MedicalResearch.com Interview with:
Samuel J. Crowe, Ph.D., M.P.H.
Food and Drug Administration
College Park, MD
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Flour has been a suspected outbreak vehicle for Shiga toxin-producing E. coli (STEC) infections since 2009, when a multistate outbreak of foodborne disease was linked to prepackaged cookie dough. The 2016 STEC outbreak investigation described in this study was the first investigation to confirm flour as the source of an E. coli outbreak. Linking the outbreak to flour was challenging for several reasons, but epidemiologic, traceback, and microbiologic data ultimately confirmed that flour produced at a single facility was the source of the illnesses.
MedicalResearch.com: What should readers take away from your report?
Response: Flour is a raw product, meaning it hasn’t been treated to make it safe to eat without further cooking. It can contain harmful pathogens that can make people sick.
It is important to never eat raw dough or batter; even tasting a small amount could make you sick. Always bake and cook dough and batter according to recipes before eating.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: It would be helpful to learn more about how wheat can become contaminated in fields, and how harvesting processes used today might facilitate the spread of pathogens. This information could help shape future efforts aimed at preventing contamination of crops.
MedicalResearch.com: Is there anything else you would like to add?
Response: Several children sickened in the outbreak were exposed to raw flour by handling raw dough. Children reported playing with raw dough at home and at restaurants. This behavior identified another route in which ill people were exposed to contaminated raw flour and underscores why children should not play with raw dough made with flour.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Samuel J. Crowe, Ph.D., M.P.H., Lyndsay Bottichio, M.P.H., Lauren N. Shade, B.S., Brooke M. Whitney, Ph.D., Nereida Corral, M.P.H., Beth Melius, M.N., M.P.H., Katherine D. Arends, M.P.H., Danielle Donovan, M.S., Jolianne Stone, M.P.H., Krisandra Allen, M.P.H., Jessica Rosner, M.P.H., Jennifer Beal, M.P.H., Laura Whitlock, M.P.H., Anna Blackstock, Ph.D., June Wetherington, M.S., Lisa A. Newberry, Ph.D., Morgan N. Schroeder, M.P.H., Darlene Wagner, Ph.D., Eija Trees, D.V.M., Ph.D., Stelios Viazis, Ph.D., Matthew E. Wise, M.P.H., Ph.D., and Karen P. Neil, M.D., M.S.P.H.
N Engl J Med 2017; 377:2036-2043
November 23, 2017 DOI: 10.1056/NEJMoa1615910
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