1/4/2010. Listeria Control and Safe Food Training for Dietary Managers Presented by: Listeria Control and Safe Food Training for Dietary Managers

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1 Listeria Control and Safe Food Training for Dietary Managers HACCP Plan Implementation to Control Listeria monocytogenes Listeria Control and Safe Food Training for Dietary Managers Presented by: Dr. Patricia Kendall, R.D. Professor and Extension Food Safety Specialist Department of Food Science and Human Nutrition Colorado State University Hanaa Thigeel, Master s Student Department of Food Science & Human Nutrition Colorado State University 1. Why elderly at high risk of foodborne illness 2. Listeria risk factors 3. Controlling Listeria through HACCP Overview 4. Cleaning and sanitizing protocols 5. Employee training 6. Other foodborne pathogens of importance to elderly 7. Food irradiation Increase in Aging Population (+65 years old) in the U.S. 20% 18% 16% 14% 12% 10% 8% 6% 4% 2% 0% Elderly in 1950 Elderly in 2000 Elderly in 2030 Aging and the Immune System Immune system affected by aging >20% of elderly over age 65 do not develop fever when they have serious bacterial infections. Aging affects lymphocytes configuration & their reaction to infection. 1

2 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 & salmonellosis ll 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 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 exposure Fever, Muscle aches, Headache, Loss of balance Bacteremia, Convulsions Meningitis, Encephalitis High death rate (10-20%) among persons >60 yrs Listeria Risk Factors Temperature Danger Zone Temperature: The growth range = F. Grows and multiplies at refrigeration temperatures (<40 F) Can survive but not grow at freezing temperatures (0 F) Easily destroyed by cooking or reheating 2

3 9 log10 cfu/ml Time (days) Growth of Listeria monocytogenes CFA 433 in chicken broth when incubated at , 34.7, and 33.4 o F. Adapted from S.J. Walker et al. (1990). 47.7F 38.3F 34.7F 33.4F Listeria Risk Factors Vacuum Packaging: Vacuum packaging allows growth of Listeria in long-term refrigerated storage. Listeria Risk Factors Water Activity and Salt: Most fresh foods have aw > 0.98 Listeria grows better in moist environment: Optimal water activity a w 0.97 But can grow & multiply at a w 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 Listeria can tolerate lower ph when kept at near refrigeration temperatures (vs. room & body temperatures) Listeria Biofilms The 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 biocides. A dental plaque is a biofilm Courtesy, ASM Image Library 3

4 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 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 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-contamination contamination. To avoid this, slicers must be cleaned & sanitized after each use and between each food item change. 4

5 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 postprocessing 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 without further heating) Cold pates,& cold meat spreads Cold smoked fish (lox, kippered) Soft cheeses (made with raw milk) - Camembert, brie, Mexican-style & blueveined 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 Contamination 3. Frequent Cleaning and Sanitizing 5

6 Safe Storage Time and Temperature Control Store refrigerated foods at 41 F or below. If 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 environment, 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 handwashing or dirty uniforms can lead to contamination of food with Listeria. Control of Listeria monocytogenes through HACCP What is HACCP? Hazard Analysis Critical Control Points: A management tool used to control biological, chemical & physical hazards at any step of the food flow. 6

7 The Food Flow Purchasing Receiving Storing Preparation Cooking Cooling Reheating Holding Serving HACCP Is: Preventive, not reactive Not a zero-risk system. Designed to minimize i i the risk of food safety hazards. HACCP Principles 1. Conduct a hazard analysis 2. Determine critical control points (CCPs) 3. Establish critical limits (CLs) 4. Establish monitoring procedures 5. Identify corrective actions 6. Verification procedures 7. Record keeping procedures 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. Hot dogs or lunch meats can be used if reheated to 165 F or until steaming hot. Source: National Advisory Committee on Microbiological Criteria for Foods Hazard Analysis Determine how food is processed in your operation 1. Prepping & serving without cooking: 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 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? Other questions. Is there any potential contamination that may occur after cooking the food? Is the food a ready-to-eat food in reduced oxygen packaging? Does the recipe incorporate leftovers? 7

8 Conducting Hazard Analysis Example Ham 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. Sodium lactate t and sodium diacetate t 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 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 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 Flow Purchasing Receiving Storing Preparation Cooking Cooling Reheating Holding Serving CCP1 CCP2 CCP3 CCP4 CCP5 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. 8

9 Receiving CCPs and CLs Microbial growth and contamination can occur if food was received at temperature that does not meet the recommended receiving temperature. t 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 Roast beef, pork, veal and lamb Whole or ground poultry. Stuffing made with PHFs, stuffed meat, poultry, seafood, or pasta. Dishes that include previously cooked PHFs. Minimum Internal Temperature 145 F for 4 minutes 165 F for 15 seconds Fish, shellfish h & crustaceans. Steak/ chops of pork, beef, veal 145 F for 15 seconds & lamb. Eggs to be served immediately. Ground meat & ground seafood, injected meat, eggs that will be hot-held for service. Commercially processed RTE (cheese sticks, deep fried vegetables) that will be hot held for service. 155 F for 15 seconds 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: 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. Fruit, vegetables, grains (rice, pasta) & legumes (beans, refried beans) that will be hot-held for service. 135 F 9

10 Reheating CCPs and CLs RTE food products that must be reheated before use: 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. 10

11 Record Keeping Examples Receiving logs record receiving temperatures of products or ingredients. 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 11

12 General Cleaning and Sanitizing Guidelines Clean the surface. Rinse the surface. Sanitize the surface. Allow the surface to air-dry. Commonly Used Sanitizers Chlorine containing compounds Quaternary Ammonium Compounds (QACs) ServSafe Factors Affecting Sanitizers Temperature of solvent Concentration of sanitizer ph Exposure time Organic matter on surface Cleanability of equipment Pro-Quat Towels Chicopee Towels Common Household Products Effective against Listeria Hydrogen Peroxide H2O2 White Vinegar Hydrogen Peroxide and Distilled White Vinegar Hydrogen Peroxide (H2O2) Environmental friendly, non corrosive Generally considered safe 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 12

13 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 Proper Handwashing Personal hygiene Thermometer calibration 1. Wet your hands 2. 2Apply soap with hot running water 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 Work attire: Personal Hygiene Policies for eating, drinking, smoking, and chewing gum or tobacco 13

14 Ice-Point Method Calibrating Thermometers 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 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) 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 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: hours; duration 4-7days. 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). 14

15 Norovirus Spread through food, drink direct contact Onset: hr of exposure. Nausea, vomiting, diarrhea & cramps 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 (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 consumption 15

16 Irradiation Logo Foods Approved for Irradiation Fruits & vegetables. Meat & Poultry. Fish & seafood. 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- irradiated 3-5 days. Reduces sprouting & delays ripening Low dose irradiation may be implemented during postpackaging 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 safe food handling! Thank You!! 16