Cases in cookie dough E coli outbreak grow to 70

Jun 23, 2009 (CIDRAP News) – The number of patients sickened in a multistate Escherichia coli O157:H7 outbreak linked to prepackaged Nestle cookie dough has grown to 70 from 30 states, the US Centers for Disease Control and Prevention (CDC) said yesterday.

The update reflects an increase of four cases and two states since the CDC's first statement on the outbreak on Jun 19. The cases are distributed broadly among all 30 of the states, with Minnesota (6), Colorado (5), and Washington (5) reporting the most. The outbreak appears to be ongoing, with cases rising above the expected baseline in May and continuing into June.

Meanwhile, the US Food and Drug Administration (FDA) said yesterday that it is working with Nestle to ensure that products that might be contaminated with E coli O157:H7 are removed from distribution and retails shelves.

The FDA also said in an update that its investigators are at the plant where the dough is made, reportedly in Danville, Va., inspecting the facility and examining records and procedures to determine how the suspected contamination could have occurred.

The E coli outbreak stain has not turned up in microbiological tests that federal officials are conducting on cookie dough samples. However, the CDC has said preliminary epidemiological studies indicate a strong association between the E coli sicknesses and eating raw prepackaged Nestle Toll House cookie dough.

Nestle voluntarily recalled all varieties and sizes of its prepackaged cookie dough products on Jun 19 after it learned of the epidemiologic findings.

The CDC said that, of the 70 people who were sick with the same E coli outbreak strain, advanced DNA testing has confirmed the link in 41, and test results are pending in the other cases.

The ages of the patients range from 2 to 65 years, though 66% are younger than 19. Seventy-five percent are female. Of 30 patients who were hospitalized, 7 developed hemolytic uremic syndrome (HUS), a potentially fatal kidney condition. No deaths have been reported.

Elsewhere, district health officials in Ontario yesterday released a report on an E coli O157:H7 outbreak that sickened hundreds of northern Ontario residents who ate at a fast food restaurant in the fall of 2008, the Canadian Press reported. They identified contaminated raw Spanish onions as the probable source and said inconsistent cleaning of a dicer might have been a contributing factor.

The reports said 47 confirmed cases were linked to that outbreak, as well as 59 probable, 118 suspected, and 11 secondary cases. Twenty-six people were hospitalized, and 1 child developed HUS. No deaths were reported.

See also:

Jun 22 CDC E coli outbreak update

Jun 22 FDA E coli outbreak update

Jun 19 CIDRAP News story "Federal officials link E coli outbreak to raw cookie dough"

Jun 2009 North Bay Parry Sound District Health Unit E coli investigation report

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