Transcript Produce Safety 1106

Fear of Fresh
A Primer on Produce Safety
Barbara Brown, Ph.D., R.D./L.D.
Food Specialist
Oklahoma Cooperative Extension
Service
2006
Oklahoma Cooperative Extension Service
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The Kyle Allgood story
• Would have been 3 in December
• Lived in Chubbuck, Idaho
• Died September 30 from E. coli
O156:H7 infection
• Drank fresh spinach smoothie his
mom made for him
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Jillian Kohl
• Graduate student in Milwaukee
• Ran marathons
• Ate fresh spinach
• Suffered stomach cramps, muscle
aches, fever, bloody diarrhea
• 2-1/2 weeks in hospital
• Discharged with less than 10%
normal kidney function
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It’s happened before
• 2003
• 16 cases, 2 deaths from spinach
contaminated with E. coli O157:H7
• Since 1995
• 19 outbreaks of E. coli O157:H7
associated with leafy greens
• Most traced back to California
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How bad is the foodborne
illness problem?
• 76 million illnesses/year
• 5,000 deaths/year
• High risk groups: elderly, young
children, pregnant women & fetuses,
immuno-compromised
• Rate of foodborne illness is not rising
• 29% decrease in infections related
to meat/poultry
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Definitions
• Outbreak:
• 2 or more people consumed same
contaminated food & come down with
same illness
• Has an identified etiology & food vehicle
• Must have occurred in U.S. or its
territories
• Can affect 100’s or 1,000’s
• Case: 1 person with foodborne illness
• May or may not be part of outbreak
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10 federal agencies involved in
food safety
• 2 inspect & regulate food
• USDA—meat & poultry
• FDA—all other foods
• 2/3 outbreaks under FDA
jurisdiction
• Neither has power to recall food
• Is voluntary
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Foods that cause foodborne illness
(source: CSPI 2005)
Food
# outbreaks
# cases
Seafood &
seafood dishes
899
9,312
Produce &
produce dishes
554
23,315
Beef & beef
dishes
438
12,702
Eggs & egg
dishes
329
10,847
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Is produce riskier now?
• Yes
• Outbreaks bigger & more frequent
than 15-30 years ago
• Partly because people eat more fresh
fruits & vegetables
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Why the risk with
ready-to-eat fresh produce?
• Generally grown in
natural environment
(field or orchard)
• Often eaten without
cooking or other
treatments that could
eliminate pathogens
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Routes of contamination
• Water
• Contaminated irrigation water
• Run-off
• Cleaning water
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Routes of contamination
• Direct application of
inadequately processed
manure to soil—by
animals or as fertilizer
• Nearby pasture, down
hill from feedlot, wild
animals roaming fields
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Routes of contamination
• Cross-contamination
• Unwashed hands/surfaces
• From raw foods in kitchen
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Contamination compounded by:
• Held too long in storage
• Temperatures too high
• Rough surface on
produce hard to clean—
even surfaces that
appear smooth
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Contamination compounded by:
• Bacteria enter
produce & cannot
be washed away
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Contamination compounded by:
• Distribution process
leaves difficult traceback of process
• Large boxes broken
down & repackaged
without point-of-origin
info.
• Parts of many plants
in 1 bag
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Symptoms of E. coli O157:H7
illness
• Symptoms appear within 3-4 days
• May take up to 10 days
• Diarrhea, often with bloody stools,
severe abdominal cramps
• Some have no symptoms
• Most healthy adults recover in a week
• 3-8% of people develop hemolytic
uremic syndrome (HUS)
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HUS
• Form of kidney failure
• Most often in young children & elderly
• Red blood cells destroyed
• E. coli toxin damages blood vessels
by creating small strands across the
insides so as red blood cells go
through they are sliced
• 3-5% of those with HUS die
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E. coli O157:H7 Outbreak Case
Counts by State (As of 10/06/06: CDC)
1-4
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5-9
10-14
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15 or
higher
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Number of persons with
outbreak strain/state (CDC):
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Arizona
California
Colorado
Connecticut
Idaho
Illinois
Indiana
Kentucky
Maryland
Maine
Michigan
Minnesota
Nebraska
8
2
1
3
7
2
10
8
3
3
4
2
11
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New Mexico
Nevada
New York
Ohio
Oregon
Pennsylvania
Tennessee
Utah
Virginia
Washington
West Virginia
Wisconsin
Wyoming
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2
11
25
6
10
1
19
2
3
1
49
1
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Investigation of outbreak
• Widely dispersed illnesses indicated
contamination early in distribution
chain
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State agencies worked
closely with FDA
• Especially California Dept. of Health
Services & Dept. of Food & Ag.
