Salmonella Outbreak Linked to This Pantry Staple—Here’s What You Need to know
The CDC is warning about a salmonella outbreak linked to flour.
As of now, no brand has been identified in the outbreak.
Experts say it’s crucial to handle flour with care.
You’re probably aware by now that you shouldn’t eat raw cookie dough because of the risk of getting Salmonella and other pathogens. But, while most people assume that’s due to the eggs, which are a known Salmonella risk, flour can carry the bacteria as well. The Centers for Disease Control and Prevention (CDC) is warning people to be especially careful with flour—any brand of the pantry staple—right now due to an ongoing Salmonella outbreak.
The CDC issued an investigation notice that notes that 12 people have gotten sick and three people have been hospitalized across 11 states due to Salmonella infections linked to flour. “Investigators are working to identify a specific brand of flour linked to this outbreak,” the notice reads. “However, any raw (unbaked) flour can have germs, like Salmonella. Do not eat or play with uncooked flour, dough, or batter.”
According to the CDC, most people who have gotten sick reported eating raw dough or batter made with flour before they developed symptoms—and flour was the only common ingredient in the raw dough or batter they ate.
Salmonella bacteria causes about 1.35 million infections, 26,500 hospitalizations, and 420 deaths in the U.S. each year, according to the CDC. While flour can be a source of Salmonella infection, it’s not usually the main one.
The investigation is ongoing and it’s understandable to have questions about flour and how Salmonella ends up in the common baking ingredient in the first place. Here’s what you need to know.
How does Salmonella end up in flour?
Confused about salmonella in flour? You’re not the only one. “When we talk about foodborne illnesses or outbreaks, we tend to assume that the food of concern is meat or poultry, perhaps even produce. One of the foods least considered as posing a risk is flour,” says Darin Detwiler, Ph.D., an author and professor of food policy at Northeastern University. But, because flour is made from raw grains, it can contain harmful bacteria like Salmonella, Detwiler says.
The way Salmonella can find its way into flour is admittedly gross. “Salmonella is found in animal intestines,” Detwiler says. “Food becomes contaminated when it comes into contact with feces—directly in the fields or even through contaminated irrigation water.” Meaning, animal poop ends up in fields where grain that becomes flour is grown or can get into the water that helps the plants flourish.
When raw grains are processed into flour, there is no step to potentially kill off bacteria that could be in those grains, Detwiler says. As a result, Salmonella and other bacteria like E.coli can end up in your flour and make you sick.
It can be tricky to pinpoint an exact cause of contamination in these situations, says Francisco Diez-Gonzalez, Ph.D., professor and director of the Center for Food Safety at the UGA College of Agricultural and Environmental Sciences. “The flour may be contaminated all the way from the field,” he says. “It could also get contaminated in different stages of the processing.”
Above all, it’s important for people to realize that there isn’t a so-called “kill step” with flour—it’s a raw ingredient that can contain pathogens, says Richina Bicette, M.D., assistant professor of emergency medicine at Baylor College of Medicine. “Much like the fruits and veggies we buy from the grocery store, the grains used to make flour are grown from the ground and are not washed or treated before being packaged and sent to stores,” she says. “If there are poor infection prevention standards at the factory producing a particular brand of flour, thousands of batches could potentially become contaminated with the bacteria before the problem is discovered.”
Once the flour is contaminated with Salmonella, it will stay there. “Salmonella is very good at surviving in a variety of environments, including the dry environment that we find in flour,” says Donald Schaffner, Ph.D., a quantitative microbial risk assessment expert and professor at Rutgers University. “The starting concentration, as well as storage time and temperature, will influence how long Salmonella can be detected in the flour.”
Salmonella infection symptoms
Most people with a Salmonella infection will have the following symptoms anywhere from six hours to six days after they’re infected, according to the CDC:
Diarrhea that can be bloody
Fever
Stomach cramps
Some people will also experience nausea, vomiting, or a headache, the CDC says—and symptoms can last four to seven days.
“Most individuals will recover with supportive care but certain groups like elderly, young children, and those actively immunosuppressed (transplants, cancer treatment, etc.) can possibly get sick enough to need hospitalization,” says Mark Conroy, M.D., an emergency medicine physician at The Ohio State University Wexner Medical Center.
How to be safe when you’re using flour
For starters, Detwiler says it’s crucial to not eat raw batter. “Despite what we may see on television or what we learned when we were kids, never eat or taste raw flour, dough, or batter,” he says. (The CDC points out that even a small amount of batter can make a child sick.) This is a real risk and one you shouldn’t brush off, says Bruce Ruck, Pharm.D., managing director and director of drug information and professional education at the New Jersey Poison Information and Education System. “It is always suggested not to eat products with flour that is raw—those tend to be a problem and we’ve seen them many times in the past nationally,” he says.
The CDC recommends doing the following to handle flour safely:
Bake or cook food made with raw flour, like cookie dough or cake batter, before eating it.
Follow the recipe or package instructions for cooking or baking, making sure to use the temperature and cooking time given in the recipe or instructions.
Buy heat-treated flour to use in recipes for homemade playdough. (The heating process kills the bacteria, Detwiler says.)
Wash any bowls, utensils, and surfaces that touched raw flour with warm water and soap.
Wash your hands with warm water and soap before and after using raw flour.
Keep raw flour, dough, and batter separate from foods that won’t be cooked.
If you happen to spill flour on a counter, it’s important to clean the surfaces well afterward, Ruck says: “Make sure it’s wiped up and washed very carefully.”
If you cook your food well and clean up afterward, you should be OK—experts say it’s just important to be mindful that there is a risk and to take the right precautions. “The potential contamination should be eradicated by the baking process but there is potential to become ill from tasting your baked goods before adequately baked,” Dr. Conroy says. “Along that line, cooking your food according to the instructions is important to ensure the dough has cooked sufficiently.”
If you bake or use flour at home, Schaffner recommends keeping tabs on the outbreak. “Once the implicated brand and production lots of flour are known, people should check their pantries to make sure that they don't have any and, if they do, return it for a refund,” he says.
Overall, Diez-Gonzalez says it’s crucial to know that there is a risk of getting sick from flour. “The best precaution is to treat flour like you treat other raw commodities. Think of it like meat,” Diez-Gonzalez says.
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