The Food and Drug Administration has officially linked a Salmonella Infantis outbreak to Gold Medal flour produced by General Mills.

The company recalled certain flour products on April 28 because of Salmonella Infantis contamination but did not mention the outbreak in its recall notice. The company did not report how many pounds of flour it recalled.

Testing by the FDA has now shown that flour produced by General Mills is contaminated with the outbreak strain of Salmonella.

On March 30 the Centers for Disease Control and Prevention announced an outbreak of Salmonella Infantis linked to flour, but did not name a specific flour. At that time there were 12 confirmed patients with three hospitalizations.

As of the posting of today’s outbreak notice by the FDA, there are 13 patients across 11 states from coast to coast. Those states and the number of sick people are California with 1, Illinois with 2, Iowa with 1, Minnesota with 1, Missouri with 1, Nebraska with 1, New Jersey with 1, New York with 1, Ohio with 1, Oregon with 1, Tennessee 1 and Virginia 1.

Sick people range in age from 12 to 81 years of age and 92 percent of them are women. In its March 30 outbreak announcement, the CDC reported that state and local public health officials are interviewing people about the foods they ate in the week before they got sick. Of the 7 people interviewed at that time, 6 reported eating raw dough or batter. Flour was the only common ingredient in the raw dough or batter people reported eating.

There will likely be additional sick people identified because of the time it takes for testing, confirmation, and reporting to federal officials.

Of patients interviewed so far, the FDA reports that five of nine of them specifically remember being exposed to raw Gold Medal brand flour before becoming ill. the CDC reports that seven of eight cases reported consuming raw dough or batter.

“FDA’s traceback investigation identified a single production facility of the flour consumed by patients. FDA initiated an inspection at the General Mills Kansas City, MO, facility and collected product samples. One sample was found to be positive for Salmonella, and subsequent analysis by Whole Genome Sequencing (WGS) found that the Salmonella in the positive sample matched the strain of Salmonella making people sick in this outbreak,” according to today’s outbreak announcement.

Current product recall information
General Mills issued a nationwide recall of 2-, 2- and 10-pound bags of its Gold Medal Unbleached and Bleached All Purpose Flour with a “Better if Used By” date of March 27, 2024, and March 28, 2024. No other types of Gold Medal Flour are affected by this recall at this time.

There is concern that consumers have the recalled flour in their homes because of its long shelf life. If consumers have gold medal flour in their homes but do not have the original packaging to check for identifying information, it is recommended that they throw out the flour.

This voluntary recall includes the following code dates currently in stores or consumers’ pantries, all with “Better if Used by” dates of 27MAR2024 and 28MAR2024:

Previous General Mills recalls and outbreak
In January 2016 General Mills Inc. initiated a recall of all 5-pound bags of its Gold Medal brand unbleached flour with the “better if used by” date of April 20, 2020, after finding Salmonella in a sample.

The iconic company did not indicate how many bags or the total pounds affected by the recall in its Jan. 23 recall notice. General Mills urged consumers to check their homes for the recalled flour, advising them to dispose of the product if they had it.

The president of the General Mills meals and baking division said in the recall notice that consumers should not consume flour — or anything containing it, such as cookie dough — that has not been cooked to a high enough temperature to kill bacteria such as Salmonella.

In May of 2016, General Mills Inc. initiated a nationwide recall of three brands of flour in response to a 20-state E. coli outbreak that had sickened at least 38 people at that time

Although government officials had reportedly been investigating the outbreak, no state or federal agencies had released any information about it at the point the Minneapolis-based company announced the recall.

“State and federal authorities have been researching 38 occurrences of illnesses across 20 states related to a specific type of E. coli O121, between Dec.21, 2015, and May 3, 2016,” according to a news release at the time from General Mills.

“While attempting to track the cause of the illness, CDC (Centers for Disease Control and Prevention) found that approximately half of the individuals reported making something homemade with flour at some point prior to becoming ill. Some reported using a General Mills brand of flour.”

The recall includes six SKUs (stock keeping units or UPC codes) of Gold Medal branded flour, two SKUs of Signature Kitchens branded flour, and one SKU of Gold Medal Wondra branded flour.

In June of 2016, General Mills Inc. and federal officials worked together to account for recalled flour that was been linked to the E. coli outbreak and that was sent to food producers in addition to retailers and restaurants.

Neither the company nor the government has included information about the flour sent to food producers in published recall or outbreak notices. General Mills recalled 10 million pounds of flour after the Centers for Disease Control and Prevention informed the company the flour had been linked to an E. coli outbreak that has been going on since December 2015.

Both General Mills and the U.S. Food and Drug Administration confirmed for Food Safety News that some of the recalled flour had been sent in bulk to food-producing companies. The outbreak spanned 20 states in June 2016.

General Mills Inc. tripled the size of its flour recall to 30 million pounds in July 2016. Investigations yielded few results in terms of the root cause of the contamination. But, FDA’s outbreak investigators reported an increasing body of DNA evidence revealing the outbreak strain of E. coli O121 was present in flour from the General Mills plant in Kansas City, MO.

The General Mills plant at 2917 Guinotte Ave. in Kansas City, MO, sits in the middle of industrial property that is surrounded by rail yards. The area is just north of the Missouri River and a few blocks west of Interstate 29.

A poultry distribution company is directly across the street from the flour plant and the area is a regular transportation route for trucks and trains hauling live animals and fowl.

Dan Cohen of the agricultural research and development company Maccabee Seed in Davis, CA, was intrigued by the whole situation.

“It’s still a little hard to imagine how the contamination took place,” said Cohen, who has been working in agriculture and food safety research and development for more than 30 years.

“If it came in on grain, I would look for wheat sourced near feedlots because of dust contamination issues.”

In September of 2016, the CDC declared the outbreak over. Federal health officials concluded their investigation involving the General Mills flour implicated in the E. coli outbreak that ultimately sickened at least 63 between December 2015 and September 2016, but they say more people are expected to become ill.

“Although the outbreak investigation is over, illnesses are expected to continue for some time,” according to the CDC report. “Consumers who don’t know about the recalls could continue to eat the products and get sick. A list of the recalled products and how to identify them is available on the Advice to Consumers page.”

The 63 confirmed outbreak victims were from 24 states and ranged in age from 1 to 95 years old. None died, but 17 had symptoms so severe they required hospitalization. One person developed a potentially fatal complication, hemolytic uremic syndrome, a type of kidney failure. The onset of the victims’ illnesses ranged from Dec. 21, 2015, through Sept. 5, 2016.

General Mills issued its first flour recall related to the outbreak on May 31. After tests showed the outbreak strain in bags of flour collected from outbreak victims’ homes in three states the company expanded the recall twice, eventually recalling 45 tons of flour