The Microworld Instructor Notes This section focuses on the microorganisms that cause foodborne illness and the conditions that allow them to grow. Understanding these conditions is the first step toward preventing foodborne illness outbreaks in your establishment.

Apply Your Knowledge: Test Your Food Safety Knowledge True or False: Bacillus cereus is commonly associated with cereal crops, such as rice 2. True or False: A foodborne intoxication results when a person eats food containing pathogens, which then grow in the intestines and cause illness 3. True or False: Cooking food to the required minimum internal temperature can help avoid listeriosis 4. True or False: A person with shigellosis may experience bloody diarrhea 5. True or False: Highly acidic food typically does not support the growth of foodborne microorganisms Instructor Notes Answers: True False 2-2

Microbial Contaminants Microorganism Small, living organism Pathogen Illness-causing microorganism Toxin Poison Instructor Notes Microorganisms are small living organisms that can only be seen with a microscope. While not all microorganisms cause illness, some do. These are called pathogens. Microorganisms pose the greatest threat to food safety. Eating food contaminated with foodborne pathogens, or their toxins, is the leading cause of foodborne illness.

Microbial Contaminants Microorganisms That Can Contaminate Food and Cause Foodborne Illness Bacteria Viruses Parasites Fungi Instructor Notes Foodborne microorganisms can be divided into two groups: spoilage microorganisms and pathogens. Mold is a spoilage microorganism. It typically does not cause illness. Pathogens like Salmonella spp. and the hepatitis A virus, can cause some form of illness when ingested. Unlike spoilage microorganisms, pathogens cannot be seen, smelled, or tasted in food.

What Microorganisms Need to Grow: FAT TOM Food Acidity Temperature Instructor Notes The acronym FAT TOM can be used to remember the six conditions that support the growth of foodborne microorganisms, with the exception of viruses. These six conditions will be discussed in the next six slides. T O M Time Oxygen Moisture

What Microorganisms Need to Grow: FAT TOM Food Foodborne microorganisms require nutrients to grow. Specifically carbohydrates and proteins These are found in potentially hazardous food including: Meat Poultry Dairy products Eggs F Food

What Microorganisms Need to Grow: FAT TOM Acidity Foodborne microorganisms grow best in food that has a neutral or slightly acidic pH (7.5 to 4.6) Most food falls into this range A Acidity pH Scale Acidic Instructor Notes pH is a measurement of how acidic or alkaline a food is. The pH scale ranges from 0.0 to 14.0. Food with a pH between 0.0 and 6.9 is acidic, while food with a pH between 7.1 and 14.0 is alkaline. A pH of 7.0 is neutral. Foodborne microorganisms typically do not grow in alkaline food items such as crackers, or highly acidic food items such as lemons. They prefer food that has a neutral or slightly acidic pH (7.5 to 4.6). The pH of most food falls in this range. 7.5–4.6 ideal for bacterial growth Neutral Alkaline

What Microorganisms Need to Grow: FAT TOM Temperature Foodborne microorganisms grow well at temperatures between 41˚F and 135˚F (5˚C and 57˚C) T Temperature 135°F (57°C) Instructor Notes Exposing microorganisms to temperatures outside the temperature danger zone (TDZ) does not necessarily kill them. Refrigeration temperatures, for example, may only slow their growth. Some foodborne microorganisms grow at refrigeration temperatures. Food must be handled very carefully when it is thawed, cooked, cooled and reheated, since it can be exposed to the TDZ during these times. The Temperature Danger Zone 41°F (5°C)

What Microorganisms Need to Grow: FAT TOM Time Foodborne microorganisms need sufficient time to grow 4 hours or more in TDZ=growth high enough to cause illness T Time Instructor Notes Given the right conditions, bacteria can double their population every twenty minutes.

What Microorganisms Need to Grow: FAT TOM Oxygen Some foodborne microorganisms require oxygen to grow, while others grow when oxygen is absent O Oxygen Instructor Notes Cooked rice, untreated garlic-and-oil mixtures, and baked potatoes have been associated with certain types of bacteria that grow without oxygen.

