDA) officials and Nestle, following reports of E.coli O157:H7 illnesses that appeared to be related to the consumption of raw cookie dough.

I bet the discussions were helpful. Probably similar to the ones ConAgra had with the U.S. Department of Agriculture geniuses who said, safe cooking instructions for frozen $0.50 pot pies should tell consumers to use a thermometer to make sure the pie is safe. Food safety is a shared responsibility apparently means it’s the consumer’s responsibility, especially in foods that may be perceived as ready-to-eat.

This is what the new Nestle cookie label looks like, on a package I picked up at a local store on Saturday (front, above, right; back, below, left).

Labeling is a lousy way to provide information about food safety risks, but better than nothing. I’m sure Nestle and ConAgra, in the best interests of their consumers, will publicly release the evaluative data they (probably? maybe?) acquired to show that these particular labels have a positive impact on consumer food safety behavior.


ABC News: 3 kinds of E. coli linked to Nestle’s cookie dough

Brian Hartman of ABC News is reporting that investigators have linked at least three different kinds of E. coli to Nestle’s cookie dough but they remain stumped as to just how the bacteria got in the product.

DNA testing of E. coli found in an unopened package of cookie dough at Nestle’s plant in Danville, Va., determined the genetic fingerprint of the E. coli found at the plant is different than E. coli that has been linked to a 30-state outbreak that has sickened at least six dozen people, and that an altogether different strain of E. coli was found in dough recovered from the home of a victim.

Dr. David Acheson, the Food and Drug Administration’s assistant commissioner for food safety said,

“The investigation is winding up. It is not exactly over yet. But we have not figured out the likely ingredient. … It is unlikely that we will ever make a final determination of how this contamination occurred. … Theres no indication that this was deliberate.”

Smoking gun’ found in cookie dough E. coli scare

Brian Hartman of ABC News appears to be first off the block reporting that U.S. Food and Drug Administration investigators today found E. coli in an unopened package of raw chocolate chip cookie dough at the plant in Danville, VA where Nestle makes Toll House cookie dough.

A FDA type said the dough had been manufactured on February 10, 2009 but had not yet been shipped.

Investigators still do not know how the E. coli got into the dough. But finding this “smoking gun” package confirms they pushed for a recall of the correct product.

Possible poop remnants and Nestle’s raw cookie dough

During the evening of Thursday, June 18, the Colorado Department of Public Health and Environment urged Coloradans not to eat raw Nestle Toll House cookie dough because of possible contamination with E. coli O157:H7.

The next morning, the U.S. Food and Drug Administration warned consumers not to eat any varieties of prepackaged Nestle Toll House refrigerated cookie dough due to the risk of contamination with E. coli O157:H7. At the same time, Nestlé announced a voluntary recall of all Toll House refrigerated cookie dough products, “out of an abundance of caution.”

My colleague Evan managed to get some of that recalled cookie dough, I got some other cookie dough, and we made cookies.

In the latest video from the Safe Food Café, I stress that cookie dough is a raw product (although the eggs have been pasteurized in any commercial product) and can therefore cross-contaminate anything in the kitchen, and that the warning labels and safe-handling instructions on packages of raw cookie dough are terrible.

Nestle Toll House cookie outbreak victim: “I had major headaches, diarrhea and cramping.”

As the Nestle-linked E. coli O157:H7 outbreak unfolds in the upcoming days, stories about affected individuals highlighting the fallout will begin to appear. In the first one I have seen, the Oregonian reports that 15-year-old girl’s craving for a treat resulted in her and her fathers illness.

Melissa made the cookies in early May. While baking, she tasted some of the dough, which a lot of people do even though it is not supposed to be eaten before baking. Her dad, 37-year-old day, Mike Kitchens, stuck his finger into the bowl as well, picking out sweet chocolate bits. The two of them soon came down with cramping and diarrhea, typical symptoms of food poisoning. Mike recovered after about four days but Melissa continued to be severely ill.

Melissa was quoted as saying "It was hard for me to do my work, I’d call my friends, but I’d get hot and sweaty and my stomach would cramp up. I tried to deal with it, but it got too be too much so I couldn’t do anything. I had major headaches, diarrhea and cramping." She did manage to take all of her tests, but she suspects that she failed at least two finals which count heavily in overall grades.

Evan finds Nestle refrigerated cookie dough; Doug cooks it (sorta)

During the evening of Thursday, June 18, the Colorado Department of Public Health and Environment urged Coloradans not to eat raw Nestle Toll House cookie dough because of possible contamination with E. coli O157:H7.

The next morning, the U.S. Food and Drug Administration warned consumers not to eat any varieties of prepackaged Nestle Toll House refrigerated cookie dough due to the risk of contamination with E. coli O157:H7. At the same time, Nestlé announced a voluntary recall of all Toll House refrigerated cookie dough products, “out of an abundance of caution.”

