DM Module.ppt - Colorado State University · HACCP Plan Implementation toHACCP Plan Implementation to ... Listeria can contaminate other vegetables if ... • Raw/ unwashed vegetables

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Listeria Control and Safe Food Training for Dietary Managers

HACCP Plan Implementation toHACCP Plan Implementation to Control Listeria monocytogenes

Listeria Control and Safe Food Training for Dietary Managers

Presented by:Dr Patricia Kendall R DDr. Patricia Kendall, R.D.Professor and Extension Food Safety SpecialistDepartment of Food Science and Human NutritionColorado State University

Hanaa Thigeel, Master’s StudentDepartment of Food Science & Human NutritionColorado State University

Overview 1. Why elderly at high

risk of foodborne illness

4. Cleaning and sanitizing protocols

5. Employee training2. Listeria risk factors

3.Controlling Listeriathrough HACCP

6. Other foodborne pathogens of importance to elderly

7. Food irradiation

14%

16%

18%

20%

Increase in Aging Population (+65 years old) in the U.S.

0%

2%

4%

6%

8%

10%

12%

Elderly in 1950 Elderly in 2000 Elderly in 2030

Aging and the Immune System

– Immune system affected by aging

% f f– >20% of elderly over age 65 do not develop fever when they have serious bacterial infections.

– Aging affects lymphocytes configuration & their reaction to infection.

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Aging and the Immune System• Thymus gland atrophies with aging

• Aging causes progressive decrease in T-cells

Chronic Diseases and Immunity Suppression

Diabetes• Affects 18-20% of persons over age 65• Patients at higher risk of listeriosis &

l ll isalmonellosis

Cancer• Chemotherapy may suppress immune system

Acquired immune Deficiency Syndrome (AIDS):• Compromised immune systems make more

vulnerable to foodborne illnesses

Listeria monocytogenes• Foodborne pathogen

• Causes listeriosis in susceptible populations:– Elderly

Pregnant women– Pregnant women

– Neonates

– Immune-compromised individuals• Cancer patients• AIDS patients• Organ transplant patients• Persons with severe cardiovascular disease• Persons with lupus; pneumonia

Listeria Pathogenesis • Listeriosis

• Mild gastrointestinal symptoms: 8-48 hrs

• Invasive illness: 2-6 weeks following gexposure– Fever, Muscle aches, Headache, Loss of balance

– Bacteremia, Convulsions

– Meningitis, Encephalitis

– High death rate (10-20%) among persons >60 yrs

Listeria Risk Factors

Temperature:

• The growth range = 29-113˚F.

• Grows and multiplies at refrigeration• Grows and multiplies at refrigeration temperatures (<40˚F)

• Can survive but not grow at freezing temperatures (0˚F)

• Easily destroyed by cooking or reheating

Temperature Danger Zone

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5

6

7

8

9

log1

0 cf

u/m

l

47.7F

38.3F

34.7F

Growth of Listeria monocytogenes CFA 433 in chicken broth when

incubated at 47.7. 38.3, 34.7, and 33.4oF. Adapted from S.J. Walker et al. (1990).

4

5

0 10 20 30 40 50

Time (days)

34.7F

33.4F

Listeria Risk Factors

Vacuum Packaging:

• Vacuum packaging allows growth of Listeriain long-term refrigerated storage.g g g

Listeria Risk Factors

Water Activity and Salt:

• Most fresh foods have aw > 0.98

• Listeria grows better in moist environment:Listeria grows better in moist environment: – Optimal water activity aw ≥ 0.97

– But can grow & multiply at aw of ≤ 0.90

• Listeria survives in high salt concentrations.

Listeria Risk Factors Acidity (pH):

• Typical pH range is 4.7 to 9.6

• Listeria can survive in hard salami at pH 4.3- 4.5p

• Listeria can tolerate lower pH when kept at near refrigeration temperatures (vs. room & body temperatures)

Listeria BiofilmsThe bacterium forms (BIOFILMS) on food contact

surfaces.

What are Biofilms?

• Microorganisms attached to a surface and covered with an expolysaccharide, which protects the bacteria from antibiotics, disinfectants and biocidesdisinfectants and biocides.

• A dental plaque is a biofilm →

Courtesy, ASM Image Library

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Listeria Biofilms•Biofilms are hard to remove once formed!

