{"id":1617,"date":"2015-03-04T00:00:30","date_gmt":"2015-03-04T00:00:30","guid":{"rendered":"http:\/\/www.outbreakmuseum.com\/mobile\/?p=1617"},"modified":"2016-03-16T19:49:53","modified_gmt":"2016-03-16T19:49:53","slug":"cold-stone-cake-batter-ice-cream","status":"publish","type":"post","link":"https:\/\/www.outbreakmuseum.com\/mobile\/salmonella-typhimurium\/cold-stone-cake-batter-ice-cream\/","title":{"rendered":"Cold Stone"},"content":{"rendered":"\n<table id=\"tablepress-47\" class=\"tablepress tablepress-id-47\">\n<thead>\n<tr class=\"row-1\">\n\t<th class=\"column-1\"><b>Outbreak:<\/b> Cold Stone Cake Batter Ice Cream<\/th>\n<\/tr>\n<\/thead>\n<tbody class=\"row-striping\">\n<tr class=\"row-2\">\n\t<td class=\"column-1\"><b>Product:<\/b> Cake Batter Ice Cream<\/td>\n<\/tr>\n<tr class=\"row-3\">\n\t<td class=\"column-1\"><b>Investigation Start Date:<\/b> 06\/29\/2005<\/td>\n<\/tr>\n<tr class=\"row-4\">\n\t<td class=\"column-1\"><b>Location:<\/b> Multi-state<\/td>\n<\/tr>\n<tr class=\"row-5\">\n\t<td class=\"column-1\"><b>Etiology:<\/b> <i>Salmonella<\/i> Typhimurium<\/td>\n<\/tr>\n<tr class=\"row-6\">\n\t<td class=\"column-1\"><b>Earliest known case onset date:<\/b> 05\/21\/2005<\/td>\n<\/tr>\n<tr class=\"row-7\">\n\t<td class=\"column-1\"><b>Latest case onset date:<\/b> 07\/04\/2005<\/td>\n<\/tr>\n<tr class=\"row-8\">\n\t<td class=\"column-1\"><b>Confirmed \/ Presumptive Case Counts:<\/b> 25 \/ 0<\/td>\n<\/tr>\n<tr class=\"row-9\">\n\t<td class=\"column-1\"><b>Positive Samples (Food):<\/b> 2<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<!-- #tablepress-47 from cache -->\n<div id=\"metaslider-id-1585\" style=\"width: 100%; margin: 0 auto;\" class=\"ml-slider-3-99-0 metaslider metaslider-flex metaslider-1585 ml-slider ms-theme-default\" role=\"region\" aria-label=\"Cold Stone\" data-width=\"400\">\n    <div id=\"metaslider_container_1585\">\n        <div id=\"metaslider_1585\" class=\"flexslider\">\n            <ul class='slides'>\n                <li style=\"display: none; width: 100%;\" class=\"slide-1866 ms-image \" aria-roledescription=\"slide\" data-date=\"2015-03-06 16:46:24\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.outbreakmuseum.com\/mobile\/wp-content\/uploads\/2015\/03\/Cold-Stone-Creamery-Seattle-02-672x372-400x300.jpg\" height=\"300\" width=\"400\" alt=\"Cold Stone Creamery in Seattle, Washington\" class=\"slider-1585 slide-1866 msDefaultImage\" \/><div class=\"caption-wrap\"><div class=\"caption\">Cold Stone Creamery in Seattle, Washington<\/div><\/div><\/li>\n                <li style=\"display: none; width: 100%;\" class=\"slide-1594 ms-image \" aria-roledescription=\"slide\" data-date=\"2015-03-03 23:49:01\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.outbreakmuseum.com\/mobile\/wp-content\/uploads\/2015\/03\/Cold-Stone-Creamery-Seattle-01-400x300.jpg\" height=\"300\" width=\"400\" alt=\"Cold Stone Creamery in Seattle, Washington\" class=\"slider-1585 slide-1594 msDefaultImage\" \/><div class=\"caption-wrap\"><div class=\"caption\">Cold Stone Creamery in Seattle, Washington<\/div><\/div><\/li>\n                <li style=\"display: none; width: 100%;\" class=\"slide-1600 ms-image \" aria-roledescription=\"slide\" data-date=\"2015-03-03 23:49:06\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.outbreakmuseum.com\/mobile\/wp-content\/uploads\/2015\/03\/Picture4-400x300.jpg\" height=\"300\" width=\"400\" alt=\"Bill Keene and Chris Van Beneden outside a Cold Stone Creamery in Seattle, WA\" class=\"slider-1585 slide-1600 