Cookie Dough: Cold Killer?

Greetings, bowl-lickers.

A friend of mine who enjoys the odd clandestine spoonful of uncooked cookie dough suggested to me last night that I look into the risks involved in his filthy habit. (Just kidding - I regularly eat raw cookie dough by the scoop.)

We're told never to eat cookie dough because raw eggs may contain the bacterium Salmonella enterica, which can make you sick. Despite all the warnings, cookie dough eating is rampant in North America. Does cookie dough cause widespread poisoning deaths, or is it just another paper tiger? Read on to find out.



Salmonellosis: Symptoms and Rates

Any medical condition with a Latin name sounds scary. However, the majority of Salmonella infections cause gastro-intestinal upset and a fever for 4 to 7 days and then go away without formal medical intervention. If you're old, an infant, or have a weak immune system, you could need antibiotics to make your infection go away, and a particularly bad Salmonella infection can cause lasting conditions like arthritis or death. However, these big-ticket fears are relatively uncommon; this CDC study says the ratio of illnesses to hospitalizations to deaths for nontyphoidal salmonellosis is roughly 2,426 to 28 to 1.

The same CDC study estimates that the number of cases of salmonellosis in the United States is about 182 000 per year, or about 1 in 1 500; but since most infections go unreported it's really hard to tell. Its best guess is that salmonellosis from shell eggs causes about 2000 hospitalizations and 70 deaths per year: in other words, salmonella from eggs is about 1000 times less deadly than the flu (from this .pdf, page 2; this comparison is apt since both flu and salmonellosis are grave threats mostly to people with compromised immune systems).

Is Cookie Dough a Big Culprit?

Most of the salmonellosis outbreaks that make the news come from large-scale slip-ups where dozens of people get ill, rather than from small families tasting the occasional batch of cookie dough. Is this just because it takes a certain number of cases before a story is newsworthy, or is there another cause at work?

This CDC page warns that in large-batch recipes where 500 eggs are used the Salmonella risk is greater, since one contaminated egg could taint the whole batch. So what's the risk of getting salmonellosis from eating cookie dough from a two-egg recipe?

This study estimates that only 1 in 30 000 eggs is potentially contaminated with Salmonella, so at most there is a 1 in 15 000 chance that your dough is going to have any Salmonella bacteria. (If the first egg doesn't have Salmonella, the second egg has a smaller than 1 in 30 000 chance of having it too, so 1 in 15 000 is an over-estimate of the risk.) Assuming that it's certain that you will catch an infection from tainted dough, that puts your risk of death from tasting the dough at less than 1 in 36 million; if you have a healthy immune system your risk is considerably smaller. The daily chance of getting a flu as bad as a non-fatal flu-like Salmonella infection are 1 in a few hundred, so you really don't need to worry about salmonella from cookie dough: background risk levels are much higher.

EDD, LED and GHAF

Let's put that 1 in 36 million figure in perspective. The Equivalent Driving Distance (EDD) is just under 2 miles (for those new here, that means a 2-mile car trip is as likely to kill you on average as eating 2 raw eggs) and the Life Expectancy Decrease (LED) is less than 37 seconds (eating 2 raw eggs decreases your life expectancy by only 37 seconds - here I assumed on average my readers might have 42 years left in life and divided by 36 million). For more on the LED and EDD risk metrics, see this introductory blog post and this wiki page for recording risk levels.

So on average the risk of being killed by your baking is negligible. But is the fear over-hyped? Considering there are 294 000 Google hits for "salmonella raw eggs America" and only 70 Americans die of Salmonella from raw eggs, the Google Hits per Annual Fatality (GHAF) hype-metric is 4 200: about as high as for West Nile virus. (See an introduction to the GHAF metric here and a list of GHAFs for various risks here.)

Conclusion: Lick On!

Eating cookie dough gives you a negligible risk unless you have a particularly weak immune system. Whip yourself up a batch and eat it all: it really doesn't matter. Oh, and please save me a spoonful while you're at it.

Bon Appetit!

LeDopore