2006 oklahoma cooperative extension service 1 fear of fresh a primer on produce safety barbara...

2006 Oklahoma Cooperative Extension Service 1

Fear of Fear of FreshFresh

A Primer on Produce A Primer on Produce SafetySafetyBarbara Brown, Ph.D., Barbara Brown, Ph.D., R.D./L.D.R.D./L.D.

Food SpecialistFood SpecialistOklahoma Cooperative Oklahoma Cooperative

Extension ServiceExtension Service


The Kyle Allgood storyThe Kyle Allgood story

• Would have been 3 in DecemberWould have been 3 in December• Lived in Chubbuck, IdahoLived in Chubbuck, Idaho• Died September 30 from Died September 30 from E. coli E. coli

O156:H7 infectionO156:H7 infection•Drank fresh spinach smoothie Drank fresh spinach smoothie

his mom made for himhis mom made for him


Jillian KohlJillian Kohl

• Graduate student in MilwaukeeGraduate student in Milwaukee• Ran marathonsRan marathons• Ate fresh spinachAte fresh spinach•Suffered stomach cramps, muscle Suffered stomach cramps, muscle

aches, fever, bloody diarrheaaches, fever, bloody diarrhea•2-1/2 weeks in hospital2-1/2 weeks in hospital•Discharged with less than 10% Discharged with less than 10%

normal kidney functionnormal kidney function


It’s happened beforeIt’s happened before

• 20032003•16 cases, 2 deaths from 16 cases, 2 deaths from

spinach contaminated with spinach contaminated with E. E. colicoli O157:H7 O157:H7

• Since 1995Since 1995•19 outbreaks of 19 outbreaks of E. coliE. coli O157:H7 O157:H7

associated with leafy greensassociated with leafy greens•Most traced back to CaliforniaMost traced back to California


How bad is the foodborne How bad is the foodborne illness problem?illness problem?

• 76 million illnesses/year76 million illnesses/year• 5,000 deaths/year5,000 deaths/year• High risk groups: elderly, young High risk groups: elderly, young

children, pregnant women & children, pregnant women & fetuses, immuno-compromisedfetuses, immuno-compromised

• Rate of foodborne illness is not Rate of foodborne illness is not risingrising•29% decrease in infections 29% decrease in infections

related to meat/poultryrelated to meat/poultry


DefinitionsDefinitions• Outbreak: Outbreak:

• 2 or more people consumed same 2 or more people consumed same contaminated food & come down with contaminated food & come down with same illness same illness

• Has an identified etiology & food Has an identified etiology & food vehiclevehicle

• Must have occurred in U.S. or its Must have occurred in U.S. or its territoriesterritories

• Can affect 100’s or 1,000’s Can affect 100’s or 1,000’s • Case: 1 person with foodborne illnessCase: 1 person with foodborne illness

• May or may not be part of outbreakMay or may not be part of outbreak


10 federal agencies 10 federal agencies involved in food safetyinvolved in food safety

• 2 inspect & regulate food 2 inspect & regulate food •USDA—meat & poultryUSDA—meat & poultry•FDA—all other foodsFDA—all other foods•2/3 outbreaks under FDA 2/3 outbreaks under FDA jurisdictionjurisdiction

•Neither has power to recall Neither has power to recall foodfood•Is voluntaryIs voluntary


Foods that cause foodborne Foods that cause foodborne illness (source: CSPI 2005)illness (source: CSPI 2005)

FoodFood # # outbreaksoutbreaks # cases# cases

Seafood & Seafood & seafood dishesseafood dishes 899899 9,3129,312

Produce & Produce & produce produce dishesdishes

554554 23,31523,315

Beef & beef Beef & beef dishesdishes 438438 12,70212,702

Eggs & egg Eggs & egg dishesdishes 329329 10,84710,847


Is produce riskier now?Is produce riskier now?

