Published Date: 2009-07-01 17:00:06
Subject: PRO/AH/EDR> E. coli O157 - USA (05): refrigerated cookie dough, CDC
Archive Number: 20090701.2381
E. COLI O157 - USA (05): REFRIGERATED COOKIE DOUGH, CDC
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Tue 30 Jun 2009
Source: US Centers for Disease Control and Prevention (CDC) [edited]
CDC is collaborating with public health officials in many states, the
United States Food and Drug Administration (FDA), and the United States
Department of Agriculture Food Safety and Inspection Service (FSIS) to
investigate an outbreak of _Escherichia coli_ O157:H7 infections.
As of Tue 30 Jun 2009, 72 persons infected with a strain of _E. coli_
O157:H7 with a particular DNA fingerprint have been reported from 30
states. Of these, 51 have been confirmed by an advanced DNA test as having
the outbreak strain; these confirmatory test results are pending on the
others. The number of ill persons identified in each state is as follows:
Arizona (2), California (3), Colorado (6), Connecticut (1), Delaware (1),
Georgia (1), Iowa (2), Illinois (5), Kentucky (2), Massachusetts (4),
Maryland (2), Maine (3), Minnesota (6), Missouri (1), Montana (1), North
Carolina (2), New Hampshire (2), New Jersey (1), Nevada (2), New York (1),
Ohio (3), Oklahoma (1), Oregon (1), Pennsylvania (2), South Carolina (1),
Texas (3), Utah (4), Virginia (2), Washington (6), and Wisconsin (1).
Ill persons range in age from 2 to 65 years; however, 65 per cent are less
than 19 years old; 71 per cent are female. 34 persons have been
hospitalized, 10 developed hemolytic uremic syndrome (HUS); none have died.
Reports of these infections increased above the expected baseline in May
and continue into June 2009.
Investigation of the outbreak
In an epidemiologic study, ill persons answered questions about foods
consumed during the days before becoming ill and investigators compared
their responses to those of persons of similar age and gender previously
reported to State Health Departments with other illnesses. Preliminary
results of this investigation indicate a strong association with eating raw
prepackaged cookie dough. Most patients reported eating refrigerated
prepackaged Nestle Toll House cookie dough products raw.
On 29 Jun 2009, the FDA announced that a culture of a sample of prepackaged
Nestle Toll House refrigerated cookie dough currently under recall yielded
_E. coli_ O157:H7. The contaminated sample was collected at the firm on 25
Jun 2009. Further laboratory testing is underway to determine whether the
_E. coli_ strain in the product matched the strain causing the outbreak.
_E. coli_ O157:H7 has not been previously associated with eating raw cookie
dough. CDC, the state health departments, and federal regulatory partners
are working together in this ongoing investigation.
Advice to consumers
The FDA and the Centers for Disease Control and Prevention are warning
consumers not to eat any varieties of prepackaged Nestle Toll House
refrigerated cookie dough due to the risk of contamination. If consumers
have any prepackaged, refrigerated Nestle Toll House cookie dough products
in their home they should throw them away. Cooking the dough is not
recommended because consumers might get the bacteria on their hands and on
other cooking surfaces. The recall does not include Nestle Toll House
morsels, which are used as an ingredient in many home-made baked goods or
other already baked cookie products.
Individuals who have recently eaten prepackaged, refrigerated Toll House
cookie dough and have experienced any of these symptoms should contact
their doctor or health care provider immediately. Any such illnesses should
be reported to state or local public health authorities.
Consumers should be reminded they should not eat raw food products that are
intended for cooking or baking before consumption. Consumers should use
safe food-handling practices when preparing such products, including
following package directions for cooking at proper temperatures; washing
hands, surfaces, and utensils after contact with these types of products;
avoiding cross contamination; and refrigerating products properly.
[The map of affected USA states and the epidemiologic curve can be found on
the original URL. The percentage of cases developing HUS is higher than
usual at this point, usually no more than 5 per cent. This posting states
that the "smoking" cough dough strain has not yet been shown to be the
outbreak strain. - Mod.LL]