Food Borne Illnesses

1. Food Borne Illnesses Manju Roy(Ph.D. Epidemiology &Public Health-8165) Dr. Howard Rubin,2011 Walden University

2. Introduction • This presentation is intended for employees who handle food for the public in supermarkets and restaurants. Awareness of foodborne illnesses are poorly understood and origin of outbreaks are unknown • Today’s Presentation will cover food borne illnesses its origin, causes, prevention ,laws and agencies responsible for food safety and its regulation. In the end of this discussion you will be familiar with all techniques and laws to food safety.

3. Causes of Food Borne Illnesses Intake of Contaminated Food with: Bacteria Viruses Parasites Toxin Pesticides Inorganic Chemicals Organic Chemicals (http://www.cdc.gov)

4. Food Safety In Public Places Components of Food Safety in Supermarkets and Restaurants are: Employee training. Food sampling and testing for contaminations Plan review for food Services. Pest control services Food Inspection Services Outbreaks of E. coli infections in Hamburgers in 1997 New law called HACCP was imposed by Clinton Administration(Kassenborg et al,2004).

5. Source of Contamination For Food Borne Illnesses Sewage water in irrigation. Employee health practices Poor sanitary services. Lack of wildlife monitoring and control. Exposure to warm storage temperature.

6. How do food borne agents spread in Restaurants and Supermarkets.. Preparation and Storage on farms. Poor hygiene practice's Toxins of S.Aureus spread from wounds& cuts No Regular hand washing Improper Storage Ref: http://www.cdc.gov

7. Epidemiology of Food borne Illnesses In USA Per Year 47.8 million illnesses 127,839 Hospitalization 3,037 people Deaths 1,027,561 Salmonella cases 965,958 Clostridium cases Campylobacter 845,024 cases (http://www.foodborneoutbreaks)

8. Infectious Dose Amount of agent consumed to onset symptoms Salmonella and Shigella need 1 million to 1 billion organisms for symptoms,1to 4 days for incubation Parasites like Amoeba need 1 to 4 weeks Viruses need 24 to 48 hours(Moeller, 2005)

9. FOOD STORAGE GUIDELINES FOR RESTARUTANTS AND SUPERMARKETS • Proper storage of food at Required Temperature. • Refrigerator temperature set at 40 degree Fahrenheit • Freezer temperature at 0 degree Fahrenheit • Cold Food at a 41 Degree Fahrenheit or below • Thermometer in refrigerator and freezer • Disinfect Freezer and refrigerators with disinfectants • Clean and disinfect countertops regularly.

10. Components of Effective Sanitation System Exercising care in processing An effective sanitation program Other factors include: • Safer water supply • Adequate garbage refuse disposal • Proper waste water and sewage disposal • Effective rodent and insect control • Equipment and facilities • Personnel training and habits • Standards, regulations, enforcement, and monitoring.

11. Food Processing Industries Clean consumable marketable products. Preservation, and distribution. Improvement in food quality Extra nutrients like vitamins Reduce food borne diseases(Norton et al.2001)

12. Equipment and facilities Cutting board of nonporous materials. Clean Vehicle for transportation Refrigerated vehicles for transport of perishable food products Refrigerated vegetables storage

13. Personnel training and habits. • Personnel hygiene • Antimicrobial cleaners , cleaning rags and sponges • Hand washing • Training in food storage, garbage disposal, insects and rodent control.

14. Standards and regulations. United States Hazard Analysis and Critical Control(HACCP) based on Seven Principles 1.Analyze potential Hazards 2.Determine Critical Control Points(CCPs) 3.Establish Critical limits 4.Establish monitoring procedures 5.Establish corrective actions 6. Establish Verification procedures. 7.Establish record-keeping and documentation procedures.

15. Federal Agencies responsible for the safety of U.S. food supply. • Department of Health Services: Food and Drug Administration. Regulates food labeling Safety of food and food additives Inspection of food processing plants & food selling places Controls food contaminants Establishes food standards. • Center for Disease Control and Prevention Analyzes and Control diseases.

16. Other Agencies Monitor and InspectFood Products National Institutes of Health Health Department of Agriculture Monitors: Pesticides Microbial and water borne contaminants Food Safety and Inspection Service Meat, poultry, and eggs Animal and Plant Health Inspection Service Imported foods

17. Department of Agriculture Food Safety and Inspection Service Meat, poultryand plant produce Human Nutrition Information Service Standard tables for the nutritive value of foods educational materials related to food for consumers.

18. Federal Trade Commission Food advertising. Food additives Pesticides New Animal Drugs Color Additives Prohibited Substances Environmental Protection Agency National Marines Fisheries Service New Animal Drug.

