Food Safety for the General Public

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Food Safety for the General PublicHeidi Jones, PhD StudentWalden UniversityPUBH 8165-3Instructor: Dr. Lezah Brown-EllingtonJanuary 2013

Thank you for the opportunity to speak with you today. My name is Heidi Jones and I am a PhD student at Walden University studying Public Health with a specialization in epidemiology. Im here to speak to you today about food safety.1Build awareness of potential food-borne illness

Identify 3 main causes of food-borne illness

Identify signs and symptoms of food-borne illness

Understand prevention methods

(Cherif, et. al., 2010)

Learning outcomesAt the end of this presentation, it is my hope that you will be able to complete the following learning outcomes:Build awareness of potential food-borne illnessIdentify 3 main causes of food-borne illnessIdentify signs and symptoms of food-borne illnessUnderstand the prevention methods associated with food-borne illness

2Illness transmitted through food or water by an infectious agent, a poisonous substance or a protein that causes an immune reaction

(Cherif, et. al. (2010). Nutrition, Health and Wellness: An Applied Approach. San Francisco, CA. Benjamin Cummings)

What is food-borne illness

So, what is a food-borne illness? Some of you may not be familiar with the term, and thats ok. Basically, a food-borne illness is transmitted through food or water by an infectious agent, a poisonous substance or a protein that causes an immune reaction.

3I in 6 Americans will get sick this year by consuming contaminated food or beverages

13 million reportable illnesses

325,000 hospitalizations

1,800 deaths annually

(Moeller, D. (2011). Environmental Health. Cambridge, MA. Harvard University Press) Food-borne illness statisticsThe following are just a few statistics regarding food-borne illnesses. 1 in 6 Americans will get sick this year by consuming contaminated food or beverages. Also, each year there are a total of 13 million reportable illnesses. 325,000 will require hospitalizations due to food-borne illnesses. Finally, as many as 1,800 deaths occur annually.

4Food that is improperly handled and subsequently consumed raw or insufficiently cooked

Food that is contaminated with animal feces and subsequently consumed raw or insufficiently cooked

Failure of food handlers to wash their hands after using the restroom

(Cherif, et. al., (2010). Nutrition, Health and Wellness: An Applied Approach. San Francisco, CA. Benjamin Cummings)

(Moeller, 2011)

Primary cause of food-borne illnessThere are many reasons why food-borne illnesses occur. Food can be improperly handled, such as cross contamination. An example of this would be using the same cutting board for chicken and vegetables. Food can also be insufficiently cooked or not cooked thoroughly to the proper temperature. Food can also be contaminated with animal feces and then not cooked to the proper temperature. Finally, one of the most common reasons occur when restaurant workers fail to wash their hands after using the restroom and then go and handle or prepare your food.

5Campylobacter jejuni

Salmonella

Escherichia coli (E coli)

3 common causes of food-borne illnessThe 3 most common causes of food-borne illness are listed here. They include campylobacter jejuni, salmonella, and escherichia coli, which will be discusses in further detail in the coming slides.

6Food-borne illness statisticsPathogen Estimated number of illnesses per yearEstimated number of hospitalizations per yearEstimated number of deaths per yearCampylobacter jejuni845,0248,46376Salmonella1,027,56119,336378Escherichia coli73,0002,13860(Centers for Disease Control and Prevention. (2012). Foodborne illness, foodborne disease. Retrieved from: http://www.cdc.gov/foodsafety/facts.html#what)This table illustrates the number of illnesses reported each year, as well as the number of hospitalizations and deaths that occur each year as a result of food-borne illnesses. As you can see, salmonella accounts for the most illnesses each year at 1,027,561. Salmonella also accounts for the most hospitalizations each year, followed by campylobacter jejuni. Finally, salmonella is responsible for the most deaths per year at 378. Based on the facts alone, you can see the importance of taking salmonella infections seriously. 7Government agencies that regulate food safetyUSDA: Oversees safety of meat, poultry and eggsCDC: Works with public health officials to promote and educate people about health and safety. Able to track information needed in identifying food-borne illness outbreaksEPA: Regulates use of pesticides and which crops they can be applied to. Establishes standards for water qualityFDA: Regulates food standards of food products and bottled water. Regulates food labeling(Cherif, et. al. (2010). Nutrition, Health and Wellness: An Applied Approach. San Francisco, CA. Benjamin Cummings)

