MINNESOTA DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH
Spring 2008
Volume 2, Issue 2
PWDU Quarterly Update
Partnership and Workforce Development Unit
Delegation Agreement Advisory Council Update
BACKGROUND
DELEGATION AGREEMENT
MANUAL WORKGROUP
April 2008 marks the first anniversary of the Delegation Agreement
Advisory Council commissioned by
MDH to review the draft Delegation
Agreement for Environmental
Health (EH)
Services.
Attorneys for one county and two
cities have provided reviews of the
draft Delegation Agreement. One or
two more reviews have been promised after the Advisory Council has
signed off on the document.
Delegated jurisdictions who
would like to review the document may contact April Bogard
at 651-201-5076.
Manual writing groups have completed work on an Introduction and
the first eight Sections of the manual,
initially focusing on food programs,
and using the FDA food program
standards as a guideline.
The Advisory
Council has held
eight day-long meetings in the past year.
That work has
resulted in a nearfinal draft of the
Delegation Agreement and the
following recommendations:
•
Continuation of the Delegation
Agreement Advisory Council in
some form;
•
Reinstitution of regular meetings among state and local EH
leaders;
•
•
•
Formation of a workgroup to
design a process for evaluation
of statewide EH programs;
Formation of a workgroup to
write a best practices manual,
including recommendations and
materials from state and local
EH programs; and
Recommendations for the implementation of the new Delegation Agreement.
Each of these Advisory Council
recommendations is in the process
of implementation.
LEADERSHIP ROUNDTABLE
While Environmental Health
Division Director, John Stine
remains committed to the
development of an EH Roundtable,
Director Stine and other staff have
been heavily involved in legislative
matters this session. Planning for
statewide EH meetings will resume
when the session is over.
EVALUATION
An Evaluation Workgroup consisting of MDH and delegated program
staff have met twice-monthly since
early November 2007. They are
charged with three related tasks:
•
Developing a process, and
tools for evaluation of MDH and
delegated programs;
These drafts are currently in the
hands of additional MDH and local
staff for review and revision. Writing
groups responsible for content related to other program areas (pools,
lodging, mobile home parks, etc.)
have also begun to add their program-specific material to the Manual.
IMPLEMENTATION
Advisory Council members agree
that the document can be finalized
by June 1, 2008. Implementation
planning, including timing, a sunset
date for the old Agreement, and
communications strategy will be
completed at the April and May
meetings of the Advisory Council.
In This Issue
Advisory Council Update
1
About Salmonella
2
3
•
Developing a self-assessment
process; and
Coughing Video / Handwashing with
a Nailbrush / Cooking for a Crowd
•
Drafting of the evaluation section of the Manual.
Pool Legislation / CDC Pool
Guidance / Beef Recall
4
Freedom to Breathe / Naked Sushi
5
Note from April Bogard
6
PWDU Staff Contact Information
6
A draft evaluation tool is expected
by May 1, 2008.
Page 2
PWDU Quarterly Update
Quarterly Bug Report - Salmonella
About Salmonellosis
Salmonellosis is an infection with a
bacteria called Salmonella. Salmonella live in the intestinal tracts of
animals, including birds. Salmonella are usually transmitted to
humans by eating foods contaminated with animal feces.
Every year, about 40,000 cases of
Salmonellosis are reported in the
United States; 600 to 700 cases are
reported annually in Minnesota.
Because many milder cases are not
diagnosed or reported, the actual
number of infections may be 30
or more times greater.
Symptoms include diarrhea, fever,
abdominal pain, and cramps.
Symptoms usually begin within 12
to 72 hours after exposure, but can
begin up to a week after exposure.
Salmonella infections usually
resolve in 5-7 days.
Contaminated foods are often of
animal origin, such as pork, beef,
poultry, milk, or eggs, but all foods,
including vegetables may become
contaminated.
Raw foods of animal origin are
frequently contaminated. We rely
on thorough cooking to kill
Salmonella in these foods.
Food may also become contaminated by the unwashed hands of an
infected food handler who did not
wash his or her hands adequately
after using the bathroom.
Salmonella may be found in the
feces of some pets. Reptiles and
baby chicks/ducks are particularly
likely to harbor Salmonellosis.
People can become infected if they
do not wash their hands after contact with these, and other animals.
SALMONELLA IN THE NEWS
In October 2007, seven cases of
Salmonellosis were reported to the
Minnesota Department of Health.
These cases matched a larger
outbreak—about 150 cases—
already being tracked by the Centers for Disease Control (CDC).
MDH joined a nationwide case
control study, and began to look at
chicken, breaded chicken products,
and eggs. Researchers noted that
cases in Minnesota and Wisconsin
fit the microwave
foods demographic,
defined as sevento-ten year olds,
and 20- to 30-year
old males.
Interviews in Minnesota revealed
three cases who
mentioned eating microwavable
Banquet pot pies. MDH notified the
CDC of this finding. By November,
more than 300 cases in 38 states
had been linked to the pot pies.