•Biofilms are so thin they can’t be seen with the naked eye.

•Bacteria in the biofilms can break off and beBacteria in the biofilms can break off and be transferred to food or food contact surfaces.

Listeria Biofilms • Can protect bacteria from sanitizers

Where is Listeria Found?

• Everywhere!

• Found in soil, water, sewage, silage, fecal materials, plants in contact with raw manure, p

• Animals can shed Listeria in their feces without symptoms

• Unwashed coleslaw that is contaminated with Listeria can contaminate other vegetables if contacts them.

Where is Listeria found? • Found on hard-to-clean equipment used to

transport, store or prepare– Meat slicers

– Wheels of carts that transport foods

– Cracks in preparation tables

– Knives, cutting boards, gloves

How Do Drains Spread Contamination?

• Listeria pools and survives in drains.

• Food and equipment may become contaminated from splashing during floor and drain cleaning.

How Do Meat Slicers Spread Contamination?

• Meat and cheese slicers can spread Listeria from contaminated products to uncontaminated ones via cross-contaminationvia cross contamination.

• To avoid this, slicers must be cleaned & sanitized after each use and between each food item change.

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Cracks in Preparation Tables• Listeria may hide in cracks in equipment,

utensils & prepping tables.

• If these utensils are not cleaned properly, food could become contaminated.

• Surfaces and worktables must be cleaned and sanitized after each use and between each food item change.

Good news is…

Proper cooking destroys Listeria

monocytogenes

Listeria and Refrigerated Ready-to-Eat Foods

• Listeria destroyed during food processing

• However, can contaminate products during post-processing handling, packaging & transportation, as well as in retail environment.

• Refrigerated RTE foods intended for long storage provide Listeria with the food, moisture, time and right temperature needed to survive and possibly grow.

Foods Implicated with Listeria

Deli meats & hot dogs (served withoutfurther heating)

Cold pates,& cold meat spreads

Cold smoked fish (lox, kippered)

Soft cheeses (made with raw milk)

- Camembert, brie, Mexican-style & blue-veined cheeses, and feta

Raw (unpasteurized) milk

Foods Implicated with Listeria

• Deli-style salads

– Any type made with potentially hazardous ingredients like seafood.

• Fruit and vegetable salads

– Pre-prepared or prepackaged

• Raw/ unwashed vegetables

– Lettuce or cabbage

Listeria Control Factors

1. Safe Storage Time and Temperature Control

2 Avoiding Cross Contamination2. Avoiding Cross Contamination

3. Frequent Cleaning and Sanitizing

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Safe Storage Time and Temperature Control

• Store refrigerated foods at 41˚F or below.

• If serving immune compromised, storeIf serving immune compromised, store refrigerated ready-to-eat foods like deli meats, cooked seafood and salads no longer than 4 days.

Avoid Cross-Contamination

• Occurs when micro-organisms are transferred from one surface to another

• Can occur between equipment, foods, the q penvironment, and even employees

Frequent Cleaning and Sanitizing

• Improper or infrequent cleaning and sanitizing of equipment & food contact surfaces allows Listeria to grow to high levels.

• If food contact surfaces remain unclean, Listeria will produce biofilms → the risk of contamination increases.

Employees can also contaminate the food

• Humans carry Listeria in their gut.

• Poor practices such as improper p p phandwashing or dirty uniforms can lead to contamination of food with Listeria.

Control of Listeriamonocytogenes through HACCP

What is HACCP?

• Hazard Analysis Critical Control Points:

• A management tool used to control biological, chemical & physical hazards at any step ofchemical & physical hazards at any step of the food flow.

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The Food FlowPurchasing

Receiving

Storing

PreparationPreparation

Cooking

Cooling

Reheating

Holding

Serving

HACCP Is:

• Preventive, not reactive

• Not a zero-risk system.

D i d t i i i th i k f f d• Designed to minimize the risk of food safety hazards.

HACCP Principles1. Conduct a hazard analysis2. Determine critical control points (CCPs) 3. Establish critical limits (CLs)4. Establish monitoring procedures5. Identify corrective actions6. Verification procedures7. Record keeping procedures

Source: National Advisory Committee on Microbiological Criteria for Foods

Hazard Analysis-Principle 1• Plan a menu that promotes food safety

• Avoid potentially hazardous foods implicated with Listeria:

soft cheeses cold smoked fish and raw milk– soft cheeses, cold smoked fish and raw milk.