There are some governmental agencies that are working every day to protect our health and safety. The United States Department of Agriculture oversees the safety of meat, poultry and eggs. The Center for Disease Control and Prevention works with public health officials to promote and educate people about health and safety. The also have the ability to track information as needed in identifying food-borne illness outbreaks. The Environmental Protection Agency regulates the use of pesticides and which crops they can be applied to. The also establish standards for water quality. Finally the Food and Drug Administration regulates food standards of food products and bottled water. They regulate food labeling, so when you go to the supermarket and check the products foods nutrition facts on the back of the product, that is the doing of the FDA. 8Most common cause bacterial cause of diarrhea in U.S.

2nd most frequently reported cause of foodborne illness

Occurs more frequently in summer months

(Centers for Disease Control and Prevention. (2010). Camplylobacter General Information. Retrieved from: http://www.cdc.gov/nczved/divisions/dfbmd/diseases/campylobacter/)

Campylobacter jejuni

Lets begin with the first type of infection, called campylobacter jejuni. This type of infection is the most common cause bacterial cause of diarrhea in the U.S. It is also the 2nd most frequently reported cause of food-borne illness. Ironically, this type of infection seems to occur more frequently in the summer months, quite the opposite from the flu pandemic that we are currently experiencing.

9Incubation period: 1-7 days

Duration: 7-10 days

Symptoms: Fever, diarrhea, nausea, cramping

Foods most commonly affected: raw or undercooked meat, raw eggs


(Moeller, 2011)

Campylobacter jejuniCampylobacter jejuni has an incubation period of 1-7 days, meaning the time from initial exposure and the onset of symptoms. The symptoms which include fever, diarrhea, nausea and abdominal cramping can last anywhere from 7-10 days. The foods that are most commonly affected include raw or undercooked meat and raw eggs.10Diagnosed: Culture from stool sample

Tx: Drink extra fluids, medications if indicated

Steps for prevention: Cook foods properly, avoid cross-contamination, proper hand washing


Campylobacter jejuniIn order to be officially diagnosed with this type of food-borne illness, you would need to see your health care professional who would take a culture from your stool. The treatment for campylobacter infection includes drinking extra fluids, getting plenty of rest and in extreme situations, your health care provider may prescribe antibiotics. Steps for prevention include: cooking foods properly to their recommended temperatures, avoid cross-contamination and proper hand washing.

11Children

Elderly

Individuals with immunocompromised systems

(Centers for Disease Control and Prevention. (2012). Salmonella. Retrieved from: http://www.cdc.gov/salmonella/general/index.html)

Groups at highest riskThe groups at the highest risk are children, the elderly and those with immunocomprised systems, such as those with HIV or cancer.

122008 campylobacter outbreak linked to unpasteurized milk 16 cases1 states0 deaths8 hospitalizations

(About Campylobacter. (2013). Alexandre EcoDairy Farms Raw Milk Campylobacter Outbreak. Retrieved from: http://www.about-campylobacter.com/campylobacter_outbreaks/view/alexandre-ecodairy-farms-raw-milk-campylobacter-outbreak/)`

Recent Campylobacter OutbreaksA recent campylobacter outbreak occurred in 2008, when it was found that Alexandre EcoDairy farms was linked to unpasteurized milk. 16 cases were confirmed, resulting in 8 hospitalizations, all within the state of California. All individuals had acute diarrhea.