What Microorganisms Need to Grow: FAT TOM Moisture Most foodborne microorganisms require moisture to grow The amount of moisture available in food for this growth is called water activity (aw) Potentially hazardous food typically has an aw of .85 or higher M Moisture Instructor Notes Water activity is measured on a scale from 0.0 to 1.0, with water having a value of 1.0. Potentially hazardous food typically has a water activity of .85 or higher.

Controlling the Growth of Microorganisms The two conditions you can control: Temperature Refrigerate or freeze food properly Cook food properly Time Minimize time food spends in the temperature danger zone (TDZ) Instructor Notes Food processors use several methods to keep microorganisms from growing including: Adding lactic or citric acid to food to make it more acidic. Adding sugar, alcohol, or acid to lower its water activity. Using vacuum packaging to remove oxygen. Time and temperature are the two important conditions for growth that can be controlled in the establishment.

Apply Your Knowledge: What I Need to Grow! Which conditions typically support the growth of microorganisms? Food that is high in fat Food that contains protein pH of 9.0 Temperature of 155F (68C) or higher Dry environment 1 2 3 4 5 Instructor Notes Answer: #2. Microorganisms need food to grow, specifically proteins and carbohydrates. 2-13

Classifying Foodborne Illness Foodborne Infections Result when a person eats food containing pathogens, which then grow in the intestines and cause illness Foodborne Intoxications Result when a person eats food containing toxins that cause illness Foodborne Toxin-Mediated Infections Result when a person eats food containing pathogens, which then produce illness-causing toxins in the intestines Instructor Notes Symptoms of a foodborne infection do not appear immediately. The toxins that cause a foodborne intoxication may have been produced by pathogens found in the food or may be the result of a chemical contamination. The toxin might also be a natural part of a plant or animal consumed. Typically, symptoms of a foodborne intoxication appear quickly, within a few hours.

Bacteria That Cause Foodborne Illness Basic Characteristics Living, single-celled organism Can be carried by food, water, soil, animals, humans, or insects Can reproduce very rapidly under favorable conditions Instructor Notes Knowing what bacteria are and understanding how they grow is the first step in controlling them.

Bacteria That Cause Foodborne Illness Basic Characteristics: continued Some survive freezing Some change into a different form called spores to protect themselves Some spoil food; others cause illness Some produce toxins that cause illness Instructor Notes Some bacteria cause illness by producing toxins as they multiply, die, and break down. Cooking typically does not destroy toxins produced by bacteria.

Spores Certain bacteria can change into a different form, called spores, to protect themselves Spores Form when nutrients are not available Are commonly found in soil and contaminate food grown there Can contaminate meat, poultry, fish, and other food exposed to soil or dust Instructor Notes Certain bacteria have the ability to change into a different form called spores to protect themselves when nutrients are not available. Spores can contaminate food grown in the soil such as vegetables, herbs, and cereal crops.

Spores Spores Can resist heat, allowing them to survive cooking temperatures Can revert back to a form capable of growth when: Food is not stored at the proper temperature Food is not held or cooled properly Instructor Notes Storing, holding, and cooling food properly can prevent spores from reverting back into a form capable of growth.

Major Foodborne Illnesses Caused by Bacteria Infections Campylobacteriosis Salmonellosis Shigellosis Listeriosis Vibrio parahaemolyticus Gastroenteritis Vibrio vulnificus Primary Septicemia/Gastroenteritis Instructor Notes This slide identifies the major bacterial foodborne illnesses classified as infections. Ask participants to describe what an infection is. An infection results when a person eats food containing pathogens, which then grow in the intestines and cause illness.

Infection: Campylobacteriosis Illness: Campylobacteriosis Bacteria: Campylobacter jejuni Most Common Symptoms Commonly Associated Food Most Common Symptoms Poultry Water contaminated with the bacteria Diarrhea (may be bloody) Abdominal cramps Fever Headache Diarrhea Abdominal Cramps Fever Headache Instructor Notes The illness is pronounced: CAMP-ee-lo-BAK-teer-ee-O-sis. The bacteria is pronounced: CAMP-ee-lo-BAK-ter Jay-JUNE-ee. Illness often occurs when poultry is improperly cooked and when raw poultry has been allowed to cross-contaminate other food and food-contact surfaces.

