Fear of Fresh A Primer on Produce Safety

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Fear of FreshA Primer on Produce Safety

• Barbara Brown, Ph.D., R.D./L.D.
• Food Specialist
• Oklahoma Cooperative Extension Service

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The Kyle Allgood story

• Would have been 3 in December
• Lived in Chubbuck, Idaho
• Died September 30 from E. coli O156H7 infection
• Drank fresh spinach smoothie his mom made for him

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Jillian Kohl

• Graduate student in Milwaukee
• Ran marathons
• Ate fresh spinach
• Suffered stomach cramps, muscle aches, fever,
  bloody diarrhea
• 2-1/2 weeks in hospital
• Discharged with less than 10 normal kidney
  function

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Its happened before

• 2003
• 16 cases, 2 deaths from spinach contaminated with
  E. coli O157H7
• Since 1995
• 19 outbreaks of E. coli O157H7 associated with
  leafy greens
• Most traced back to California

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How bad is the foodborne illness problem?

• 76 million illnesses/year
• 5,000 deaths/year
• High risk groups elderly, young children,
  pregnant women fetuses, immuno-compromised
• Rate of foodborne illness is not rising
• 29 decrease in infections related to meat/poultry

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Definitions

• Outbreak
• 2 or more people consumed same contaminated food
  come down with same illness
• Has an identified etiology food vehicle
• Must have occurred in U.S. or its territories
• Can affect 100s or 1,000s
• Case 1 person with foodborne illness
• May or may not be part of outbreak

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10 federal agencies involved in food safety

• 2 inspect regulate food
• USDAmeat poultry
• FDAall other foods
• 2/3 outbreaks under FDA jurisdiction
• Neither has power to recall food
• Is voluntary

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Foods that cause foodborne illness (source CSPI
2005)
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Is produce riskier now?

• Yes
• Outbreaks bigger more frequent than 15-30 years
  ago
• Partly because people eat more fresh fruits
  vegetables

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Why the risk with ready-to-eat fresh produce?

• Generally grown in natural environment (field or
  orchard)
• Often eaten without cooking or other treatments
  that could eliminate pathogens

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Routes of contamination

• Water
• Contaminated irrigation water
• Run-off
• Cleaning water

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Routes of contamination

• Direct application of inadequately processed
  manure to soilby animals or as fertilizer
• Nearby pasture, down hill from feedlot, wild
  animals roaming fields

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Routes of contamination

• Cross-contamination
• Unwashed hands/surfaces
• From raw foods in kitchen

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Contamination compounded by

• Held too long in storage
• Temperatures too high
• Rough surface on produce hard to cleaneven
  surfaces that appear smooth

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Contamination compounded by

• Bacteria enter produce cannot be washed away

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Contamination compounded by

• Distribution process leaves difficult trace-back
  of process
• Large boxes broken down repackaged without
  point-of-origin info.
• Parts of many plants in 1 bag

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Symptoms of E. coli O157H7 illness

• Symptoms appear within 3-4 days
• May take up to 10 days
• Diarrhea, often with bloody stools, severe
  abdominal cramps
• Some have no symptoms
• Most healthy adults recover in a week
• 3-8 of people develop hemolytic uremic syndrome
  (HUS)

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HUS

• Form of kidney failure
• Most often in young children elderly
• Red blood cells destroyed
• E. coli toxin damages blood vessels by creating
  small strands across the insides so as red blood
  cells go through they are sliced
• 3-5 of those with HUS die

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E. coli O157H7 Outbreak Case Counts by State (As
of 10/06/06 CDC)
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Number of persons with outbreak strain/state
(CDC)

• Arizona 8
• California 2
• Colorado 1
• Connecticut 3
• Idaho 7
• Illinois 2
• Indiana 10
• Kentucky 8
• Maryland 3
• Maine 3
• Michigan 4
• Minnesota 2
• Nebraska 11

• New Mexico 5
• Nevada 2
• New York 11
• Ohio 25
• Oregon 6
• Pennsylvania 10
• Tennessee 1
• Utah 19
• Virginia 2
• Washington 3
• West Virginia 1
• Wisconsin 49
• Wyoming 1

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Investigation of outbreak

• Widely dispersed illnesses indicated
  contamination early in distribution chain

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State agencies workedclosely with FDA

• Especially California Dept. of Health Services
  Dept. of Food Ag.
• Western Institute for Food Safety Security

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Investigation found

• Same strain of E. coli O157H7 DNA as in the
  illness outbreak in samples taken from stream
  feces of cattle wild pigs present on ranches
  implicated in outbreak
• Found evidence of wild pigs in spinach fields
• Continue looking for more information on source
  mechanism of contamination

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Produce most apt to haveE. coli O157H7

• Recurrent outbreaks from leafy greens, sprouts,
  unpasteurized juices cider
• Common factors grown fairly close to ground or
  harvested from ground, not cooked, not acidic
• Popular apple/tomato varieties are becoming less
  acidic sweeter

