food borne illness

Lettuce Learn a Bit About E. Coli

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By Diane Wright Hirsch, MPH

Senior Extension Educator/Food Safety

 

romaine lettuce
Photo: Wikimedia Commons

Recent news reports regarding the romaine lettuce outbreak have, yet again, raised concern about pathogens in our food supply. In particular, leafy greens continue to show up as a source for outbreaks. Two outbreaks since late fall have implicated romaine and/or leafy greens. In both outbreaks, E. coli O157:H7 was the culprit.

What exactly is E. coli?

Escherichia colior E. coliis a group of bacteria, some of which are harmless, and some of which are pathogenic, or disease causing. These bacteria are ubiquitous in the environment: they can survive in water, soil, on plants, and in the intestinal tracts of people and animals. Some types of E. colicause diarrhea, some cause urinary tract infections, and other may cause pneumonia or other diseases.

If you have a well, you are likely familiar with the term “generic E. coli.”  Generic E. coli(sometimes referred to as Biotype I), is found in the intestinal tracts of animals. Therefore, the public health and regulatory community use the presence of generic E. coliis an indicator that some type of fecal contamination (poop) is present. A test for generic E. colican determine if well water is drinkable, if food processing environments are clean, if meat is potentially contaminated with fecal matter or if irrigation water is safe to use on crops.

Generic E. coli, because it is found in fecal matter, may also indicate the potential for the presence of other pathogens that can be found in feces: bacteria such as Salmonellaand pathogenic types of E. coli; viruses such as hepatitis A or norovirus; and parasitic protozoa including Cryptosporidium parvum. All of these microorganisms have been associated with foodborne disease outbreaks.

While there are a number of pathogenic strains, it is Shiga toxin-producing E. coli(STEC) or enterohemorrhagic E. coli(EHEC) that is identified most often as a cause of foodborne illness. O157:H7 is one of several STEC strains. Hamburger, spinach, lettuce, sprouts, unpasteurized or “raw” milk and cheeses, unpasteurized fruit juice including cider, and  flour have all been identified as food sources in O157:H7 outbreaks.

This can be an awful disease. This type of E. coliproduces a Shiga toxin, which can be associated with more severe disease, including bloody diarrhea and hemolytic uremic syndrome (HUS), a type of kidney failure. The experience of an STEC infection can be different for each person. Contributing factors might include the age of the patient (very young or older people may have more severe infections due to compromised or undeveloped immune systems) and the general health of the person (again, if the immune system is already compromised, the disease may be more severe). However, a healthy adult can also experience more severe disease. Often, the symptoms include severe stomach cramps, diarrhea (often bloody), and vomiting. Again, the CDC states, “If there is fever, it usually is not very high (less than 101˚F/less than 38.5˚C). Most people get better within 5–7 days. Some infections are very mild, but others are severe or even life-threatening.”

Life threatening complications can occur when the Shiga toxin latches onto specific organs, such as the kidney. HUS can result in short term kidney failure or may result in long term disability, or even death.

How does E. coli get into our food?

We have been aware of the risk of E. coliin animal products for years. According to the Centers for Disease Control, “STEC live in the guts of ruminant animals, including cattle, goats, sheep, deer, and elk. The major source for human illnesses is cattle. STEC that cause human illness generally do not make animals sick. Other kinds of animals, including pigs and birds, sometimes pick up STEC from the environment and may spread it.”

It was likely the Jack in the Box hamburger related outbreak in 1993 that increased the awareness of both the public and the public health community of the relationship. After that outbreak, Rhode Island passed a law that does not allow restaurants to serve undercooked hamburgers to kids under 12 – a population that is at risk for the worst consequences of an E. coliinfection. At the same time, the recommended safe end-cooking temperature of hamburger was increased to 160 degrees F and sweeping regulation was passed that required meat and poultry processors, to develop food safety plans and be part of a food safety regulation program that included testing for generic E. coli,as well as pathogenic strains of the bacteria.

That makes sense to consumers. After all, if these pathogens are found in the intestinal tracts of animals and in fecal matter, then animal foods are most likely at risk for contamination.

So, how are fruits and vegetables contaminated with E. coli? As stated earlier, E. colican live in ruminants, including deer. Other wildlife may carry the bacteria after picking it up from the environment—the soil, dead animals, or contaminated water. The great outdoors is also the great toilet for these animals. Their feces end up in the soil and water or on the feed of birds or insects. Fruits and vegetables are grown in this soil. There is some risk of contamination as a result. Birds poop on tomatoes, apples fall on deer poop, etc.