• Hot dogs or lunch meats can be used if reheated to 165˚F or until steaming hot.

Hazard Analysis• Determine how food is processed in your operation

1. Prepping & serving without cooking:

2 Prepping & cooking for same day service:2. Prepping & cooking for same day service:

3. Prepping, cooking, holding, cooling, reheating & serving:

Hazard Analysis - Menu plan• Does the food ever go

through the critical temperature range?

• Is the food prepared In advance? How long is it

• Other questions…….• Is there any potential

contamination that may occur after cooking the food?advance? How long is it

stored? At what temperature?

• Does the food require multi-preparation steps?

• Is the food handled a lot by workers?

• Is the food consumed hot? Cold?

food?

• Is the food a ready-to-eat food in reduced oxygen packaging?

• Does the recipe incorporate leftovers?

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Conducting Hazard Analysis ExampleHam and Melon starters:

• Potentially hazardous ingredients:– fresh cut melon and refrigerated RTE ham.

• Microbiological hazards:– Listeria & Salmonella.

• Cross contamination may occur during food prepping.

Safe Food Procurement• Obtain foods from reputable suppliers.

• Notice Listeria growth inhibitors on labels of refrigerated RTE meats .

S di l t t d di di t t• Sodium lactate and sodium diacetate

• Check use-by or sell-by date on the package of RTE foods

Critical Control Points (CCPs)Principle 2

• Determine the points or steps in the food flow where hazard(s) can be prevented, eliminated, or reduced to safe levelsor reduced to safe levels.

• Ex.1 pathogen growth can be controlled by refrigerated storage or chilling.

• Ex.2 some biological and chemical hazards can be minimized by obtaining foods from approved sources.

Multiple CCPs and Hazards

• A CCP can be used to control more than one hazard– A refrigerated storage CCP may control pathogen g g y p g

growth and toxin production.

• More than one CCP may be needed to control a hazard– Cooking step and cooling right after are 2 CCPs

to reduce microbial growth.

CCPs of the Food FlowPurchasing

• CCP1Receiving

• CCP2Storing

PreparationPreparation

• CCP3Cooking

• CCP4Cooling

• CCP5Reheating

Holding

Serving

Critical Limits (CLs)Principle 3

• Critical Limits (CL): Defined as the specific criteria that determine the difference between safe and unsafe products being produced. – Eg., Cooking to an end point temperature of 160°F

for 15 seconds in the center of a hamburger patty is a CL for safely cooked hamburgers.

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Receiving CCPs and CLs• Microbial growth and contamination can

occur if food was received at temperature that does not meet the recommended receiving t ttemperature.– Ex. Fluid milk must be received at 41˚F or below.

Storing CCPs and CLs• Storage Time and temperature are important

CCPs for perishable RTE foods.

• The refrigerator or walk-in should be kept at 41˚F or below.

• Use unopened packages of refrigerated ready-to-eat foods within 2 weeks and not past their “best used by date.”

• Once opened, use within 4 days, especially if serving the elderly.

Cooking CCPs and CLs• You must cook food until it reaches the

minimum safe internal temperature as needed for that food product.

• All foods are safe from foodborne pathogens at 165°C, but some can be safely cooked to lower internal temperatures.

Type of Food Minimum Internal Temperature

Roast beef, pork, veal and lamb 145 ˚F for 4 minutes

Whole or ground poultry. Stuffing made with PHFs, stuffed meat, poultry, seafood, or pasta. Dishes that include previously cooked PHFs.

165 ˚F for 15 seconds

Fi h h llfi h & t St k/ h f k b f l 145 ˚F f 15 dFish, shellfish & crustaceans. Steak/ chops of pork, beef, veal & lamb. Eggs to be served immediately.

145 ˚F for 15 seconds

Ground meat & ground seafood, injected meat, eggs that will be hot-held for service.

155˚F for 15 seconds

Commercially processed RTE (cheese sticks, deep fried vegetables) that will be hot held for service.

135 ˚F

Fruit, vegetables, grains (rice, pasta) & legumes (beans, refried beans) that will be hot-held for service.

