Flour Recall Expanded Due to Additional Cases of E. coli Infection

General Mills expanded their recall of retail flour from which was initially announced on May 21, 2017 due to 4 additional cases of E. coli infection.  According to the report, these cases are "connected with consumers reporting that they ate or handled uncooked dough or ate uncooked batter made with raw flour"

Also in the news report:

"At this time, it is unknown if we are experiencing a higher prevalence of E.coli in flour than normal, if this is an issue isolated to General Mills' flour, or if this is an issue across the flour industry. The newer detection and genome sequencing tools are also possibly making a connection to flour that may have always existed at these levels." 

Whole genome sequencing has changed the game in terms of tracking the organism responsible for foodborne illness outbreaks.  But is this why see these outbreaks, or is there something occurring in the food supply chain, specifically higher contamination levels of E. coli in grains.


PR Newswire
http://www.prnewswire.com/news-releases/general-mills-expands-retail-flour-recall-300303366.html
General Mills Expands Retail Flour Recall

General Mills Flour Tests Positive for E. coli O121

FDA has confirmed that a sample of recalled General Mills flour has tested positive for E. coli O121.  This comes as General Mills is recalling 10 million pounds of flour after 38 people have gotten ill.

So if you have this flour, either dispose of it or return it if it has not been opened.


General Mills Website
http://www.generalmills.com/flour
Flour recall
Gold Medal, Gold Medal Wondra, and Signature Kitchens flour recalled due to possible E. coli O121 contamination

June 11
Update:
The FDA has alerted General Mills that it has confirmed one sample from our recalled flour has now tested positive for E. coli O121. The positive test was in flour from the recalled time period noted in the recall below:

Allergen Free Tiger Nut Flour Gains Popularity as Wheat Flour Alternative

Tiger nut flour is gaining popularity as an gluten-free alternative to wheat flour. Actually, it is not a nut either, so it is allergen free. So what is tiger nut flour?

Tiger nut or chufa is a tuber from the plant Cyperus esculentus. This tuber is ground and sifted to produce a flour said to have favorable characteristics. Chufa is an ancient food source originating in the Eastern Hemisphere, primarily Africa. In the Western Hemisphere, it has been considered an invasive weed in certain areas.

"Tiger nut flour is rich in calcium, phosphorus, sodium, potassium, iron and zinc, vitamins C and E and folic acid, as well as unsaturated fats and proteins. It is low in carbohydrates, which makes it ideal for Paleo and Ketogenic diets, and is high in fiber and antioxidants."

"Tiger nut flour is ideal for gluten-free, grain-free, nut-free, vegan, keto and paleo diets and can be cooked, baked or fried. While the moist, chewy texture is ideal for a number of applications and recipes, the milky sugary taste is perfect for baked goods as well as sweet breads and tart shells and can be used to add ‘bulk’ to no-bake treats."

And you can even make beer from Chufa.

Forbes
https://www.forbes.com/sites/daphneewingchow/2021/08/31/five-reasons-why-tiger-nut-flour-is-the-trendiest-alternative-flour/
Five Reasons Why Tiger Nut Flour Is The Trendiest Alternative Flour

Tiger nut (or chufa nut) flour, which is ground from tubers that grow on the yellow nutsedge plant, is gaining popularity globally as the perfect substitute for wheat flour, given its gluten-free properties, its status as a super food and its natural sweet taste. The flour, which is made by grinding tiger nut tubers and sieving the powder through a fine screen, acts like almond flour, adding moisture and chewiness but with a sweeter taste.

Flour Recalled As Investigators Try to Link to E. coli Outbreak

General Mills is recalling 10 million pounds of raw flour as federal and state agencies are investing 38 occurrences of E.coli infections across 20 states between December 21, 2015, and May 3, 2016.  The specific type of E. coli is E. coli O121, a non-O157 STEC, that can cause bloody diarrhea, dehydration, and in more susceptible people, it can cause kidney damage.   In 2013, this organism was responsible for an outbreak linked to frozen chicken quesadilla, a product that required cooking.

