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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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Oklahoma Cooperative Extension Service
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 2006 Oklahoma Cooperative Extension Service
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Oklahoma Cooperative Extension Service
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 2006 Oklahoma Cooperative Extension Service
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Oklahoma Cooperative Extension Service
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 2006 Oklahoma Cooperative Extension Service
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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 2006 Oklahoma Cooperative Extension Service
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Oklahoma Cooperative Extension Service
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 2006 Oklahoma Cooperative Extension Service
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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 2006 Oklahoma Cooperative Extension Service
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Foods that cause foodborne illness (source: CSPI 2005)
# 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 2006 Oklahoma Cooperative Extension Service
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Oklahoma Cooperative Extension Service
Is produce riskier now? Yes Outbreaks bigger & more frequent than years ago Partly because people eat more fresh fruits & vegetables 2006 Oklahoma Cooperative Extension Service
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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 2006 Oklahoma Cooperative Extension Service
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Oklahoma Cooperative Extension Service
2006 Oklahoma Cooperative Extension Service
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Routes of contamination
Water Contaminated irrigation water Run-off Cleaning water 2006 Oklahoma Cooperative Extension Service
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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 2006 Oklahoma Cooperative Extension Service
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Routes of contamination
Cross-contamination Unwashed hands/surfaces From raw foods in kitchen 2006 Oklahoma Cooperative Extension Service
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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 2006 Oklahoma Cooperative Extension Service
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Contamination compounded by:
Bacteria enter produce & cannot be washed away 2006 Oklahoma Cooperative Extension Service
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Contamination compounded by:
Distribution process leaves difficult trace-back of process Large boxes broken down & repackaged without point-of-origin info. Parts of many plants in 1 bag 2006 Oklahoma Cooperative Extension Service
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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) 2006 Oklahoma Cooperative Extension Service
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Oklahoma Cooperative Extension Service
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 2006 Oklahoma Cooperative Extension Service
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E. coli O157:H7 Outbreak Case Counts by State (As of 10/06/06: CDC)
1-4 5-9 10-14 15 or higher 2006 Oklahoma Cooperative Extension Service
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Number of persons with outbreak strain/state (CDC):
Arizona 8 California 2 Colorado 1 Connecticut 3 Idaho 7 Illinois 2 Indiana 10 Kentucky 8 Maryland 3 Maine 3 Michigan 4 Minnesota 2 Nebraska 11 New Mexico 5 Nevada 2 New York 11 Ohio 25 Oregon 6 Pennsylvania 10 Tennessee 1 Utah 19 Virginia 2 Washington 3 West Virginia 1 Wisconsin 49 Wyoming 1 2006 Oklahoma Cooperative Extension Service
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Investigation of outbreak
Widely dispersed illnesses indicated contamination early in distribution chain 2006 Oklahoma Cooperative Extension Service
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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 2006 Oklahoma Cooperative Extension Service
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Oklahoma Cooperative Extension Service
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 2006 Oklahoma Cooperative Extension Service
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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 2006 Oklahoma Cooperative Extension Service
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Oklahoma Cooperative Extension Service
Spinach not alone Nov. 2006: FDA notifies consumers tomatoes in restaurants were linked to Salmonella Typhimurium outbreak 2006 Oklahoma Cooperative Extension Service
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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 2006 Oklahoma Cooperative Extension Service
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FDA actions to reduce risk
1998—Guide to Minimize Microbial Food Safety Hazards for Fresh Fruits and Vegetables 2006 Oklahoma Cooperative Extension Service
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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 2006 Oklahoma Cooperative Extension Service
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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 2006 Oklahoma Cooperative Extension Service
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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 2006 Oklahoma Cooperative Extension Service
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Oklahoma Cooperative Extension Service
Potential safeguards Cooking to 160oF for 15 seconds Irradiation? FDA has been petitioned to allow Suitability & efficacy to be determined 2006 Oklahoma Cooperative Extension Service
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Oklahoma Cooperative Extension Service
So what do consumers do? Option: Quit eating raw produce 2006 Oklahoma Cooperative Extension Service
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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" 2006 Oklahoma Cooperative Extension Service
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Oklahoma Cooperative Extension Service
Caution on greens Do not buy prewashed salads with considerable amount of brown-edged pieces or if greens appear excessively wet 2006 Oklahoma Cooperative Extension Service
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Oklahoma Cooperative Extension Service
Consumer resource Available at: 2006 Oklahoma Cooperative Extension Service
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Oklahoma Cooperative Extension Service
Buying fresh produce For fresh cut produce (such as 1/2 watermelon, bagged mixed salad greens) choose only those refrigerated or surrounded by ice 2006 Oklahoma Cooperative Extension Service
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Oklahoma Cooperative Extension Service
Buying fresh produce Bag fresh fruits & vegetables separately from meat, poultry & seafood products when packing them to take home from market 2006 Oklahoma Cooperative Extension Service
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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 2006 Oklahoma Cooperative Extension Service
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Oklahoma Cooperative Extension Service
Refrigeration needed? To maintain quality, safety Ask grocer 2006 Oklahoma Cooperative Extension Service
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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 2006 Oklahoma Cooperative Extension Service
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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 2006 Oklahoma Cooperative Extension Service
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Preparation of fresh produce
Cut away damaged &/or bruised areas before preparing &/or eating Discard produce that looks rotten 2006 Oklahoma Cooperative Extension Service
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Oklahoma Cooperative Extension Service
Preparation tips All unpackaged fruits & vegetables & those packaged & not marked pre-washed, should be thoroughly washed before eating Includes conventionally or organically grown, home grown & produce bought from grocery stores & farmer's markets 2006 Oklahoma Cooperative Extension Service
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Oklahoma Cooperative Extension Service
French lesson 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? 2006 Oklahoma Cooperative Extension Service
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Oklahoma Cooperative Extension Service
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 2006 Oklahoma Cooperative Extension Service
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Oklahoma Cooperative Extension Service
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 2006 Oklahoma Cooperative Extension Service
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Oklahoma Cooperative Extension Service
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 2006 Oklahoma Cooperative Extension Service
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Oklahoma Cooperative Extension Service
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 2006 Oklahoma Cooperative Extension Service
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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 2006 Oklahoma Cooperative Extension Service
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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 Bleach 2006 Oklahoma Cooperative Extension Service
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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 2006 Oklahoma Cooperative Extension Service
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Oklahoma Cooperative Extension Service
2006 Oklahoma Cooperative Extension Service
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