National Cookie Day: Say No to Raw Dough

As the holidays approach, families are spending more time together in the kitchen baking holiday treats and desserts. As such, it’s important for health care practitioners to remind their patients that tasting anything before it has been properly cooked could lead to trouble.

Did you know that one of the biggest culprits responsible for several food-borne illnesses is raw cookie dough? Especially, on National Cookie Day, it’s important to be cognizant of the risks of eating or tasting baking products before they are fully cooked. Consuming raw cookie dough is not a good idea, as the raw ingredients that make up the dough are known to harbor harmful pathogens such as Salmonella or Escherichia coli.

For example, just last year, in 2016, a large outbreak of Shiga toxin-producing Escherichia coli (STEC) sprung up in 24 states and infected a total of 56 individuals. A thorough investigation conducted by a multijurisdictional team yielded the source of the outbreak: contaminated flour.

Flour is a low-water-content ingredient, and, as such, it does not typically support the growth of bacteria. However, it is also a raw agricultural product that hasn’t been treated to kill harmful pathogens, and microorganisms on the wheat or other ingredients that comprise flour, “can survive the drying process and remain viable for months in a desiccated state,” according to the study on the investigation. STEC is known to cause a staggering 265,000 infections each year in the United States; it’s also one of a group of pathogens capable of contaminating flour.

After an exhaustive investigation, health officials questioned those individuals who had been infected to learn if they had been baking during the week before illness onset. In open-ended telephone interviews with 10 infected patients, 5 of the patients recalled baking. Furthermore, 4 reported eating or tasting homemade batter, and 3 used the same brand of flour. Two of the patients still had their bags of flour, and so investigators were able to collect samples to test.

Investigators also found that 3 children had fallen ill in Maryland, Virginia, and Texas—all had been exposed to raw flour at restaurants where the staff had provided them with raw dough to play with while they waited for their food. Trace-back investigation of the flour collected from 2 patients found that the flour came from the same source. The flour used in the 3 restaurants were also from the same facility, along with flour that was collected from 3 other case-patients.

In response, the company in charge of producing the flour issued 3 recalls of multiple brands of flour produced at the facility. Other companies using the producing company’s product followed suit; 250 flour products were recalled in total.

This outbreak underscores the fact that flour can serve as a possible vehicle for food-borne pathogens, and thus, potentially be at the root of infectious disease outbreaks. For these reasons, it’s important to remember to “Say No to Raw Dough!” as the Centers for Disease Control and Prevention puts it.

Included below are a few helpful tips for handling flour or other raw ingredients that practitioners may want to share with their patients:

• Don’t consume flour, raw dough, or any other raw ingredients.
• Don’t let children play with or eat raw dough.
• Follow recipe/packaging directions to ensure your baked goods are adequately cooked.
• Keep raw foods separate from other foods.
• Clean your hands thoroughly after handling any raw materials.
• Flour tends to have a long shelf life—remember to throw away any products that may have been recalled.

By following these steps, individuals can decrease their risk of illness from contaminated flour or other raw products.