Salmonella typhi is famous.  It’s killed millions since it first received attention in 430 BC when it swept through Athens and killed one third of the population–including their leader, Pericles.  More commonly known as “Typhoid Fever,” salmonella typhi is identified as a “serious public health problem” by the World Health Organization (WHO).  Anywhere from 16-33 million cases worldwide are reported annually.  People still die from this disease today–about 216,000 per year–most frequently in locations where food is not cleansed and handled properly.

Salmonella typhi presents with a number of symptoms including fever, heavy sweating, abdominal cramps, diarrhea, headache, cough, bloody noses, and rose-colored spots.  Lasting for as many as four weeks, typhoid fever can also seriously affect the lungs, spleen, liver, and brain.  As with most salmonella strains, infection generally comes from cross-contamination of contaminated foods to clean, ready-to-eat foods.  Poor sanitation and personal hygiene are also major factors.  In locations where salmonella typhi is prevalent, animals and insects are in regular contact with both feces and ready-to-eat foods, spreading bacteria from one to the other.  In the United States, salmonella typhi infections have been reduced due to education about the importance of hand washing after using the bathroom and covering the mouth and nose when coughing.  In addition to these personal hygiene measures, we are also fortunate to enjoy modern plumbing and chlorinated water that separate us from the bacteria our bodies produce.

Unlike most foodborne illnesses, certain persons infected with typhoid fever may not even know they’re sick.  In one famous case, a woman named Mary Mallon infected 53 people during her career as a cook–three of whom died.  Although she denied being infected with salmonella typhi until her death, the disease followed her from home to home, leaving a trail of suffering in her wake.  Typhoid Mary unwittingly infected the families for whom she worked by coughing, sneezing, not washing her hands, and then handling ready-to-eat foods and preparing beverages.  The legacy she left behind when she passed away from unrelated causes, was the critical importance of hand washing, vaccination, and cooking food thoroughly. Click here and here for some period posters about the ability to prevent this disease.

Finally, here is a list of famous victims of salmonella typhi:

• Abigail Adams–second First Lady of the United States
• Louisa May Alcott–author of Little Women
• Charles Darwin–naturalist, author of On the Origin of Species
• Mary Todd Lincoln–wife of Abraham Lincoln
• Wilbur Wright–one of the Wright Brothers
• Anne Frank–famous diary writer (Diary of Anne Frank)
• Pericles–famous orator and statesman in ancient Athens

Facts Source:  Wikipedia

The U.S. Center for Disease Control (CDC) has successfully identified the culprit in a recent multi-state outbreak of typhoid fever:  sapote fruit.  Called “mamey” fruit in the U.S., the grapefruit-size Sapote is grown commonly in Mexico and has a sweet, juicy pulp commonly used in ice creams and milkshakes.  The CDC became involved when local health departments in California and Nevada began reporting consumers infected with typhoid fever.  About 400 Americans become ill with typhoid fever annually, most while traveling in South America.  This scenario was strange because the infected persons had not been outside the United States when they contracted the disease.

CDC officials report that frozen sapote fruit pulp, used in milkshakes consumed by every person involved in the outbreak, was infected with Salmonella Typhi–more commonly known as typhoid fever.  The distributor, Goya Foods, Inc., has recalled its 14oz bags of Sapote (mamey) Fruit Pulp which were distributed in Alaska, Arizona, California, Colorado, New Mexico, Nevada, Oregon, Texas, Utah, and Washington.   Unfortunately (and curiously) additional information is not available on the distributor’s website.

This morning the USDA announced a major recall of approximately one million pounds of frozen ground beef patties that may be contaminated with E. coli.    The California-based company, Valley Meat Co.,  distributed the suspect beef patties to vendors in California, Texas, Arizona, and Oregon.  Thirty separate products are included in the recall.  For a complete list and additional information about the recall, read their press release:  Valley Meat Co.

Do you know your summer food safety IQ?  The USDHHS website, Foodsafety.gov, has a short quiz to help you find out.  Don’t worry, if you’ve completed the StateFoodSafety.com™ Online Food Handler Course, you’ll do just fine.  Trust us . . . we got 100%.

