Food Safety and Contamination

Biological contamination is a common danger, covering fungi, bacteria, and viruses.
Microorganisms are small living organisms visible only through a microscope and exist everywhere.
Pathogens are microorganisms that cause illness; some cause illness when eaten, while others produce toxins in food.
Four types of pathogens can contaminate food: bacteria, viruses, parasites, and fungi (including molds and yeast).

The Big Six Pathogens

The FDA identifies over 40 kinds of bacteria, viruses, parasites, and molds that can cause foodborne illness.
The "Big Six" are highly contagious and cause severe illness: Shigella SPP, Salmonella typhi, nontyphoidal Salmonella (NTS), Shiga toxin-producing Escherichia coli (STEC or E. coli), Hepatitis A, and Norovirus.

Symptoms and Onset Times of Foodborne Illnesses

Common symptoms include diarrhea, vomiting, fever, nausea, abdominal cramps, and jaundice (yellowing of skin and eyes).
Onset times vary from 30 minutes to 6 weeks, depending on the illness, with severity ranging from mild diarrhea to death.

Bacteria

Bacteria are found almost everywhere, including in and on our bodies; some are harmless, others cause illness.
Bacteria cannot be seen, smelled, or tasted; they grow rapidly under the right conditions.
Preventing bacterial foodborne illness involves controlling time and temperature.
Bacteria grow best in TCS (Time and Temperature Control for Safety) foods.

Factors Affecting Bacterial Growth (FAT TOM)

Food: Bacteria need nutrients to survive, and TCS foods support their growth.
Acidity: Bacteria grow best in neutral to slightly acidic foods (pH near 7).
Temperature: Bacteria grow rapidly between $41^{\circ}F$ and $135^{\circ}F$ ( $5^{\circ}C$ and $57^{\circ}C$ ), known as the temperature danger zone. Rapid growth occurs between $70^{\circ}F$ and $125^{\circ}F$ ( $21^{\circ}C$ and $52^{\circ}C$ ).
Time: The more time bacteria spend in the temperature danger zone, the more they grow.
Oxygen: Some bacteria need oxygen, while others grow in its absence.
Moisture: Bacteria grow well in foods with high water activity (A subscript w), ranging from 0 to 1.0; water has a water activity of 1.0.

Controlling Bacterial Growth

Control time and temperature to keep TCS food safe, keeping it out of the temperature danger zone.

Specific Bacteria of Concern

Four bacteria are highly contagious: Salmonella typhi, nontyphoidal Salmonella (NTS), Shigella SPP, and Shiga toxin-producing E. coli (STEC).
Food handlers diagnosed with these illnesses cannot work in food service while sick.

Salmonella Typhi

Only lives in humans; causes typhoid fever; carried in bloodstream and intestinal tract.
Eating a small amount can cause illness; symptoms depend on health and amount eaten.
Found in feces for weeks after symptoms end; linked to ready-to-eat food and beverages.
Prevention: Exclude infected food handlers, ensure handwashing, and cook food to required temperatures.

Nontyphoidal Salmonella (NTS)

Carried by farm animals; eating a small amount can cause illness.
Found in feces for weeks after symptoms end; linked to poultry, eggs, meat, milk, dairy, produce (tomatoes, peppers, cantaloupe).
Prevention: Cook poultry and eggs to required temperatures, prevent cross-contamination, and exclude infected food handlers.

Shigella SPP

Found in feces of infected people; spread through contaminated food/water and flies.
High levels in feces for weeks after symptoms end; eating a small amount causes illness.
Linked to salads containing TCS food (potato, tuna, shrimp, macaroni, chicken salad) and contaminated produce.
Prevention: Exclude infected food handlers, ensure handwashing, and control flies.

Shiga Toxin-Producing E. Coli (STEC)

Found in intestines of cattle and infected people; contaminates meat during slaughtering.
Eating a small amount causes illness; produces toxins in intestines.
Raw or undercooked ground beef and contaminated produce are common sources.
Prevention: Exclude infected food handlers, cook food (especially ground beef) to required temperatures, purchase produce from approved suppliers, and prevent cross-contamination.

Viruses

Viruses require a living host to grow; they don't grow in food but are transferred through it.
Foodborne illnesses from viruses occur through fecal-oral routes.
Viruses on food are not destroyed by normal cooking temperatures; practice good hygiene when handling food.
Norovirus is a leading cause of foodborne illness, spread through airborne vomit particles; quick cleanup is important.
Hepatitis A and Norovirus are particularly contagious; infected food handlers should not work while sick.

Hepatitis A

Lives in feces of infected individuals; can infect others for weeks before symptoms appear.
Spreads when food handlers don't wash hands after using the restroom.
Can be found in shellfish from contaminated water.
Prevention: Exclude diagnosed food handlers, exclude jaundicey folks, ensure handwashing, avoid bare hand contact, and purchase shellfish from approved suppliers.

Norovirus

Lives in feces; spreads on ready-to-eat food and shellfish from contaminated water.
Spreads from poopy fingers to food and equipment; only a tiny bit needed to get sick.
Vomiting is a common symptom.
Prevention: Exclude staff diagnosed with Norovirus, ensure handwashing, avoid bare hand contact, and get shellfish from approved suppliers.