• Yes Yes • Outbreaks bigger & more Outbreaks bigger & more

frequent than 15-30 years agofrequent than 15-30 years ago• Partly because people eat more Partly because people eat more

fresh fruits & vegetablesfresh fruits & vegetables


Why the risk withWhy the risk with ready-to-eat fresh ready-to-eat fresh

produce?produce?• Generally grown in Generally grown in

natural natural environment (field environment (field or orchard)or orchard)

• Often eaten without Often eaten without cooking or other cooking or other treatments that treatments that could eliminate could eliminate pathogenspathogens


Routes of contaminationRoutes of contamination

• WaterWater•Contaminated irrigation waterContaminated irrigation water•Run-offRun-off•Cleaning waterCleaning water



• Direct application of Direct application of inadequately inadequately processed manure to processed manure to soil—by animals or as soil—by animals or as fertilizerfertilizer• Nearby pasture, Nearby pasture,

down hill from down hill from feedlot, wild feedlot, wild animals roaming animals roaming fieldsfields



• Cross-contaminationCross-contamination•Unwashed hands/surfacesUnwashed hands/surfaces•From raw foods in kitchenFrom raw foods in kitchen


Contamination Contamination compounded by:compounded by:

• Held too long in Held too long in storagestorage

• Temperatures too Temperatures too highhigh

• Rough surface on Rough surface on produce hard to produce hard to clean—even surfaces clean—even surfaces that appear smooththat appear smooth



• Bacteria enter Bacteria enter produce & produce & cannot be cannot be washed awaywashed away



• Distribution process Distribution process leaves difficult trace-leaves difficult trace-back of processback of process•Large boxes broken Large boxes broken

down & repackaged down & repackaged without point-of-without point-of-origin info.origin info.

•Parts of many Parts of many plants in 1 bagplants in 1 bag


Symptoms of Symptoms of E. coliE. coli O157:H7 O157:H7 illnessillness

• Symptoms appear within 3-4 daysSymptoms appear within 3-4 days•May take up to 10 daysMay take up to 10 days

• Diarrhea, often with bloody stools, Diarrhea, often with bloody stools, severe abdominal crampssevere abdominal cramps•Some have no symptomsSome have no symptoms

• Most healthy adults recover in a Most healthy adults recover in a weekweek

• 3-8% of people develop hemolytic 3-8% of people develop hemolytic uremic syndrome (HUS)uremic syndrome (HUS)


HUSHUS

• Form of kidney failure Form of kidney failure • Most often in young children & Most often in young children &

elderlyelderly• Red blood cells destroyedRed blood cells destroyed•E. coliE. coli toxin damages blood toxin damages blood

vessels by creating small strands vessels by creating small strands across the insides so as red blood across the insides so as red blood cells go through they are slicedcells go through they are sliced

• 3-5% of those with HUS die3-5% of those with HUS die


E. coliE. coli O157:H7 Outbreak Case O157:H7 Outbreak Case Counts by StateCounts by State (As of 10/06/06: (As of 10/06/06:

CDC)CDC)

1-4 1-4 5-9 5-9 10-1410-14 15 or15 orhigher higher


Number of persons with Number of persons with outbreak strain/state outbreak strain/state

(CDC): (CDC): • Arizona Arizona 88• California California 22• Colorado Colorado 11• ConnecticutConnecticut 33• Idaho Idaho 77• Illinois Illinois 22• Indiana Indiana

1010• KentuckyKentucky 88• Maryland Maryland 33• Maine Maine 33• Michigan Michigan 44• Minnesota Minnesota 22• Nebraska Nebraska 1111

• New Mexico New Mexico 55• Nevada Nevada 22• New York New York 1111• Ohio Ohio 2525• Oregon Oregon 66• Pennsylvania Pennsylvania

1010• Tennessee Tennessee 11• Utah Utah 1919• Virginia Virginia 22• Washington Washington 33• West Virginia West Virginia 11• Wisconsin Wisconsin 4949• Wyoming Wyoming 11


Investigation of outbreakInvestigation of outbreak

• Widely dispersed illnesses Widely dispersed illnesses indicated contamination early in indicated contamination early in distribution chaindistribution chain


State agencies workedState agencies workedclosely with FDAclosely with FDA

• Especially California Dept. of Especially California Dept. of Health Services & Dept. of Food Health Services & Dept. of Food & Ag.& Ag.