msDefaultImage\" \/><div class=\"caption-wrap\"><div class=\"caption\">Bill Keene and Chris Van Beneden outside a Cold Stone Creamery in Seattle, WA<\/div><\/div><\/li>\n                <li style=\"display: none; width: 100%;\" class=\"slide-1598 ms-image \" aria-roledescription=\"slide\" data-date=\"2015-03-03 23:49:04\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.outbreakmuseum.com\/mobile\/wp-content\/uploads\/2015\/03\/Picture1-400x300-e1425660556864.jpg\" height=\"300\" width=\"400\" alt=\"At a store, mix-in ingredients are combined with ice cream to create various customized sundaes and treats.\" class=\"slider-1585 slide-1598 msDefaultImage\" \/><div class=\"caption-wrap\"><div class=\"caption\">At a store, mix-in ingredients are combined with ice cream to create various customized sundaes and treats.<\/div><\/div><\/li>\n                <li style=\"display: none; width: 100%;\" class=\"slide-1601 ms-image \" aria-roledescription=\"slide\" data-date=\"2015-03-03 23:49:07\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.outbreakmuseum.com\/mobile\/wp-content\/uploads\/2015\/03\/Picture5-400x300.jpg\" height=\"300\" width=\"400\" alt=\"Melissa Plantega holding a box of cake mix at a Cold Stone Creamery store in Tigard, OR.\" class=\"slider-1585 slide-1601 msDefaultImage\" \/><div class=\"caption-wrap\"><div class=\"caption\">Melissa Plantega holding a box of cake mix at a Cold Stone Creamery store in Tigard, OR.<\/div><\/div><\/li>\n                <li style=\"display: none; width: 100%;\" class=\"slide-1604 ms-image \" aria-roledescription=\"slide\" data-date=\"2015-03-03 23:49:10\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.outbreakmuseum.com\/mobile\/wp-content\/uploads\/2015\/03\/Untitled-1-400x300.gif\" height=\"300\" width=\"400\" alt=\"Illness onset dates of cases by state of residence.\" class=\"slider-1585 slide-1604 msDefaultImage\" \/><div class=\"caption-wrap\"><div class=\"caption\">Illness onset dates of cases by state of residence.<\/div><\/div><\/li>\n                <li style=\"display: none; width: 100%;\" class=\"slide-1603 ms-image \" aria-roledescription=\"slide\" data-date=\"2015-03-03 23:49:09\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.outbreakmuseum.com\/mobile\/wp-content\/uploads\/2015\/03\/traceback-diagram-400x300.jpg\" height=\"300\" width=\"400\" alt=\"Traceback results for cake mix used in cake batter ice cream.\" class=\"slider-1585 slide-1603 msDefaultImage\" \/><div class=\"caption-wrap\"><div class=\"caption\">Traceback results for cake mix used in cake batter ice cream.<\/div><\/div><\/li>\n                <li style=\"display: none; width: 100%;\" class=\"slide-1597 ms-image \" aria-roledescription=\"slide\" data-date=\"2015-03-03 23:49:03\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.outbreakmuseum.com\/mobile\/wp-content\/uploads\/2015\/03\/ingredients-list-400x300.jpg\" height=\"300\" width=\"400\" alt=\"Selected Cold Stone Creamery ice cream flavors and ingredients.\" class=\"slider-1585 slide-1597 msDefaultImage\" \/><div class=\"caption-wrap\"><div class=\"caption\">Selected Cold Stone Creamery ice cream flavors and ingredients.<\/div><\/div><\/li>\n                <li style=\"display: none; width: 100%;\" class=\"slide-1599 ms-image \" aria-roledescription=\"slide\" data-date=\"2015-03-03 23:49:05\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.outbreakmuseum.com\/mobile\/wp-content\/uploads\/2015\/03\/Picture3-400x300.jpg\" height=\"300\" width=\"400\" alt=\"Cold Stone Creamery \u2013 Tigard, OR: A Cold Stone Creamery store posted this sign on their walk-in cooler.