The federal Centers for Disease Control and Prevention (CDC) in Atlanta is calling the end to an outbreak of E. coli infections linked to flour. But there is one significant caveat.

The flour recalled in the 9-state outbreak of relatively rare E. coli O26 has a long shelf life, and it is likely still stored in many a home and restaurant pantry. Consumers should review the brands of recalled flour.

The outbreak, as measured by the onset of illnesses, extended from Dec. 11, 2018, to May 21, 2019, infecting a total of 21 people. Three required hospitalization, but there were no deaths.

The E. coli O26 outbreak linked to flour led to the recall of several brands and types. The CDC advises consumers to avoid using any of these recalled products:

Brand Castle Mixes

On June 21, 2019, Brand Castle LLC of Bedford Heights, OH, recalled several brands of cookie and brownie mix because the flour used in them was potentially contaminated with E. coli.  The following Brand Castle mixes, sold in 25-ounce and 32-ounce glass jars, were recalled:

• Brand Castle Arctic Chill Chocolate Mint cookie Mix: UPC 6-54448-01035-2, Lot L6112618
• Brand Castle Hot Cocoa cookie Mix: UPC 6-54448-01036-9, Lot L5111918
• Sisters Gourmet Million Dollar cookie Mix: UPC 6-54448-00002-5, Lot L2121818
• Sisters Gourmet Billion Dollar Brownie Mix: UPC 6-54448-00017-9, Lot 31OCT2019BC8324
• In the Mix Chocolate Mint Chip cookie Mix: UPC 6-54448-01081-9, Lot LM101518
• Brand Castle The Grinch Sugar cookie Mix with Sprinkles: UPC 6-54448-01038-3, Lot 25JUL2019BC8324

Pillsbury Best Bread Flour

On June 14, 2019, Hometown Food Co., a customer of ADM Milling Co., announced a recall of 5-pound bags of Pillsbury Best Bread Flour with UPC Code 0 5150020031 5 and the following lot codes and use-by dates:

• Lot Code: 8 342, Use-By Date: JUN 08 2020
• Lot Code: 8 343, Use-By Date: JUN 09 2020

King Arthur Flour

On June 13, 2019, King Arthur Flour Inc., a customer of ADM Milling Co., announced a recall of 14,218 cases of 5-pound bags of King Arthur Unbleached All-Purpose Flour. You can identify recalled flour by looking for the following best-used-by dates and lot codes on the bag’s side panel, below the nutrition facts box:

• Best Used By 12/07/19, Lot: L18A07C
• Best Used By 12/08/19, Lots: L18A08A, L18A08B.
• Best Used By 12/14/19, Lots: L18A14A, L18A14B, L18A14C

ALDI Baker’s Corner All Purpose Flour

On May 23, 2019, ALDI, in association with ADM Milling, recalled all 5-pound bags of Baker’s Corner All Purpose Flour.

• Recalled flour was sold at retail locations in the following states: Connecticut, Delaware, Massachusetts, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, Vermont, and West Virginia.

In declaring the outbreak over, CDC also repeated its cautions about contaminated flour and raw dough:

CDC: Consumers should not use any of the recalled flour. Throw it out.

• If you stored flour in another container without the packaging and don’t remember the brand or “use by” date, throw it away.
• Thoroughly wash the container before using it again.

CDC: Eating raw dough can make you sick.

• Any flour or raw eggs used to make dough or batter might be contaminated with harmful germs.
• Bake or cook food made with raw dough or batter before eating it. Follow the recipe or instructions on the package.Do not use recalled flour in cooking or baking.
• Do not taste raw dough or batter. Even licking a small amount could make you sick.

CDC: Clean up thoroughly after baking.

• Wash any bowls, utensils, and other surfaces that were used when baking with warm water and soap.
• Wash your hands with water and soap before and after baking.

CDC: Contact your healthcare provider if you think you may have become ill from eating raw dough.

CDC: Restaurants and other retailers should not use, sell, or serve any of the recalled flour.

• If you stored flour in another container without the packaging and don’t remember the brand or “use by” date, throw it away.
• Restaurants and retailers should thoroughly wash flour storage containers before using them again.

Restaurants and other retailers should always be safe with raw dough.

• Do not give customers raw dough to play with or eat. It is not safe to eat or play with raw dough, whether made from recalled flour or any other flour.
• Bake or cook food made with raw dough or batter before serving or selling it. Follow the recipe or instructions on the package. Do not use recalled flour in cooking or baking.

Again, as of July 11, CDC said the outbreak appears to be over. It was linked to flour by both epidemiologic and laboratory evidence.  CDC made these additionl points about the O26 outbreak:

• In interviews, ill people answered questions about the foods they ate and other exposures in the week before they became ill. Of 13 people who were asked, 6 (46 percent) reported eating, licking, or tasting raw, homemade dough or batter. Three people with detailed information reported eating raw dough or batter made with Baker’s Corner All-Purpose flour.
• Investigators with the Rhode Island Department of Health collected records and flour samples at a bakery wher an ill person reported eating raw dough. Records indicated that the bakery used Baker’s Corner All Purpose Flour from ALDI. The outbreak strain was isolated from an unopened bag of Baker’s Corner All Purpose Flour collected at the bakery.
• WGS results showed that the E. coli O26 strain identified in the Baker’s Corner All Purpose Flour sample was closely related genetically to the E. coli O26 strain identified in ill people. These results provide additional evidence that people in this outbreak got sick from eating flour.