Food Safety Training November 12, 13

1. Food Safety TrainingNovember 12, 13

2. Real Stories • Hemolytic uremic syndrome (HUS), a condition that arises when toxins produced by E. coli bacteria get into the bloodstream and damage the tissues of small vessels. The resulting decreased blood flow compromises the kidney's ability to filter waste from the body.  • Spinach and E. Coli

3. Real Stories Cont. • Multistate Outbreak of SalmonellaBredeney Infections Linked to Peanut Butter Manufactured By Sunland, Inc. • A total of 41 persons infected with the outbreak strain of SalmonellaBredeney have been reported from 20 states. • 28% of ill persons have been hospitalized, and no deaths have been reported. • 63% percent of ill persons are children under the age of 10 years. • Multistate Outbreak of SalmonellaTyphimurium and Salmonella Newport Infections Linked to Cantaloupe • A total of 261 persons infected with the outbreak strains of SalmonellaTyphimurium (228 persons) and Salmonella Newport (33 persons) were reported from 24 states. 94 ill persons were hospitalized. Three deaths were reported in Kentucky.

4. Real Stories Cont. • School Lunch Suspected in Chinese Food Poisonings • A broccoli salad that had been served at a school lunch was blamed for causing an outbreak of Salmonellosis that involved more than 1,500 students and teachers at nine schools in Iwamizawa City, Hokkaido Prefecture, Japan. • Two school principals lost their jobs when authorities found the school involved was operating without health department certification and the Chinese State Food and Drug Administration • The schools lacked the management and equipment needed to safely implement the new school lunch program • China's food safety authorities have ordered the School to suspend serving lunches while the probe is underway • The students' symptoms included vomiting, diarrhea and fever.  

5. Real Stories Cont. • Oregon Raw Milk Tests Positive for E. Coli O157 • Raw milk from Foundation Farm near Wilsonville, Oregon, has been identified as the link in an outbreak of E. coli infections that has put four children in the hospital and may have sickened as many as 18 people. • Of the four children hospitalized, all have developed hemolytic uremic syndrome (HUS), a type of kidney failure. • E. coli O157 infections are characterized by diarrhea -- sometimes bloody -- and abdominal pain. Kidney failure and related complications may occur, especially among young children and the elderly. Symptoms usually develop within two to eight days of eating contaminated food.

6. Foodborne Illness • Foodborne illness can occur in any foodservice operation. Therefore, food safety training is essential. • Good food safety habits practiced on a routine basis are a critical part of preventing foodborne illness. • Food handling and preparation practices are the last line of defense for preventing infection from food-borne pathogens.

7. Facts • Between 1973 and 1997, >600 foodborne disease outbreaks in schools were reported to CDC. These outbreaks resulted in nearly 50,000 illnesses, >1500 hospitalizations and 1 death(2). • A recent report found that school-related foodborne illness has been increasing at a rate of 10% a year from 1990 – 1999 (1). • CDC estimates that each year roughly 1 in 6 Americans (or 48 million people) gets sick, 128,000 are hospitalized, and 3,000 die of foodborne diseases (4).

8. Facts cont. • Practices identified as contributing to outbreaks in schools include improper refrigeration, prolonged handling and inadequate reheating of cooked foods (2). • Several outbreaks in schools have been attributed to contamination of food by food-handlers who worked while illor had poor personal hygiene (2). • Do not come to work if you are sick (see HACCP SOP 8 Employee Health) • 57% of outbreaks were attributed to contamination by a food-handler (2).

9. Examples Nov 6: Norovirus Sickens 39 in Peoria, IL After Banquet At least 39 people fell ill with Norovirus infections after eating at a restaurant in central Illinois last week, according to the local health department. Nov 5: NY Spinach E. coli Outbreak Rises to 19 • At least 19 New Yorkers have fallen ill in an E. coli O157:H7 outbreak linked to spinach salad mix purchased at Wegmans stores. That number has risen from the 16 cases first confirmed by the New York State Department of Health on Friday. • Of those ill, five have been hospitalized, with four already having been discharged. • The illnesses are spread across five counties: Monroe, Niagara, Steuben, Wayne and Erie. Oct 30: WA Restaurant Salmonella Outbreak up to 120 Cases • At least 120 people are suspected to have fallen ill in a Salmonella outbreak tied to an On the Border restaurant in Vancouver, Wash., Clark County Health told Food Safety News Tuesday.