The outbreak investigation showed that roughly half of the 38 people infected used flour, some of them stated using Gold Medal brand.  So far, the flour has not tested positive for the organism.

So how does E. coli get into flour?  Probably from the raw material.  One study looking at a large number of samples, found that 12.8% of flour samples found E. coli (not strain specific) in raw flour. 

Of course, if the products made from the flour are properly cooked, that cooking will destroy the organism. However, people do eat raw dough products, including cookie dough. Nestle raw cookie dough was involved in an E. coli outbreak in 2009 where people were probably eating raw cookie dough.   In a report of that incident, investigators were not able to find the actual source of the E. coli. And like that case, it is not likely that they will be able to find this strain of E. coli.From that report:

Despite extensive traceback and environmental investigations and testing by regulatory agencies and company A, the source and route of product contamination remains undetermined. Possible means of contamination include introduction of a contaminated ingredient during processing, a lapse in plant biosecurity measures, intentional contamination, or cross contamination with another food processed in the plant. Although the manufacturing plant is located in a rural area in the mid-Atlantic United States, investigators did not observe any obvious breach in biosecurity that would facilitate introduction of E. coli O157 into the facility from the outside. No significant food handling or safety violations were identified at the plant that could result in cross-contamination within the plant.

In the end, don't eat raw dough, including cookie dough.  Clean up as you go, washing up any spilt flour.




 FDA News Release
http://www.fda.gov/Safety/Recalls/ucm504235.htm
Gold Medal, Gold Medal Wondra, and Signature Kitchens Flour Recalled Due to Possible E. coli O121 Contamination

Aldi Recalling Bagged Flour Due to Potential E. coli Contamination, Linked to Outbreak Affecting 17

ALDI is recalling All Purpose Flour, which was produced by ADM, after RI Department of Health discovered the organism during sample testing.  The organism isolated from the bag is closely related by whole genome sequencing to the strain of E. coli O26 that has caused an outbreak affecting 17 people in 8 states.  [Okay raw-cookie-dough eaters, time to pay attention.]

ALDI has recalled Bakers Corner All Purpose Flour sold at retail locations in the Northeastern United States due to a potential presence of E. coli.  This product was sourced from an ADM Milling Co. production facility in Buffalo, N.Y. and was distributed to select ALDI stores in 11 states: Connecticut, Delaware, Massachusetts, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, Vermont and West Virginia.

The contamination was discovered during testing of a five-pound bag of Baker’s Corner All Purpose Flour by the Rhode Island Department of Health.   There are two lot numbers involved in this recall: Lot L18A02 and L18A03. The products have Best If Used By Dates of Dec. 2 and Dec. 3, 2019. The product was manufactured at ADM’s flour mill in Buffalo, New York.

On May 24, 2019, further DNA analysis found that the E. coli in the unopened sample of flour was closely related by whole genome sequencing to the strain of E. coli O26 that has caused an outbreak affecting 17 people in 8 states.

https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/association-adm-milling-co-aldi-issues-isolated-recall-5-lb-bakers-corner-all-purpose-flour
In Association with ADM Milling Co., ALDI Issues Isolated Recall for 5 lb. Bakers Corner All Purpose Flour

Summary
Company Announcement Date: May 22, 2019
FDA Publish Date: May 23, 2019
Product Type:Food & Beverages
Reason for Announcement:
Company Name: ALDI
Brand Name: Bakers Corner
Product Description:  Flour

King Arthur Expands Recall of Flour After Testing Finds E. coli Contamination

In association with ADM Milling Company, King Arthur Flour, Inc.,is expanding its recall to include specific lots of its Unbleached All-Purpose Flour (5 lb. & 25 lb.) after sampling found E. coli 026. King Arthur Flour has not received any confirmed reports of illnesses related to this product.  No illness have been reported.

