By: James Peacock

Over the past few months, an E. coli outbreak has been raging across Canada. Its source was eventually found to be Canadian flour, which triggered a growing string of recalls for flour and flour related products. Now, for the first time in this investigation, flour distributed in the United States is coming under recall. On May 31, 2017, Smucker Foods of Canada issued a recall in collaboration with the FDA. The recall affected various lots of flour that were sold under the Golden Temple, Swad, and Maya brand names. These products may be contaminated with E. coli O121, the same pathogen that has caused an outbreak in Canada. The flour subject to the recall was produced by Ardent Mills, a Saskatoon, Saskatchewan based company has been forced to recall quite a few different products as a result of the E. coli contamination. The contamination appears to be traceable to 11 loads of Canadian wheat used to make the flour. Once made, the flour was packaged in 20 pound paper bags. Bags of flour were then sent to 19 different distributors and two small retailers across the United States. A table detailing the brands, UPC codes, and other identifying information can be found below. There are no other Smucker Foods of Canada products under recall, and there have yet to be any illnesses connected to the recall.

 

 

Product Name Size UPC Code Lot Code Best By Date
Maya Durum Wheat Atta Flour 20 lbs 0 20843 10001 9 6 286 548 No Best If Used By Date
6 287 548 No Best If Used By Date
Swad Durum Atta Flour Chappati Flour 20 lbs 0 51179 16030 9 6 294 548 No Best If Used By Date
6 299 548 No Best If Used By Date
6 300 548 No Best If Used By Date
6 308 548 No Best If Used By Date
Golden Temple #1 Fine Durum Atta Flour Blend 20 lbs 0 59000 40540 7 6 286 548 Best if Used By Jan 2018
6 299 548 Best if Used By Jan 2018
Golden Temple Durum Atta Flour Blend 20 lbs 0 59000 41556 7 6 287 548 Best if Used By Jan 2018
6 288 548 Best if Used By Jan 2018
6 294 548 Best if Used By Jan 2018
6 295 548 Best if Used By Jan 2018
6 300 548 Best if Used By Jan 2018
6 301 548 Best if Used By Jan 2018
6 306 548 Best If Used By Feb 2018
6 307 548 Best If Used By Feb 2018
6 308 548 Best If Used By Feb 2018

 The Canadian Outbreak: A Sign of Things to Come?

The fact that no illnesses have been connected yet to contaminated flour sold in the United States does not mean that there is a reduced risk of catching a case of E. coli poisoning. Illnesses have already been connected to other flour involved in the E. coli contamination, leading to a full investigation by the Public Health Agency of Canada. In fact, there have been confirmed cases of E. coli poisoning connected to other Smucker Foods of Canada products. The FDA recommends that any potentially contaminated flour be disposed of immediately to prevent any illnesses. Stores have also been instructed to remove recalled flour from their shelves, but as previous flour related outbreaks have shown, stores are sometimes slow to respond to these requests. Flour products also have very long shelf lives, which only increases the risk associated with them.

Again, recalled flour has been connected to a large outbreak of E. coli poisoning in Canada already. Canadian health officials began to track the outbreak as early as January. As of the most recent update, published on May 18, 30 people have been sickened in the outbreak. These cases all have matching genetic fingerprints and are located in 6 different provinces. Provinces affected include British Columbia with 13 reported cases, Newfoundland and Labrador with 5 reported cases, Saskatchewan with 4 reported cases, Alberta with 5 reported cases, Quebec with 1 reported case, and Ontario with 1 reported case. Those illnesses began between November 2016 and April 2017, and have led to 8 cases of hospitalization. No deaths have been reported in relation to this outbreak.

Related Foodborne Illness Outbreaks

Flour based outbreaks are not unheard of. Just last year, there was a large outbreak linked to flour produced by General Mills. That outbreak, investigated by the CDC for more than 3 months, would eventually cause 63 cases of illness in more than 20 states. This would make it one of the largest outbreaks of 2016, earning a spot on our year in review. The General Mills outbreak would cause 17 of the 63 sickened to be hospitalized, but thankfully did not prove to be fatal. The CDC investigation revealed that flour produced in a General Mills facility located in Kansas City, Missouri. That outbreak would not only cause a General Mills recall that would expand several times, but would also result in a host of secondary recalls.

