A 2009 E. coli outbreak that affected 77 people across 30 states may have been caused by raw flour that was an ingredient in ready-to-cook cookie dough, a new report published in the journal Clinical Infectious Disease has discovered.
According to Jeannine Stein of the Los Angeles Times, the investigation, which was conducted by the Centers for Disease Control and Prevention (CDC), involved analyzing records and interviewing patients who were infected by the disease-causing agent.
The researchers matched each of the patients with control subjects suffering from intestinal illnesses unrelated to E. coli, and were also asked to fill out questionnaires about the types of food that they had eaten before falling ill, Stein added. Among the most frequently eaten types of food was a specific brand of cookie dough, samples of which had tested positive for the bacteria.
Which specific ingredient was to blame? According to Stein, the researchers — including the CDC’s Dr. Karen Neil and other experts from both the federal disease control and prevention organization as well as from state health departments — still don’t know.
“After ruling out the likelihood of being caused by factors such as food handling, safety violations or intentional contamination, the study authors considered ingredients like molasses, unpasteurized eggs, sugar, margarine, chocolate chips and baking soda. But each of those was also ruled out,” she wrote on Friday.
“That pretty much left flour, which, the authors noted, is a raw product,” Stein added. “Although no conclusive evidence was found to pin the illnesses on flour, they made the case that flour is purchased in large quantities and could have been distributed to a number of lots. Also, it’s not processed to kill pathogens.”
In a December 9 press release discussing the investigation, the Infectious Diseases Society of America said that Neil and colleagues came to two main conclusions. First, they decreed that cookie dough manufacturers should try to reformulate their product in order to make it safe to eat before cooking. Second, they called for increased consumer education about the dangers of eating unbaked goods out of the package.
Neil and her associates also said that foods that contain raw flour “should be considered as possible vehicles of infection of future outbreaks of STEC,” and suggested that manufacturers switch to heat-treated or pasteurized flour in all products labeled ready to cook or ready to bake, so that the contents will be safe to eat out of the package, even if the product warns against such practices.
“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,” the press release added. “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.”
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