Parasites

Need a host to live and reproduce; associated with seafood and wild game.
Can be found on produce processed with contaminated water.
Prevention: Purchase food from approved suppliers and cook to required temperatures; freeze fish correctly if serving raw or undercooked.

Fungi

Includes yeasts, molds, and mushrooms; some produce toxins causing foodborne illness.
Throw out moldy food (unless mold is a natural part of the food). Purchase mushrooms from approved suppliers.

Biological Toxins

Food can be contaminated with biological toxins from external sources.
Shellfish can be contaminated by marine algae containing toxins.
Ciguateratoxin found in large fish that eat smaller contaminated fish (barracuda, snapper, grouper, amberjack).
Histamine is a toxin produced by pathogens on time-temperature abused fish (tuna, bonito, mackerel, mahi-mahi).
Some toxins are naturally associated with plants, mushrooms, and seafood.
Symptoms of seafood toxin illnesses include diarrhea, vomiting, neurological symptoms (tingling, reversal of hot and cold sensations), flushing, breathing difficulty, burning in the mouth, heart palpitations, and hives.
Prevention: Cannot be destroyed by cooking or freezing; purchase plants, mushrooms, and seafood from approved suppliers; control time and temperature when handling raw fish.

Chemical Contaminants

Chemicals (cleaners, sanitizers, polishes, lubricants, pesticides, deodorizers, first aid products, beauty products) can contaminate food if used or stored incorrectly.
Kitchenware made from pewter, copper, zinc, and some pottery can cause contamination, especially with acidic foods.
Symptoms include vomiting and diarrhea.
Use approved chemicals, store them away from food prep areas, and follow manufacturer's directions. Only use approved equipment and utensils.

Physical Contaminants

Objects in food can cause contamination (glass, metal shavings, staples, dirt, jewelry, wood, fingernails, bandages).
Injuries range from mild to fatal (cuts, dental damage, choking).
Prevention: Purchase food from approved suppliers and inspect it closely; ensure good personal hygiene among food handlers.

Deliberate Contamination

Terrorists, activists, disgruntled staff, vendors, and competitors can deliberately contaminate food with biological, chemical, or physical contaminants, even radioactive materials.
Food defense programs should address points where food is at risk. The FDA's ALERT tool can help develop a food defense program.

ALERT

Assure: Ensure products are from safe sources; supervise deliveries; use approved suppliers; request locked or sealed delivery vehicles.
Look: Monitor the security of products; limit access to prep and storage areas; create a system for damaged products; store chemicals securely; train staff to spot food defense threats.
Employees: Know who is in your facility; identify visitors; conduct background checks on staff; limit access to prep and storage areas.
Reports: Keep information related to food defense accessible (receiving logs, office files, staff files, self-inspections).
Threat: Identify what to do if there is suspicious activity or a threat; be prepared to hold suspected product; contact regulatory authority immediately; maintain an emergency contact list.

Responding to a Foodborne Illness Outbreak

Gather information from the complaining customer (contact info, what they ate, symptoms, when they became sick).
Contact the local regulatory authority.
Segregate suspected product with "do not use" labels.
Document information about suspected product (description, production date, lot number, sell-by date, pack size).
Identify all staff working during the suspected contamination period; interview staff about their health status.
Cooperate with regulatory authorities and provide documentation (temperature logs, HACCP documents, staff files).
Review food handling procedures to see if standards aren't being met.

Food Allergens

A food allergen is a protein in a food or ingredient that causes an allergic reaction.
When enough of an allergen is eaten, it can cause an allergic reaction in some people.
Be able to recognize signs of an allergic reaction and know how to respond to them.

Symptoms of an Allergic Reaction

Symptoms can include wheezing, difficulty breathing, hives, rashes, itching, tingling in the mouth, swelling (tongue and throat), abdominal cramps, diarrhea, drop in blood pressure, or loss of consciousness.
Anaphylaxis is a severe, life-threatening allergic reaction that can lead to death; act immediately and call emergency medical services.

The Big Nine Allergens

Milk, eggs, soybeans, fish, tree nuts, peanuts, crustacean shellfish, wheat, and sesame.

Preventing Allergic Reactions

Front of house and back of house staff need to prevent serving food containing allergens.
Know what's in the products purchased; food labels identify allergens.
Front of house staff should inform guests about allergens on the menu and listen to their concerns.
Take allergen special orders and communicate them to back of house staff with written notes.
Prevent cross-contact; deliver allergen special orders separately; keep workstations clean; use separate equipment.

Preventing Cross Contact

Cross contact occurs when a food item containing an allergen comes in contact with another food item or food contact surface and their proteins mix.
Kitchen staff should review the menu and ingredients for Big Nine allergens, checking recipes and ingredient labels; ingredient substitutions should be identified and tested.
Receive and store items correctly; check deliveries, reject inappropriate substitutions, and label allergen special orders.
Maintain clean surfaces, utensils, and equipment; use fresh cleaning solutions; use separate identified equipment for allergen special orders.
Practice good personal hygiene; wash hands and change gloves before preparing orders for guests with allergies.
Prepare allergen special orders correctly; check the ticket, confirm with the server, follow recipes, and discard if cross contact occurs. Never add anything to a plated item.

