ServSafe Part 1: Keeping Food Safe

• Topic 1.1: Foodborne Illness

  • Foodborne Illness - a disease transmitted to people by food

  • Foodborne Illness Outbreak - a foodborne illness is considered an outbreak when two or more people have the same symptoms after eating the same food

    • Requires an investigation by a state/local regulatory authority

    • Requires a confirmation by a laboratory

      • This is vital because we will need to protect and warn others

  • Challenges to Food Safety

    • Time - pressure to work quickly in kitchens can cause issues

    • Language - communication barriers can prevent people from understanding what needs to be done

    • Culture - influence how food handlers view safety 

    • Literacy and Education - challenge to teach and learn

    • Pathogens - illness-causing microorganisms

    • Unapproved Suppliers - not practicing proper food safety

    • High-risk customers - example: growing elderly population, those with food allergies

    • Staff Turnover - need for ongoing, frequent, timely training

  • Costs (Outcomes) to Foodborne Illness and Outbreak

    • Loss of customers and sales 

    • Loss of reputation

    • Negative media exposure

    • Lowered staff morale

    • Lawsuits and legal fees

    • Staff missing work

    • Increased insurance premiums 

    • Staff retraining

• Topic 1.2: How Foodborne Illnesses Occur

  • Something incorrect/improper happens, food becomes unsafe, person consumes unsafe food, person gets a foodborne illness

    • Typically the result of contamination - the presence of harmful substances in the food

  • Contaminants come in three categories:

    • Biological - pathogens (microorganisms that cause disease) are the greatest threat to food safety 

      • Bacteria 

      • Viruses

      • Parasites 

      • Fungi

      • Some plants, mushrooms, and seafood that carry harmful toxins (poisons) included in this group

    • Chemical - foodservice chemicals can contaminate food if they are used/stored incorrectly

      • Cleaners 

      • Sanitizers

      • Polishes

    • Physical - these hazards pose a threat to food safety

      • Metal shavings

      • Staples

      • Bandages

      • Glass

      • Dirt 

      • Naturally occurring objects (example: fish bones in a filet)

  • Food handlers who do not follow correct procedures can threaten the safety of food and cause food to become unsafe

  • 5 Risk Factors

    • Purchasing food from an unsafe source (including private homes)

    • Failing to cook food correctly

    • Holding food at incorrect temperatures

      • The fridge and freezer need to be at correct temperatures

    • Using contaminated equipment

    • Practicing poor personal hygiene

  • 4 Food Handler Practices

    • Time temperature abuse

      • If food stays too long at a temperature that promotes pathogen growth

        • Within four hours, this food can become inedible 

      • This can happen if you didn’t store food at the correct temperature, reheated properly, and cooked or cooled correctly 

    • Cross contamination

      • Pathogens transfer from one surface to the next

      • If the food isn’t cooked, the pathogens won’t die, making it unsafe

      • Ready to eat food that touches contaminated surfaces can make those RTE food unsafe and contaminated

      • Contaminated wiping clothes and food handlers can also spread bacteria to food

    • Poor personal hygiene

      • Failing to wash your hands 

      • Coughing or sneezing on food

      • Touch or scratch wounds and then touch food

      • Come to work while sick

    • Poor cleaning and sanitizing

      • Pathogens can be spread to food of equipment isn’t properly cleaned or sanitized

      • Utensils and food surfaces aren’t cleaned properly

      • Wiping cloths aren’t stored in a sanitizer solution between uses

  • What types of food are most likely to become unsafe?

    • TCS Food - (time and temperature control for safety) food that requires time and temperature control to limit pathogen growth

      • Examples:

        • Milk and dairy products

        • Shell eggs (except those unpasteurized)

        • Meat: beef, pork lamb

        • Poultry 

        • Fish

        • Shellfish and crustaceans

        • Baked potatoes

          • Can contain one of the most deadly toxins to humans if not baked properly and taken out of the foil on time

        • Heat-treated plant foods 

          • Cooked rice, beans, and vegetables

        • Tofu or any time of soy protein, synthetic ingredients, such as textured soy protein in meat alternatives

        • Sprouts and sprout seeds

        • Sliced melons, cut tomatoes, and cut leafy greens

        • Untreated garlic and oil mixtures

    • Ready-to-eat-food - food that can be eaten without further preparation, washing or cooking

      • Examples:

        • Cooked food

        • Washed fruit and vegetables (whole and cut)

        • Deli meat

        • Bakery items

        • Sugar spices, and seasonings

  • What groups of people are at highest risk of getting sick from unsafe food?