Newer regulation target produce growers in an effort to reduce the risk for foodborne illness from fresh fruits and veggies. The Food Safety Modernization Act Produce Safety Rule includes requirements to test irrigation water, keep records of sanitation practices in the packing house, and employee training concerning personal hygiene and safe handling of produce.

Leafy greens continue to be associated with more outbreaks than other types of vegetables, with the exception of fresh sprouts. First, we eat them raw. There is no kill step to destroy pathogens. Second, they are leafy and grow close to the soil. If contaminated, those leaves can harbor and protect the bacteria. If lettuces are cut and then washed, the contamination can spread to greens that have not been contaminated, making the problem bigger. Once cut or chopped, the greens have even more open surface area that may allow the bacteria to internalize.

Like meat and poultry, any food product that is grown in the field will never be 100% risk free. The industry is hard at work doing what they can to reduce your risk.

So what should a consumer do?

First, do not stop eating greens, tomatoes, or other fresh fruits and vegetables. The benefits of a diet high in fresh produce far outweigh the risk of contracting a foodborne disease from them. Learn how to choose, store, prepare and handle them safely.

Purchase your produce from a farmer that has instituted good agricultural practices and good produce handling practices. If you buy from a local farmer at the farm or at a farmers’ market, ask the farmer if they have attended a food safety course or if they have a food safety program on their farm.

When buying fresh produce, avoid those that are bruised or cut if you are going to eat them raw.  Openings in the skin or bruises may increase the ability of bacteria or other microorganisms to reach the flesh of the fruit or vegetable. Refrigerate produce that should be refrigerated (leafy greens, scallions, broccoli, cucumbers) to minimize growth of microorganisms. In addition, refrigerate all cut produce.

Other food safety tips:

  • Wash all produce prior to eating.
  • Use clean knives, cutting boards, hands and other utensils when preparing raw lettuce for a salad or cutting a melon for breakfast.
  • Don’t cross contaminate ready-to-eat fresh produce with raw meat or poultry. I always prepare the salad first, then the meat for my meal.
  • Store raw, ready-to-eat produce to protect it from raw meat, poultry or fish.
  • Place the meat on a plate if it must be stored above the veggies. (I can never understand why produce drawers are under all other shelves in the fridge, making it a bit easier for meat juices to drip down onto the fresh produce.)

Some folks may want to consider purchasing heads of lettuce rather than chopped greens, though even whole heads of romaine were implicated in the most recent outbreak. If you do purchase pre-cut greens, make sure they are of good quality without a lot of browning or slimy leaves in the bag. If they are washed it is best not to rewash as you risk contamination during the process. However, if there are beginning signs of wilting or mushy leaves, I would wash, dry and store the remaining greens in the refrigerator, wrapped in a clean paper towel.

Continue to enjoy salads, fresh fruit and other veggies on a daily basis. It is an important part of a healthy diet. Just be sure to pay attention good safe food handling practices as you prepare to enjoy your meal.

For more information about food safety, visit our website at www.foodsafety.uconn.edu, check out some of the links in the article, or contact the Home and Garden Education Center at ladybug@uconn.edu or 1-877-486-6271.

Basic Food Safety Practices at Home

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What made you sick? Is it food you cooked at home?

By Diane Wright Hirsch, MPH, Senior Extension Educator/Food Safety

 

bar graph showing thoughts of consumers on food borne illness causes
Source: FDA

As winter wanes and we begin to eat more seasonally—perhaps eat more salads, raw fruits and veggies, using the barbecue—it may be a good time to take stock of our safe food preparation skills.

Many Americans believe that the food that they prepare at home is unlikely to be the source of a foodborne illness. In 2016, the US Food and Drug Administration surveyed over 4,000 adults regarding the source of food “poisoning” in the U.S. According to the data, 53 percent of respondents believed that food poisoning from foods prepared at home is “not very common.” Only 12 percent thought it was “very common.”

I recently read an article that addressed European Food Safety Authority (an agency that addresses foodborne illness and food safety policy for the European Union [EU]) concerns about safe food handling in the home. The agency reported that 40 percent of foodborne outbreaks in the EU were traced to food prepared in private homes. There, the major sources were identified as meat, meat products; mixed food and buffet meals, eggs, fish and milk. Vegetables and fruits were further down the list, but not considered to be insignificant.

