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December 23, 2019
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Q&A: Tell your patients to drop the dough this holiday season

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As tempting as it is, people should refrain from sneaking a bite of raw cookie dough while baking during the holiday season.

Multiple agencies, including the FDA and CDC, have advised against any consumption of raw dough and batter due to the risks for food poisoning.

Healio Primary Care spoke with Bruce Ruck, PharmD, DABAT, managing director at the New Jersey Poison Control Center at Rutgers New Jersey Medical School’s department of emergency medicine, about the ingredients in cookie dough that lead to illness, what physicians should tell their patients and how to avoid food-related illnesses around the holidays. – by Erin Michael

What should physicians know about the dangers of eating raw cookie dough?

cake mix 
As tempting as it is, people should refrain from sneaking a bite of raw cookie dough while baking during the holiday season.
Source: Adobe Stock

A: One of the major things that we want physicians to know is that it is really important to educate their patients during well-care visits and follow-up appointments in general, about not only eating raw cookie dough, but eating raw dough in general. Whether the dough is being used for bread, cookies, pizza or for anything else — it’s not just the cookie dough, it’s dough in general. Most people think of cookie dough because it tends to sometimes have other stuff in it that makes it even better tasting; but it’s all raw dough that we want to make sure physicians educate their patients not to eat.

Which ingredients can make people sick?

A: It’s two ingredients — raw flour, and raw eggs. There have been outbreaks in the past from both flour and eggs that are not cooked.

Flour tends to have bacteria in it — it may have bacteria contamination from E. coli that hopefully gets destroyed when it’s cooked, and the eggs may have Salmonella. We want to make sure with both of those ingredients, that people do not eat it raw.

How high is the risk for getting sick from eating raw cookie dough?

A: That’s a very hard question to answer, and I don’t think anybody has — or at least I do not have — a perfect answer for that question. The risk is high enough that the health care professional community suggests not eating the raw products. And even if the numbers are not hugely high for people getting sick, if any individual gets sick, it could be bad. We’re looking at two similar, but separate issues. One is the total number of people who get sick, and the other is what happens if you get sick. That’s the reason for the warning.

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What should physicians tell concerned parents to do if their child eats raw cookie dough?

A: The only thing at that point — if it’s already been eaten — is to look at the signs and symptoms of the child getting sick. And interestingly enough, it’s not just little children that do this. We see people of all ages doing this, teenagers to adults. You want to look out for any stomach cramping, stomach upset, nausea, vomiting, blood in the stool, fevers, and things like that. People who have weakened immune systems tend to be at even greater risk. Very young children and the elderly are also at greater risk. And it’s not just eating it — sometimes children or caregivers may have dough leftover, so the kids play with it, almost like a clay-like substance. We want to make sure that people, children, anybody touching or handling this, even if they don’t eat it, washes their hands very well after the fact. Surfaces that may have come in contact with the cookie dough, kitchen counters, plates, cookie sheets, things of that nature — you want to make sure that those are also washed very well.

What are some food safety tips that physicians can pass along to their patients during the holiday season?

A: This is very important — as I just said, the washing of hands, or the washing of surfaces in general. Off the topic of cookie dough — if you have meat in the refrigerator, chicken in the refrigerator, or anything with any kind of meat juice, it should be on the lowest shelf of the refrigerator so it doesn’t drip onto other foods. Always keep it covered in the refrigerator, not just open, because again, you want to keep any drippings from cross-contamination. All utensils and cookware should be cleaned very well, both before and obviously after cooking with it as well. We don’t want to leave food that needs to be refrigerated at room temperature too long, because that can also breed increased bacterial infections or things like that. Foods that should be refrigerated, you should keep refrigerated as soon as possible after the meal is over.

One of the important things that we would like everyone to remember is that the local poison center is always available if people have questions. The number for the local poison center across the United States, where somebody can reach their local professional, is 800-222-1222. Even though that’s the phone number for us at the New Jersey poison center — located at Rutgers University New Jersey Medical School — and if you call that number from New Jersey you will reach us. But if you’re standing in Florida, you will get the Florida poison center by calling that phone number. If you’re standing in Michigan, you’ll get the Michigan center from that phone number. That’s the national number that reaches your poison center, and we want everybody to preprogram it on their phone, in case they do have questions about food poisoning, or poisoning from other sources, or accidental ingestions. A lot of people are visiting relatives this time of year, and people have medicine left out that they normally don’t think about.

And the other thing is, don’t forget your pets — you don’t want to give your pets raw cookie dough and things like that. They’ll also be at risk.

Reference:

CDC. Say no to raw dough. https://www.cdc.gov/foodsafety/communication/no-raw-dough.html. Accessed on Dec. 20, 2019.

Disclosure: Ruck reports no relevant financial disclosures.