10. Examples cont. May 11 Mum's Kitchen Catering to Singaporian Preschools Seafood Marinara Pasta 2011 Organism: Salmonella Vehicle: Grains, Pasta Dishes, Seafood Marinara Pasta Seafood An outbreak of Salmonella Enteritidis occurred at 10 pre-schools in Singapore. The vehicle of infection was the seafood marinara pasta that had been catered by Mum's Kitchen. The investigation suggested that the pasta may have been contaminated wit…Read More » May 11 North Carolina School Snokist Growers Applesauce 2011 Organism: Toxin Vehicle: Fruit, Apple, Applesauce A firm that reprocessed moldy applesauce in Yakima, Washington, was linked to an outbreak of illness at a North Carolina school in early 2011. The applesauce was packed in #10 cans and intended for use in school cafeterias. The specific applesauce …Read More » February 11 Japan School Lunch Broccoli Salad 2011 Organism: Salmonella Vehicle: Produce-Based Salads, Broccoli Salad A broccoli salad that had been served at a school lunch was blamed for causing an outbreak of Salmonellosis that involved more than 1,500 students and teachers at nine schools in Iwamizawa City, Hokkaido Prefecture, Japan. The identical strain of Sa…Read More »

11. Examples cont. February 11 Haven Middle School Parent/Teacher Conference Buffet Food Catered by Merle's Smokehouse Barbequed Pulled Chicken 2011 Organism: Clostridium perfringens Vehicle: Poultry, Chicken, Barbequed Pulled Chicken At least 30 people became ill due to Clostridium perfringens after eating food served at the Haven Middle School Parent/Teacher Conference. The food had been catered by Merle's Smokehouse of Evanston, Illinois. Clostridium perfringens was isolated f…Read More » October 10 Clearview High School Unknown 2010 Organism: Salmonella Vehicle: Unknown An outbreak of Salmonella Group B occurred among people who attended a Clearview High School football dinner, in Lorain County, Ohio. At least eight of the illnesses were confirmed as caused by Salmonellosis. The Health Commissioner stated that so…Read More » February 10 Feltham Hill Infant & Nursery School 2010 Organism: E. coli O157:H7 Vehicle: Unknown As many as 25 pupils at Feltham Hill Infant & Nursery School, in England, developed gastroenteritis. The day care program closed after two children were taken to the hospital. Thirteen illnesses were subsequently confirmed as E. coli O157:H7. On Fe…Read More »

12. Examples cont. October 09 Michigan Prison and School Beef-Based Soup 2009 Organism: Clostridium perfringens Vehicle: Soup, Beef A confirmed outbreak of Clostridium perfringens was associated with eating a beef-based soup at a prison, or school, in Michigan.…Read More » September 09 Ohio School Pasta 2009 Organism: Salmonella Vehicle: Grains, Pasta A confirmed outbreak of Salmonella Enteritidis occurred among people who had eaten pasta at a school in Ohio. A description of the pasta dish was not given.…Read More » June 09 Connecticut School 2 Macaroni and Cheese 2009 Organism: Other Vehicle: Grains, Pasta Dishes, Macaroni and Cheese A confirmed outbreak of Bacillus cereus was associated with eating macaroni and cheese at a school in Connecticut.…Read More »

13. Examples cont. May 09 Ohio School Chicken 2009 Organism: Clostridium perfringens Vehicle: Poultry, Chicken A confirmed outbreak of Clostridium perfringens was associated with eating chicken at a school in Ohio.…Read More » May 09 California School Rolls 2009 Organism: Norovirus Vehicle: Breads and Bakery, Rolls A confirmed outbreak of Norovirus occurred among people who had eaten rolls at a school in California.…Read More » March 09 Oregon School Unknown 2009 Organism: Norovirus Vehicle: Unknown A confirmed outbreak of Norovirus was associated with eating at a school in Oregon. The vehicle of infection was not described.…Read More »

14. High-Risk Population • High-risk populations include: • Seniors • Young children • Pregnant women • Immune-compromised

15. You are essential to food-safe schools • You: Knowledgeable and adequately trained foodservice staff can prevent foodborne illness outbreaks from originating in the cafeteria. • SOPs: By following established guidelines on food purchasing, storage, preparation, handling, and service, foodservice staff can greatly reduce the risk of students becoming seriously, or even fatally, ill with a foodborne illness. • HACCP: Safe food handling and preparation can reduce the risk of foodborne illness, even if food is contaminated before it comes into the school.

16. HACCP from Purchasing to Student • Purchasing safe foods i.e. bid specs, farm and vendor inspections • Vendor: Refrigerated trucks • Receiving and rejecting procedures at warehouse • HACCP documentation when receiving, distribution • NS drivers: Refrigerated trucks • Staff at schools: proper holding, storing, etc. • Student: served safe foods

17. USDA requires a minimum of… • Standard Operating Procedures. • A written plan for applying HACCP principles at each site which prepares and/or serves food. • Documenting Critical Control Points during food production • Monitoring • Establishing and documenting corrective actions • Recordkeeping • Reviewing and revising the overall food safety program

18. SOP’s

19. HACCP SOP 2 Calibrating Thermometers • Thermometers are to be calibrated and initialed on the Production Record when they are first taken out of the original package. Afterwards, re-calibration is done on a weekly basisor each time it is dropped.