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Spinach not alone

• Nov. 2006 FDA notifies consumers tomatoes in
  restaurants were linked to Salmonella Typhimurium
  outbreak

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Salmonella Typhimurium outbreak

• Reported in 21 states, 183 cases of illnesses to
  the CDC
• Outbreak over by time of announcement

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FDA actions to reduce risk

• 1998Guide to Minimize Microbial Food Safety
  Hazards for Fresh Fruits and Vegetables

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FDA actions to reduce risk

• 2004FDA Produce Safety Action Plan objectives
• Prevent contamination of fresh
• Minimize public health impact of contamination
  when it happens
• Improve communication
• Facilitate research relevant to contamination of
  fresh produce

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2006Lettuce Safety Initiative

• Assess current industry approaches actions to
  address issue of improving lettuce safety
• Stimulate segments of industry to further advance
  efforts in addressing all aspects of improving
  lettuce safety
• Alert consumers early respond rapidly in event
  of outbreak

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2006Lettuce Safety Initiative

• Document observations that identify practices
  that potentially lead to product contamination,
  develop /or refine guidance policy that will
  minimize opportunities for future outbreaks /or
  identify research needs
• Consider regulatory action based on conditions
  practices that could lead to, or spread,
  contamination or when lettuce has been adulterated

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Potential safeguards

• Cooking to 160oF for 15 seconds
• Irradiation?
• FDA has been petitioned to allow
• Suitability efficacy to be determined

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So what do consumers do?

• Option Quit eating raw produce

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FDA advice buying fresh produce

• Purchase produce not bruised or damaged
• Check package date
• Eat greens by "Best if Used by Date"

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Caution on greens

• Do not buy prewashed salads with considerable
  amount of brown-edged pieces or if greens appear
  excessively wet

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Consumer resource

• Available at
• http//www.cfsan.fda.gov/dms/prodsafe.html

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Buying fresh produce

• For fresh cut produce (such as 1/2 watermelon,
  bagged mixed salad greens) choose only those
  refrigerated or surrounded by ice

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Buying fresh produce

• Bag fresh fruits vegetables separately from
  meat, poultry seafood products when packing
  them to take home from market

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Storage tips for fresh produce

• Certain perishable fresh fruits vegetables
  (like strawberries, lettuce, herbs, mushrooms)
  can be best maintained by storing in a clean
  refrigerator at 40F or below

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Refrigeration needed?

• To maintain quality, safety
• Ask grocer

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Storage tips for fresh produce

• All produce purchased pre-cut or peeled should be
  refrigerated within 2 hours to maintain quality
  safety
• Keep refrigerator at or below 40F
• Use refrigerator thermometer

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Preparation of fresh produce

• Pre-washed greens in sealed bags
• Will be stated on packaging
• Can use without further washing
• Can wash again just before use as extra caution
• Wash precut or prewashed produce in open bags

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Preparation of fresh produce

• Cut away damaged /or bruised areas before
  preparing /or eating
• Discard produce that looks rotten

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Preparation tips

• All unpackaged fruits vegetables those
  packaged not marked pre-washed, should be
  thoroughly washed before eating
• Includes conventionally or organically grown,
  home grown produce bought from grocery stores
  farmer's markets

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French lesson

• French salade
• English lettuce
• Example Phrase Using Word
• French Ah, Robert, est-ce que tu peux laver la
  salade?
• English Robert, can you wash the lettuce?

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About washing produce

• First wash hands
• 20 seconds with warm water soap
• Before after preparing fresh produce
• Wash fruits vegetables under running water just
  before eating, cutting or cooking
• Even when planning to peel produce before eating,
  important to wash it first

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About washing produce

• Soap, detergent, commercial produce washes not
  recommended
• Scrub firm produce with clean produce brush
• Drying produce with clean cloth or paper towel
  may reduce bacteria that may be present

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Does washing help?

• Bacteria are sticky, cant wash off greens even
  if bleach, detergent, commercial produce washes
  are used
• Cant wash off bacteria if inside produce
• Enters apples through hole at bottom where flower
  used to be
• Sliced into melons

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Separate for Safety

• Keep produce to be eaten raw separate from other
  foods, such as raw meat, poultry or seafood
  kitchen utensils used for those products

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Reducing cross-contamination risk

• Wash cutting boards, dishes, utensils counter
  tops with hot water soap between preparation of
  raw meat, poultry, seafood produce
  preparation of produce that will not be cooked or
  only briefly cooked
• Wash plastic other non-porous cutting boards in
  dishwasher after use

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Reducing cross-contamination risk

• Kitchen sanitizers can be used on cutting boards
  counter tops periodically
• 1 teaspoon chlorine bleach/1 quart water

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What do we tell consumers

• Health benefits still outweigh risk
• Use selection handling practices that reduce
  risk
• Be alert for health bulletins
• Especially people in high risk groups
• We need a whole lot more research on food safety
  fresh produce

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