In the United States, the news is not quite so bad for the consumer. A 2014 report from the Center for Science in the Public Interest indicated that Americans are twice as likely to get food poisoning from food prepared at a restaurant than from food we cook at home. But that still equates to about 30% of outbreaks being tied to home food preparation.

Why are these figures different? Maybe food is prepared in the home more consistently in Europe? Americans go out for breakfast, lunch or dinner more frequently? Is it possible that those with more health care options are more likely to report their illnesses? The outbreaks that go unreported, especially sporadic incidents that affect low numbers of consumers, is a number we don’t have a great handle on.

The bottom line is that while we continue to blame farmers, processors, foodservice and restaurants for making the food that makes us sick, the fact is that home cooks are quite likely to handle food in a way that results in a foodborne illness. Each part of the food system from the farmer or producer all the way to the home cook has some responsibility to prepare, serve and store food so that risks for foodborne illness are minimized.

So, how can you lower your risk of contributing to the statistics of home-sourced food borne illness? It really is not all that difficult. We are often so busy with our lives that we just don’t think about how we handle food at home—or consumers just don’t know the risks, because no one told them. It can be really scary when you are attending a pot luck or bringing a dish to soup kitchen or elementary school event where kids are sharing their favorite cultural foods.

Did that person clean up before they cooked? How long did was that casserole at room temperature after it was cooked? Was a food thermometer used to make sure the food was cooked long enough to be safe? What does their refrigerator look like? Kitchens in most homes are used for many different activities: feeding the dog; creating the latest art project; counters become a resting place for cats when you are not at home; sinks are used for washing hands and cleaning fresh lettuce; cleaning the cutting board after boning a chicken; washing your hair. So many opportunities for cross-contamination of perfectly clean and healthy food with those pesky pathogens that make us sick.

I have tried to distill all of the food safety rules down to an easy five points. Copy, paste, and pin this on your fridge for a few days and see if you can make these habits part of your everyday food prep routine.

  • Keep your kitchen, utensils, and hands clean. At the very least, clean surfaces before cooking and use clean utensils. Wash your hands before food preparation—no matter what. Even if you just went to the bathroom and washed your hands. Wash out your sink regularly, especially after washing knives used on raw meat or cleaning freshly harvested garden tomatoes or cucumbers.
  • Handle raw and cooked foods with care—do not let them cross paths. If you are making a salad for dinner, time it so that you can do that BEFORE you prepare the chicken or the fish. Then revisit #1—wash every surface and utensil before using it on another food. If you do prepare raw foods (i.e. cracking eggs) before the cooked or ready to eat foods (slicing bread or chopping washed lettuce), preventing cross contamination is essential to reduce risks.
  • Use a food thermometer. No matter what you have been told by anyone (including the chef who insists they know meat is done by pressing it with his or her finger), you CANNOT tell the temperature of a food without a thermometer. This is especially important when checking if a meat, poultry, fish or egg dish is fully cooked. Or, if leftovers are heated to the proper temperature (165 degrees F). Once I purchased a good digital thermometer, I actually found that I was actually less likely to over cook meat and chicken.
  • Use a refrigerator thermometer. While refrigeration can slow the growth of bacteria, it does not totally stop it. For example, Listeria is a bacteria that loves a cold, wet environment. So, keep your fridge clean, wipe up spills quickly, do not let lettuce, herbs, and other perishables melt into a wet mush in the veggie drawer. Remove outdated or old foods when you are collecting the household trash for weekly collection. If your refrigerator does not have a built-in temperature gauge, buy one and place it near the door, the warmest part of the fridge. It should read between 38 and 40 degrees F. Also, look at that thermometer or temperature gauge periodically to ensure that the fridge is maintaining that safe temperature range.
  • Get leftovers into the refrigerator ASAP after eating. Many consumers are under the mistaken impression that once you clean a food (fruits and veggies) or cook a food (chicken, fish) to the safe end temperature, your food safety worries are over. Not so. Washing alone will never totally remove all risk of pathogens. Get that leftover salad back into the refrigerator ASAP. Once cooked, soups, stews, steaks and mac and cheese need to be sent back to the fridge as soon as they are cool enough to handle. No reason to let them cool to room temperature. Modern fridges can handle reasonable amounts of warm food—break the food down to smaller amounts, about no more than three inches deep. They will cool faster. Don’t leave leftovers on the counter for long. It is too easy to forget them!