Preventing Campylobacteriosis To reduce the bacteria in food: Cook food, particularly poultry, to required minimum internal temperatures To prevent the transfer of the bacteria: Prevent cross-contamination between raw poultry and ready-to-eat food. Instructor Notes Campylobacteriosis is best controlled through proper cooking and the prevention of cross-contamination.

Infection: Salmonellosis Illness: Salmonellosis Bacteria: Salmonella spp. Commonly Associated Food Most Common Symptoms Poultry and eggs Dairy products Beef Diarrhea Abdominal cramps Vomiting Fever Instructor Notes The illness is pronounced: SAL-men-uh-LO-sis. The bacteria is pronounced: Sal-ma-NEL-uh. Many farm animals naturally carry Salmonella spp. It has also been found in ready-to-eat food such as produce that has come in contact with these animals or their waste. The severity of symptoms depends upon the health of the person and the amount of bacteria consumed. Salmonella spp. is often present in a person’s feces for several weeks after symptoms have ended.

Preventing Salmonellosis To reduce the bacteria in food: Cook raw beef, poultry, and eggs to required minimum internal temperatures. To prevent the transfer of the bacteria: Minimize cross-contamination between raw meat and poultry and ready-to-eat food. Exclude foodhandlers diagnosed with salmonellosis. Instructor Notes Since illness can occur after consuming only a small amount of this type of bacteria, it is critical to cook food properly and to prevent cross-contamination.

Infection: Shigellosis Illness: Shigellosis Bacteria: Shigella spp. Most Common Symptoms Commonly Associated Food Most Common Symptoms Food easily contaminated by hands Food in contact with contaminated water (i.e., produce) Bloody diarrhea Abdominal pain and cramps Fever (occasionally) Instructor Notes The illness is pronounced: SHIG-uh-LO-sis. The bacteria is pronounced: Shi-GEL-uh. Shigella spp. is found in the feces of humans with shigellosis. High levels can be found for weeks after symptoms have ended. Most illnesses occur when people consume food or water contaminated with this type of bacteria. It can be transferred to food when foodhandlers fail to wash hands after using the restroom. Flies can also transfer the bacteria to food. It is only necessary to consume a small amount of Shigella spp. to become ill. Severe cases of illness can result in hemolytic uremic syndrome (HUS).

Preventing Shigellosis To prevent the transfer of the bacteria: Exclude foodhandlers if they: Have diarrhea Have been diagnosed with shigellosis Wash hands when necessary Control flies inside and outside the establishment Instructor Notes Preventing illness is dependant upon proper hygiene and excluding foodhandlers with diarrhea from the establishment.

Infection: Listeriosis Illness: Listeriosis Bacteria: Listeria monocytogenes Most Common Symptoms Commonly Associated Food Most Common Symptoms Raw meat Unpasteurized milk and milk products Ready-to-eat food including: Deli meats Hot dogs Soft cheese Pregnant women Spontaneous abortion of the fetus Newborns Sepsis Pneumonia Meningitis Instructor Notes The illness is pronounced: liss-TEER-ee-O-sis. The bacteria is pronounced: liss-TEER-ee-uh MON-o-SI-TAHJ-uh-neez. Naturally found in soil, water, and plants. Unlike other types of bacteria, it grows in cool, moist environments. While illness is uncommon in healthy people, high-risk populations are especially vulnerable, particularly pregnant women in their 3rd trimester.

Preventing Listeriosis It is critical to: Discard product that has passed its use-by or expiration date Avoid using unpasteurized dairy products To reduce the bacteria in food: Cook raw meat to required minimum internal temperatures To prevent the transfer of the bacteria: Prevent cross-contamination between raw or undercooked and ready-to-eat food Instructor Notes To prevent illness, it is critical to discard food that has passed its use-by or expiration date. It is also important to cook food properly and avoid cross-contamination.

