From March to July of 2009, an outbreak of E. coli linked to Nestlé Toll House prepackaged cookie dough sickened 77 people in 30 states. Ultimately, 55 of the 77 sickened individuals landed in the hospital as a result of their E. coli O157:H7 infections. In addition, and at least 10 developed Hemolytic Uremic Syndrome (HUS), which leads to kidney failure. Due to the outbreak, Nestlé initiated a recall of 3.6 million packages of its cookie dough batter.
Expert Study: Flour Most Likely Suspect in Cookie Dough Outbreak
Investigators launched traceback efforts during the outbreak, including laboratory and environmental analysis. Although they isolated cookie dough as the source, they could not identify the specific ingredient. While they also looked at production processes, they could not reach a conclusion.
As a result of the outbreak, researchers led by CDC epidemiologist Dr. Karen Neil tried to isolate the source of the E. coli. The team ruled out potential sources one by one. First, batter used pasteurized eggs, making them an unlikely culprit. In addition, many other ingredients (molasses, sugar, baking soda, margarine) go through “kill steps” that eliminate pathogens during processing.
Consequently, the team turned its attention to chocolate chips, a food implicated in past outbreaks. However, it turned out that other cookie dough “flavors” had a stronger association with illness in this outbreak.
Ultimately, the team settled on flour as the likely offender. “Flour doesn’t usually undergo a kill step.” Also, food manufacturers frequently purchase flour in large quantities for use in their products. Therefore, a manufacturer could use flour from a single purchase to make many lots of dough in many flavors over a long period of time. The team concluded officials should look at foods with raw flour as sources for future outbreaks.
Nestlé Details Post-Outbreak Testing, Discusses Flour as Potential Source
Furthermore, Nestlé food safety staff lent credibility to flour as the outbreak source. After the outbreak, at a 2010 International Association of Food Protection (IAFP) meeting, the company food safety specialist discussed the testing that occurred after the outbreak. The Nestlé rep said that the company never determined the root cause of the E. coli O157:H7 contamination. However, he did concede that the only ingredient not cleared at the supplier level was flour.
As a result of the outbreak, the rep said that the company now uses heat-treated flour for their cookie dough.
The conference took place after Nestlé Toll House cookie dough again tested positive for E. coli in January 2010, six months after the outbreak ended. However, the tainted dough never left the factory. After the 2009 recall, the company started testing samples of every batch of cookie dough for E. coli O157:H7.
Lessons (Apparently) Not Learned: Similarities to the Ongoing Flour E. Coli Outbreak
While the exact strains of E. coli involved in the 2009 Nestlé and 2016 General Mills outbreaks differ, they both belong to the same family of E. coli: Shiga toxin-producing E. coli, or STEC. While the most commonly identified STEC in the US is STEC O157, the current outbreak involves STEC O121.
In addition, many cases in the current outbreak resulted from raw cookie dough. In the 2009 outbreak, many patients said they bought the dough just to eat, and never intended to cook it. The 2009 outbreak affected mostly females, two-thirds of them under 19. In this outbreak, females account for the majority of cases as well.
Although some people advise that cooking recalled flour solves the problem, this case poses unique issues. Loose flour easily gets onto other surfaces. Since even very small amounts of E. coli can make you sick, even if properly baked cookies may be okay, the sprinkle of flour on your counter that makes its way onto an apple slice poses just as much of a threat as cookie dough — and you might not even be able to see it.
If you or a family member became ill with an E. coli infection after consuming food and you’re interested in pursuing a legal claim, contact the Ron Simon & Associates attorneys for a free case evaluation.
