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Nestlé Recall Leaves A Mystery in Its Wake
Officials Probe E. Coli Link to Cookie Dough

By Lyndsey Layton and Valerie Strauss
Washington Post Staff Writers
Sunday, June 21, 2009

Federal microbiologists and food safety investigators have descended on the Danville, Va., plant that makes Nestlé's refrigerated cookie dough, trying to crack a scientific mystery surrounding a national outbreak of illness from E. coli 0157, a deadly strain of bacteria, which has been linked to the product.

Health officials and food producers puzzled yesterday over how E. coli 0157, a bacterium that lives in the intestines of cattle, could have ended up in a product that seems so unlikely to contain it. "It's a fascinating outbreak," said Craig Hedberg, an expert on food-borne diseases at the University of Minnesota. "By just looking at package labeling, there is no reason you would expect an event like this to occur."

The outbreak, which has sickened at least 65 people in 29 states, is the latest worry for consumers in the Washington area and across the country unnerved by a wave of food-borne illnesses, including botulism associated with canned chili and infections from salmonella linked to peanut products. With cookie dough, like peanut butter, being a favorite of children, the latest outbreak is particularly alarming because the young and the elderly are more likely to develop severe complications if infected with E. coli 0157. More than two-thirds of the 65 victims are younger than 19, according to the federal Centers for Disease Control and Prevention. None has died.

Two of the victims live in Maryland, and two live in Virginia, the CDC reported. Their identities have not been revealed.

In supermarkets yesterday, Nestlé products had been pulled from the refrigerated section, and consumers were left to ponder the safety of the U.S. food system.

"When I heard about the recall, I thought, 'Is nothing safe anymore?' " said Carole Feld, a D.C. resident who has a 13-year-old child, pushing a shopping cart through a Glover Park Whole Foods Market yesterday. "If bacteria has gotten into Nestlé's Toll House cookie dough, then everything is suspect."

David Evans, who was shopping in a Safeway in McLean with stepdaughter Kelly Ready, said that when he heard about the recall, he immediately checked to see whether there was any of the suspect cookie dough -- which Kelly, 14, said she sometimes eats raw -- in his home. There wasn't.

"I think [the food supply] is basically safe," Evans said. "But we need tighter controls, though I'm not a believer in big government."

The outbreak comes as the federal government is attempting to revamp the nation's outdated food safety system. President Obama has identified food safety as a priority, and Congress is moving legislation that would place new requirements on food manufacturers while beefing up the Food and Drug Administration's inspection and enforcement powers. A key House committee passed legislation last week that could be voted on as early as this week, and a companion bill is pending in the Senate.

Nestlé has a solid reputation within the food industry for manufacturing practices designed to prevent contamination. The company has cooperated fully with the investigation, said David Acheson, assistant commissioner for food safety at the FDA.

Nestlé recalled all its refrigerated Toll House cookie dough products, or about 300,000 cases, on Friday, within 24 hours of being notified by the FDA that it suspected a problem, said Laurie MacDonald, a vice president at Nestlé USA.

The company also suspended operations at the Danville plant that day, she said. About 500 people work at the plant, which is a major employer in the small community near the North Carolina border.

Nestlé, which has a 41 percent share of the prepared cookie dough market, has not estimated the cost of the recall, MacDonald said.

Investigators have not confirmed the presence of E. coli 0157 in any Nestlé product; they are testing samples of dough collected from the plant as well as from victims. But William E. Keene, chief epidemiologist for the state of Oregon, said he was "100 percent" certain that the culprit was the cookie dough. "Virtually everyone [who got sick] ate the same brand of cookie dough," he said. "I have absolute confidence in the conclusion."

Because the appearance of E. coli 0157 in cookie dough is so unusual, investigators are looking at a broad range of possible factors, analyzing the ingredients, the plant's equipment and interior, the health of workers and whether the facility is located near cattle. Federal officials are also considering whether the dough might have been intentionally contaminated.

State health officials first noticed cases of E. coli 0157 emerging in March. Initially, they suspected ground beef or strawberries. But after interviewing victims, state officials and the CDC compared notes during a conference call Tuesday and settled on the refrigerated cookie dough as the prime suspect.

The risk usually associated with cookie dough is salmonella, a bacteria that can be found in raw eggs contained in the dough. Nestlé's cookie dough is packaged with labels warning consumers not to eat it raw. But people tend to disregard the warning -- 39 percent of consumers eat raw cookie dough, according to Consumer Reports. It has become such a popular snack that many ice cream makers have developed a cookie dough flavor.

William Marler, a prominent food safety lawyer in Seattle who is representing six of the E. coli 0157 victims, said Nestlé's warning label is not a defense. "It doesn't absolve them of liability," he said.

E. coli refers to many kinds of bacteria, most of which are harmless or even beneficial. But certain types, including E. coli 0157, produce a toxin that can cause severe illness and even death in humans. The E. coli 0157 bacterium lives in the intestines of cows and other animals -- goats, sheep, deer and elk -- and is found most often in ground beef. But over the past decade, a number of E. coli 0157 illness outbreaks have been associated with green, leafy produce, such as spinach.

"Food-borne diseases are generally a moving target," Hedberg said. "We can't get too comfortable thinking we know how these organisms behave."

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