Infection: Vibrio parahaemolyticus Gastroenteritis Illness: Vibrio parahaemolyticus Gastroenteritis Bacteria: Vibrio parahaemolyticus Commonly Associated Food Most Common Symptoms Raw or partially cooked oysters Diarrhea and abdominal cramps Nausea and vomiting Low grade fever and chills The illness is pronounced: VIB-ree-O PAIR-uh-hee-mo-LIT-ih-kus GAS-tro-EN-ter-I-tiss. The bacteria is pronounced: VIB-ree-O PAIR-uh-hee-mo-LIT-ih-kus. Vibrio parahaemolyticus is naturally found in the waters of the Gulf of Mexico as well as the Atlantic and Pacific Coasts. It is commonly associated with raw or partially cooked oysters harvested from warm waters during the months of April to October. This type of bacteria can grow very rapidly at temperatures in the middle of the TDZ.

Preventing Vibrio parahaemolyticus Gastroenteritis Most Important Prevention Measures Purchase oysters from approved, reputable suppliers Cook oysters to the required minimum internal temperature

Infection: Vibrio vulnificus Primary Septicemia Illness: Vibrio vulnificus Primary Septicemia Bacteria: Vibro vulnificus Commonly Associated Food Most Common Symptoms Raw or partially cooked oysters (People with liver disease and diabetes) Fever and chills Nausea Skin lesions Diarrhea and vomiting possible Instructor Notes The illness is pronounced: VIB-ree-o vul-NIF-ih-kus Primary SEP-ti-CEE-mee-uh. The bacteria is pronounced: VIB-ree-o vul-NIF-ih-kus. Vibrio vulnificus is naturally found in the waters of the Gulf of Mexico and the Atlantic and Pacific Coasts. It is commonly associated with oysters harvested from warm waters during the months of April to October. This type of bacteria causes two different illnesses: primary septicemia and gastroenteritis.

Infection: Vibrio vulnificus Gastroenteritis Illness: Vibrio vulnificus Gastroenteritis Bacteria: Vibrio vulnificus Commonly Associated Food Most Common Symptoms Raw or partially cooked oysters (Otherwise healthy people) Diarrhea Abdominal cramps Instructor Notes The illness is pronounced: VIB-ree-o vul-NIF-ih-kus GAS-tro-EN-ter-I-tiss. The bacteria is pronounced: VIB-ree-o vul-NIF-ih-kus. Vibrio vulnificus is naturally found in the waters of the Gulf of Mexico and the Atlantic and Pacific Coasts. It is commonly associated with oysters harvested from warm waters during the months of April to October. This type of bacteria causes two different illnesses: primary septicemia and gastroenteritis.

Preventing Vibrio vulnificus Septicemia/Gastroenteritis Most Important Prevention Measures Purchase oysters from approved, reputable suppliers. Cook oysters to the required minimum internal temperature. Inform people at risk to consult a physician before regularly consuming raw or partially cooked oysters Instructor Notes Preventing these illnesses depends upon purchasing oysters from approved, reputable suppliers and cooking them to the required minimum internal temperature.

Major Foodborne Illnesses Caused by Bacteria Intoxications Bacillus cereus Gastroenteritis Staphylococcal Gastroenteritis Botulism Instructor Notes This slide identifies the major bacterial foodborne illnesses classified as intoxications. Ask participants to describe what an intoxication is. An intoxication results when a person eats food containing toxins that cause illness.

Intoxication: Bacillus cereus Gastroenteritis Illness: Bacillus cereus Gastroenteritis Bacteria: Bacillus cereus (Diarrheal Toxin) Most Common Symptoms Commonly Associated Food Most Common Symptoms Cooked corn Cooked potatoes Cooked vegetables Meat products Watery diarrhea Abdominal cramps and pain Vomiting is absent Instructor Notes The illness is pronounced: ba-CIL-us SEER-ee-us GAS-tro-EN-ter-I-tiss. The bacteria is pronounced: ba-CIL-us SEER-ee-us. Bacillus cereus is a spore forming bacteria found in soil. It is commonly associated with plants and cereal crops such as rice. The bacteria can produce two different toxins when allowed to grow to high levels. Each causes a different type of illness. The diarrheal toxin is created while the bacteria is in the human intestine.