13CDC: Through FoodNet, monitors the incidence and trends of campylobacter infections over time and conducts surveillance

UDSA: Conducts research on how to prevent infection in chickens

FDA: Produced Model Food Code for restaurants(Centers for Disease Control and Prevention. (2010). Camplylobacter General Information. Retrieved from: http://www.cdc.gov/nczved/divisions/dfbmd/diseases/campylobacter/)

What are public health agencies doing for campylobacter jejuni?Specifically related to campylobacter jejuni, the Centers for Disease Control and Prevention monitors the incidence and trends of campylobacter infections over time and conducts surveillance. The United States Department of Agriculture conducts research on how to prevent infection in chickens. The Food and Drug Administration has produced the Model Food Code for restaurants, a model that assists food control jurisdictions at all levels of government by providing them with a scientifically sound technical and legal basis for regulating the retail and food service segment of the industry (restaurants and grocery stores and institutions such as nursing homes).

14Discovered by American scientist named Dr. Daniel Salmon

Bacteria

(Centers for Disease Control and Prevention. (2010). Camplylobacter General Information. Retrieved from: http://www.cdc.gov/nczved/divisions/dfbmd/diseases/campylobacter/)

Salmonella

Salmonella, a bacteria, was first discovered by the scientist Dr. Daniel Salmon in 1900.

15Incubation period: 12-24 hours

Duration: 4-7 days

Symptoms: Diarrhea, chills, fever, vomiting

Foods most commonly affected: Raw or undercooked eggs, undercooked poultry and meat, seafood, fruits and veggies


SalmonellaThe incubation period can last anywhere from 12-24 hours and last for 4-7 days. The symptoms include diarrhea, chills, fever and vomiting. The foods most commonly affected are raw or undercooked eggs, undercooked poultry and meat, seafood, fruits and vegetables. 16Diagnosed: Culture from stool sample

Tx: Drink extra fluids, in severe cases: IV fluids, antibiotics

Steps for prevention: Cook foods properly, avoid cross-contamination


SalmonellaAgain, as with the case with campylobacter, salmonella is diagnosed by your health care provider via a stool sample which yields the organism. The treatment for this type of infection requires extra hydration and in severe cases. IV fluids and antibiotics, as indicated by your health care professional.

17Children

Elderly



Groups at highest riskChildren are the most likely to get salmonellosis. The rate of diagnosed infections in children less than 5 years old is higher than the rate for all other individuals. The elderly and those with immunocompromised systems, such as HIV and cancer, are also at risk.

182012 Salmonella outbreak linked to Peanut Butter 42 cases20 states0 deaths20 hospitalizationsRecall

2012 Salmonella outbreak linked to cantaloupes261 cases24 states3 deaths94 hospitalizationsRecall(Centers for Disease Control and Prevention. (2012). Salmonella Outbreaks. Retrieved from: http://www.cdc.gov/salmonella/typhimurium-cantaloupe-08-12/index.html)Recent Salmonella OutbreaksSome recent salmonella outbreaks that have occurred recently which you may have heard about thru the media include an outbreak linked to peanut bitter. Salmonella outbreak manufactured by Sunland, Inc. 42 cases were confirmed in 20 states. Thankfully no deaths occurred, but 20 required hospitalization. Also, this type of peanut butter was recalled by the FDA. Also, in 2012, there was an outbreak linked to cantaloupes. During this outbreak, there were 261 confirmed cases in 24 states. 94 people were hospitalized with 3 deaths. This outbreak also prompted a recall by the FDA.

19CDC: Monitors frequency of salmonella infections in U.S.

FDA: Inspects imported foods, promotes better food preparation techniques

USDA: Monitors health of food animals, inspects egg pasteurization plants, regulates quality of slaughtered and processed meats

(Centers for Disease Control and Prevention. 2010. Salmonella Additional Information. Retrieved from: http://www.cdc.gov/salmonella/general/additional.html)

What are public health agencies doing for salmonella?

The public health agencies that are The Center for Disease Control and Prevention monitors the frequency of salmonella infections in the U.S., as well as assists state and local health departments in investigating outbreaks and devising control measures. The Food and Drug Administration inspects imported foods, oversees inspection of milk pasteurization plants, promotes better food preparation techniques in restaurants. Finally, the United States Department of Agriculture monitors the health of food animals, inspects egg pasteurization plants and regulates the quality of slaughtered and processed meats.