135 ˚F

Cooling CCPs and CLs • Pathogens grow well between 135˚F & 41˚F

– They grow most quickly between 125˚F & 70˚F

• FDA allows 2 cooling methods: g

1.Cool from 135˚F to 41˚F in 4 hours.

2.Cool from 135˚F to 70˚F in 2 hours. Then cool to 41˚F in the next 4 hours.

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Reheating CCPs and CLs

• RTE food products that must be reheatedbefore use:• hot dogs• hot dogs• luncheon meats• cold cuts• other refrigerated deli-style meat and

poultry products• These products must be reheated until they

reach 165˚F & are steaming hot.

Monitoring - Principle 4

• You must monitor consistently each critical limits to ensure that criteria are met.

• Ex.1 While cooking you must check the temperature of chicken breast by using a good calibrated thermometer. The temperature must reach165˚F.

• Ex.2 The internal temperature of a fruit salad should be 41˚F. You must check this temperature 3 times/day.

Corrective Action - Principle 5• Corrective actions are taken when critical

limits are not met.

• Ex.1-if RTE food stored for longer than 7 days, this food must be discarded.

• Ex.2-reject any milk received at temperature higher than 41˚F.

Corrective Action - Principle 5• Ex.3-if dirt is found on the surface of melons,

you may rewash it before slicing it.

Verification - Principle 6• Your food safety plan should be verified on a

regular basis.

• Check records such as hazard analysis & monitoring charts, temperature logs, corrective actions and shipment records.

• Also, evaluate employee performance.

Record Keeping - Principle 7• Keeping records of factors that are critical to

control Listeria is important and makes verification easier

• Records are reviewed to verify that:– Jobs are completed and done correctly.

– Critical factors such as time and temperature do not exceed critical limits.

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Record Keeping Examples• Receiving logs

– record receiving temperatures of products or ingredients.

• Temperature logs• Temperature logs– record temperatures of products when hot holding or

cold holding.

• Sanitation logs

• Corrective action logs

• Equipment validation logs, etc.

Recap…• Listeria is a deadly foodborne pathogen to

older adults.

• Listeria can be prevented:– Purchase foods from reputable suppliers.

– Reheat refrigerated RTE foods like luncheon meats and hot dogs to 165˚F or until steaming hot to minimize exposure.

– Monitor the storage time & temperature of refrigerated RTE foods.

Recap…• Check for Listeria inhibitors on packages of

refrigerated RTE meat products.

• Use date marking to ensure prompt use of RTE foods stored in the refrigerator after use.

• Refrigerated RTE foods can be stored for 7 days only.– if serving the elderly, store for 4 days only.

• Make sure your HACCP plan is sufficient to control Listeria.

Control of Listeria through Enhanced Cleaning and Sanitizing

Protocols

Why Clean and Sanitize?• It is important in preventing cross

contamination.

• Frequent cleaning & sanitizing prevents the build-up of Listeria biofilms.

Cleaning vs Sanitizing

• Cleaning removes dirt and grease on surface.

• Sanitizing reduces pathogens on a safe level.

• All surfaces must be cleaned and sanitized including food contact surfaces.

ServSafe®

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General Cleaning and SanitizingGuidelines

• Clean the surface.

• Rinse the surface.

S iti th f• Sanitize the surface.

• Allow the surface to air-dry.

ServSafe®

Commonly Used Sanitizers

• Chlorine containing compounds

• Quaternary Ammonium Compounds (QACs)

Factors Affecting Sanitizers• Temperature of solvent

• Concentration of sanitizer

• pHp

• Exposure time

• Organic matter on surface

• Cleanability of equipment

Pro-Quat TowelsChicopee® Towels

• Hydrogen Peroxide H2O2

Common Household Products Effective against Listeria

• White Vinegar

• Hydrogen Peroxide (H2O2)

– Environmental friendly, non corrosive

– Generally considered safe

Hydrogen Peroxide and Distilled White Vinegar

– Not approved for use as sanitizer

• White Vinegar– Food ingredient– Helps dissolve soap froth, deodorizes– Natural, nontoxic– Not approved for use as sanitizer in food service

operations

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Developing a Cleaning and Sanitizing Plan

• Create a plan for regular cleaning and sanitizing

• Ask 4 questions:– What – How– When– Who

• Make a schedule to clean:– Equipment in constant use– Drains– Slicers– Preparation surfaces