Intoxication: Bacillus cereus Gastroenteritis Illness: Bacillus cereus Gastroenteritis Bacteria: Bacillus cereus (Emetic Toxin) Commonly Associated Food Most Common Symptoms Cooked rice dishes including: Fried rice Rice pudding Nausea Vomiting Instructor Notes The illness is pronounced: ba-CIL-us SEER-ee-us GAS-tro-EN-ter-I-tiss. The bacteria is pronounced: ba-CIL-us SEER-ee-us. Bacillus cereus is a spore forming bacteria found in soil. It is commonly associated with plants and cereal crops such as rice. The bacteria can produce two different toxins when allowed to grow to high levels. Each causes a different type of illness. The emetic toxin is produced by the bacteria while in the food.

Preventing Bacillus cereus Gastroenteritis To reduce the bacteria in food: Cook food to required minimum internal temperatures To prevent the growth of the bacteria: Hold food at the proper temperature Cool food properly Instructor Notes Preventing these illnesses is dependent upon preventing bacterial growth and toxin production. This can be accomplished by cooking, holding, and cooling food properly.

Intoxication: Staphylococcal Gastroenteritis Illness: Staphylococcal Gastroenteritis Bacteria: Staphylococcus aureus Most Common Symptoms Commonly Associated Food Most Common Symptoms Commonly Associated Food Salads containing potentially hazardous food: Egg, tuna, chicken, macaroni Deli meats Nausea Vomiting and retching Abdominal cramps Instructor Notes The illness is pronounced: STAF-ul-lo-KOK-al GAS-tro-EN-ter-I-tiss. The bacteria is pronounced: STAF-uh-lo-KOK-us OR-ee-us. Staphylococcus aureus is primarily found in humans—particularly in the hair, nose, throat, and sores. It is often transferred to food when people carrying this bacteria touch these areas and handle food without washing their hands. This bacteria is commonly associated with food that requires handling during preparation. If allowed to grow to large numbers in food, the bacteria can produce toxins that cause the illness when eaten.

Preventing Staphylococcal Gastroenteritis To prevent the transfer of the bacteria to food: Wash hands after touching the body Cover cuts on hands and arms Restrict foodhandlers with infected cuts on hands and arms To prevent the growth of the bacteria in food: Minimize the time food spends in the TDZ Cook, hold, and cool food properly Instructor Notes Since cooking cannot destroy the toxins produced by the bacteria, it is critical to prevent bacterial growth. Practicing good personal hygiene can prevent the transfer of the bacteria to food.

Intoxication: Botulism Illness: Botulism Bacteria: Clostridium botulinum Commonly Associated Food Most Common Symptoms Improperly canned food ROP food Temperature abused vegetables like: Baked potatoes Untreated garlic-and-oil mixtures Initially: Nausea and Vomiting Later: Weakness Double vision Difficulty speaking and swallowing Instructor Notes The illness is pronounced: BOT-chew-liz-um. The bacteria is pronounced: klos-TRID-ee-um BOT-chew-line-um. While clostridium botulinum forms spores that can be found in almost any food, it is commonly associated with produce grown in the soil, such as onions, potatoes, and carrots. This type of bacteria does not grow well in refrigerated or highly acidic food, nor in food with low water activity. However, it does grow without oxygen and can produce a deadly toxin when food is temperature abused. Without treatment death is likely.

Preventing Botulism Most Important Prevention Measures: Hold, cool, and reheat food properly Inspect canned food for damage Instructor Notes Holding, cooling, and reheating food properly inhibits the growth of the bacteria and reduces the potential for illness.

Major Foodborne Illnesses Caused by Bacteria Toxin-Mediated Infections: Clostridium perfringens Gastroenteritis Hemorrhagic Colitis Instructor Notes This slide identifies the major bacterial foodborne illnesses classified as toxin-mediated infections. Ask participants to describe what a toxin-mediated infection is. A toxin-mediated infection results when a person eats food containing pathogens, which then produce illness-causing toxins in the intestines.

