With the flurry of news about possible E. coli O157:H7 in Nestle Toll House raw cookie dough products, let’s not forget the most common source of foodborne E. coli, raw beef. The Source news reports that raw beef products including ground meat and beef kabobs sold from Vince and Joe’s Fruit Market of Shelby Township, Michigan, between May 10-17 may be contaminated with E. coli 0157:H7. E. coli O157:H7 is a dangerous bacteria that can lead to the sometimes fatal hemolytic uremic syndrome (HUS), a condition characterized by anemia and kidney failure that can quickly become deadly. From the Source story:

The Michigan Department of Community Health has tested and confirmed E.coli 0157:H7 in ground beef from that timeframe. The exact source of the contamination has not yet been identified.

Vince and Joe’s are working in close cooperation with MDA, MDCH and the U.S. Department of Agriculture as part of an ongoing multi-state E.coli 0157:H7 outbreak investigation to identify the source of the contamination.

…E.coli 0157:H7 infections can cause diarrhea (bloody or nonbloody), dehydration, abdominal cramps and in severe cases, a serious condition involving kidney failure called Hemolytic uremic syndrome. The very young, the elderly and persons with compromised immune systems are the most susceptible to foodborne illness. People experiencing these problems should seek immediate medical attention.

Consumers should only eat beef products that have been cooked to a safe, internal temperature in order to kill harmful bacteria such as E. coli O157:H7. For example, 160 degrees for ground beef as color is not a reliable indicator that beef has been properly cooked.

The Centers for Disease Control and Prevention has weighed in on the risk of E. Coli O157:H7 contamination in Nestle Toll House raw cookie dough products. Here’s the report:

Multistate Outbreak of E. coli O157:H7 Infections Linked to Eating Raw Refrigerated, Prepackaged Cookie Dough

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 E. coli O157:H7 infections.

As of Thursday, June 18, 2009, 65 persons infected with a strain of E. coli O157:H7 with a particular DNA fingerprint have been reported from 29 states. Of these, 23 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: Arkansas (1), Arizona (2), California (2), Colorado (5), Delaware (1), Hawaii (1), Iowa (2), Illinois (5), Kentucky (1), Massachusetts (4), Maryland (2), Maine (3), Minnesota (5), Missouri (2), Montana (1), North Carolina (1), New Hampshire (2), New Jersey (1), Nevada (2), Ohio (4), Oklahoma (1), Oregon (1), Pennsylvania (2), South Carolina (1), Texas (3), Utah (2), Virginia (2), Washington (5), and Wisconsin (1).

Ill persons range in age from 2 to 57 years; however, more than 70% are less than 19 years old and none are over 60 years old; 75% are female. Twenty-five persons have been hospitalized, 7 developed hemolytic uremic syndrome (HUS); none have died. Reports of these infections increased above the expected baseline in May and continue into June.

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.

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.

Clinical Features

Most people infected with E. coli O157:H7 develop diarrhea (often bloody) and abdominal cramps 2-8 days (average of 3-4 days) after swallowing the organism, but some illnesses last longer and are more severe. Infection is usually diagnosed by culture of a stool sample. Most people recover within a week, but some develop a severe infection. A type of kidney failure called hemolytic uremic syndrome (HUS) can begin as the diarrhea is improving; this can occur in people of any age but is most common in children under 5 years old and the elderly.

Advice to Consumers

The Food and Drug Administration (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 with E. coli O157:H7. 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 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.

Advice to Retailers, Restaurateurs, and Food-service Operators

Retailers, restaurateurs, and personnel at other food-service operations should not sell or serve any Nestle Toll House prepackaged, refrigerated cookie dough products subject to the recall.

According to an AP report, Nestle USA has temporarily stopped production of refrigerated cookie dough at its Danville plant, after preliminary evidence has suggested a potential link between these products and a multistate outbreak of E. coli O157:H7. The plant and product samples are being investigated in an effort to find the source of E. coli O157:H7 contamination.

It will be interesting to see if the pathogen is discovered as a function of poor facility sanitation or inappropriate processing methods (cross-contamination, pest infestation, environmental exposure, or any of the other “usuals” as seen with the Peanut Corporation of America plant investigation), or if an ingredient sourced by Nestle from another food production company may be to blame.

In another tragic foodborne illness and another recall with more questions than answers; Nestle Toll House cookies are suspected in an outbreak of E. coli O157:H7 across many states throughout the US. While parents are always understandably concerned about food safety and their children; it has become increasingly difficult to protect them when foodborne illness is showing up in unusual places.

E. coli O157:H7 is a bacterium that lives in the intestines of various mammals that are immune to its affects. The most common animal associated with this type of E. coli is the cow.