 

For more information about food safety at home, visit our website at www.foodsafety.uconn.edu, or contact the Home and Garden Education Center at ladybug@uconn.edu or 1-877-486-6271.

Cook Before Eating

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By Diane Wright Hirsch, MPH, Senior Extension Educator/Food Safety

eggs
Photo: Iowa Extension

During the holiday season, from Thanksgiving dinner through New Year’s celebrations, people who rarely spend time in the kitchen may be more likely to pick up a cookbook and make some cookies. Or, they may be stuffing their first turkey for Christmas day family dinner. Or possibly trying out a new appetizer for the office party—maybe even ceviche. (For those how may be unfamiliar with the term, “ceviche” it commonly refers to a shrimp or fish dish where citric acid, typically in the form of lemon juice or lime juice, is used to marinate raw fish or shrimp, often giving the appearance that the fish has been cooked.) Ceviche looks opaque and firm. But it is not cooked. The bacteria or viruses that may have been in the raw product have not been cooked away. They are still there. I have seen recipes for “faux ceviche,” that include cooking the shrimp or fish, but traditionally, it is not a cooked product. Consequently, it is risky. Ask your host or hostess if you are not sure of what they are serving.

Here is some guidance regarding foods or ingredients you may consider eating raw, whether you are a new cook or a seasoned cook who has always “done it this way” and “NEVER made anyone sick.” Keep in mind that your family may include very young children, the elderly or a chronically ill family member who may be at greater risk for the more severe consequences of a foodborne illness. So while you, a healthy adult, may be comfortable throwing caution to the winds and eating raw fish, uncooked cookie dough or even a taste of raw stuffing, the higher risk members of your family/friends circle really should not do this.

Be careful with raw eggs.

Raw eggs contain Salmonella. Not every egg. But no use betting on it. If you are choosing a recipe, such as eggnog, which calls for uncooked eggs, there is a safer alternative. Even if everyone is a healthy adult (and do you really know if they are all “healthy”?), it might be best to use a pasteurized egg product. They are often sold by the carton in the refrigerated egg or milk case. Otherwise, you might want to use a recipe for eggnog that preheats the egg to 160 degrees F to ensure that eggs are cooked sufficiently. Here is one from FoodSafety.gov: https://www.foodsafety.gov/blog/eggnog.html. Unfortunately, contrary to some popular cooking shows and magazines, adding alcohol to eggnog does not kill the Salmonella.

Watch out for raw doughs and batters.

We have all heard the warnings to avoid eating raw cookie dough—even though we may have all done it at one time with no apparent ill effects. Raw cookie dough or raw batters containing eggs share the same risk as raw eggnog. This would also be true of raw cookie dough that you might add to homemade ice cream. Commercial makers of cookie ice cream and other foods will use pasteurized eggs in their products.

There is another potential risk to eating raw batters and doughs that you may not even be aware of.  It is the flour.  Yes, the flour.  Flour is considered a raw agricultural product. It has not been treated to kill potential foodborne pathogens (microbes that cause illness). Since 2008, there have been five foodborne disease outbreaks tied to flour, two in Canada, one in New Zealand, and two in the US. So, even if a dough contains no eggs (pastry dough, for example), it is best not to eat it raw.

Think twice before serving raw meat, fish, or shellfish.

Honestly, I like a raw clam now and then. Some of my food safety colleagues look on aghast while others join in. Maybe you prefer raw oysters or sashimi. However, I do this knowing the risks I am taking. I do it rarely and only when I think the purveyor has been meticulous—and I still know there is a risk! Lots of folks do not know or understand the risks. Bacteria, such as Listeria, Salmonella, Vibrio vulnificous and parasites that include tapeworm and Anisakid nematodes may be associated with raw fish and shellfish. Again, if you are healthy, and visit restaurant or seafood retailers who are very careful, your risk may be less than that of an immune compromised adult or young child. However, the risk is never zero. So, during the holidays, choose a faux “ceviche” recipe that involves marinating cooked shrimp or fish. Serve oyster stew or clams casino that have been checked with a food thermometer.