Foodservice Workers Training

Training of Foodservice Workers• Foodservice managers are responsible for training

their employees on the following:

– Proper handwashing

– Personal hygiene

– Thermometer calibration

1 W t h d 2 A l •3 Rub hands

•Proper Handwashing

•1. Wet your hands with hot running water

•2. Apply soap 3. Rub hands• together for at• least twenty • seconds

•4. Clean under fingernails and between fingers

•5. Rinse hands thoroughly

• under running • water

•6. Dry hands

•ServSafe®

Hand Care• Keep fingernails short

• Do not wear false fingernails or nail polish

• Hand wounds: – Wear a bandage over wounds on hands and

arms.

– Wear a single-use glove or finger cot over bandages on hands or fingers

• Change gloves as needed

Personal Hygiene• Work attire:

• Policies for eating, drinking, smoking, and chewing gum or tobacco

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Ice-Point MethodCalibrating Thermometers

1. Fill a large container with crushed ice and water

2. Submerge the thermometer stem or probe in the water for thirty seconds

3. Hold the calibration nut and rotate the thermometer head until it reads 32˚F (0˚C)

Sick Worker Policy

If a foodhandler has: Then:

Sore throat with fever Exclude the foodhandler from the operation

Vomiting, diarrhea or jaundice Exclude the foodhandler from the operation

Salmonella Typhi, Shigella spp., Shiga toxin producing E. coli, Hepatitis A, Norovirus

Exclude the foodhandler from the operation

Recap…• Proper cleaning and sanitizing protocol is

very significant to control Listeria monocytogenes.

Train your personnel to maintain appropriate• Train your personnel to maintain appropriate schedule to clean food contact surfaces frequently.

• Handwashing and proper personal hygiene are important factors to prevent the transmission of contamination to food.

Other Pathogens of Special Importance among Elderly

Salmonella• Salmonellosis in elderly: severe diarrhea &

septicemia.

• Onset time: 12-72 hours; duration 4-7days.

• Implicated foods: raw meats poultry eggs dairy• Implicated foods: raw meats, poultry, eggs, dairy products, produce, fish & seafood.

• Salmonella Enteritidis = contamination of eggs.

• Proper cooking destroys Salmonella.

Escherichia coli O157:H7

• Common sources:• undercooked ground beef products, raw

milk, unwashed produce.

• Severe illness in elderly (cramps, bloody diarrhea, kidney or neuro damage, or death).

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Norovirus• Spread through food, drink direct contact• Onset: 12-48 hr of exposure. • Nausea, vomiting, diarrhea & cramps

Lasts 1 2 days severe dehydration in the• Lasts 1-2 days, severe dehydration in the elderly

Food Irradiation

Irradiation

A new technology used to ensure food safety by exposing food to an ionizing energy

( di i ) d h f l(radiation) to destroy harmful microorganisms.

How does irradiation work?• Food is briefly exposed to energy source

• The energy source (usually gamma rays or electron beams) breaks up the DNA of pathogens & insects:– this prevents organisms from reproduction &

surviving.

Irradiation and the Nutritional Value of Foods

• Irradiated food still wholesome and nutritious

• Insignificant nutrition loss

Irradiated Foods• Irradiation in our environment

• Irradiated foods are not radioactive

• Radiolytic products are not harmful

• Irradiated foods are safe for consumptionIrradiated foods are safe for consumption

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Irradiation Logo Foods Approved for Irradiation• Fruits & vegetables.

• Meat & Poultry.

• Fish & seafood.

R & b• Roots & tubers.

• Cereals & legumes.

• Spices & dried vegetable seasonings.

• Recently, FDA approved irradiation

for greens.

Benefits of Irradiation • Enhance food safety & kills bacteria such as Listeria,

Salmonella & E. coli O157:H7

• Prevents food spoilage

– Irradiated strawberries stay fresh >3wks vs. non-yirradiated 3-5 days.

– Reduces sprouting & delays ripening

• Low dose irradiation may be implemented during post-packaging of products like prepared salad mixes, fruit salads & minimally processed vegetable products.

• Food irradiation is allowed in up to 40 countries.

Remember.. Irradiation is not a substitute of proper handling. You still need to practice safeYou still need to practice safe

food handling!

Thank You!!