19. CDC’s Role in food safety Gather data on food borne illnesses. Investigate food borne illnesses and outbreaks. Monitor the effectiveness of prevention Work closely with food safety agencies Food Safety and Inspection Service of the U.S. Department of Agriculture. Build State Department Epidemiology, laboratory and environmental health.

20. Investigation of recent Bacterial outbreaks in April 2011 Salmonella outbreaks in Germany E.Coli epidemic strain isolated in Massachusetts, Michigan ,Wisconsin , North Carolina E.Coli infections reported from cows and goat milk cheese in California, Nevada and Washington D.C.(http://www.CDC.gov)

21. Epidemiology of food borne illnesses in Ice creams, desserts Meat and Poultry have Salmonella infections Cookie dough's Other microbes are Clostridium, Shigella, Vibrio cholerae and Parasites(http://www.fsis.usda.gov/fact )

22. Food illnesses caused by Mycotoxins and Mycotoxicoses Aspergillus flavus Alterneria Fusarium moniliformie Myrothecium Trichoderma Fumitremorgen B, Paxilline, Penitrem A, Verrucosidin, and Verruculogen An outbreak in USSR in World War 2, killed 5,000 people with contaminated mycotoxins in peanuts maize and other oil seeds. Long term illness are neutropenia ,aplastic anemia, thrombocytopenia(Froquet et at,2001)

23. Outbreaks of food borne and waterborne viral gastroenteritis. Norwalk viral infection lack of surveillance Human Enterovirus A,B,C &D Human Rhinovirus A,B,C Porcine Enterovirus Hepatitis E Rotavirus

24. Prevention of Food Poisoning Public Service Veterinary Surveying of Animal Products. Tracing origin of illness and penalizing the place where outbreak started. Removal of the products from the sale. Power to control and law enforcement of veterinarians.

25. Ten Rules for safe food preparation and consumption • 1.Choose food processed for safety. • 2.Cook food thoroughly • 3.Eat cooked food immediately. • 4.Store cooked food immediately. • 5.Reheat cooked foods thoroughly. • 6.Avoid contact between raw and cooked foods. • 7.Wash hands repeatedly. • 8.Keep all kitchen surfaces meticulously. • 9.Protect foods from insects ,rodents, and other animals. • 10.Use pure water.

26. Long Term Effects of Bacterial Infections in food U.S. Food supply safest in the world. Long term effects are: E.Coli causes kidney failure Salmonella reactive arthritis and serious infections Listeria and Campylobacter cause precipitating factor for a debilitating disease(Kaferstein,1997)

27. Safe Food Handling Fight BAC in supermarkets and fast food restaurants by employees: • Clean: Wash Hands • Separate: Don’t cross contaminate • Cook: Cook to proper temperature • Chill: Refrigerate promptly

28. Be Food Safe • 60 retailers participate in this campaign with the Food and Drug Administration and CDC • Reminds consumers and sellers to shop for safe food • Reduces risk of Food Borne Illnesses

29. How can you help your customers and employees? Food safe tips for supermarkets and restaurant's: 1.Partner with local media 2.Establish National Food Safety Education month. 3.Food safe message on business advertisements. 4.Display food safe posters in business logos as giveaways.

30. Conclusion: Today’s Highlights • In today’s presentation we learned: • Importance of Food Safety in Public Places • Sources of Contamination • Spread and Control of Infectious Agents • Epidemiology of Food Borne Illnesses • Laws and Agencies to Control infections in Public places • Personnel Training of Employees and Prevention.

31. References • 1.Kassenborg,H.D.,Hedberg,C.,W., Hoekstra, M., Evans M.C., Chin, A.E., Ahuja, S.D., Slutsker,L., Farm Visits and undercooked Hamburgers are Major Factors for Sporadic Escherichia coli O157.H7 Infection Data from Case Control Study in 5 FoodNet Sites. Clinical Infectious Diseases Supplement (2004):38,271-278 • 2. Moeller, Dade(2005): Environmental health(3 Edition). Harvard Press • 3.Norton,D., McCamey,M., Gall, Kenneth., Scarlett, J., Boor, K., Weidman M.(2001): Molecular Studies on the Ecology Of Listeria monocytogenes in the Smoked Fish Processing Industry. Applied Environmental Health 67(1), 198-205. • 4.Froquet ,R., Sibiril,Y., Parent Massin, D.,(2001): Trichothecene toxicity on human megakaryocyte progenitors(CFU-MK).Human and Experimental Toxicology 20(2),84-89. • 5. Kaferstein,A., Food safety: a commonly underestimated public health issue.(1997). World Health Statistics Quarterly 50(1/2):3.

32. Web Resources Disease Resources: http://www.cdc.gov http://www.cdc.gov/foodborneoutbreaks/ Food Safety Resources: http://www.fsis.usda.gov/facts http://www.foodsafety.gov http://www.fsis.usda.gov/factsheets.gov http://www.befoodsafe.gov