    • Preschool Age Children - have not built up strong immune systems

    • Elderly People - stomach acid production decreases with age, giving toxins more time to form

    • People with compromised immune systems - certain medical conditions and medications can weaken the immune system

• Topic 1.3: Managing Food Safety

  • *notes are on slides

ServSafe Part 3: Contamination, Food Allergies, and Foodborne Illness

• Topic 3.1: Physical and Chemical Contaminants

  • Physical Contamination

    • Food can become contaminated when objects get into it, or when natural occurring contaminants are left in food

      • Common Objects: fingernails, dirt, hair, jewelry, glass

      • Naturally occurring: fruit pits and even ice

    • Common symptoms in contamination:

      • Bleeding and pain

      • Mild fatal injuries (cuts, dental damage, choking)

    • Contamination can be prevented by:

      • Purchasing food from trusted places

      • Inspect the food you receive

      • Practice personal hygiene while working with food

  • Chemical Contamination

    • Common sources include cleaners, sanitizers, nail polish, pesticides, deodorizers, first-aid products, health and beauty products (hard lotion, hairsprays, makeup)

    • Certain types of kitchenware and equipment - items made from pewter, copper, and zinc

    • Common  symptoms in contamination:

      • Varies depending on chemicals consumed

      • IMMEDIATE RESPONSE - Most illnesses occur within minutes

      • Vomiting and diarrhea and typical

    • If illness is suspected: 

      • Call an emergy number

      • Call poison control

    • Contamination can be prevented by:

      • Use ONLY contamination chemicals that are approved in food service operation - they also must be necessary for the maintenance of the food service operation

      • Purchase approved chemicals from reputable suppliers

      • Store chemicals away from prep areas, food-storage areas, and service areas - spacing and partitioning

      • NEVER store chemicals above on on the same surface as food

      • Always use chemicals for their intended use

      • ONLY handle food with equipment and utensils approved for foodservice use

      • Make sure labels on chemicals are readable

      • Follow the manufacturer’s directions and local regulatory requirements when throwing out chemicals

• Topic 3.2: Deliberate Contamination

  • You must take steps to stop people who attempt to contaminate food, whether deliberate or not

  • Common Sources

    • Terrorists, activists, disgruntled current or former staff, vendors, competitors

  • Attacks can occur anywhere in the food supply chain

  • Prevention Measures:

    • Best way to protect food is to make it as difficult as possible for someone to tamper with it

    • A food defense program should deal with the points in your operation where food is at risk

    • FDA created tool - A.L.E.R.T. (assure look employees reports threat)

• Topic 3.3: Food Allergies

  • Allergic Reaction - when the immune system mistakenly considers an allergies to be harmful and attacks the food protein 

    • Can happen immediately or after several hours

    • Common symptoms include nausea, vomiting and/or diarrhea, abdominal pain, swelling in various parts of the body, and anaphylaxis in several cases - where your throat could close up and you could suffocate

    • Prevention Measures:

      • Staff should be able to tell customers what types of allergens are contained in items on a menu

      • One person at minimum to answers customers’ questions about allergens

        • Clearly identify guest’s order for kitchen and staff

      • Deliver food separately to prevent cross contact

        • Hand deliver allergen order

      • Kitchen staff needs to cross contact - when allergens transfer from one food to another

        • This can be avoided by have sanitary practices for equipment, utensils, and staff

      • Do NOT cook different types of food in the same fryer oil

      • Do NOT put food on surface near other food with allergens

  • Food Allergen - a protein in food or ingredient to which some people are sensitive 

    • These proteins occur naturally

    • When enough of an allergen is eaten, an allergic reaction can occur

    • The Big 9 Food Allergies - make up 90% of allergic reactions in the United States

      • Milk

      • Soy

      • Eggs

      • Wheat

      • Fish

      • Shellfish

      • Peanuts

      • Tree Nuts

      • Sesame

ServSafe Part 2: Understanding the Microworld

• Topic 2.1: Pathogens

  • Pathogens - a harmful microorganisms that we cannot see, but can ingest and make people sick

  • Four types of Pathogens that cause foodborne illness:

    • Bacteria 

    • Viruses

    • Parasites

    • Fungi

  • Pathogens get into food if food handlers don’t handle food correctly

  • Symptoms of a foodborne illness (biological contamination):

    • Diarrhea

    • Vomiting

    • Fever

    • Nausea

    • Abdominal Cramps

    • Jaundice - yellowing of skin and eyes

      • Symptoms can vary depending on the person

      • These symptoms can develop within 30 minutes or even up to 6 weeks

      • Severity - wide range; no symptoms to mild diarrhea to death

  • Six pathogens have been singled out by the FDA because they can cause severe foodborne illness

    • They are found in high numbers in infected people, spread through food very easily

  • The “Big 6”

    • Salmonella Typhi

    • Shigella spp.