https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/association-adm-milling-co-king-arthur-flour-inc-expands-recall-unbleached-all-purpose-flour-5-lb-25
In Association with ADM Milling Co, King Arthur Flour, Inc. Expands Recall of Unbleached All-Purpose Flour (5 Lb & 25 Lb)
Summary
Company Announcement Date: October 03, 2019
FDA Publish Date: October 03, 2019
Product Type: Food & Beverages Bakery Product/Mix
Reason for Announcement: E. coli O26
Company Name: King Arthur Flour, Inc.
Brand Name: King Arthur Flour
Product Description: Unbleached All-Purpose Flour

More Flour Recalled After Notified Product May Be Linked to Ongoing E.coli Outbreak

King Arthur Flour, Inc. of Norwich, VT is voluntarily recalling 14,218 cases of 5 lb. Unbleached All-Purpose Flour after being informed by ADM Milling Co. that certain wheat used to make these lots of King Arthur flour has been linked to an ongoing outbreak of E. coli infections that was issued on May 24th.  No illnesses have been reported to date in connection with King Arthur flour.


https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/association-adm-milling-co-king-arthur-flour-inc-voluntarily-recalls-limited-quantity-unbleached-all
In Association with ADM Milling Co, King Arthur Flour, Inc. Voluntarily Recalls Limited Quantity of Unbleached All-Purpose Flour (5 Lb.) Because of Possible Health Risk
Summary
Company Announcement Date:  June 13, 2019
FDA Publish Date:  June 13, 2019

FDA Issues Recall Notice on Flour Recall for Salmonella

After reports of Pillsbury Flour was issued last week, FDA issued an announcement on March 12th, that Hometown Food Company initiated a limited, voluntary retail-level recall on two specific lot codes of its Pillsbury® Unbleached All-Purpose 5 lb Flour (UPC 51500-22241)because it may be contaminated with Salmonella.  There have been no reports of any illnesses associated with this recall. Product is being recalled out of an abundance of caution.

No specific information was provided on how the contamination was detected.

FDA added the reminder that flour is a raw product - "Flour is made from wheat that is minimally processed. Flour should not be considered a ready-to-eat product. It is an ingredient for baked, fried, and cooked products, and these heating processes ensure the safety of flour with proper handling. All surfaces and utensils should be properly cleaned after contact with flour or uncooked dough or batter. Consumers should wash their hands after handling flour or uncooked dough or batter. Consumers should not eat uncooked dough or batter made with raw flour. If you think you became sick from a food containing flour as an ingredient, please call your healthcare provider."

Hometown Food Company Recalls Two Production LOT Codes of Pillsbury® Unbleached All-Purpose 5lb Flour Due to Possible Health Risk
For Immediate Release
March 12, 2019

CDC Report - 2016-2017 E.coli non-O157 Outbreak in Canada Associated with Flour

CDC issued a field note on the 2016-2017 E. coli non-O157 outbreak in Canada associated with flour.  In all, 29 people were infected in Canada and one in the US.   Robin Hood flour was the identified brand.  According to the report, "Eleven of these sixteen patients reported they ate or probably ate raw dough during their exposure period."  "Eight patients were hospitalized, and one developed hemolytic uremic syndrome. Clinical isolates were typed as E. coli O121:H19."