If your holiday recipes include some of these risky ingredients, keep in mind that you can spread the pathogens that cause foodborne illness during the preparation steps. When you are cranking out trays and trays of cookies or appetizers, you need to practice the basic sanitation skills that will keep your food safe. Always use clean hands when handling any raw food and wash them again after handling that food. Use clean surfaces, cutting boards, knives, mixing spoons or other utensils: then wash them thoroughly in hot, soapy water before using them to prepare other foods. If that flour you used to dust the pie shell gets spread around or the raw egg drips onto the counter where you are decorating sugar cookies, it could end up in your salad or on your kid’s hands (which at some point will end up in their mouth).

Check the clock as you are baking and try not to leave doughs (or other raw ingredients, for that matter) out for more than four hours at a time. This allows the pathogens to multiply, increasing the risk for cross-contamination.

Finally, every cook is told to taste their dishes before presenting them to the guests. It’s one of the first questions asked of competing chefs on the cooking shows: “Did you even taste this?”  But, please, do not taste until the risky ingredients are cooked through. I will never forget a Christmas Eve in my childhood when Mom had made the stuffing, containing raw sausage and eggs, the day before. She always liked to taste the raw stuffing. (Right!) She spent Christmas day in bed….and the bathroom.

For more information about safe food preparation during the holidays, visit our website at www.foodsafety.uconn.edu, or foodsafety.gov, or contact the Home and Garden Education Center at ladybug@uconn.edu or 1-877-486-6271.

How Clean is That Refrigerator of Yours?

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By Diane Wright Hirsch, MPH

Senior Extension Educator/Food Safety

healthy foodThe invention of mechanical refrigeration was one of the most important developments in the history of keeping food safe (others include the pasteurization of milk and commercial canning).  Ask anyone who has suffered through the aftermath of a hurricane or ice storm without the benefit of electricity to keep their food cold. But even a plugged-in fridge, humming along and doing its job, can be a place that harbors pathogens that cause foodborne illness or spoilage organisms that result in food waste.

A little microbiology lesson might be helpful before we go on. When talking about food, food safety and safe food storage, we often discuss the microbes that can cause foodborne illness. Especially we talk about how to prevent or eliminate them from our food or food preparation areas. The foodborne microorganisms that cause illness are called pathogens. Certain strains of bacteria such as Salmonella, E. coli, Listeria, and Staphylococcus are pathogens—they can cause foodborne illness. Some viruses and parasites can be the source of foodborne illness as well.

Other microorganisms may cause food to spoil. Spoilage organisms are generally not pathogenic.  Spoilage makes food unappetizing, so we are unlikely to eat it. But the slimy, discolored, smelly, or fermented foods that result from the action of spoilage organisms are not as apt to make us sick, though some molds produce toxins that do have serious health effects.

The “good” thing about spoilage organisms is that they tell us that they are there. They make food smell funny or look weird. They turn food odd colors (cottage cheese that looks pink) or make things fizzy (juice that is fermented). We know it is best not to eat them. Spoilage organisms, will grow or multiply quite well at colder temperatures. This is why milk can spoil, juice can ferment and cheese or fruit can get moldy in your refrigerator.

On the other hand, pathogens are quiet, invisible. We never know for sure if they are lurking in the lettuce or hanging out on the chicken. Therefore we must take special care to prevent their growth or their spread to other foods or food-contact surfaces. We must assume that they are always there and do our best to control them.

Generally speaking, pathogens do not grow well in refrigerator temperatures. They prefer what we call the “danger zone” of approximately 41 degrees F to 135 degrees F. This is why it is recommended that you keep your refrigerator temperature at no more than 40 degrees F. If E. coli, Salmonella or other pathogens contaminate your food before you refrigerate it, these microbes will remain on the food. Refrigeration does not kill them, though it does limit their growth. One exception to this is Listeria. This bacteria actually likes the cold and can grow in temperatures as low as 32-45 degrees F.

Clean your fridge regularly

The best way to keep your refrigerator from being the source of a bout with foodborne illness is to keep it clean. A 2013 study of home kitchen environments conducted by the NSF, an organization that sets standards for cleanability of commercial food equipment, found that two of the “germiest” areas in the kitchen were the meat and vegetable bins in the home refrigerator.  They found Salmonella, Listeria, E. coli, yeast, and mold.