What’s Your Summer IQ?

Foodsafety.gov is the official website of the United States Department of Health & Human Services.

Photo Credit:  British Foods Worldwide

ESPN’s “Outside the Lines” recently published their findings of a year’s worth of health department violations for all Major League football, hockey, baseball, and basketball stadiums in North America operating in 2009.  The comprehensive article entitled What’s Lurking in your Stadium Food? can be read in its entirety here.  The website contains an interactive map that divides all the stadiums by the percentage of concessions stands that received critical violations, from “No Violations” to “79-100%.”  The highest category (100%) means that every single concession stand in the stadium received a critical violation in 2009.

A “critical violation” as defined by health department officials, is a violation of safe food handling and storage procedures that could result in employee or consumer illness or injury.  However, as ESPN clarified, a critical violation can mean different things to different health departments.  “For example,” states the article, “some [health departments] consider mouse droppings a critical violation, while others classify them as a minor problem.”  Dexter King of the International Association of Assembly Managers explained that “different inspectors interpret different violations almost as a referee would look at it, ‘Should I call this a foul or not a foul?’”

We recommend reading the full article, but if you don’t have time, here are some highlights:

• 107 stadiums were investigated for this article.  Of those, 28% had received critical violation at more than half their concession stands.
• 11 stadiums received zero critical violations.
• 8 stadiums received critical violations at all of their concessions stands.  7 of those stadiums are located in Florida.
• California stadiums scored well, with the percentage of critical violations in the 1-25% range.
• Specific complaints and violations included chemicals stored too close to food, “slime” in frozen drink machines, food residue in coolers, insects mixed into frozen drinks, under-cooked meat, employees touching ready-to-eat food with bare hands, insufficient hand washing, time/temperature abuse, cross-contamination, and rodent infestations.
• Food establishment inspections are all carried out in different ways.  In some locations, inspections come from the state level (Florida) and others come from the city or county level (California).  Some inspectors drop in unannounced in the middle of a game (Kansas City, Missouri) and others schedule inspections days in advance (Chicago, Illinois).  Each of these factors can affect the establishment’s scores and violation numbers.

Source:  ESPN “Outside the Lines”

Photo Source:  Artichoke Heart

As an adult working the food safety industry, it horrifies me to think of how many food items my childhood self dropped on the floor and promptly picked up and put into my mouth.  I believed in the “5-Second Rule” like it was the 11th commandment.  In my young mind, it made perfect sense that the quicker I retrieved the tasty treat I had dropped, the greater were my chances of it arriving to my mouth “germ free.”  As I grew older I amended the rule:  “Does not apply if:  sticky, gooey, cheesy, or dropped in a public place/floor of car . . . “  That having been said, I admit that anything that qualifies as having a “candy shell” will probably still make it to my mouth after hitting the floor.  You would think I’d have a stronger immune system.

The July 2010 edition of National Geographic profiles the recent findings of Paul Dawson, Ph.D. and his graduate students (complete findings published in the Journal of Applied Microbiology).  He states, “The five-second-rule is a popular belief that if you drop food on the floor and pick it up within five seconds, it won’t be too germ laden to eat. It’s not true and we’ve proven it, it’s well, bologna.”  His study shows that foodborne illnesses like Salmonella can survive on a dry surface for up to four weeks and transfer immediately to food items upon contact.  In fact, the research was so conclusive that National Geographic has coined the new phrase “the Zero-Second Rule.”  That’s how much time, they state, your food has on the floor before it’s contaminated.  Bummer.

Sources:  National Geographic, Clemson University, Delish.com

Photo Credit:  Rebecca Hale, National Geographic Staff

On April 20, 2010, a section of British Petroleum’s (BP) Deepwater Horizon underwater oil pipeline burst, gushing oil into the Gulf of Mexico.  Since the initial incident, it has been difficult for experts and BP officials to determine how much oil has been and continues to spill into the gulf, although some experts put the number at well over a million gallons every day.  During the explosion of the pipeline, eleven men lost their lives.  Since then, countless people involved in the gulf seafood, tourism, and hospitality industries  have watched the spill threaten their livelihoods and even their health.

