Study of E. coli outbreak finds current ready-to-bake cookie dough not ready-to-eat.
Food containing raw flour possible vehicles of infection of future outbreaks of STEC.
Ready-to-bake cookie dough not ready-to-eat, study of E. coli outbreak finds - Consumer education and manufacturing changes may help prevent illness.
Cookie dough is a blend of cookie ingredients which has been mixed into a malleable form which has not yet been hardened by heat. The dough is often then separated and the portions baked to individual cookies, or eaten as is. Cookie dough can be homemade or bought pre-made in packs (frozen logs, buckets, etc.). Desserts containing cookie dough, such as ice cream, candy, and milkshake are also frequently marketed. Because of the presence of raw egg, consumption of uncooked cookie dough increases the possibility of contracting the foodborne illness salmonellosis.
The U.S. Food and Drug Administration (FDA) strongly discourages the consumption of all food products containing raw egg because of this threat. Cookie dough designed specifically for eating raw (such as that found in ice cream) is made either without raw egg or with pasteurized eggs and is safe to eat. In June 2009, the FDA issued a recall for Nestle Cookie Dough for potentially dangerous amounts of E. coli. There have been more than 7,000 cases of E. coli poisoning linked to this cookie dough, but none of the cases were fatal.
The investigation of a 2009 multi-state 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:
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.
"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.