Foodborne illnesses are diseases transmitted to people through food. 'An outbreak of foodborne illness occurs when a group of people consume the same contaminated food and two or more of them come down with the same illness' (CDC, 2004). Table 1 contains a list of common foodborne-illness pathogens, along with their sources, symptoms, and methods of prevention.
The Centers for Disease Control (CDC) estimate that over 76 million people in the United States are sickened with a foodborne illness each year. Of those cases, over 300,000 require hospitalization and about 5000 result in death (Mead et al., 1999, as reported by the CDC). Worldwide, the numbers are suspected to be much higher; however, because of variations in reporting methods or lack of reporting altogether, it is difficult to get an accurate estimate of the true magnitude of the problem. Table 2 breaks down by percentage of total infections the pathogens responsible for making people sick.
Development and implementation of an effective HACCP program (Hazard Analysis of Critical Control Points) by the operator may significantly reduce the risk of an outbreak of foodborne illness. In addition, food handlers must be thoroughly trained and constantly retrained in proper food safety and sanitation procedures. Food Safety Update (2001) offers five basic tips to increase the effectiveness of training programs. These include:
- Promote participation: Get employees involved in the training—the more interactively, the better.
- Make it relevant: People prefer listening to what's real over what's theoretical. Encourage storytelling; everyone has one.
- Offer rewards: What gets measured gets done. Create incentives that encourage people to do what's right.
- Link food safety to performance: Assess employees' knowledge of food safety and sanitation during the review process and reward them accordingly.
- Lead by example: Walk the talk. Managers must always provide the model they want their employees to emulate.
Beyond instituting meaningful training as a means of illness prevention, foodservice operators should encourage the development of good personal hygiene habits among those who handle food. Proper hand washing (which includes the use of soap, a nail brush, and at least 20 seconds of time) is one of the simplest, yet most effective, methods of stopping the transference of Page 248
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disease-causing pathogens from hands to food. 'Clean' (free of visible dirt) and 'sanitary' (free of disease-causing pathogens) are two very important words when it comes to protecting the public from foodborne illness.
|Table 1 Common foodborne illness pathogens|
|Source: CDC (2004)|
|Norwalk-like virus||Shellfish, beef, chicken, pork, salads, dressings, infected worker||Diarrhea, abdominal cramps, nausea, vomiting, fever; 10-51 hours||Thorough cooking, rapid chilling, proper hand washing, hold at below 40 °F (4 °C) or above 140 °F (60 °C)|
|Campylobacter||Raw milk, uncooked chicken, raw hamburger, water||Nausea, cramps, headache, fever, diarrhea; 1-10 days||Thorough cooking, use boiled/treated water|
|Salmonella||Undercooked poultry, eggs or foods containing such; meat, dairy products||Abdominal pain, diarrhea, chills, fever, vomiting, cramps; 6-72 hours||Thorough cooking; clean/sanitized hands, utensils, surfaces; prompt refrigeration|
|Clostridium perfringens||Soups, stews, gravies held at warm temperatures||Nausea, vomiting, pain, diarrhea; 6-24 hours||Thorough cooking, rapid chilling, hold at below 40 °F (4 °C) or above 140 °F (60 °C)|
|Giardia lamblia||Contaminated water, infected worker||Sudden diarrhea, cramps, nausea, vomiting; 1-3 days||Use boiled/treated water, proper hand washing|
|Escherichia coli||Contaminated ground beef; unpasteurized juice, milk, cider; water||Cramps, bloody diarrhea, fever, vomiting; 12-72 hours||Cook ground beef to 160 °F (71 °C); consume pasteurized products; boiled/treated water; clean/sanitized hands, utensils, surfaces|
|Staphylococcus||Meats, salads containing proteins, sauces, reheated foods||Nausea, vomiting, cramps, diarrhea; 1-6 hours||Thorough cooking, hold at below 40 °F (4 °C) or bove 140 °F (60 °C), proper hand washing, open sores properly covered|
|Shigella||Moist foods, dairy products, salads, water, infected worker||Diarrhea, fever, vomiting, cramps; 1-7 days||Use boiled/treated water; clean/sanitized hands, utensils, surfaces|
|Listeria||Unwashed vegetables, unpasteurized dairy products, improperly processed meats||Flu-like symptoms with fever and nausea, pregnancy interruption; 4 days to 3 weeks||Thorough cooking, use pasteurized products, wash produce|
|Hepatitis A virus||Infected worker, water, seafood from polluted waters||Nausea, abdominal pain, weakness/discomfort, fever||Proper hand washing, use boiled/treated water, use reputable suppliers|
Finally, it should be noted that a foodborne illness does not have to affect many people in order to be considered an 'outbreak.' In fact, an outbreak is defined as an incidence of foodborne illness that involves two or more people who eat a Page 249
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common food, which is confirmed as the source of the illness through laboratory analysis (National Restaurant Association, 1992). The only exceptions, which qualify an outbreak on the basis of only a single incidence, are those that result from botulism or a chemical-caused outbreak.
|Table 2 Estimated percentages of foodborne pathogens leading to illness in the United States|
|Source: Mead et al. (1999), as reported by the Centers for Disease Control|
|Hepatitis A virus||<0.1|
CDC (Centers for Disease Control) (2004) Foodborne Illness. Available at http://www.cdc.gov/ncidod/dbmd/diseaseinfo/foodborneinfections_g.htm#whatoutbreak . Accessed 11 March 2004.
Food Safety Update (2001) Five basic training tips. Food Safety Update, 13.
Mead, P., Slutsker, L., Dietz, V., McCaig, L., Bresee, J., Shapiro, C., Griffin, P., and Tauxe, R. (1999) Food-related illness and death in the United States. Emerging Infectious Diseases, 5 (5). Available at http://www.cdc.gov/ncidod/EID/vol5no5/mead.htm . Accessed 21 August 2002.
National Restaurant Association (1992) Applied Foodservice Sanitation. New York: John Wiley & Sons.
WASHINGTON STATE UNIVERSITY, USA