• Western Institute for Food Western Institute for Food Safety & SecuritySafety & Security


Investigation foundInvestigation found• Same strain of Same strain of E. coli E. coli

O157:H7 DNA as in the O157:H7 DNA as in the illness outbreak in samples illness outbreak in samples taken from stream & feces taken from stream & feces of cattle & wild pigs present of cattle & wild pigs present on ranches implicated in on ranches implicated in outbreakoutbreak

• Found evidence of wild pigs Found evidence of wild pigs in spinach fieldsin spinach fields

• Continue looking for more Continue looking for more information on source & information on source & mechanism of mechanism of contaminationcontamination


Produce most apt to haveProduce most apt to haveE. coli E. coli O157:H7O157:H7

• Recurrent outbreaks from leafy Recurrent outbreaks from leafy greens, sprouts, unpasteurized greens, sprouts, unpasteurized juices & ciderjuices & cider

• Common factors: grown fairly Common factors: grown fairly close to ground or harvested from close to ground or harvested from ground, not cooked, not acidicground, not cooked, not acidic•Popular apple/tomato varieties Popular apple/tomato varieties

are becoming less acidic & are becoming less acidic & sweetersweeter


Spinach not aloneSpinach not alone• Nov. 2006: FDA notifies Nov. 2006: FDA notifies

consumers tomatoes in consumers tomatoes in restaurants were restaurants were linked to linked to Salmonella Salmonella TyphimuriumTyphimurium outbreak outbreak


Salmonella TyphimuriumSalmonella Typhimurium outbreakoutbreak

• Reported in 21 states, 183 cases of Reported in 21 states, 183 cases of illnesses to the CDCillnesses to the CDC

• Outbreak over by time of Outbreak over by time of announcementannouncementAlabama, 1Alabama, 1 Arkansas, 4Arkansas, 4 Connecticut, 28Connecticut, 28

Georgia, 1Georgia, 1 Indiana, 1Indiana, 1 Kentucky, 19Kentucky, 19

Massachusetts, Massachusetts, 5050

Maine, 8Maine, 8 Michigan, 2Michigan, 2

Minnesota, 14 Minnesota, 14 North Carolina, 4 North Carolina, 4 Nebraska, 1Nebraska, 1

New Hampshire, New Hampshire, 1414

Ohio, 4Ohio, 4 Pennsylvania, 3Pennsylvania, 3

Rhode Island, 6Rhode Island, 6 Tennessee, 9Tennessee, 9 Virginia, 3Virginia, 3

Vermont, 8Vermont, 8 Washington, 1Washington, 1 Wisconsin, 2Wisconsin, 2


FDA actions to reduce FDA actions to reduce riskrisk

• 1998—Guide to 1998—Guide to Minimize Minimize Microbial Food Microbial Food Safety Hazards Safety Hazards for Fresh Fruits for Fresh Fruits and Vegetablesand Vegetables


FDA actions to reduce FDA actions to reduce riskrisk

• 2004—FDA Produce Safety Action 2004—FDA Produce Safety Action Plan objectives:Plan objectives:

•Prevent contamination of freshPrevent contamination of fresh•Minimize public health impact of Minimize public health impact of contamination when it happenscontamination when it happens

•Improve communicationImprove communication•Facilitate research relevant to Facilitate research relevant to contamination of fresh producecontamination of fresh produce


2006—Lettuce Safety 2006—Lettuce Safety InitiativeInitiative

• Assess current industry Assess current industry approaches & actions to address approaches & actions to address issue of improving lettuce safetyissue of improving lettuce safety•Stimulate segments of industry Stimulate segments of industry

to further advance efforts in to further advance efforts in addressing all aspects of addressing all aspects of improving lettuce safetyimproving lettuce safety

