General Mills, owner of the venerable Gold Medal brand, has recalled over 10 million pounds of flour after 38 people in 20 states got sick from a potentially deadly strain of E. coli that may have originated in the company’s products.

The Golden Valley-based packaged food giant Tuesday announced the voluntary recall of some lots of Gold Medal — the nation’s bestselling retail flour — as well as flour sold under the Wondra and Signature Kitchens brands. Signature Kitchens is a store brand sold at several major U.S. grocery chains including Safeway, Albertsons, Jewel, Vons and Acme.

The federal Centers for Disease Control and Prevention (CDC) said Tuesday there have been 10 hospitalizations associated with an outbreak linked to flour. No deaths have been reported.

The Minnesota Department of Health confirmed that three of the 38 victims lived in the Twin Cities area. All three — two adults and a child — have recovered, and none was hospitalized, said spokesman Doug Schultz.

The flour flap is the second significant recall for General Mills in less than a year.

The company in October recalled 1.8 million boxes of gluten-free Cheerios and Honey Nut Cheerios after discovering the cereal inadvertently contained gluten, a wheat protein that’s an allergen to some. In that case, oat flour was offloaded from a train car into a truck that had previously hauled wheat but had not been properly cleaned. The truck was owned by an independent contractor.

E. coli O121 — a less common strain of the E. coli bacteria — can cause bloody diarrhea, cramps and dehydration. Seniors, very young children and people with weak immune systems are the most susceptible to such an illness.

State and federal health authorities have been investigating a flour-related outbreak of E. coli O121 from Dec. 21 to May 3, General Mills said in a statement. The Minnesota health department said the cases here occurred in January and March. The CDC has not released information on other states involved in the outbreak.

“It must have been substantial contamination for the outbreak to basically go nationwide,” said Bill Marler, a Seattle lawyer who specializes in food safety and suing food companies.

Marler noted that Mills made its recall even though the CDC has yet to detail the outbreak on its website. “I think what General Mills has done here is that they are getting ahead of an obvious problem, which is a positive thing.”

The CDC found that about half of the 38 sickened people reported making homemade food with flour before becoming ill, according to General Mills. Some reported using a General Mills brand of flour, and some also might have consumed raw dough or batter.

General Mills said it has not found E. coli O121 in any of its products or at its flour facilities, nor has it received any illness reports directly from consumers. The flour involved in the recall was mostly produced at General Mills’ plant in Kansas City, Mo.

E. coli outbreaks are most common in meat and produce, and they are ultimately traced back to bacteria in the guts of animals.

“E. coli is typically an indicator of fecal contamination,” said Mike Doyle, director of the University of Georgia’s Center for Food Safety. Vegetables and fruit are often contaminated with E. coli, as well as salmonella, through tainted water. The same could happen to wheat — grist for flour — even though it’s processed.

E. coli outbreaks from flour-related products aren’t common, but a handful have occurred in recent years. The most well-known was a 2009 outbreak of E. coli O157:H7 linked to Nestlé’s Toll House cookie dough. It sickened over 70 people in 30 states, including six in Minnesota. Nestlé issued a big recall due to the outbreak.

The CDC reported that many victims ate raw Toll House cookie dough, a practice frowned upon by food safety experts.

Just as cooking meat properly kills E. coli bacteria, fully cooked baked goods should pose less of a threat.

Also, General Mills says that in order to kill bacteria such as E. coli, it heat-treats flour used in its Pillsbury refrigerated dough products. However, raw flour sold as an ingredient for baking is not heat-treated, because the process “would impact its performance such as rising properties,” the company said in a statement.

General Mills said it made the recall out of an “abundance of caution.”

Liz Nordlie, president of General Mills’ baking division, said in a statement: “As a leading provider of flour for 150 years, we felt it was important to not only recall the product and replace it for consumers if there was any doubt, but also to take this opportunity to remind our consumers how to safely handle flour.”

The company advises consumers never to eat raw dough or batter.

Specific product recall information can be found at generalmills.com/flour. Consumers with additional questions can contact the company at 1-800-230-8103.