CDC MMWR
https://www.cdc.gov/mmwr/volumes/66/wr/mm6626a6.htm?s_cid=mm6626a6_e
Notes from the Field: An Outbreak of Shiga Toxin–Producing Escherichia coli O121 Infections Associated with Flour — Canada, 2016–2017
Weekly / July 7, 2017

Study Links Pathogenic E. coli (STEC) to Flour in 2016 Outbreak

A study published in the New England Journal of Medicine shows that flour was the source of a 2016 pathogenic E. coli (STEC) outbreak. In this outbreak 56 cases were identified in 24 states, with more than a quarter of those cases developing hemolytic–uremic syndrome - very severe kidney damage.   Although there were many challenges related to flour as an ingredient, this study was able to conclude that the flour was the source of the contamination. In concluding, the study highlights the risky behaviors that led to infection - "These behaviors included the consumption of raw or undercooked homemade dough or batter, which has long been discouraged because of the known risk of salmonellosis from consuming raw eggs, as well as allowing children to play with raw dough in restaurants and using flour to make play-dough for children at home. Our data show that although it is a low-moisture food, raw flour can be a vehicle for foodborne pathogens."

Still, people continue to eat raw dough
New England Journal of Medicine
http://www.nejm.org/doi/full/10.1056/NEJMoa1615910#t=article
Shiga Toxin–Producing E. coli Infections Associated with Flour

More Flour Recalled Due to Potential E. coli Contamination

Two companies, UNFI and Hodgson Mills, recalled 5lb bags of flower due to potential E. coli contamination.  The Hodgsen products is linked to the ADM recall - "This lot of flour was milled at an ADM Milling Facility in St Louis, MO and repacked at Hodgson Mill, Inc. facility in Effingham, IL and was distributed by Hodgson Mill through retailers and distribution nationwide and sold through our website www.hodgsonmill.com"

No illnesses have been reported.


https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/unfi-voluntarily-recalls-wild-harvestr-organic-all-purpose-flour-unbleached
UNFI Voluntarily Recalls Wild Harvest® Organic All-Purpose Flour, Unbleached
Summary
Company Announcement Date: November 27, 2019
FDA Publish Date:November 27, 2019
Product Type:Food & Beverages
Reason for Announcement: Potential E.coli Contamination
Company Name:UNFI
Brand Name: Wild Harvest
Product Description: Organic All-Purpose Flour

Gold Medal Flour Recalled After Product Testing Indicated Potential Salmonella Contamination

General Mills issued a recall of five-pound bags of its Gold Medal Unbleached Flour with a better if used by date of April 20, 2020 for the potential of Salmonella after sample testing of the product. 

While proper cooking of product made from flour would eliminate Salmonella, the concern is that people may under cook items made from flour or that flour dust in the kitchen may contaminate food or food contact surfaces.

https://www.fda.gov/Safety/Recalls/ucm629754.htm
General Mills Recalls Five Pound Bags of Gold Medal Unbleached Flour
For Immediate Release
January 23, 2019

CDC MMWR - 2019 Multistate Outbreak of Escherichia coli O26 Infections Linked to Raw Flour

CDC released a report in MMWR on the 2019 E. coil O26 outbreak linked to raw flour.

"Twenty-one cases were reported from nine states. The median age of patients was 24 years (range = 7–86 years); 71% were female. Three patients were hospitalized, and none died. Among 13 patients asked about flour exposures, six reported eating, licking, or tasting raw homemade dough or batter during the week before illness onset. Three patients reported eating raw dough or batter made with the same grocery store brand of all-purpose flour, including a patient who reported eating raw dough at a bakery in Rhode Island. Overall, of 18 patients with store information, 11 reported shopping at this same grocery store chain."

"Flour is increasingly recognized as a cause of STEC outbreaks (1–5). Raw flour is not a ready-to-eat product, and this outbreak highlights the continuing risk for illness associated with consumption of flour and raw dough or batter."

https://www.cdc.gov/mmwr/volumes/70/wr/mm7016a4.htm
Notes from the Field: Multistate Outbreak of Escherichia coli O26 Infections Linked to Raw Flour — United States, 2019
Weekly / April 23, 2021 / 70(16);600–601
Michael Vasser, MPH1,2; Jonathan Barkley, MPH3,4; Adam Miller, MS3,5; Ellen Gee6; Katherine Purcell7; Morgan N. Schroeder, MPH1; Colin Basler, DVM1; Karen P. Neil, MD1 (View author affiliations)