If you look at the ingredients in a package of Nestlé’s Toll House Cookies, there are only a few ingredients that would be derived from an animal. There is Milkfat used in the chocolate morsels. This shouldn’t have been a problem if the milk ingredients were properly pasteurized. But all it takes is one contaminated item and the machines used to process this item are now pathogenic. There are also eggs that are used, but E. coli is a disease usually associated with mammal intestines, not bird eggs. If this was a salmonella outbreak, eggs would be a likely suspect. However, this is an E. coli O157:H7 outbreak.

There are some vegetable derived ingredients and vegetables can carry E. coli O157:H7. Remember back to 2006, spinach was the culprit behind an E. coli outbreak. But the spinach was raw and the Toll House cookie ingredients are processed vegetable by-products.

A possible scenario could be a cross contamination event.  As an attorney who has represented hundreds of victims of waterborne illnesses, I know how easy it is for a water source to get contaminated. Everywhere contaminated water is used, a potential for E. coli exists. There is also the possibility of an employee who was sick with E. coli to pass it along to others.

Then, there is animal cross contamination from infestation. Since mammals can carry E. coli, any mouse or rat could be a potential introduction.  Just look at what happened with the Peanut Corporation of America (PCA) salmonella outbreak.  Rats and insects were able to permeate the area where the peanuts were stored.  A rat or mouse infected with E. coli O157:H7 might not be immune from its damaging effects but could easily spread E. coli through its feces.

We are now looking into what went wrong in this situation on behalf of injured consumers. Let’s hope answers are discovered before more become victims of this latest foodborne illness outbreak.

E. Coli 0157:H7 – Nestle Toll House recall update: Here’s is the list of products Nestle has voluntaily recalled for possible contamination of E. Coli 0157:H7.

Nestle Toll House Cookie & Brownie Dough E. Coli 0157:H7 Recall:

COOKIE & BROWNIE DOUGH BAR
Chocolate Chip bar 16.5oz 0 50000 62231 3
Chocolate Chip bar 16.5oz 0 50000 11308 8
Chocolate Chunk bar 16.5oz 0 50000 62235 1
Walnut Chocolate Chip bar 16.5oz 0 50000 62233 7
Jumbo Chocolate Chip bar 16.5oz 0 50000 62237 5
Oatmeal Raisin bar 16.5oz 0 50000 06219 5
Sugar Cookies bar 16.5oz 0 50000 62244 3
Sugar Cookies bar 16.5oz 0 50000 12178 6
Mini Chocolate Chip bar 16.5oz 0 50000 62242 9
Mini Chocolate Chip bar 16.5oz 0 50000 12188 5
Mini Brownie Bites bar 16oz 0 50000 62227 6
Fudgy Brownie With Peanut Butter Filling 19oz 0 50000 00820 9

COOKIE DOUGH TUB
Chocolate Chip tub 40oz 0 50000 62246 7
Chocolate Chip tub 80oz (5 lb) 0 50000 00934 3
Sugar tub 40oz. 0 50000 62253 5
Gingerbread tub 40oz 0 50000 44060 3
Peanut Butter tub 40oz 0 50000 44062 7

TUBE (CHUB) DOUGH
Chocolate Chip tube 16.5oz 0 50000 62239 9
Chocolate Chip tube 32oz 0 50000 00400 3

ULTIMATES COOKIE BAR DOUGH
Ultimates Peanut Butter Cups, Chips & Chocolate Chunks bar 16oz 0 50000 00922 0
Ultimates White Chip Macadamia Nut bar 16oz 0 50000 00923 7
Ultimates Chocolate Chip & Chunks with Pecans bar 16oz 0 50000 00925 1
Ultimates Chocolate Chip Lovers 16oz 0 50000 00926 8
Ultimates Turtles bar 16oz 0 50000 00928 2
Ultimates Peanut Butter Lovers bar 16oz 0 50000 00507 9
Ultimates Chocolate Chip with Caramel Filling bar 16oz 0 50000 44066 5
Ultimates Chocolate Chip with Chocolate Filling bar 16oz 0 50000 44069 6

SEASONAL COOKIE & BROWNIE DOUGH
Valentine Hearts Sugar Cookie Shapes 15.5oz 0 50000 12009 3
Valentine Swirled Chocolate Chip bar 16oz 0 50000 00931 2
Fudgy Brownies With Raspberry Filling 19oz 0 50000 20090 0
Easter Eggs Sugar Cookie Shapes 15.5oz 0 50000 52009 1
Easter Swirled Chocolate Chip bar 16oz 0 50000 00932 9
Easter Swirled Mini Brownie Bites bar 18 oz 0 50000 20093 1
Red, White & Blue Swirled Choc Chip bar 16oz 0 50000 00937 4
Halloween Pumpkin Pals Sugar Cookies 13.5oz 0 50000 06217 1
Halloween Swirled Chocolate Chip bar 16oz 0 50000 00929 9
Halloween Swirled Fudgy Brownies bar 18oz 0 50000 00088 3
Christmas Shapes Sugar Cookies 15.5oz 0 50000 00505 5
Christmas Swirled Chocolate Chip bar 16oz 0 50000 00930 5
Christmas Swirled Fudgy Brownies bar 18oz 0 50000 00089 0
Limited Edition Mint Swirled Chocolate Chip 16oz 0 50000 00827 8