\" class=\"slider-1585 slide-1599 msDefaultImage\" \/><div class=\"caption-wrap\"><div class=\"caption\">Cold Stone Creamery \u2013 Tigard, OR: A Cold Stone Creamery store posted this sign on their walk-in cooler.<\/div><\/div><\/li>\n                <li style=\"display: none; width: 100%;\" class=\"slide-1596 ms-image \" aria-roledescription=\"slide\" data-date=\"2015-03-03 23:49:02\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.outbreakmuseum.com\/mobile\/wp-content\/uploads\/2015\/03\/Cold-Stone-Creamery-Tigard-20-400x300.jpg\" height=\"300\" width=\"400\" alt=\"Gold Medal SuperMoist Yellow Cake Mix.\" class=\"slider-1585 slide-1596 msDefaultImage\" \/><div class=\"caption-wrap\"><div class=\"caption\">Gold Medal SuperMoist Yellow Cake Mix.<\/div><\/div><\/li>\n                <li style=\"display: none; width: 100%;\" class=\"slide-1602 ms-image \" aria-roledescription=\"slide\" data-date=\"2015-03-03 23:49:08\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.outbreakmuseum.com\/mobile\/wp-content\/uploads\/2015\/03\/Picture6-400x300.jpg\" height=\"300\" width=\"400\" alt=\"Cake batter mix ingredients.\" class=\"slider-1585 slide-1602 msDefaultImage\" \/><div class=\"caption-wrap\"><div class=\"caption\">Cake batter mix ingredients.<\/div><\/div><\/li>\n            <\/ul>\n        <\/div>\n        \n    <\/div>\n<\/div>\n\n<table id=\"tablepress-60\" class=\"tablepress tablepress-id-60\">\n<thead>\n<tr class=\"row-1\">\n\t<th class=\"column-1\">Outbreak Summary:<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr class=\"row-2\">\n\t<td class=\"column-1\">The vehicle for this outbreak was ice cream made with a contaminated cake mix ingredient. Four patients reported eating cake batter flavor ice cream from two separate outlets of Cold Stone Creamery.<br \/>\n<br \/>\n<ul><li>\u2022 <a href=\"http:\/\/www.outbreakmuseum.com\/mobile\/wp-content\/uploads\/2015\/03\/Cold-Stone-Q-v1-final-questionnaire-1.pdf\" target=\"_blank\">Final outbreak questionnaire (PDF)<\/a><\/li><li>\u2022 <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/17477273\" target=\"_blank\">PubMed.gov publication (Center for Food Safety, University of Georgia)<\/a><\/li><\/ul><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<!-- #tablepress-60 from cache -->\n\n<table id=\"tablepress-52\" class=\"tablepress tablepress-id-52\">\n<thead>\n<tr class=\"row-1\">\n\t<th class=\"column-1\">Details:<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr class=\"row-2\">\n\t<td class=\"column-1\"><b><i>Salmonella<\/i> Typhimurium Outbreak Associated with Cake Batter Ice Cream from Cold Stone Creamery<\/b><br \/>\n<br \/>\n<b>Background<\/b><br \/>\nOn June 29, 2005, the Minnesota Department of Health identified four <i>Salmonella<\/i> Typhimurium isolates with a pulsed-field gel electrophoresis (PFGE) subtype that was new to the PulseNet national database. Four patients reported eating cake batter flavor ice cream from two separate outlets of Cold Stone Creamery. <br \/>\n<br \/>\n<b>Methods<\/b><br \/>\nThe PulseNet national database was queried to identify potential cases in other states. A case was defined as infection with an S. Typhimurium isolate that matched the outbreak PFGE pattern, and illness onset since May 2005. All cases were interviewed with a standard questionnaire. State and federal officials conducted a traceback of ice cream ingredients.