Prevention of messes is the first step to a clean refrigerator. When storing raw meat, poultry, or fish, be sure to separate them from other foods. Store them in a way that prevents juices from contaminating other foods or refrigerator shelves—place them on a plate or tray. Store fresh raw fruits or vegetables loosely in plastic bags or storage containers. Often it makes sense not to wash fresh produce until you are ready to use it, so it is especially important to keep fresh produce in the fruit and vegetable bin if possible. Keep eggs in their original carton. Leftovers should be refrigerated in closed containers, date labeled, so that they are used before spoilage organisms set up shop. If you have a leaky milk carton, put a plate under it.

If spills do occur, wipe them up immediately. If meat, poultry or fish juices contaminate a ready to eat food (lettuce, cut fruit, cheese), it is best to toss it.

A least weekly—maybe the night before garbage pickup–go through your fridge and throw out any perishable foods that are past their prime. Check dates on milk, yogurt and soft cheeses. They generally are best if used by 5-7 days after the “use by” date. Toss anything that is moldy, slimy, or just looks or smells spoiled. Take a look at your leftovers: generally, leftovers should be kept no longer than 3-5 days. Throw out those that have been there too long.

A thorough, deep cleaning should be done monthly.

  • Empty the food out of the refrigerator. In summer months, it may make sense to put some things in a cooler with ice—especially raw meat, fish, cut fruits or vegetables, and leftovers.
  • Take out shelving, drawers, and any other removable parts.
  • Wash shelving, drawers, and any other removable parts by hand with warm, soapy water. Dry with a CLEAN towel. (Air drying is preferable, but you want to get this job done quickly and get food back into the refrigerator within an hour or so.)
  • Wipe the inside of the empty refrigerator with warm, soapy water, then wipe with clean water to rinse off soap. Dry with a clean towel.
  • If you want to, mix one tablespoon of liquid household bleach (unscented) with a gallon of water and wipe the interior and any shelving with this sanitizing solution. Always clean first, then sanitize. Allow to air dry. Sanitizing alone will not be effective.
  • Finally, as you place items back in the refrigerator, take time to wipe off container surfaces.
  • Wipe off door handles and be sure, if you have a water/ice dispenser on the outside of your fridge, to clean that as well.

For more information about safe food preparation and storage check out our website at www.foodsafety.uconn.edu or contact the Home and Garden Education Center at www.ladybug.uconn.edu.

Storage Times For Refrigerated Foods (www.fsis.usda.gov)
NOTE: These short but safe time limits will help keep home-refrigerated food from spoiling.

food storage times

Food Safety and Foodborne Illness: There Will Always Be Surprises

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By:           Diane Wright Hirsch, MPH

Senior Extension Educator/Food Safety

dole spinach
Photo: FDA

I took on food safety as a focus of my Extension programming in the early 1990’s: little did I know that for the next 20-plus years my food safety educator life would be full of surprises. Early on, the issues were what a consumer would expect them to be—salmonella and eggs, salmonella and chicken, seafood as a source of a variety of foodborne illnesses. After all, these are all animal based products, high in protein, low in acid, the perfect breeding ground for the bacteria that cause much foodborne illness.

But at the same time, Listeria monocytogenes was an emerging pathogen that would soon become ubiquitous in the food processing industry. We learned that E. coli COULD survive an acid environment such as apple cider. And then came an onslaught of outbreaks related to fresh produce, which heretofore was not considered what were called, potentially hazardous foods or PHF, in the FDA Model Food code.

Like all science, the science of food safety is ever evolving. And so too are the unfortunate targets of the microorganisms that cause foodborne illness.

Some of the surprises over the years have resulted in additional regulation. The Jack in the Box E. coli outbreak (as well as others), was one driver of the 1996 USDA “Mega-reg” that required all meat and poultry processing plants to develop food safety systems based on HACCP or Hazard Analysis Critical Control Point programs. These programs lay the onus on the industry to identify the food safety hazards that could potentially affect their products and/or processes and to adopt controls to prevent the hazards or at least to minimize the risk of a foodborne illness from these hazards once their product gets into commerce and ultimately the consumer.

Similarly, it was a series of outbreaks affecting apple cider, apple juice (Odwalla, 1994) and other fresh juices that resulted in the FDA Fresh Juice HACCP regulation in 2001.