Discontinued Varieties
Valentine Hearts Sugar Cookies 13.5oz 0 50000 44056 6
Easter Brownie Bar 18oz 0 50000 00518 5
Easter Bunnies Sugar Cookies 13.5oz 0 50000 44058 0
Halloween Sugar Shapes 15.5oz 0 50000 00829 2
Christmas Sugar Cookie Tube 16oz 0 50000 00448 5
Oatmeal Cranberry Cookie Tub 48 oz. 0 50000 62229 0

(more…)

As expected, the Food Safety Enhancement Act of 2009 has made its way through the full House Energy and Commerce Committee, and is likely to be considered by the full House of Representatives near the end of the month. Learn more about this food safety legislation with the links below:

Summary of Issues Addressed by Food Safety Enhancement Act of 2009

Weighing In on the Food Safety Enhancement Act

Full Text of FSEA, or HR 2749

Nestle USA’s Baking Division has issued a voluntary recall in response to the potential connection between a widespread national outbreak of E. coli O157:H7 and Nestle raw cookie dough products. E. coli O157:H7 infection and related hemolytic uremic syndrome (HUS) are very serious and often fatal conditions that require intensive medical treatment; if you think you may be experiencing symptoms of E. coli infection or HUS, seek medical attention immediately. From the Nestle recall:

June 19th, 2009 – Nestlé USA’s Baking Division is initiating a voluntary recall of Nestlé® TOLL HOUSE® refrigerated cookie dough products. Nestlé is taking this action out of an abundance of caution after being notified that the Food and Drug Administration, together with the Centers for Disease Control, are conducting an investigation into reported E. coli 0157:H7 illnesses that may be related to consumption of raw cookie dough.

A number of consumers reporting illness reported consuming raw Nestlé TOLL HOUSE refrigerated cookie dough. While the E. coli strain implicated in this investigation has not been detected in our product, the health and safety of our consumers is paramount so we are initiating this voluntary recall. We have been and will continue to cooperate fully with the Food and Drug Administration and the Centers for Disease Control in this investigation. Providing safe, high quality products to our consumers is our number one priority.

No other Nestlé TOLL HOUSE products are impacted, including already baked TOLL HOUSE cookies purchased outside the home, all varieties of Nestlé TOLL HOUSE morsels, chocolate baking bars, or cocoa, and Dreyer’s and Edy’s ice cream products with Nestlé TOLL HOUSE cookie dough ingredients.

We want to strongly advise consumers that raw cookie dough should not be eaten. This message also appears prominently on our packaging. Nestlé TOLL HOUSE cookies made from refrigerated dough are safe to consume when baked as directed on the package.

Consumers who have purchased these products should not consume them. Instead, we are asking that consumers return these products to their local grocer for a full refund. We invite consumers with questions to contact Nestlé Consumer Services at 1-800-559-5025 and visit our web site at www.verybestbaking.com.

The products involved in the voluntary recall include all varieties of Nestlé TOLL HOUSE refrigerated Cookie Bar Dough, Cookie Dough Tub; Cookie Dough Tube; Limited Edition Cookie Dough items; Seasonal Cookie Dough and Ultimates Cookie Bar Dough.

For a list of recalled products, see the table at the end of the Nestle recall full text.

As a dad with young kids, I am especially concerned about food safety.  And as a lawyer who represents victims of food borne illness, I see — all too often – the danger that eating contaminated food can cause, particularly with young kids.  That is why the recall announced today that Nestle Toll House cookies could be the source of the dangerous E. coli O157:H7 bacterium is doubly – troubling.

Kids love eating cookies.  And kids love to help cook them, too.  Now we learn that Nestle Toll House Cookies could be the source of E. coli O157:H7.  For those of you who do not know, E. coli O157:H7 is a dangerous bacteria.  E. coli O157:H7 causes abdominal cramping, vomiting and a diarrheal illness, often with bloody stools.   E. Coli strikes the young and the elderly the worst.

Those age groups are at highest risk for developing Hemolytic Uremic Syndrome (HUS).  HUS can lead to serious kidney damage and even death.   According to the CDC, since March 2009, there have been 66 reports of illness across 28 states that may be linked to Nestle Toll House cookies.   Here is a link to the FDA news release about the Nestle Toll House recall.