20Normally live in intestines of healthy people and animals

Most common cause of travelers diarrhea

Hundreds of different strains

O157:H7

(Centers for Disease Control and Prevention. (2012). E Coli General Information. Retrieved from: http://www.cdc.gov/ecoli/general/index.html/)

Escherichia coli

The last bacteria we will discuss is escherichia coli, or more commonly referred to as E coli. The type of bacteria typically lives in the intestines of healthy individuals. It is the most common cause of travelers diarrhea. There are hundreds of different strains of E coli, but e coli O157: H7 is the most common.

21Incubation period: 2-4 days

Duration: 5-10 days

Symptoms: Diarrhea, abdominal cramps, nausea

Foods most commonly affected: Contaminated water, raw milk, rare ground beef, uncooked fruits and veggies


Escherichia coliThe incubation period for E coli occurs from 2-4 days. The duration of this type of bacteria lasts from 5-10 days. Some symptoms include: dairrhea, abdominal cramps and nausea. The foods that are most commonly affected are contaminated water, raw milk, raw or rare ground beef and uncooked fruits and vegetables.22Diagnosed: Culture from stool samples

Treatment: Drink fluids

Steps for prevention: Thoroughly cook meat, avoid cross-contamination, wash hands thoroughly

(Moeller, D. (2011). Environmental Health. Cambridge, MA. Harvard University Press)

Escherichia coli

E coli can be diagnosed by your health care professional via a stool sample that yields an organism. Treatments for E coli infections involve rest and plenty of hydration. In order to prevent E coli infections, it is recommended that you cook meats thoroughly to their proper temperature, avoid cross-contamination and proper hand washing.

23Children

Elderly


(Mayo Clinic. (2011). E coli Risk factors. Retrieved from: http://www.mayoclinic.com/health/e-coli/DS01006/DSECTION=risk-factors)

Groups at highest riskAs was the case with campylobacter and salmonella, children, the elderly and those with already compromised immune systems are at the greatest risk for this type of infection.

242012 E coli outbreak linked to Organic spinach33 cases5 states0 deaths13 hospitalizationsRecall

2012 E coli outbreak linked raw clover sprouts at Jimmy Johns 29 cases11 states0 deaths7 hospitalizations(Centers for Disease Control and Prevention. (2012). Salmonella Outbreaks. Retrieved from: http://www.cdc.gov/salmonella/typhimurium-cantaloupe-08-12/index.html)

Recent E coli OutbreaksSome recent E coli outbreaks occurred just this past year. There was an outbreak linked to organic spinach produced by State Garden in Massachusetts. 33 cases were confirmed in 5 states. No deaths occurred, but 13 individuals required hospitalization. A recall was obtained by the FDA. Also, as was prevalent in the media, an E coli outbreak was associated with raw clover sprouts at Jimmy Johns restaurants. 29 cases were confirmed in 11 different states. No deaths occurred, but 7 required hospitalization.

25CDC: Monitors frequency of e coli infections in U.S.

FDA: Inspects imported foods, promotes better food preparation techniques

UDSA: Monitors health of food animals, inspects egg pasteurization plants, regulates quality of slaughtered and processed meats

EPA: Regulates and monitors safety of drinking water(Centers for Disease Control and Prevention. 2010. Salmonella Additional Information. Retrieved from: http://www.cdc.gov/salmonella/general/additional.html)

What are public health agencies doing for E coli?

With regards to E coli and public health agencies, the Center for Disease Control and Prevention monitors the frequency of e coli infections in the U.S., as well as assists state and local health departments in investigating outbreaks and devising control measures. The Food and Drug Administration inspects imported foods, oversees inspection of milk pasteurization plants, promotes better food preparation techniques in restaurants. The United States Department of Agriculture monitors the health of food animals, inspects egg pasteurization plants and regulates the quality of slaughtered and processed meats. Finally, the Environmental Protection Agency regulates and monitors the safety of drinking water.

