Federal officials have identified flour as the source of a Salmonella Infantis outbreak that has sickened people in 11 states. Three people have been hospitalized.

The Food and Drug Administration and Centers for Disease Control and Prevention have both released outbreak notices confirming that raw flour is the source of the pathogen. The FDA first reported the outbreak on March 29.

As of the posting of the notices today, a specific brand or brands of flour have not been confirmed as being the source of the Salmonella. However, most of the patients reported eating raw dough or batter made with flour before they got sick. Flour was the only common ingredient in the raw dough or batter people reported eating. Investigators are working to identify a specific brand of flour linked to illnesses, according to the FDA.

The 12 sick people live across the country, suggesting a nationally distributed product is behind the outbreak. The patients live in Oregon, California, Nebraska, Minnesota, Iowa, Illinois, Missouri, Tennessee, Ohio, Virginia, and New York. 

Illnesses started on dates ranging from Dec. 6, 2022, to Feb. 13 this year. Sick people range in age from 12 to 81 years, with a median age of 64, and 92 percent are female.

The true number of sick people in this outbreak is likely much higher than the number reported, and the outbreak may not be limited to the states with known illnesses, according to the CDC. This is because many people recover without medical care and are not tested for Salmonella. In addition, recent illnesses may not yet be reported as it usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak.

“Flour doesn’t look like raw food, but most flour is raw. This means that it hasn’t been treated to kill germs that cause food poisoning,” according to the CDC. 

“Any raw (unbaked) flour used to make dough or batter can be contaminated with germs like Salmonella, but Salmonella germs are killed when flour is cooked or baked. You can get sick after eating or tasting raw dough or batter. Children can get sick from handling or eating raw dough used for crafts or play clay.”

People and kitchens can also become contaminated when using raw flour for batter such as that used for fried chicken and other fried foods.

about Salmonella infections
Food contaminated with Salmonella bacteria does not usually look, smell, or taste spoiled. Anyone can become sick with a Salmonella infection. Infants, children, seniors, and people with weakened immune systems are at higher risk of serious illness because their immune systems are fragile, according to the CDC.

Anyone who has eaten or cooked with any raw flour and developed symptoms of Salmonella infection should seek medical attention. Sick people should tell their doctors about the possible exposure to Salmonella bacteria because special tests are necessary to diagnose salmonellosis. Salmonella infection symptoms can mimic other illnesses, frequently leading to misdiagnosis.

Symptoms of Salmonella infection can include diarrhea, abdominal cramps, and fever within 6 to 72 hours after eating contaminated food. Healthy adults are usually sick for four to seven days. In some cases, however, diarrhea may be so severe that patients require hospitalization.

Older adults, children, pregnant women, and people with weakened immune systems, such as cancer patients, are more likely to develop severe illness and serious, sometimes life-threatening conditions.

Some people get infected without getting sick or showing any symptoms. However, they may still spread the infections to others.