    • Non Typical Salmonella (NTS)

    • Shiga toxin-producing Escherichia coli (STEC), AKA E. coli

    • Hepatitis A

    • Norovirus

• Topic 2.2: Bacteria

  • Bacteria - single celled, living microorganisms

    • They are found almost everywhere

  • How can we prevent foodborne illness from bacteria?

    • Control time and temperature 

      • Cook and store things appropriately and for the right amount of time

  • 6 Conditions Needed for Bacteria to Grow (FAT TOM)

    • Food - bacteria needs food (proteins) to survive

      • TCS food best support the growth of bacteria

    • Acidity - measured on the pH scale, bacteria grows best in food that is slightly acidic or not acidic

      • The ideal pH for bacteria ranges from 7.5 to 4.6

      • Example foods: bread, raw chicken, cooked corn

    • Temperature - bacteria rapidly grows between 41 degrees F to 135 degrees F, which is considered the Temperature Danger Zone

      • When bacteria is in this zone, they can double every 20 minutes

      • Bacteria grows even more rapidly between 70-125 degrees F

    • Time - bacteria needs time to grow

      • The more time spent in a temperature danger zone, the more bacteria can grow

    • Oxygen - some bacteria need oxygen to grow

    • Moisture - bacteria grows well in food with high levels of moisture 

      • Aw (subscript w) = water activity 

      • Scale ranges from 0.0 - 1.0 (water has aw of 1.0)

  • How can we control these 6 conditions?

    • In reality, we can only control time and temperature

      • This is why it is the best way to prevent foodborne illness

  • Spores - bacteria can change into this form to prevent dying if they have a lack of nutrients 

    • Often found in dirt, which can contaminate food grown in dirt or exposed to dirt, including veggies, potatoes, rice, meat, poultry, and fish

    • We can prevent this by storing food at the correct temp and hold and cool food correctly

  • Bacteria that Causes Foodborne Illness:

    • Bacillus Cereus - causes watery diarrhea, found in rice, typically fried rice or cooked rice dishes

    • Listeriosis - illness is uncommon in healthy people, but can cause a miscarriage in pregnant women

      • Commonly linked food include any lunch meat and unpasteurized dairy products

    • Hemorrhagic Colitis - one of the big 6 pathogens 

      • Found in the intestines of cattle and in infected people

      • Commonly linked foods include ground beef (raw and undercooked) contaminated produce

      • Common symptoms include bloody diarrhea and kidney failure in severe cases

      • Purchase ground beef from reliable suppliers, prevent cross contamination, and keep infected staff out of the kitchen

    • Campylobacteriosis - associated with poultry

      • Common symptoms include bloody or watery diarrhea

    • Clostridium Perfringens - found in dirt where is forms spores, grows EXTREMELY rapidly in the temperature danger zone

      • Commonly linked food include meat and poultry

      • Commonly linked symptoms are diarrhea, but not fever or vomiting

    • Botulism - comes from bacteria Clostridium botulinum

      • Forms spores commonly found in water and dirt

      • Grows without oxygen and can produce a lethal toxin - without medical treatment, death is likely

      • Common symptoms include nausea and vomiting initially, but can the lead to weakness, double vision, and breathing problems

      • To prevent infections, inspect canned foods for bloating or damage

    • Salmonellosis -  comes from bacteria Nontyphoidal Salmonella 

      • Many farm animals naturally carry this bacteria 

      • Often linked with poultry and poultry products, and cut produce, especially tomatoes and cantaloupes

      • Common symptoms include diarrhea, abdominal cramps, vomiting, fever

      • Prevent this illness by preventing cross contamination between poultry and ready to eat food

        • Exclude food handlers who are vomiting or having diarrhea form the operation

    • Typhoid Fever - comes from salmonella typhi, a big 6

      • People infected with this have it in the bloodstream and intestinal tract

      • Commonly linked with ready-to-eat food and beverages

      • Common symptoms include abdominal pain, headaches, loss of appetite, and rashes