• Alert consumers early & respond Alert consumers early & respond rapidly in event of outbreakrapidly in event of outbreak


2006—Lettuce Safety 2006—Lettuce Safety InitiativeInitiative

• Document observations that identify Document observations that identify practices that potentially lead to practices that potentially lead to product contamination, develop &/or product contamination, develop &/or refine guidance & policy that will refine guidance & policy that will minimize opportunities for future minimize opportunities for future outbreaks &/or identify research outbreaks &/or identify research needs needs

• Consider regulatory action based on Consider regulatory action based on conditions & practices that could lead conditions & practices that could lead to, or spread, contamination or when to, or spread, contamination or when lettuce has been adulteratedlettuce has been adulterated


Potential safeguardsPotential safeguards

• Cooking to 160Cooking to 160ooF for 15 secondsF for 15 seconds• Irradiation?Irradiation?•FDA has been petitioned to FDA has been petitioned to

allowallow•Suitability & efficacy to be Suitability & efficacy to be determineddetermined


So what do consumers So what do consumers do?do?

• Option: Quit Option: Quit eating raw eating raw produceproduce


FDA advice: FDA advice: buying fresh produce buying fresh produce

• Purchase produce Purchase produce not bruised or not bruised or damageddamaged

• Check package Check package datedate• Eat greens by "Best Eat greens by "Best

if Used by Date"if Used by Date"


Caution on greensCaution on greens

• Do not buy prewashed salads Do not buy prewashed salads with considerable amount of with considerable amount of brown-edged pieces or if greens brown-edged pieces or if greens appear excessively wetappear excessively wet


Consumer resourceConsumer resource

• Available at:Available at:• http://http://

www.cfsan.fda.gov/www.cfsan.fda.gov/~dms/prodsafe.html~dms/prodsafe.html


Buying fresh produceBuying fresh produce

• For fresh cut For fresh cut produce (such as 1/2 produce (such as 1/2 watermelon, bagged watermelon, bagged mixed salad greens) mixed salad greens) choose only those choose only those refrigerated or refrigerated or surrounded by icesurrounded by ice


Buying fresh produceBuying fresh produce

• Bag fresh fruits & Bag fresh fruits & vegetables vegetables separately from separately from meat, poultry & meat, poultry & seafood products seafood products when packing them when packing them to take home from to take home from marketmarket


Storage tips for fresh Storage tips for fresh produceproduce

• Certain perishable fresh fruits & Certain perishable fresh fruits & vegetables (like strawberries, vegetables (like strawberries, lettuce, herbs, mushrooms) can lettuce, herbs, mushrooms) can be best maintained by storing in be best maintained by storing in a clean refrigerator at 40°F or a clean refrigerator at 40°F or belowbelow


Refrigeration needed?Refrigeration needed?

• To maintain To maintain quality, safetyquality, safety

• Ask grocerAsk grocer


Storage tips for fresh Storage tips for fresh produceproduce

• All produce purchased pre-cut or All produce purchased pre-cut or peeled should be refrigerated peeled should be refrigerated within 2 hours to maintain within 2 hours to maintain quality & safetyquality & safety

• Keep refrigerator at or below Keep refrigerator at or below 40°F40°F•Use refrigerator thermometerUse refrigerator thermometer


Preparation of fresh Preparation of fresh produceproduce

• Pre-washed greens in sealed Pre-washed greens in sealed bagsbags•Will be stated on packagingWill be stated on packaging•Can use without further Can use without further

washingwashing•Can wash again Can wash again just before just before useuse as extra caution as extra caution

• Wash precut or prewashed Wash precut or prewashed produce in open bagsproduce in open bags