20. HACCP SOP 3 Preventing Cross-Contamination • Nutrition Services employees may not use a single utensil more than once to taste food that is to be served. • Nutrition Services employees will taste food as follows: • Place a small amount of food into a separate container. • Step away from exposed food and food contact surfaces. • Use a spoon to taste the food. Remove the used spoon and container to the dirty dish area. • Never reuse a spoon that has already been used for tasting. • Wash hands immediately.

21. HACCP SOP 1 Hand Washing &HACCP SOP 4 Personal Hygiene • Food employees shall clean their hands by using a cleaning procedure of approximately 20 seconds that includes: • Vigorous friction on the surfaces of the lathered fingers, finger tips, areas between the fingers, hands and arms for at least 10 to 15 seconds, followed by; • Thorough rinsing under clean, running water. • Nutrition Services employees will wear single-use gloves when handling RTE foods. Single-use gloves shall be used for only one task such as working with ready-to-eat food, used for no other purpose, and discarded when damaged or soiled, or when interruptions occur in the operation. Your hands must be washed between uses of gloves.

22. HACCP SOP 17 Holding Hot & Cold Potentially Hazardous Foods • Verify and record on the HACCP Charts that the air temperature of any refrigeration unit is at 40ºF or below and the freezer unit is 0ºF or below first thing each morning.

23. HACCP SOP 21 Date Marking Ready-to-Eat, PHFs • Label and date ready-to-eat, potentially hazardous foods that are prepared on-site or processed foods which have been opened. • Refrigerate all ready-to-eat, potentially hazardous foods at 41ºF or below.

24. HACCP SOP 23 Mixing Sanitizing Solution • Record the time and ppm on your HACCP Chart every time you mix up a new bucket. • Every four hours or more frequently as needed. • Before any food prep occurs.

25. HACCP SOP 24 Checking Dishwasher Water Temperature • High-Temp Dishwasher: • The water temperature should reach 160°F or higher at rack level to achieve sanitizing temperatures. The outside gauge reading does not provide an accurate rack level temperature and may NOT be used. Check and record before use daily. • Low- temp dishwasher : • The water temperature should reach 120°F-150°F to achieve sanitizing temperatures. The outside gauge reading does not provide an accurate rack level temperature and may NOT be used. • You must also check and record the parts per million (ppm), before use daily, it should register at 50-100ppm. • The following schools have Low-temp dishwashers: Ainsworth, Beach, Harrison Park, James John, Jefferson, King, Lent, Marysville Site, Scott and Sitton. • 3-Compartment sink: • You must also check and record the parts per million (ppm), before use daily, it should register at 50-100ppm of bleach Or 150-400ppm of quaternary.

26. HACCP SOP 25 Washing and Sanitizing Food Contact Surfaces • Wash, rinse, and sanitize food contact surfaces of sinks, tables, equipment, utensils, thermometers, carts, and equipment: • Before each use • Between uses when preparing different types of raw animal foods, such as eggs, fish, meat, and poultry • Between uses when preparing ready-to-eat foods and raw animal foods, such as eggs, fish, meat, and poultry • Any time contamination occurs or is suspected • After prepping with high-allergen foods • i.e. peanut butter

27. SOP 30 Using Time Alone as a Public Health Control to Limit Bacteria Growth in Potentially Hazardous Foods • Record time and temperature for all hot food items which you cook on the production record (i.e. hamburgers, hot dogs, chili). • Record time (rather than temperature) on all cold foods immediately after removing them from refrigeration and when replacing them i.e. salad bar items, condiments, milk, etc. Foods in which time will be used to limit bacteria growth, document an ‘NA’ in the temperature section of the production record for not applicable. • Only pull out what you immediately need.

28. Health Inspections • 2004 federal law requires school cafeterias to be inspected twice a year and that the results of the inspections be made publicly available. • USA Today request a copy of all of our Health Inspections. • We will be posting these on our Nutrition Services webpage.

29. Questions

30. References • Foodborne Illness Rates Increase in Schools. Edited by: Mary Schroeder, M.S., R.D. & Pat Kendall, Ph.D., R.D., Colorado State - Fall 2002. • Foodborne Disease Outbreaks in United States Schools: Discussion. From the Foodborne and Diarrheal Diseases Branch (NAD, SMR, PMG, PSM) and the Biostatistics and Information Management Branch (LM, NHB), Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, and the Epidemic Intelligence Service, Epidemiology Program Office (NAD), Centers for Disease Control and Prevention, Atlanta, GA. • Examples from Foodborne Illness Outbreak Database. • http://www.cdc.gov/foodborneburden/2011-foodborne-estimates.html