Outbreaks that affect both Canada and the United States are also not unheard of. In another outbreak from last year, salads produced by Dole were linked to a number of cases of Listeria monocytogenes poisoning. The CDC investigation, which centered on the outbreak occurring in the United States, revealed 19 cases of illness were reported in 9 different states. All 19 cases required hospitalization, and 1 death was reported. The Springfield, Ohio facility was connected with this outbreak, and it soon became clear that potentially contaminated products were also shipped to Canada. An investigation run by the Public Health Agency of Canada would eventually find 14 cases of Listeria poisoning in 5 different provinces, bringing the total number of cases to 36. Dole would eventually come under federal investigation regarding whether or not they had prior knowledge of the Listeria contamination.

With both of these outbreaks taking place in the past year, health officials in both countries have made several recommendations on how to best prevent infection. Officials have repeatedly stressed that flour is not a ready to eat product, and when it is consumed raw it has the potential to cause illness. This applies not only to raw bread dough but also to cookie dough. Raw dough needs to be properly and thoroughly cooked in order to eliminate any bacteria that may be found in it. Though heat will kill any bacteria present, it is still not a good idea to cook with flour that has been recalled. Raw dough and flour should also not be given to children to play with, as that can also lead to illness. If you have flour made by a company involved in the recall, check the table above to make sure that any recalled flour is properly disposed of.

E. coli

E. coli infections remain one of the most common forms of foodborne illness in the Unites States. While there are several different types of E. coli that cause illness in humans, the strain responsible for this recall and outbreak, E. coli O121, is from the class known as enterohemorrhagic Escherichia coli. These E. coli bacteria produce Shiga toxins, which cause a gastrointestinal illness in humans. These bacteria will also be commonly referred to as E. coli (STEC). The CDC estimates that there are around 265,000 cases of E. coli poisoning each year in the United States. E. coli are found naturally in the environment, and outbreaks have been caused by a number of sources, including beef products, raw milk, yogurt, mayonnaise, cheeses, unpasteurized fruit juices, bagged lettuce, alfalfa sprouts, spinach, various water sources, and more. After exposure to even a small amount of bacteria, it is possible for an infection to develop. Symptoms of the infection will usually occur between 3 and 4 days after exposure, but E. coli infections can begin to cause symptoms anywhere between 1 and 9 days after exposure. Symptoms of an E. coli infection will typically include severe cramping, vomiting, nausea, and watery or bloody diarrhea. There is sometimes a low-grade fever associated with the infection as well. These symptoms will, much of the time, go away on their own after about a week, but can last longer. There are a couple of complications associated with an E. coli infection. Diarrhea can cause dehydration, which can be very serious if left untreated. E. coli infections can also cause a rare but potentially fatal complication called hemolytic uremic syndrome (HUS).

Hemolytic uremic syndrome occurs in about 3 to 7 percent of E. coli cases. HUS damages red blood cells, which are then sent to the kidneys in order to be filtered out. Removing these damaged blood cells can damage the kidneys. The damage from the filtration process, coupled with the increased rate of damage inflicted on the kidneys by shiga toxins, can lead to serious kidney damage and even kidney failure. If a case of E. coli poisoning has progressed to HUS, symptoms such as decreased frequency in urination, fatigue, and loss of color in the eyes and cheeks will be present. HUS is a very serious complication that needs to be treated as quickly as possible. If you or a loved one begins to show the symptoms of E. coli poisoning, contact a medical professional.

Sources:

http://www.ardentmills.com/uploads/news-entry/CFIA%20Recall%20-%20AM%20Complies%20-%20May%2026%202017%20Draft%20AD.pdf

http://www.phac-aspc.gc.ca/phn-asp/2017/outbreak-ecoli-eng.php

http://www.inspection.gc.ca/about-the-cfia/newsroom/food-recall-warnings/complete-listing/2017-03-28/eng/1490721738461/1490721741554

https://www.fda.gov/Safety/Recalls/ucm561190.htm?source=govdelivery&utm_medium=email&utm_source=govdelivery

https://www.cdc.gov/ecoli/2016/o121-06-16/index.html

http://www.phac-aspc.gc.ca/phn-asp/2016/listeria-eng.php