The safety of seafood from the Gulf of Mexico has been a major health concern since the spill.  The seafood industry around the gulf–and its impact on local restaurants, hotels, and other seafood vendors–amounts to hundreds of millions of dollars annually.  In fact, sales from seafood in the five states bordering the Gulf of Mexico totaled $662 million in 2008.   Due to the size and duration of the spill, and the fish and shellfish that may be living in such toxic waters, the security of the entire gulf seafood industry is in jeopardy.

Monday, in a press conference from a Louisiana spill sight, President Obama declared Gulf seafood currently safe for consumption (he even admitted to eating some for lunch!).  However, some food safety experts haven’t always been so confident.  In April, shortly after the oil rig exploded, officials from the FDA, EPA, and National Oceanic and Atmospheric Administration went to the gulf to collect samples of fish and shellfish which they found to be relatively free from oil–however safety testing is ongoing.  Regions of the gulf where fish have tested highly contaminated have been closed for fishing in order to protect the public.  Those regions will not re-open until the seafood there is determined by authorities to be free from contaminants.

Restaurants and consumers nationwide need not be concerned.  More than 83% of all seafood is imported into the United States, including 90% of all shrimp.  However, the financial impact on seafood vendors around the spill cannot be estimated until experts have a clearer idea of just how massive the spill will become–and how soon it can be stopped.

Photo Credit:  Rich Matthews, AP

The Washington Post published an interesting article this morning, spotlighting the recent E. coli outbreak associated with pre-cut, bagged lettuce that infected 23 people in four states during March and April of this year.  The lettuce was not purchased by consumers, but rather by several food service companies and supermarkets as part of their salad bars and prepared meals.  In fact, the majority of infected people were students at colleges in Michigan, Ohio, and New York who consumed the lettuce at their college dining halls.  This issue brings up an interesting question, however:  Are pre-cut, bagged vegetables more dangerous than whole vegetables?

First, how could E. coli, which is generally associated with animal feces, infect vegetables?  According to Caroline Smith De Wall, the food safety director at the Center for Science in the Public Interest, “The process of harvesting lettuce, chopping it or tearing, washing and putting it in a bag is a process similar to mixing ground beef.”  As any food handler should know, ground beef is potentially more hazardous than whole beef because bacteria on the outside of the meat is mixed into the center during the grinding process.  The same is true for lettuce, and other leafy greens which are grown in fertilized soil.  Fertilizer is largely composed of animal feces, and therefore is full of E. coli and other contaminants.  So when vegetables are processed for packaging, greens from multiple farmers’ fields (both contaminated and uncontaminated) may be tossed in and cut together–infecting all the produce.

Still, there are strong arguments on both sides of this debate.  Those who believe bagged vegetables are more dangerous argue that chlorine spray used to clean the produce before it is packaged does not kill enough of the bacteria.  Whereas when consumers purchase whole vegetables, they will commonly remove the outer leaves, thus physically removing the majority of potentially infectious bacteria.

James Gorny, senior advisor for produce safety at the FDA disagrees with the idea the bagged produce is more dangerous.  He stated that “bagged greens represent a disproportionate number of recalls, chiefly because they’re easier to identify than whole produce.  When you buy a head of lettuce, you have no idea what the brand name is, or who the grower is–so tracing it back is that much harder.”  Essentially he is stating that because the source of contaminated bagged vegetables is so much clearer than for whole vegetables, complaints about foodborne illness for those products is much higher.  In addition, it is much easier for health department officials to trace the source of the infection for packaged produce, and so it often appears as though pre-cut vegetables are more dangerous, even though they may not be.

Unfortunately there is no clear statistic proving that either whole or pre-cut vegetables are more dangerous.  In order to keep your patrons, family, and employees safe at the salad bar–wash your veggies.  Even if the bag states “pre-washed” it is always a good idea to rinse your leafy greens and vegetables that will be served as ready-to-eat items.  There are also several vegetable washes on the market that may be advisable for households with at-risk individuals.  For additional guidance, contact your health department.