The FDA Food Code has also adapted over time as new foods or food processes have added risk to foods that weren’t identified as hazards in previous editions. Currently, seed sprouts, sliced melons, sliced tomatoes, and cut lettuces are all considered time-temperature for control foods (formerly PHF). Each of these were added following outbreaks that affected them. All are low acid foods that support the growth of microorganisms.

So, yes, outbreaks can surprise us. Consider some of the food products that have shown up in the news recently.

  • Deer antler tea and botulism—affected two in California. (Maybe the biggest surprise here is that someone actually drinks deer antler tea?)
  • coli in flour, including a rare form, O121 in a Canadian flour source
  • Botulism in carrot juice (was mishandled by consumers)
  • A variety of outbreaks tied to pet food
  • Frozen vegetables: this Listeria outbreak and subsequent recalls affected as many as 350 consumer products sold under 42 brand names.
  • Chicken pot pies (a result of unclear labeling, consumer handling)
  • Not an outbreak, but still a hazard—golf balls in hash browns?
  • Pepper and other spices in ready to eat products (coatings on cheese or salami), in spice mixes and simply on their own in a bottle.

Sometimes, it is not the outbreak that surprises us, but the extent of the consequences. Raw milk is an example of this. Outbreaks tied to raw milk are not unusual, but a soon to be released report from the Centers for Disease Control indicates that unpasteurized milk and cheese products caused 96% of illnesses attributed to dairy products. This is an important statistic.

In several recent outbreaks, including the Peanut Corporation of America and the Jensen Brothers Farm Listeria outbreak in cantaloupe, the owners and some employees of the companies were arrested and given hefty fines, probation, and in some cases, prison sentences.

Lessons learned, changes made

There will always be surprises. In my food safety courses for industry personnel, I use some of these examples as lessons for those who insist that an outbreak or recall will never happen to them. The Food Safety Modernization Act (FSMA) was itself the end result of many surprises. The foods regulated by the FDA are not under as much scrutiny as those regulated by the USDA. Inspections are less frequent. Businesses really do need to take responsibility for the safety of their food as the government agency that oversees them simply does not have the resources to do so. So after a series of outbreaks tied to FDA regulated foods (peanut butter, cheese, spinach, melon, sprouts, pet foods and others) that were not previously required to have a food safety program in place, FSMA was adopted. Included in the regulation were rules addressing fresh produce, processed foods (except those currently under HACCP regulations such as juice and seafood), pet foods and imports. A thriving third party audit industry has also developed as customers of food processors seek greater assurances that the products they are buying are produced under a food safety program.

What is a consumer to do?

Consumers should simply remain vigilant. Keep up on recalls or outbreaks that affect the foods you eat. If you like to get emails, you can sign up for notifications of recalls on both the FDA site (www.fda.gov) and the USDA Food Safety Inspection Service site (www.fsis.usda.gov). Consider using shopper loyalty cards when your supermarket makes them available. They are often used to contact consumers who may have purchased a product associated with an outbreak or recall.

A more reasonable approach may simply to be to learn about how you get sick from food. Learn about the importance of temperature controls, including cooking times and temperatures, keeping cold foods cold, and cooling foods properly. Learn about cross contamination of ready to eat foods with contaminated foods (raw meat), dirty hands or dirty countertops. Don’t eat raw foods that should be cooked for safety (raw, undercooked meat or eggs or doughs for example) and handle ready to eat foods like lettuce and cantaloupe carefully. Follow cooking instructions on the processed foods you buy—especially if you are using a microwave oven. You can learn about how to handle food safely at the UConn Food Safety website (www.foodsafety.uconn.edu) or by visiting www.foodsafety.gov .

In other words, take responsibility for the foods that you handle. While that may not ensure that you will be forever free from foodborne illness, at least you will be less likely to be the cause of that illness.

Oh Nuts!

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By Diane Wright Hirsch, MPH

Senior Extension Educator/Food Safety

FDA nutsEggs, chicken, lettuce, sprouts, and now pistachios. Some readers may think that this association of pistachios with a Salmonellosis outbreak is unusual if not rare. Well, though not likely to be defined as “common,” in recent years a number of outbreaks have been traced to nuts and nut products.