      • Prevent cross contamination and do NOT let people with typhoid fever into the operation

    • Shigellosis - comes from the bacteria shigella, a big 6

      • Found in the feces of humans with the illness

      • Typically linked with foods that are contaminated by your hands including salads containing TCS foods and food that come in contact with contaminated water, such as produce

      • Common symptoms include diarrhea 

      • The best way to prevent this is WASHING YOUR HANDS (personal hygiene) 

      • Control flies inside and outside of operation because they carry shigellosis

    • Staphylococcal Gastroenteritis - comes from bacteria Staphylococcus aureus

      • Can be found in humans, often in the nose, hair, throat, and infected wounds

      • Often transferred to food when people carrying it touch these areas on their bodies and then handle food without washing their hands

      • Most commonly linked to any ready-to-eat food and salads containing TCS foods

      • Common symptoms include retching, nausea, vomiting, and abdominal pain

      • The best prevention measure is to practice good personal hygiene

    • Vibrio gastroenteritis and Vibrio vulnificus -  comes from bacteria vibrio vulnificus and vibrio parahaemolytics 

    • Found in water shellfish are harvested

      • Common linked foods include oyster

    • People who get sick with this can die

      • Common symptoms include diarrhea, abdominal cramps

    • The best prevention measure is to purchase oysters from approved, reputable suppliers

      • Also cook oyster appropriately 

• Topic 2.3: Viruses

  • Viruses - the smallest microbial food contaminants 

    • They require a living host to exist and grow

    • Can be transferred to food and remain infectious in food

    • Sources can include food, water, or any contaminated surface

    • Consumption occurs typically through the fecal-oral route

    • We can viruses in our feces and can put them on food if we don’t wash our hands after using the restroom

  • Some viruses cannot be destroyed by cooking (example: hepatitis A)

  • Prevention Measures:

    • Make sure food handlers wash their hands

    • Avoid bare-hand contact with RTE food

    • Keep sick individuals away from operation

  • Hepatitis A - part of the big 6, causes the majority of foodborne illnesses

    • Mainly found in the feces of people infected with it, often transferred to food when infected food handlers touch food or equipment with finger that have feces on them

    • Commonly linked foods include ready-to-eat food, and shellfish from contaminated water

    • Common symptoms include jaundice, fever, nausea, general weakness, and abdominal pain

    • Practice good personal hygiene and do not let infected individuals in the operation

  • Norovirus - part of the big 6, causes the majority of foodborne illnesses

    • Often transferred to food when infected food handlers touch food or equipment with fingers that have feces on them

    • HIGHLY contagious, people become contagious within a few hours after consumption

    • Commonly linked foods include RTE foods and shellfish from contaminated water

    • Common symptoms include vomiting, diarrhea, nausea, and abdominal cramps

    • Prevention measures include washing your hands and keeping people with these symptoms out of operation

• Topic 2.4: Parasites

  • Parasites - cannot grow in food and require a living host

    • Sources:

      • Seafood

      • Wil game

      • Food processed with contaminated water, such as produce

        • Parasites can exist in water for a period time

    • Prevention Measures:

      • Purchasing food from an approved, reputable supplier (the best way - important!!)

        • Applies to ANY of the illnesses caused by parasites

      • Cook food to required minimum or internal temperatures

      • Fish that will be served raw or undercooked must be frozen correctly by the manufacturer

    • Parasites that cause foodborne illnesses

      • Anisakis Simplex - causes anisakiasis

        • Commonly linked foods are raw and undercooked fish

        • Common symptoms are tingling in the throat and coughing up worms

        • Purchase sushi grade fish that has been frozen to the correct time

      • Cryptosporidium Parvum - causes cryptosporidiosis

        • Can be found in the feces of infected people, food handlers can transfer this parasite to food if they do not properly wash their hands

        • Outbreaks of this illness can often happen in daycare centers and medical communities

        • Commonly linked foods include water and produce

        • Symptoms include watery diarrhea, abdominal cramps, nausea, weight loss

        • Use correctly treated water, wash hands and keep people with diarrhea out of the operation

      • Giardia Duodenalis - causes giardiasis

        • Can be found in the feces of infected people

        • Commonly linked to produce and water

        • Symptoms include diarrhea, abdominal cramps, and nausea

      • Cyclospora Cayetanensis - causes cyclosporiasis

        • Can be found in the feces of infected people

        • Food handlers pass this illness around if they took food with feces on their fingers or if they do not wash their hands