About 4:30 p.m. central time on Friday, June 19, 2009 (happy birthday, daughter Jaucelynn, avoid the raw cookie dough) colleague Evan reported that he had successfully obtained a package of Nestle Toll House refrigerated cookie dough (above, right, exactly as shown). I say obtained because he didn’t have to pay for it. Evan went to a local supermarket, and saw, “a young kid, armed with a box cutter, standing beside a cart full of Nestle Toll House products.

“I asked if I could have one of them, to which he replied, ‘you’re not going to get a refund for it are you?’ I told him no, but he said he had to cut open the package so I couldn’t return it. The kid wasn’t wearing any gloves and was sweating, so I’m guessing he was out there for a while handling a potentially contaminated product.”

And he gave Evan the raw cookie dough, which Evan triple-bagged and refrigerated until Saturday.

Amy and Sorenne and I went grocery shopping this morning, and observed that the Nestle refrigerated products had been dutifully cleared out (left, exactly as shown). We did, however, buy a couple of other raw cookie dough products. I never eat the stuff, but understand that many are quite passionate about their raw cookie dough.

There are at least two potential problems with raw cookie dough: eating it, and cross-contamination. Evan and I videotaped a cooking experiment and the cookies get plenty hot to kill off potential pathogens (we’ll post that later).

Bill Marler has written about the uh, inadequacies of the labels on Nestle raw cookie dough. Not that anyone reads labels, or that everyone speaks English, but maybe there shoud be more of a declaration of potential risk.

And bigger type: not to sound like ole-man-grouchy-Powell, but even with my reading glasses I could barely read a damn thing on the label. The Kroger private selection brand says,

Keep refrigerated
Use before date on package
Do not eat unbaked cookie dough.

The Pillsbury refrigerated cookie dough says,

Do not microwave unbaked Poppin Fresh dough
Bake before enjoying
Do not use if unsealed.

It would seems with at least 66 people sick with a serious illness – E. coli O157:H7 – of which 25 had to be hospitalized and seven will suffer long-term kidney damage, these labels sorta suck.

Oh, and according to a story carried by Bloomberg,

“The Toll House cookie brand is named for the Toll House Inn in Whitman, Massachusetts, whose owner, Ruth Wakefield, is credited with inventing the chocolate chip cookie in the 1930s."

D-listed and the problem with raw cookie dough

Michael K of celebrity blog D-listed encapsulates the problem with Nestle, raw cookie dough, labels and E. coli O157:H7, which has so far sickened 66 people in 28 states.

If you get the craving to eat cookie dough this weekend, lick this picture and don’t eat the real thing or you may doody until you dieeeeeee. … This weekend the grocery stores are totally going to be full of single depressed ladies trading in their unused cookie dough for SnackWells.

Why do they always recall delicious things? They never recall crap like peas or multi-grain Cheerios. … I always eat raw cookie dough. I tell myself that I’m going to bake it like a normal person, but then suddenly the bowl is empty and I have the guilties.

Cookie dough? Cookie dough contaminated with E. coli O157:H7?

In yet another example of different jurisdictions having different opinions about when to go public, the Colorado Department of Public Health and Environment sent out a press release last night urging Coloradans not to eat raw Nestle Toll House cookie dough because of possible contamination with E. coli O157:H7.

If the link is proven, cookie dough would join a long list of foods like produce, pet food, peanut butter and pot pies that consumers really have very little control over; it’s up to the producers and processors. Which makes various consumer education programs like FightBac sorta backwards. Consumers have a role in food safety, but not with this stuff.

Colorado state health officials, the CDC and several other state health departments are investigating an outbreak of E. coli O157:H7 infections.

To date, 66 cases from 28 states have been identified. Preliminary evidence from the multi-state investigation suggests that Nestle Toll House cookie dough may be the source of the outbreak, although further investigation is ongoing.

Five cases have been reported in Colorado in the following counties: Denver, Douglas (2), Jefferson and Weld. Two of the people have been hospitalized, and one has developed a severe complication called hemolytic uremic syndrome. Of the four people interviewed so far by the state health department, all had consumed the raw cookie dough during the week before they became ill.

Alicia Cronquist, the foodborne disease epidemiologist at the state health department, said,

“We can’t be certain that raw cookie dough is the source of these infections, but we are concerned enough that it might be and want consumers to be aware.”

Daniel Rifkin, Wholesale Food Program manager for the Department of Public Health and Environment’s Consumer Protection Division, said,

“Nestle is currently evaluating what actions they will take regarding their product. In the meantime, it is important that consumers do not eat or use raw Nestle Toll House cookie dough for now. If you decide to use the product, ensure that the cookies are cooked thoroughly and wash your hands well after handling the raw dough. More information will be forthcoming.”