2610 Rules for safe food preparation and consumption at homeChoose food processed for safety

Cook food thoroughly

Eat cooked food immediately

Reheat cooked food thoroughly

Store cooked foods immediately

(Moeller, D. (2011). Environmental Health. Cambridge, MA. Harvard University Press)

The following 5 items are suggestions for safe food preparation and consumption that you can practice and follow at home. Choose foods processed for safety, cook food thoroughly and to the proper temperatures. Did you know that chicken and turkey need to be cooked to the highest temperature, more than pork or beef? Also, eat cooked food immediately, reheat cooked foods thoroughly and store foods cooked foods immediately in the refrigerator or freezer. 2710 Rules for safe food preparation and consumption at homeAvoid contact between raw & cooked foods

Wash hands repeatedly

Keep all kitchen surfaces clean

Protect foods from insects, rodents, etc.

Use clean water(Moeller, D. (2011). Environmental Health. Cambridge, MA. Harvard University Press)

Following along from the previous slide, continued methods of safe food prep and consumption are to avoid contact between raw and cooked foods, which can also be referred to as cross-contamination, wash hands repeatedly, especially after handling raw meats and poultry, keep all kitchen surfaces clean. Disinfectants are a good way to accomplish this. Protect foods from animals, insects or rodents and finally, always use clean water. 28Temp. rules for cooking at home(United States Department of Agriculture. (2012). Thermy Image. Retrieved from: http://www.fsis.usda.gov/news_&_events/thermy_image_library/index.asp

The following illustration is called Thermy and was adapted by the United States Department of Agriculture to illustrate proper cooking temperatures for beef, lamb, veal, pork, chicken, turkey, egg dishes and leftovers. As you can see the internal temperatures range anywhere from 145 degrees to 165 degrees. The best tool for measurement is a metal food thermometer which can be directly inserted into the food to determine its temperature. 29Prevention methods (FightBac. (2010). Partnership for Food Safety Education. Retrieved from: http://www.fightbac.org/)

The following picture illustrates a promotional tool presented by the USDA titled Fight Bac, with Bac standing for bacteria. Bacteria multiplies rapidly between 40 F and 140 F. In order to keep food out of this "Danger Zone," keep cold food cold and hot food hot. Store food in the refrigerator (40 F or below) or freezer (0 F or below). Cook food to a safe minimum internal temperature. Maintain hot cooked food at 140 F or above. When reheating cooked food, reheat to 165 F .*Follow 4 easy basic steps to avoid foodborne illness. Clean wash hands, utensils, and cutting boards, before/after contact with raw meat, poultry, seafood and eggs. Separate keep raw meat, poultry and seafood apart from foods that wont be cooked. Cook use a food thermometer because you can not tell food is cooked just by the appearance. Chill leftovers and takeover foods within 2 hours and keep at 40 degrees or below.30Click on the link below or right click and select open hyperlink to view video

http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm204328.htm

(Food and Drug Administration. (2012). Start at the Store: Prevent Foodborne Illness. Retrieved from: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm204328.htm)

Prevention tip video from FDA

This link provides some enlightening information from the Food and Drug Administration on preventing foodborne illness. Please feel free to clink on or write down the link for further information. It is a short consumer update video which lasts less than 2 minutes. 31Click on the link below or right click and select open hyperlink to view video

http://www.medicinenet.com/tummy_trouble_quiz/quiz.htm

(Medicinenet.com. (2013). Tummy Trouble Quiz: Test your IQ of Digestive Diseases. Retrieved from: http://www.medicinenet.com/tummy_trouble_quiz/quiz.htm)

Tummy Trouble Quiz

Please feel free to click on the link to take the 15 question quiz on Digestive Diseases. 32Preserve the evidence