        • Common symptoms include nausea, abdominal cramps, mild fever, diarrhea alternating with constipation

        • Use correctly treated water, wash hands and keep people with diarrhea out of the operation

• Topic 2.5: Fungi

  • Fungi - pathogens that spoil food and sometimes make people sick

    • Not always unsafe

    • Mold and yeast are common examples

    • Sources:

      • Air

      • Dirt

    • Mold - some molds can produce toxins, such as aflatoxins

      • Can grow under almost any condition, especially in acidic food with low water activity (in jams, jellies, cured salty meats like ham and bacon)

      • Are only slowed, not destroyed, by cooler or freezer temperatures

      • Prevention measures:

        • Throw out all moldy food unless the mold is a natural part of the food

        • FDA recommends cutting away moldy areas in hard cheese, salami, firm fruits, and firm vegetables (by at least 2.5 cm = about 1 inch)

    • Yeast - also grow well in acidic food with low water activity, like jams, jellies, syrup, honey, fruit, fruit juice

      • Can spoil food quickly

      • Signs of spoilage can include a smell or taste of alcohol

      • May look white or pink or may slime and may bubble

      • Prevention measures:

        • Throw away any food that has been spoiled by yeast

• Topic 2.6: Biological Toxins

  • Seafood toxins - come from fish and shellfish

    • Cannot be smelled or tasted, cannot be destroyed by freezing or cooking

    • Sources in fish

      • Naturally occurring systemic toxins - puffer fish (required licensed specialized chef to prepare and serve); moray eels; freshwater minnows

      • Produced by pathogens already on the fish

      • Some other fish that have eaten smaller fish with the toxin can be contaminated

    • Sources in shellfish

      • Shellfish that have eaten algae that have a toxin

  • BY ALL ITEMS FROM A REPUTABLE SUPPLIER

  • Fish Toxins that Cause Foodborne Illnesses

    • Histamine - causes scombroid poisoning 

      • Occurs when scombroid and other species of fish are eaten

      • When the fish are time-temperature abused, bacteria on the fish make the toxin

      • Cannot be destroyed by freezing, cooking, smoking, or curing

      • Commonly linked foods include tuna, bonitio, mackerel, and mahimahi

    • Ciguatoxin - causes ciguatera fish poisoning

      • Can be found in submarine algae, and can occur because of the food chain (toxins are passed up the chain)

      • Cannot be detected by smell or taste, cannot be destroyed by cooking or freezing

      • Symptoms may last months or years depending on severity

      • Commonly linked foods include predatory tropical reef fish from Pacific Ocean, Western Indian Ocean, and Caribbean Sea

      • Common symptoms include reversal of hot and cold sensations, nausea, vomiting, tingling in fingers or lips or toes, joint and muscle pain

    • Saxitoxin - causes paralytic shellfish poisoning (PSP)

      • Some types of fish can become contaminated as they filter toxic algae from the water, people can get sick with PSP when they eat these shellfish

      • Cannot be detected by smell or taste, cannot be destroyed by cooking or freezing

      • Death from paralysis may result from consumption of high levels

      • Commonly linked foods include shellfish found in colder waters, such as those found in the Pacific and New England coasts, including clams, oysters, mussels, scallops

    • Brevetoxin - causes neurotoxic shellfish poisoning (NSP)

      • Commonly linked food include shellfish in warm west coast waters

      • Symptoms include numbness of the lips

    • Domoic Acid - causes amnesic shellfish poisoning (ASP)

      • Often found in shellfish in the pacific northwest

      • Often linked to amnesia, initially causes diarrhea and nausea, and eventually can cause memory loss, disorientation, seizure, coma

  • Mushroom Toxins - illnesses with mushrooms are almost always caused caused by eating toxic, wild mushrooms collected by amateur hunters (mistaken for edible ones)

    • Cannot be destroyed by cooking or freezing

    • Purchase mushrooms from APPROVED SUPPLIERS 

  • Plant Toxins - illnesses from plant toxins usually happen because an operation has purchased plants from an unapproved source

    • People can get sick from toxic plants when they mistake toxic plants for an edible plant (fool’s parsley, wild turnips)

    • If honey from bees harvest nectar from toxic plants, people can get sick from consuming that honey