Federal health officials are warning the consumer public to stay away from oysters harvested in the “Area 7″ near Port Sulpher, LA.  Area 7 is located in the Gulf of Mexico, near the mouth of the Mississippi River.  After a dozen people became sick after eating raw oysters, the state health authorities notified the FDA that the oysters-in-question were contaminated with Norovirus–which causes acute gastroenteritis.  Gastroenteritis is a fancy word for “food poisoning” or “the 24-hour flu.”  Symptoms frequently include stomach pain, nausea, vomiting, diarrhea, and chills.

Oysters, and other shellfish, are animals that live underwater.  Because you eat their entire body (except the shell) you also consume the organs the animals use to filter impurities from the water.  Traditionally people commonly ate shellfish raw, but today many shellfish live in water that has been contaminated by harmful toxins that remain in the shellfish.  The meat can become harmful to humans if not cleaned and cooked thoroughly.  Once cooked, most shellfish are perfectly safe to consume.

Again, the FDA has warned people not to consume oysters from the Area 7 location in Louisiana.  If you are a food vendor and are unsure from where your shellfish originated, please contact the distributor.  If you serve oysters or other shellfish raw, please ensure you place a health notice on your menu to inform the consumer of any possible risks involved with eating raw shellfish.

Source:  FDA

Salmonella

When talking about food safety, salmonella is a disease that gets brought up frequently.  This year, salmonella has prompted hundreds of food recalls from items as diverse as salami, tortilla chips, and salad dressing.  During the past few years, health officials have identified the bacteria in eggs, peanuts, black pepper, spinach, meat products and the list goes on and on.  Salmonella contamination becomes an even greater issue when contaminated food items are sent to multiple locations as ingredients as other products.  It becomes extremely difficult to trace where the infection began, and how far it spread.  This year alone, salmonella-contaminated black pepper was distributed as an ingredient in Italian-style deli meats, which then infected 252 people in 44 different states!  The same contaminated black pepper has also sparked countless spice, snack, and condiment recalls since January 2010.

Of the 2,000 strains of salmonella, only about a dozen can infect humans.  Still, the number of persons infected annually remains high from year to year.  The CDC estimates that there are a 1.4 million cases of salmonella infection each year in the United States, with only about 3% officially reported.  These numbers make is clear that it is impossible to overstate how crucial it is that food handlers become aware of this disease and how to protect consumers from it.

A few things to know about Salmonella:

• Salmonella can be transmitted from animals to humans (see Kissing Frogs) and from food to humans.
• Persons at greater risk for serious infection include infants, small children, chronically ill persons with weak immune systems, and the elderly.
• Salmonella can survive for weeks outside a living body.
• Salmonella is not destroyed by freezing.
• An infectious dose of salmonella can be as small as 15-20 cells (bacteria).
• Incubation period–the time it takes to get sick once a patient has contracted the disease–is anywhere from six to 72 hours.
• Common symptoms of salmonella infection include exhaustion, nausea, vomiting, and diarrhea (which can be bloody in serious cases!).

What can you do to prevent salmonella infection in the workplace?  One of the first things each food service employee must do to prevent infection of any kind is wash their hands.  For salmonella-specific prevention, the Mayo Clinic recommends the following practices:

1. Cook poultry, ground beef, and eggs thoroughly before eating (or serving).   Poultry specifically must reach 160º F throughout before it can be served.
2. Eggs must be cooked until they have a hard yoke.  Pasteurized eggs may also be used.  If consumers insist on soft yokes, they must be made aware of the risk of salmonella infection.
3. Never consume or serve raw milk.  Milk must be pasteurized to be used in a consumer setting.
4. Wash and sterilize hands, utensils, and surfaces immediately after they have come in contact with foods of animal origin.
5. Be extremely cautious when preparing food for babies, children, sick persons, or the elderly as they are at a greater risk of infection.

If you have additional questions about salmonella and how to prevent it, please contact your local health department.

Sources:  Mayo Clinic, Wikipedia