Seek treatment as necessary

Call the local health department

Call the USDA Hotline

(United States Department of Agriculture. (2011). Foodborne Illness and Disease. Retrieved from: http://www.fsis.usda.gov/Fact_Sheets/Foodborne_Illness_What_Consumers_Need_to_Know/index.asp)In the event of a suspected food-borne illnessEven with stringent precautions in place, unfortunately, food-borne illnesses still occur. In the event that you suspect a food-borne illness, the USDAs Food Safety and Inspection Service recommends you take the following steps: Preserve the evidence: if a portion of the food is still available, wrap it up and mark danger on it so no one else consumes it and freeze it. Save any packaging materials and write down the date, time consumed and symptoms occurred. Seek treatment as necessary: if the victim is one from one of the at risk groups, please seek medical attention immediately or as soon as possible. If symptoms persist or are severe, please see your health care professional. Call your local health department if the food was served at a large gathering or from a local restaurant. Finally, call the USDA Hotline at 1-888-MPHotline (888-674-6854) if you believe the product is a USDA inspected product and you still have the packaging.

33CDC: www.cdc.gov

FoodNet: www.cdc.gov/foodnet

USDA Food Inspection & Safety Service: www.fsis.usda.gov

FDA: www.fda.gov

Your local health department

Additional information

The following is a list which will provide you with additional information on food-borne illness 34

ConclusionConclusion of presentation

Any questions?

This concludes my presentation at this time. Does any one have questions, comments, or contributions?

Once again, thank you for your time. I hope this presentation has been enlightening for you. 35

ReferencesAbout Campylobacter. (2013). Alexandre EcoDairy Farms Raw Milk Campylobacter Outbreak. Retrieved from: http://www.about-campylobacter.com/campylobacter_outbreaks/view/alexandre-ecodairy-farms-raw-milk-campylobacter-outbreak/)

Centers for Disease Control and Prevention. (2010). Camplylobacter General Information. Retrieved from: http://www.cdc.gov/nczved/divisions/dfbmd/diseases/campylobacter/

Centers for Disease Control and Prevention. (2012). E Coli General Information. Retrieved from: http://www.cdc.gov/ecoli/general/index.html/)

Centers for Disease Control and Prevention. (2012). Foodborne illness, foodborne disease. Retrieved from: http://www.cdc.gov/foodsafety/facts.html#what

References included36ReferencesCenters for Disease Control and Prevention. (2012). Salmonella. Retrieved from: http://www.cdc.gov/salmonella/general/index.html

Centers for Disease Control and Prevention. 2010. Salmonella Additional Information. Retrieved from: http://www.cdc.gov/salmonella/general/additional.html

Centers for Disease Control and Prevention. (2012). Salmonella Outbreaks. Retrieved from: http://www.cdc.gov/salmonella/typhimurium-cantaloupe-08-

Cherif, et. al. (2010). Nutrition, Health and Wellness: An Applied Approach. San Francisco, CA. Benjamin Cummings)

References included37ReferencesFightBac. (2010). Partnership for Food Safety Education. Retrieved from: http://www.fightbac.org/)

Food and Drug Administration. (2012). Start at the Store: Prevent Foodborne Illness. Retrieved from: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm204328.htm

Mayo Clinic. (2011). E coli Risk factors. Retrieved from: http://www.mayoclinic.com/health/e-coli/DS01006/DSECTION=risk-factors

Medicinenet.com. (2013). Tummy Trouble Quiz: Test your IQ of Digestive Diseases. Retrieved from: http://www.medicinenet.com/tummy_trouble_quiz/quiz.htm

References included38ReferencesMoeller, D. (2011). Environmental Health. Cambridge, MA. Harvard University Press

United States Department of Agriculture. (2011). Foodborne Illness and Disease. Retrieved from: http://www.fsis.usda.gov/Fact_Sheets/Foodborne_Illness_What_Consumers_Need_to_Know/index.asp

United States Department of Agriculture. (2012). Thermy Image. Retrieved from: http://www.fsis.usda.gov/news_&_events/thermy_image_library/index.asp

References included39

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Food Safety for the General Public