Toxin-Mediated Infection: Clostridium perfringens Gastroenteritis Illness: Clostridium perfringens Gastroenteritis Bacteria: Clostridium perfringens Commonly Associated Food Most Common Symptoms Meat Poultry Meat and poultry dishes: Stews Gravies Diarrhea Severe abdominal pain Fever and vomiting are absent Instructor Notes The illness is pronounced: klos-TRID-ee-um per-FRIN-jins GAS-tro-EN-ter-I-tiss. The bacteria is pronounced: klos-TRID-ee-um per-FRIN-jins. Clostridium perfringens is found naturally in soil where it forms spores that allow it to survive. It is also carried in the intestines of animals and humans. People become ill after eating this type of bacteria, which produces toxins once inside the intestines. While Clostridium perfringens does not grow at refrigeration temperatures, it grows very rapidly in food in the temperature danger zone.

Preventing Clostridium perfringens Gastroenteritis To prevent growth of the bacteria (especially in meat dishes): Cool and reheat food properly Hold food at the proper temperature Instructor Notes To prevent illness, it is critical to keep the bacteria from growing, especially when holding, cooling, and reheating food.

Toxin-Mediated Infection: Hemorrhagic Colitis Illness: Hemorrhagic Colitis Bacteria: Shiga toxin-producing Escherichia coli Most Common Symptoms Commonly Associated Food Most Common Symptoms Ground beef (raw and undercooked) Contaminated produce Diarrhea (eventually becomes bloody) Abdominal cramps Severe cases can result in hemolytic uremic syndrome (HUS) Instructor Notes The illness is pronounced: hem-or-AJ-ik ko-LI-tiss. The bacteria is pronounced: ess-chur-EE-kee-UH KO-LI. Escherichia coli include: O157:H7, O26:H11, O111H8, 0158:NM. Shiga toxin-producing E. coli is naturally found in the intestines of cattle, which can contaminate the meat during the slaughtering process. Although it has also been associated with contaminated produce, it is more commonly associated with undercooked ground beef. A person needs to consume only a small amount of the bacteria to become ill. Once eaten, it produces toxins in the intestines, which cause the illness. The bacteria can be present in the feces of infected individuals for several weeks after symptoms appear.

Preventing Hemorrhagic Colitis To reduce the bacteria in food: Cook food, particularly ground beef, to required minimum internal temperatures To prevent the transfer of the bacteria to food: Prevent cross-contamination between raw meat and ready-to-eat food Exclude employees from the establishment if: They have diarrhea They have been diagnosed with hemorrhagic colitis Instructor Notes It is critical to cook food properly and avoid cross-contamination to prevent illness.

Basic Characteristics of Viruses Some may survive freezing Can be transmitted from: Person to person People to food People to food-contact surfaces Usually contaminate food through a foodhandler’s improper hygiene Can contaminate both food and water supplies Instructor Notes Practicing good personal hygiene is an important way to prevent the contamination of food by foodborne viruses. It is especially important to minimize bare-hand contact with ready-to-eat food. Viruses are classified as infections.

Major Foodborne Illnesses Caused by Viruses Viral Foodborne Illnesses Hepatitis A Norovirus Gastroenteritis

Infection: Hepatitis A Illness: Hepatitis A Virus: Hepatitis A Most Common Symptoms Commonly Associated Food Most Common Symptoms Ready-to-eat food including: Deli meats Produce Salads Raw and partially cooked shellfish Initially: Fever (mild) General weakness Nausea Abdominal pain Later: Jaundice Instructor Notes The illness is pronounced: HEP-a-TI-tiss A The virus is pronounced: HEP-a-TI-tiss A Hepatitis A is primarily found in the feces of people infected with the virus. While water and many types of food can become contaminated, the virus is more commonly associated with ready-to-eat items. It has also been found in shellfish contaminated by sewage. Hepatitis A is often transferred to food when infected foodhandlers touch food or equipment with fingers containing feces. It is only necessary to consume a small amount of the virus to become ill. An infected person may not show symptoms for weeks, but can be very infectious.