Currently, there is an ongoing outbreak associated with pistachios, with the US Food and Drug Administration (FDA) issuing a recall notice on March 10. The brand of the pistachios was the Wonderful brand, but these were also distributed under the Paramount Farms and Trader Joe’s brands, and others. A list of all lot numbers that have been recalled can be found on the FDA web site (www.fda.gov). At this point, eleven people from nine states have been identified as infected with the outbreak strain of Salmonella Montevideo, including one person in Connecticut. Two ill people have been hospitalized. No deaths have been reported. Because the shelf life for these products is long, some may still be on consumer shelves, so be sure to check your pantry for the recalled lot numbers.

Salmonella is a foodborne illness causing bacteria that is estimated to cause more than one million foodborne illnesses in the United States, with 19,000 hospitalizations and 450 deaths. Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually lasts four to seven days, and most persons recover without treatment. However, in some persons, particularly those with compromised immune systems, the elderly and the very young, the diarrhea may be so severe that the patient needs to be hospitalized.

There are a many strains or serotypes of the bacteria: S. Montevideo has caused this outbreak. You may be more familiar with S. Enteriditis. Some strains may be more virulent than others, causing more severe symptoms and side effects.

But why pistachios?

Historically, it was thought that nuts were likely too low in moisture to support the growth of foodborne illness causing bacteria. However, researchers have shown now that Salmonella can live on dry products and in peanut butter for as long as six months.

There have been 11 outbreaks from nuts and nut products (butters, spreads, “cheese”) since 2010, affecting 169 people. There were 25 recalls of contaminated nut products just in 2015. Recalls are often conducted as a result of a testing program—while a foodborne pathogen may show up during testing, it may not result in widespread illness.

And of course, there was the Peanut Corporation of America’s outbreak that resulted in the recall of more than 3,900 products from more than 200 companies, all containing peanut butter or peanut paste from PCA. This outbreak was due to a company that was negligent in its sanitation programs and knowingly shipped contaminated products: four people have been sentenced to prison terms in this case, including the owners of the company, the Parnell brothers.

But most cases are not the result of gross mismanagement and fraud. Nuts like any other product grown in orchards and fields can be contaminated by bird poop or irrigation water or during harvest, especially if the nuts come into contact with the ground. This is one reason, after several outbreaks traced back to almonds, in 2007, the USDA Agricultural Marketing Service (AMS) passed a rule that requires all handlers of almonds to use a process, such as pasteurization, that will significantly reduce the presence of Salmonella.

In addition, during processing, nuts may be soaked in water to soften shells—if the shells are contaminated, this process could spread the bacteria. And, like any other processed food, a good sanitation program is essential. Otherwise a processor runs the risk of cross-contaminating clean product with dirty surfaces or utensils. Or, Listeria can take up residence in the processing environment, risking the contamination of nuts after they are cooked, roasted, or pasteurized.

So, is this something to be concerned about? Well the good news is no, you do not need to be stressed out over your favorite peanut butter. However, if you or a family member is elderly, very young or has an immune system compromised by chronic illness, medications or other condition, then maybe you should steer clear of raw nuts or raw nut butters.

The FDA is presently considering conducting a risk assessment for salmonella in tree nuts (almonds, cashews, macadamia nuts, pistachios, walnuts, etc.) as a result of increasing numbers of recalls and outbreaks. The results of this risk assessment may lead to additional regulations, rules, or guidance documents focused on the nut industry.

Recently, the Food Safety Modernization Act (FSMA) rules were finalized. This, too, will increase jurisdiction of the FDA over both growers and processors of nuts and nut products. The Produce Safety Rule will address what goes on in the field; the Prevention and Controls Rule will impact processing operations. Attention is drawn to safer irrigation methods, worker health and hygiene (important during harvest), sanitation in the field and in the packinghouse. Regular inspections of farms and processing plants will be part of the new regulations.

If you grow nut trees at home, keep these points in mind:

  • Minimize contact with ground during harvest. Consider covering the ground with a CLEAN tarp or sheet to catch the nuts.
  • Handle harvested nuts with clean hands.
  • Always wash surfaces that come into contact with harvested nuts—counters, table tops, etc.
  • When opening raw nuts, be sure to use clean hands and utensils.
  • Dry/cure nuts completely before storage—again using clean equipment.
  • Store nuts in a clean container. Freezing or refrigerating will further reduce the risk of bacterial growth.

For more information on growing and the safe handling of nuts, contact the Home and Garden Education Center at ladybug@uconn.edu or 1-877-486-6271.