FDA Warns Consumers Not to Eat Nestle Toll House Prepackaged, Refrigerated Cookie Dough Nestle Voluntarily Recalls all Varieties of Prepackaged, Refrigerated Toll House Cookie Dough

 The U.S. Food and Drug Administration 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 with E. coli O157:H7 (a bacterium that causes food borne illness).   

The FDA advises that if consumers have any prepackaged, refrigerated Nestle Toll House cookie dough products in their home that they throw them away. Cooking the dough is not recommended because consumers might get the bacteria on their hands and on other cooking surfaces.

Retailers, restaurateurs, and personnel at other food-service operations should not sell or serve any Nestle Toll House prepackaged, refrigerated cookie dough products subject to the recall.

Nestle USA, which manufactures and markets the Toll House cookie dough, is fully cooperating with the ongoing investigation by the FDA and CDC. The warning is based on an ongoing epidemiological study conducted by the CDC and several state and local health departments. Since March 2009 there have been 66 reports of illness across 28 states. Twenty-five persons were hospitalized; 7 with a severe complication called Hemolytic Uremic Syndrome (HUS). No one has died.

E. coli O157:H7 causes abdominal cramping, vomiting and a diarrheal illness, often with bloody stools. Most healthy adults can recover completely within a week. Young children and the elderly are at highest risk for developing HUS, which can lead to serious kidney damage and even death.

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 health authorities.

The FDA reminds consumers 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. 

For more information on safe food handling practices, go to http://www.fda.gov/Food/ResourcesForYou/Consumers/ucm109899.htm.

Consumers who have additional questions about these products should contact Nestle consumer services at 1-800-559-5025 and/or visit their Web site at http://www.verybestbaking.com/.

For a complete listing of the recalled products go to: 
http://www.nestleusa.com/PubNews/PressReleaseLibraryDetails.aspx?id=133CC131-A79F-4E84-9C43-C9F99FE5BC99.

Children are more susceptible to complications from E. coli infections. A child contracting the especially harmful E. coli O157:H7 can lead to the rare blood disease Hemolytic uremic syndrome (HUS). HUS affects the red blood cells and can lead to kidney damage and even kidney failure. In 15% of the cases the disease proves to be fatal.

If the investigation confirms the Toll House cookies contamination, it would be rather upsetting that a food marketed as a family friendly product for parents and children to enjoy baking and eating together, could be so careless. This isn’t a matter of just eating the dough, either. If this food is contaminated, it opens up the opportunity for cross contamination. Your child helps you cut the cookies or scoop the dough and now their fingers can potentially turn deadly. The counter where the cookies were prepared now becomes a bacterial battlefield waiting to wage war on your insides. As someone who represents victims of E. coli O157:H7 poisoning and HUS, we are all too familiar with the dangers posed by this horrific bacteria.

Stay tuned, we will continue to watch the investigation closely and follow this story until the end.

As over 60 cases of E. coli O157:H7 from 28 states have been identified, the Colorado Department of Public Health and Environment has issued a statement urging Coloradans to avoid consuming raw Nestle Toll House cookie dough products, which may be linked to the E. coli O157:H7 outbreak.  E. coli O157:H7 can lead to the potentially fatal hemolytic uremic syndrome (HUS). According to the CDPHE release:

The Colorado Department of Public Health and Environment is urging Coloradans not to eat raw Nestle Toll House cookie dough because of possible contamination with E. coli O157:H7.

Colorado state health officials, the CDC and several other state health departments are investigating an outbreak of E. coli O157:H7 infections. To date, 66 cases from 28 states have been identified. Preliminary evidence from the multi-state investigation suggests that Nestle Toll House cookie dough may be the source of the outbreak, although further investigation is ongoing.

Five cases have been reported in Colorado in the following counties: Denver, Douglas (2), Jefferson and Weld. Two of the people have been hospitalized, and one has developed a severe complication called hemolytic uremic syndrome. Of the four people interviewed so far by the state health department, all had consumed the raw cookie dough during the week before they became ill.

Alicia Cronquist, the foodborne disease epidemiologist at the state health department, said, “We can’t be certain that raw cookie dough is the source of these infections, but we are concerned enough that it might be and want consumers to be aware.”

Daniel Rifkin, Wholesale Food Program manager for the Department of Public Health and Environment’s Consumer Protection Division, said, “Nestle is currently evaluating what actions they will take regarding their product. In the meantime, it is important that consumers do not eat or use raw Nestle Toll House cookie dough for now. If you decide to use the product, ensure that the cookies are cooked thoroughly and wash your hands well after handling the raw dough. More information will be forthcoming.”

Cronquist explained that E. coli O157:H7 is a potentially deadly bacterium that can cause bloody diarrhea and dehydration. The very young, seniors and people with compromised immune systems are the most susceptible to foodborne illness. People who are experiencing illness should contact their health care providers. For more information about E. coli O157, please visit the CDC website: http://www.cdc.gov/