People and Contamination

Food handlers can contaminate food through sneezing, coughing, having a wound with pathogens, contact with a sick person, and not washing hands after restroom use.
Carriers are people who carry pathogens and infect others without getting sick themselves.

Actions that Contaminate Food

Scratching the scalp, sneezing or coughing into hand, and wearing dirty clothing can contaminate food.
Rubbing an ear, wiping or touching the nose, touching a pimple or infected wound, or spitting can contaminate food.
Personal hygiene policies need to be created, revised, and staff should be trained on them; managers should supervise practices and model correct behavior.

Handwashing

Hands should only be washed in a sink designed for handwashing, never in food prep or dishwashing sinks.
The process involves wetting hands and arms with warm water, applying soap, scrubbing for 10-15 seconds (fingertips, under fingernails, between fingers), rinsing, and drying with a hand dryer or single-use towel.
Use a paper towel to turn off faucet and open the door when leaving the restroom.
If food handlers aren't washing their hands correctly, dispose of contaminated food, clean and sanitize utensils, and retrain food handlers.

When to Wash Hands

Before preparing food or working with clean equipment, after using the restroom, after handling soiled items, after touching your body or clothing, after handling raw meat/poultry/seafood, after taking out garbage, after sneezing/coughing/blowing your nose.
After eating/drinking/chewing gum/using tobacco products, after handling money, after handling chemicals, after touching animals, after leaving/returning to the kitchen, before putting on gloves, and after touching electronic devices.

Hand Antiseptics

Hand antiseptics should only be used after handwashing and must comply with CFR and FDA standards; allow to dry before touching food or equipment.

Hand Care

Keep fingernails short and clean; file them to avoid ragged edges; if food handlers wear nail polish or have false fingernails, they must wear single-use gloves.
Cover infected wounds on the hand with an impermeable cover (finger cot or bandage) and a single-use glove; arm wounds need to be covered completely with an impermeable cover, while wounds on other parts of the body must be covered with dry, durable, tight-fitting bandages.

Single Use Gloves

Gloves should be approved for food service, made for single use, and available in various sizes (consider non-latex). They aren't a replacement for correct handwashing.

Using Single Use Gloves

Staff should wash their hands before putting on gloves when starting a new task, holding them by the edge and checking for rips or tears.
Change gloves after handling raw meat, seafood, or poultry and before handling ready-to-eat food like salad; as soon as they become dirty or torn; before beginning a different task; and after four hours of continuous use.

Bare Hand Contact

Avoid touching ready-to-eat food with bare hands, wear gloves; bare hand contact is okay when washing produce or when handling ready-to-eat ingredients for a dish that will be cooked to a required minimum temperature.

Personal Cleanliness and Hygiene

Shower or bathe before work; wear clean clothes; keep hair out of food with a clean hat or hair covering (limit accessories, and use beard restraints for facial hair).
Store street clothes and personal items in designated areas to prevent contamination; remove aprons and store them correctly when leaving food prep areas; do not wipe hands on aprons.
Remove jewelry (bracelets, medical bracelets, watches, and rings - except for plain band rings) from hands and arms before prepping food; servers can wear jewelry if allowed by company policy.
Staff should only eat, drink, smoke and chew gum or tobacco in designated areas away from food prep areas; use containers with sip lids or lids and straws if drinking in food prep areas.

Sick Employees

Staff must let managers know when they are sick, even new staff; the regulatory authority may ask to see proof that you've done this with signed agreement statements from staff.
Depending on the illness, employees may need to be restricted (from working with exposed food, utensils, or equipment) or excluded (from coming to work).

Illnesses and Actions

Sore throat and fever simultaneously = restrict from working with exposed food, utensils, or equipment unless they primarily serve a high-risk population in which case they should be excluded from the operation. They shouldn't return to the operation or food handling duties until they get a written release from a medical practitioner.
Infected wound with draining fluid = restrict from working with exposed food, utensils, and equipment.
Persistent cough and runny nose causes discharge from the eyes, nose, or mouth = restrict from working with exposed food, utensils, and equipment.
Vomiting or diarrhea from an infectious condition = they shouldn't return to work until they either get a written release from a medical practitioner or until they have had no symptoms for at least twenty four hours.
Jaundice for less than 7 days = excluded; report to the local regulatory authority; written release is required.
Diagnosed with Salmonella typhi or hepatitis A (or vomiting/diarrhea + Norovirus, Shigella, Nontyphoidal Salmonella, or Shiga toxin producing E. Coli) = exclude
If any employees are diagnosed with an illness, work with a medical practitioner and local regulatory authority in order to determine if they should be excluded or restricted from working with exposed food. Then, they can help determine when the person can handle food again.
Report any diagnosis of a big Illness to the Local Regulatory Authority.

Maintaining Health and Oversight

Pay attention to the health of your staff i.e. nasal discharge, cold sweats, yellowing, employees who are vomiting, or taking excessive trips to the bathroom.