King Arthur Adds Additional Lots to Flour to E. coli Recall from Early October

King Arthur is forced to expand it recall of flour again as it supplier, ADM Milling, notified the company that three additional product lot codes of 5lb bags of unbleached all-purpose flour were omitted on the original date provided.  This comes after a month from the expanded recall date of October 3, 2019.  The earlier recall was due to positive E. coli O26 testing in a sample.  There have been no illnesses.

https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/king-arthur-flour-updates-three-lot-codes-voluntarily-recalled-unbleached-all-purpose-flour-5-lb
King Arthur Flour Updates Three Lot Codes of Voluntarily Recalled Unbleached All-Purpose Flour (5 lb.)
Summary
Company Announcement Date: November 01, 2019 

FDA Publish Date: November 01, 2019

Product Type: Food & Beverages 

Reason for Announcement: E. coli O26
Company Name:King Arthur Flour, Inc.

Brand Name: King Arthur Flour
Product Description:  Unbleached All-Purpose Flour

More Flour Recalled Due to Potential E. coli Contamination

Two specific lot codes of its Pillsbury® Best 5 lb. Bread Flour  were recalled due to a potential presence of pathogenic E. coli. The product was manufactured by ADM Milling Co., at the company’s mill in Buffalo, NY.  :Approximately 4,620 cases of impacted Pillsbury® Best 5 lb. Bread Flour were distributed to a limited number of retailers and distributors across the following 10 states: Connecticut, Delaware, Maryland, Maine, New Hampshire, New Jersey, New York, Ohio, Pennsylvania and Virginia."

ADM flour with potential E.coli contamination was also involved in recent recalls under brands foe Aldi and King Author Flour.

https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/cooperation-adm-milling-co-hometown-food-company-issues-voluntary-recall-specific-lot-codes
In Cooperation with ADM Milling Co., Hometown Food Company Issues Voluntary Recall of Specific Lot Codes Pillsbury® Best Bread Flour Due to Possible Health Risk

Summary

Company Announcement Date: June 14, 2019

FDA Publish Date: June 14, 2019

Product Type: Food & Beverages 

Bakery Product/Mix

Reason for Announcement: E.coli

Company Name: Hometown Food Company

Brand Name: Pillsbury BEST

Product Description: Flour

Organic Coconut Flour Recalled after Testing Reveals Positive Test Result

King Arthur Flour issued a voluntary recall for Organic Coconut Flour (16 oz.) after testing revealed the presence of Salmonella in 1 pouch of Organic Coconut Flour (16 oz.).

It is not stated if this recall is related to the ongoing investigation of dried coconut that has been linked to a Salmonella outbreak, or whether testing was done as a result of that FDA news release.

https://www.fda.gov/Safety/Recalls/ucm602489.htm
King Arthur Flour Company, Inc. Voluntarily Recalls Organic Coconut Flour (16 Oz.) Because of Possible Health Risk
For Immediate Release
March 23, 2018

All Purpose Flour Recalled After Sample Testing Finds Salmonella

General Mills today announced a voluntary national recall of two-, five- and 10-pound bags of its Gold Medal Unbleached and Bleached All Purpose Flour with a “better if used by” date of March 27, 2024, and March 28, 2024 due to the potential presence of Salmonella.  The recall is being issued for the potential presence of Salmonella Infantis,which was discovered during sampling of the five-pound bag product.