• Western Institute for Food Safety &
Security
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Investigation found
• Same strain of E. coli
O157:H7 DNA as in the
illness outbreak in samples
taken from stream & feces of
cattle & wild pigs present on
ranches implicated in outbreak
• Found evidence of wild pigs in
spinach fields
• Continue looking for more
information on source &
mechanism of contamination
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Produce most apt to have
E. coli O157:H7
• Recurrent outbreaks from leafy
greens, sprouts, unpasteurized juices
& cider
• Common factors: grown fairly close
to ground or harvested from ground,
not cooked, not acidic
• Popular apple/tomato varieties are
becoming less acidic & sweeter
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Spinach not alone
• Nov. 2006: FDA notifies
consumers tomatoes in
restaurants were linked to
Salmonella Typhimurium
outbreak
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Salmonella Typhimurium
outbreak
• Reported in 21 states, 183 cases of
illnesses to the CDC
• Outbreak over by time of announcement
Alabama, 1
Arkansas, 4
Connecticut, 28
Georgia, 1
Indiana, 1
Kentucky, 19
Massachusetts, 50
Maine, 8
Michigan, 2
Minnesota, 14
North Carolina, 4
Nebraska, 1
New Hampshire, 14
Ohio, 4
Pennsylvania, 3
Rhode Island, 6
Tennessee, 9
Virginia, 3
Vermont, 8
Washington, 1
Wisconsin, 2
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FDA actions to reduce risk
• 1998—Guide to
Minimize Microbial
Food Safety
Hazards for Fresh
Fruits and
Vegetables
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FDA actions to reduce risk
• 2004—FDA Produce Safety Action
Plan objectives:
• Prevent contamination of fresh
• Minimize public health impact of
contamination when it happens
• Improve communication
• Facilitate research relevant to
contamination of fresh produce
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2006—Lettuce Safety Initiative
• Assess current industry approaches &
actions to address issue of improving
lettuce safety
• Stimulate segments of industry to
further advance efforts in
addressing all aspects of improving
lettuce safety
• Alert consumers early & respond
rapidly in event of outbreak
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2006—Lettuce Safety Initiative
• Document observations that identify
practices that potentially lead to product
contamination, develop &/or refine guidance
& policy that will minimize opportunities for
future outbreaks &/or identify research
needs
• Consider regulatory action based on
conditions & practices that could lead to,
or spread, contamination or when lettuce
has been adulterated
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Potential safeguards
• Cooking to 160oF for 15 seconds
• Irradiation?
• FDA has been petitioned to allow
• Suitability & efficacy to be
determined
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So what do consumers do?
• Option: Quit eating
raw produce
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FDA advice:
buying fresh produce
• Purchase produce not
bruised or damaged
• Check package date
• Eat greens by "Best if
Used by Date"
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Caution on greens
• Do not buy prewashed salads with
considerable amount of brown-edged
pieces or if greens appear excessively
wet
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Consumer resource
• Available at:
• http://www.cfsan.fda.gov/
~dms/prodsafe.html
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Buying fresh produce
• For fresh cut produce
(such as 1/2
watermelon, bagged
mixed salad greens)
choose only those
refrigerated or
surrounded by ice
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Buying fresh produce
• Bag fresh fruits &
vegetables separately
from meat, poultry &
seafood products when
packing them to take
home from market
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Storage tips for fresh produce
• Certain perishable fresh fruits &
vegetables (like strawberries, lettuce,
herbs, mushrooms) can be best
maintained by storing in a clean
refrigerator at 40°F or below
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Refrigeration needed?
• To maintain
quality, safety
• Ask grocer
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Storage tips for fresh produce
• All produce purchased pre-cut or
peeled should be refrigerated within 2
hours to maintain quality & safety
• Keep refrigerator at or below 40°F
• Use refrigerator thermometer
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Preparation of fresh produce
• Pre-washed greens in sealed bags
• Will be stated on packaging
• Can use without further washing
• Can wash again just before use as
extra caution
• Wash precut or prewashed produce in
open bags
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Preparation of fresh produce
• Cut away damaged
&/or bruised areas
before preparing &/or
eating
• Discard produce
that looks rotten
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Preparation tips
• All unpackaged fruits & vegetables &
those packaged & not marked prewashed, should be thoroughly washed
before eating
• Includes conventionally or
organically grown, home grown &
produce bought from grocery stores
& farmer's markets
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French lesson
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French: salade
English: lettuce
Example Phrase Using Word:
French: Ah, Robert, est-ce
que tu peux laver la salade?
• English: Robert, can you wash
the lettuce?
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About washing produce
• First wash hands
• 20 seconds with warm water & soap
• Before & after preparing fresh produce
• Wash fruits & vegetables under running
water just before eating, cutting or cooking
• Even when planning to peel produce before
eating, important to wash it first
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About washing produce
• Soap, detergent, commercial produce
washes not recommended
• Scrub firm produce with clean produce
brush
• Drying produce with clean cloth or
paper towel may reduce bacteria that
may be present
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Does washing help?
• Bacteria are sticky, can’t wash off
greens even if bleach, detergent,
commercial produce washes are used
• Can’t wash off bacteria if inside
produce
• Enters apples through hole at
bottom where flower used to be
• Sliced into melons
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Separate for Safety
• Keep produce to be eaten raw
separate from other foods, such as
raw meat, poultry or seafood &
kitchen utensils used for those
products
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Reducing cross-contamination risk
• Wash cutting boards, dishes, utensils
& counter tops with hot water & soap
between preparation of raw meat,
poultry, seafood & produce &
preparation of produce that will not
be cooked or only briefly cooked
• Wash plastic & other non-porous
cutting boards in dishwasher after use
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Reducing cross-contamination risk
• Kitchen sanitizers can be used on
cutting boards & counter tops
periodically
• 1 teaspoon chlorine bleach/1 quart
water
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What do we tell consumers
• Health benefits still outweigh risk
• Use selection & handling practices
that reduce risk
• Be alert for health bulletins
• Especially people in high risk groups
• We need a whole lot more research on
food safety & fresh produce
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