Preventing Hepatitis A To prevent the transfer of the virus to food: Wash hands properly Exclude employees who have jaundice or hepatitis A Minimize bare-hand contact with ready-to-eat food Other prevention measures: Purchase shellfish from approved, reputable suppliers Inform high-risk populations to consult a physician before regularly consuming raw or partially cooked shellfish Instructor Notes Proper handwashing is critical to preventing this illness, since cooking does not destroy the hepatitis A virus.

Infection: Norovirus Gastroenteritis Illness: Norovirus Gastroenteritis Virus: Norovirus Most Common Symptoms Commonly Associated Food Most Common Symptoms Ready-to-eat food Shellfish contaminated by sewage Vomiting Diarrhea Nausea Abdominal cramps Instructor Notes The illness is pronounced: NOR-o-VI-rus GAS-tro-EN-ter-I-tiss. The virus is pronounced: NOR-o-VI-rus. Norovirus is primarily found in the feces of people infected with the virus. It has also been found in contaminated water. Like hepatitis A, it is commonly associated with ready-to-eat food. The virus is very contagious and is often transferred to food when infected foodhandlers touch the food with fingers containing feces. Consuming even a small amount of the virus can lead to infection. People become contagious within a few hours of eating contaminated food.

Preventing Norovirus Gastroenteritis To prevent the transfer of the virus to food: Exclude foodhandlers with diarrhea and vomiting Exclude employees who have been diagnosed with Norovirus Gastroenteritis Wash hands properly Other prevention measures: Purchase shellfish from approved, reputable suppliers Instructor Notes Proper handwashing is essential to prevent this illness. It is also critical to prevent foodhandlers from working with food if they have symptoms related to the illness.

Basic Characteristics of Parasites Are living organisms that need a host to survive Are small, often microscopic Infect many animals and can be transmitted to humans Are a hazard to food and water Instructor Notes Parasites infect many animals, such as cows, chickens, pigs, and fish.

Major Foodborne Illnesses Caused by Parasites Parasitic Foodborne Illnesses Anisakiasis Cyclosporiasis Cryptosporidiosis Giardiasis Instructor Notes The next several slides will highlight some of the most commonly occurring parasitic illnesses identified in this list.

Infection: Anisakiasis Illness: Anisakiasis Parasite: Anisakis simplex Most Common Symptoms Commonly Associated Food Most Common Symptoms Raw and undercooked: Herring Cod Halibut Mackerel Pacific salmon Non-invasive Tingling in throat Coughing up worms Invasive Stomach pain Nausea Vomiting Diarrhea Instructor Notes The illness is pronounced: ANN-ih-SAHK-ee-AH-sis. The parasite is pronounced: ANN-ih-SAHK-iss SIM-plex. Anisakis simplex is a worm-like parasite found in certain fish and shellfish. An illness can develop when raw or undercooked seafood containing the parasite is eaten. The illness can be either invasive or noninvasive. In its noninvasive form, the person coughs the parasite from the body. In the invasive form, the parasite penetrates the lining of the stomach or small intestine and must be surgically removed.

Preventing Anisakiasis Most Important Prevention Measures Cook fish to required minimum internal temperatures Purchase fish from approved, reputable suppliers If fish will be served raw or undercooked: Purchase sushi-grade fish Ensure sushi-grade fish has been frozen properly by the supplier Instructor Notes To prevent this illness it is critical to cook seafood properly. If seafood will be served raw or undercooked, it is important to purchase it from an approved, reputable supplier.

Infection: Cyclosporiasis Illness: Cyclosporiasis Parasite: Cyclospora cayetanensis Commonly Associated Food Most Common Symptoms Produce irrigated or washed with water containing the parasite Nausea (mild to severe) Abdominal cramping Mild fever Diarrhea alternating with constipation Instructor Notes The illness is pronounced: SI-klo-spor-I-uh-sis. The parasite is pronounced: SI-klo-SPOR-uh KI-uh-te-NEN-sis. Cyclospora cayetanensis is a parasite that has been found in contaminated water and has been associated with produce irrigated or washed with contaminated water. The parasite can also be found in the feces of people infected with the parasite. Foodhandlers can transfer the parasite to food when they touch it with fingers containing feces.