Preparation of fresh Preparation of fresh produceproduce

• Cut away damaged Cut away damaged &/or bruised areas &/or bruised areas before preparing before preparing &/or eating&/or eating•Discard produce Discard produce

that looks rottenthat looks rotten


Preparation tipsPreparation tips

• All unpackaged fruits & All unpackaged fruits & vegetables & those packaged & vegetables & those packaged & not marked pre-washed, should not marked pre-washed, should be thoroughly washed before be thoroughly washed before eatingeating• Includes Includes conventionally or conventionally or

organically grownorganically grown, home grown , home grown & produce bought from grocery & produce bought from grocery stores & farmer's marketsstores & farmer's markets


French lessonFrench lesson

• French: saladeFrench: salade• English: lettuceEnglish: lettuce• Example Phrase Using Example Phrase Using

Word: Word: • French: Ah, Robert, est-ce French: Ah, Robert, est-ce

que tu peux laver la que tu peux laver la salade?salade?

• English: Robert, can you English: Robert, can you wash the lettuce?wash the lettuce?


About washing produceAbout washing produce

• First wash handsFirst wash hands• 20 seconds with warm water & soap20 seconds with warm water & soap• Before & after preparing fresh Before & after preparing fresh

produceproduce• Wash fruits & vegetables under Wash fruits & vegetables under

running water just before eating, running water just before eating, cutting or cookingcutting or cooking

• Even when planning to peel produce Even when planning to peel produce before eating, important to wash it before eating, important to wash it firstfirst


About washing produceAbout washing produce

• Soap, detergent, commercial Soap, detergent, commercial produce washes not produce washes not recommendedrecommended

• Scrub firm produce with clean Scrub firm produce with clean produce brushproduce brush

• Drying produce with clean cloth Drying produce with clean cloth or paper towel may reduce or paper towel may reduce bacteria that may be presentbacteria that may be present


Does washing help?Does washing help?

• Bacteria are sticky, can’t wash off Bacteria are sticky, can’t wash off greens even if bleach, detergent, greens even if bleach, detergent, commercial produce washes are commercial produce washes are usedused

• Can’t wash off bacteria if inside Can’t wash off bacteria if inside produceproduce•Enters apples through hole at Enters apples through hole at

bottom where flower used to bebottom where flower used to be•Sliced into melonsSliced into melons


Separate for Safety Separate for Safety

• Keep produce to be eaten raw Keep produce to be eaten raw separate from other foods, such separate from other foods, such as raw meat, poultry or seafood as raw meat, poultry or seafood & kitchen utensils used for those & kitchen utensils used for those productsproducts


Reducing cross-contamination Reducing cross-contamination riskrisk

• Wash cutting boards, dishes, Wash cutting boards, dishes, utensils & counter tops with hot utensils & counter tops with hot water & soap between preparation water & soap between preparation of raw meat, poultry, seafood & of raw meat, poultry, seafood & produce & preparation of produce produce & preparation of produce that will not be cooked or only that will not be cooked or only briefly cookedbriefly cooked

• Wash plastic & other non-porous Wash plastic & other non-porous cutting boards in dishwasher after cutting boards in dishwasher after useuse


Reducing cross-contamination Reducing cross-contamination riskrisk

• Kitchen sanitizers can be used Kitchen sanitizers can be used on cutting boards & counter tops on cutting boards & counter tops periodicallyperiodically•1 teaspoon chlorine bleach/1 1 teaspoon chlorine bleach/1

quart waterquart water

Bleach


What do we tell What do we tell consumersconsumers

• Health benefits still outweigh riskHealth benefits still outweigh risk• Use selection & handling practices Use selection & handling practices

that reduce riskthat reduce risk• Be alert for health bulletinsBe alert for health bulletins•Especially people in high risk Especially people in high risk

groupsgroups• We need a whole lot more We need a whole lot more

research on food safety & fresh research on food safety & fresh produceproduce

2006 oklahoma cooperative extension service 1 fear of fresh a primer on produce safety barbara...

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