 
  

https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/general-mills-recalls-four-gold-medal-unbleached-and-bleached-all-purpose-flour-varieties-dated
General Mills Recalls Four Gold Medal Unbleached and Bleached All Purpose Flour Varieties Dated March 27, 2024 and March 28, 2024
Summary
Company Announcement Date:  April 28, 2023
FDA Publish Date:  April 28, 2023
Product Type:  Food & Beverages  Bakery Product/Mix
Reason for Announcement:  Potential to be contaminated with Salmonella
Company Name:  General Mills
Brand Name:  Gold Medal
Product Description:  All Purpose Flour, bleached and unbleached

Snack Items Recalled After Supplier's Supplier Has Peanut Allergen Cross Contact Issue

Frito Lay and Hostess announced recalls of a number of their flour containing snacks after their supplier found that peanut allergen may be present in the flour they provided.  That supplier, Grain Craft, announced that the issue came from one of their suppliers, a flour mill in Georgia (where there are plenty of peanuts).  Hostess has reported two potential allergen issues, Frito Lay has not had any reports of issues.
 Grain Craft stated in their press release:

"These recent recalls bring to light the challenge of agricultural cross-contact, which is the result of customary methods of growing, harvesting and shipping of wheat and other agricultural products."

So was Grain Craft managing peanut allergen as a potential hazard?  It was not stated in their press release [attached below].

 

So if your company is buying bulk wheat flour, good time to assess whether peanut allergen can be a risk.  Part of that will be checking with the supplier to see if they are controlling allergens as part of their food safety procedures, especially when they are sourcing their product from various mills.

  

CNN

http://www.cnn.com/2016/06/07/health/rold-gold-hostess-recalls-pretzels-snacks/

Rold Gold pretzels, Hostess snacks recalled for possible peanut contamination

By Debra Goldschmidt, CNN

Updated 7:01 PM ET, Tue June 7, 2016

 

CDC Report - 2016 Outbreak of Pathogenic E. coli O157:H7 Associated with Dough Mix

In this week's MMWR, CDC reviews the 2016 outbreak or E. coli O157:H7 associated with a dough mix.  There were 13 people in 9 different states who became ill.  Eight of those people were hospitalized, and two developed HUS (hemolytic uremic syndrome - a condition that can lead to loss of kidney function). 8 of these individuals ate a desert pizza made iwht the mix while one other ate bread sticks made with that dough.

Government inspectors sampled 88 samples of the dough mix at the restaurants and 6 samples of the dry dough mix at the manufacturer and did not find this strain of E. coli, (although strains of  identified non-O157 STEC were found.)

Flour is a raw agricultural commodity, and while level of pathogens such as E. coli and Salmonella are normally very low, there are times when sufficient pathogens can be present to cause illness.  While it seems not one was affected from eating the pizza with this dough, the investigators felt that the thicker desert pizza may not have been cooked as thoroughly.  And when people spread flour on surfaces, such as when working dough, this flour may then get upon other foods.

It is important for not only consumers, but also foodservice operations to treat flour as potentially contaminated.  This means cooking dough thoroughly, cleaning up spilled flour as well as flour spread on surfaces so that it does not come in contact with ready-to-eat foods, and of course, not eating raw dough.

CDC - MMWR
https://www.cdc.gov/mmwr/volumes/66/wr/mm6603a6.htm?s_cid=mm6603a6_e
Notes from the Field: Multistate Outbreak of Escherichia coli O157:H7 Infections Linked to Dough Mix — United States, 2016

Canada - E.coli Outbreak Linked to Flour

In Canada, there have been 25 cases of E.coli infection linked to Robin Hood flour, with 6 of those cases requiring hospitalizations.  The CFIA found that the flour was contaminated with E. coli O121.

Don't eat raw dough.  Treat raw flour as though it can be potentially contaminated by cleaning it up from the counter or other surfaces.

For the hazard analysis, include E. coli and Salmonella as a hazard in flour (unless it is treated in some way.)

CBC News
http://www.cbc.ca/news/canada/calgary/flour-ecoli-sick-recall-robin-hood-brand-cfia-public-health-agency-1.4046011
25 illnesses in 4 provinces linked to E. coli-tainted Robin Hood flour
10-kilogram bags with best-before date of April 17, 2018, should be thrown out or returned