Preventing Cyclosporiasis It is critical to: Purchase produce from approved, reputable suppliers To prevent the transfer of the parasite to food: Exclude foodhandlers with diarrhea Wash hands properly to minimize the risk of cross-contamination Instructor Notes Foodhandlers with diarrhea must be excluded from the establishment. It is also critical to purchase produce from an approved, reputable supplier.

Infection: Cryptosporidiosis Illness: Cryptosporidiosis Parasite: Cryptosporidium parvum Commonly Associated Food Most Common Symptoms Untreated or improperly treated water Contaminated produce Watery diarrhea Stomach cramps Nausea Weight loss Instructor Notes The illness is pronounced: KRIP-TOH-spor-id-ee-O-sis. The parasite is pronounced: KRIP-TOH-spor-ID-ee-um PAR-vum. Cryptosporidium parvum is a parasite that has been found in contaminated water, produce that has been irrigated with contaminated water, and cows and other herd animals. It can also be found in the feces of people infected with the parasite. Foodhandlers can transfer the parasite to food when they touch it with fingers containing feces. It is common for the parasite to be spread from person to person in day-care and medical communities.

Preventing Cryptosporidiosis It is critical to: Purchase produce from approved, reputable suppliers Use properly treated water To prevent the transfer of the parasite to food: Exclude foodhandlers with diarrhea Wash hands properly to minimize the risk of cross-contamination Instructor Notes Proper handwashing is essential to prevent this illness. It is also critical to purchase produce from an approved, reputable supplier.

Infection: Giardiasis Illness: Giardiasis Parasite: Giardia duodenalis Commonly Associated Food Most Common Symptoms Initially: Fever Later: Loose stools Abdominal cramps Nausea Improperly treated water Instructor Notes The illness is pronounced: jee-are-dee-AH-sis. The parasite is pronounced: jee-ARE-dee-uh do-WAH-den-AL-is. Giardia duodenalis is a parasite that has been found in improperly treated water. It can be found in the feces of infected people. Foodhandlers can transfer the parasite to food when they touch it with fingers contaminated with feces. It is common for the parasite to be spread from person to person in day-care centers.

Preventing Giardiasis Most Important Prevention Measure Use properly treated water To prevent the transfer of the parasite to food: Exclude foodhandlers with diarrhea Wash hands properly to minimize the risk of cross-contamination Instructor Notes Proper handwashing is essential to prevent the illness. It is also critical to use water that has been properly treated.

Fungi Fungi Commonly cause food spoilage and sometimes illness Fungi Instructor Notes Fungi are found naturally in air, soil, plants, water, and some food. Molds and yeasts are of the greatest concern. Molds Yeasts

Basic Characteristics of Mold Spoils food and sometimes causes illness Grows well in acidic food with low water activity Is not destroyed by freezing Can produce toxins such as aflatoxins Instructor Notes While cooking can destroy mold cells and spores, some toxins can remain. To avoid illness, throw out all moldy food, unless the mold is a natural part of the product (e.g., cheese such as Gorgonzola, Brie, and Camembert). The FDA recommends cutting away any moldy areas in hard cheese—at least one inch (2.5 centimeters) around them.

Basic Characteristics of Yeast Can spoil food rapidly May produce a smell or taste of alcohol as it spoils food May appear as a pink discoloration or slime and may bubble Instructor Notes Carbon dioxide and alcohol are produced as yeast consumes food. Yeast spoilage may therefore produce a smell or taste of alcohol. Yeasts are similar to molds in that they grow well in acidic food with low water activity, such as jellies, jams, syrup, honey, and fruit juice. Food that has been spoiled by yeast should be discarded. Remind participants that the Take It Back section in ServSafe Essentials (page 2-40) can be used to teach important concepts from section 2 to their employees.

Updated for 2010 Edition