<br \/>\n<br \/>\n<b>Results<\/b><br \/>\nWe identified 25 cases in nine states (MN, 5; OR, 5; WA, 5; VA, 3; OH, 2; CA, IL, MA, MI, PA, 1 each); 24 reported eating cake batter ice cream from Chain A. The median age of cases was 13years (range, 2\u201332 years). The median incubation was 4 days (range, 1\u20137 days). Illness onset dates ranged from May 21 to July 4; four cases were hospitalized. Cold Stone Creamery voluntarily recalled cake batter ice cream on July 1. This flavor\u2019s ingredients included a pasteurized liquid sweet cream base and Gold Medal Super Moist yellow cake mix. The sweet cream base was used in numerous other ice cream flavors, but the cake mix was used only in cake batter ice cream. The cake mix comprised spray-dried egg whites, flour, and several low-risk components. Tracebacks in Minnesota, Oregon, and Virginia implicated a single lot of cake mix produced on April 14, 2005. No manufacturing anomalies were identified for this lot; but two cake mix samples yielded the outbreak strain of S. Typhimurium. The Food and Drug Administration warned food retailers that cake mixes and flour are not considered \u201cready to eat\u201d and should be heat processed before consumption. <br \/>\n<br \/>\n<b>Conclusion<\/b><br \/>\nThe vehicle for this outbreak was ice cream made with a contaminated cake mix ingredient. While the ultimate source of contamination was not confirmed, we recommend a review of the efficacy of spray-drying egg whites as a kill step for <i>Salmonella<\/i>. Routine and rapid subtyping of bacterial isolates, coupled with a vigorous epidemiological response, is critical to identifying and abating multi-state outbreaks.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<!-- #tablepress-52 from cache -->\n<p><a href=\"https:\/\/www.outbreakmuseum.com\/mobile\/exhibits\/\"><strong>Back to Outbreak Exhibits<\/strong><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Back to Outbreak Exhibits<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[65],"tags":[81,85,84,77,82,80,76,79,86,78],"class_list":["post-1617","post","type-post","status-publish","format-standard","hentry","category-salmonella-typhimurium","tag-acute-and-communicable-disease-prevention","tag-cake-batter-ice-cream","tag-cold-stone","tag-dr-bill-keene","tag-fomes","tag-integrated-food-safety-center-of-excellence","tag-international-outbreak-museum-iom","tag-oregon-health-authority","tag-salmonella-typhimurium","tag-tribute"],"_links":{"self":[{"href":"https:\/\/www.outbreakmuseum.com\/mobile\/wp-json\/wp\/v2\/posts\/1617","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.outbreakmuseum.com\/mobile\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.outbreakmuseum.com\/mobile\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.outbreakmuseum.com\/mobile\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.outbreakmuseum.com\/mobile\/wp-json\/wp\/v2\/comments?post=1617"}],"version-history":[{"count":6,"href":"https:\/\/www.outbreakmuseum.com\/mobile\/wp-json\/wp\/v2\/posts\/1617\/revisions"}],"predecessor-version":[{"id":1785,"href":"https:\/\/www.outbreakmuseum.com\/mobile\/wp-json\/wp\/v2\/posts\/1617\/revisions\/1785"}],"wp:attachment":[{"href":"https:\/\/www.outbreakmuseum.com\/mobile\/wp-json\/wp\/v2\/media?parent=1617"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.outbreakmuseum.com\/mobile\/wp-json\/wp\/v2\/categories?post=1617"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.outbreakmuseum.com\/mobile\/wp-json\/wp\/v2\/tags?post=1617"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}