SAFE FOOD—STEAMING HOT
The national investigation into this
outbreak revealed that undercooking was a likely contributing factor.
Although Salmonella in food can be
killed by thorough cooking, the bacteria can survive undercooking or
uneven cooking, as can happen in
many microwave ovens.
Banquet package fronts advertised,
“Ready in 4 minutes!” Instructions
on the reverse side advised consumers to cook the pies for four
minutes in a medium or high wattage microwave, or for six minutes in
a low wattage microwave. This instruction presumes that consumers
will know whether their ovens are
high, medium, or low wattage.
The package also advised consumers to let the product stand for three
more minutes after cooking. It did
not explain that this is necessary to
allow heat to distribute in the pie.
After the pot pies were associated
with this outbreak, a company
spokesperson said that “A good
sign that the pot pie is done is when
steam rises out of it.” Food safety
experts did not endorse this view,
saying that there were many circumstances when steam may be
present and the product may not
have reached a safe temperature.
ConAgra has since revised pot pie
cooking instructions to advise the
use of a food thermometer to
determine when the centers of the
pies reach 165 degrees F.
AND IN THE NEWS AGAIN
On March 28, 2008 an MDH press
release warned that two (now three)
cases of Salmonellosis in Minnesota had been linked to raw, frozen,
breaded and pre-browned, stuffed
chicken entrees. This was the fifth
Minnesota outbreak of Salmonellosis linked to these types of products
since 1998. Once again, consumers
were warned to make sure that all
raw poultry products are handled
carefully and cooked thoroughly,
and to avoid cooking raw chicken
products in the microwave because
of the risk of undercooking.
Salmonella Information:
Minnesota Department of Health:
http://www.health.state.mn.us/divs/idepc/
Centers for Disease Control (CDC):
http://www.cdc.gov/ncidod/dbmd/diseasei
nfo/salmonellosis_g.htm and
http://www.cdc.gov/salmonella
Page 3
PWDU Quarterly Update
Odd and Ends - From Our Friends
COUGHING CORRECTLY
The University of Missouri (MU)
Extension Service knows that
catching a cough correctly can
minimize the spread of germs and
disease.
As part of their effort to promote
good coughing and sneezing techniques, the MU Community Emergency Management group has produced a video, “Why Don’t We Do
It In Our Sleeves?”
They ask: “Are you still coughing
and sneezing the way they did during the plague? Into the air, your
hands, tissues and handkerchiefs?
Then you need to see this video.
You'll learn to cough and sneeze in
places that are less likely to spread
infections and keep germs alive.“
The five minute video by Ben
Lounsbury, MD, shows you where
to cough and sneeze according to
the infection control guidelines put
forth by the Centers for Disease
Control and Prevention. The video
is amusing, engaging, informative,
and available in English, Spanish,
and American Sign Language at:
http://extension.missouri.edu/cemp/c
ough.html
[Thanks to: Suzanne Driessen, Regional Extension Educator, Food
Science, University of Minnesota
Extension]
HANDWASHING WITH A NAIL
BRUSH
At the request of Joe Hibberd, St.
Paul-Ramsey County Environmental Health, MDH staff did a
search for a handwashing poster
that demonstrated proper use of a
nail brush.
Only one image resulted from that
Google search. The poster had
been created in 1978 and updated
in 1997. With the generous permission of Dr. Pete Snyder, this poster
has been revised once more by Elly
Pretzel and is available on the MDH
website at:
http://www.health.state.mn.us/handh
ygiene/wash/nailbrush.html
[Thanks to: O. Peter Snyder, Hospitality Institute of Technology and
Management. St. Paul, MN, and
Elly Pretzel, Infectious Disease Epidemiology, Prevention and Control
(IDEPC) Division, MDH]
MEHA
SPRING CONFERENCE
The MEHA Spring Conference will
be held at Cragun’s Resort on Gull
Lake, April 30-May 2, 2008. For
more details, see MEHA website at:
hhttp://www.mehaonline.org/springc
onference.htm
COOKING FOR A CROWD
We learned recently about a
valuable resource for communities
where food-fueled celebrations and
fund raisers are common but where
licensure and/or oversight of these
events are uncommon.
If you have concerns about the
safety of food prepared for large
groups in your community, we
encourage you to promote
Cooking Safely for a Crowd
workshops taught by University of
Minnesota Regional Extension
Educators in Food Science.
The workshops are tailored for the
group requesting them. Anyone who
volunteers to help plan, prepare,
serve, or otherwise handle food at a
large group event should take this
course. Training topics include:
•
•
•
•
•
•
•
•
•
Planning
Culprits of foodborne illness
Personal hygiene
Cross-contamination
Time and temperatures
Storing food supplies
Preparing quantity food
Holding and serving
Handling leftovers
See: http://www.extension.umn.edu/
FoodSafety/components/
quantitycooks.htm
[Thanks to Extension Educators,
LouAnn Jopp and Glenyce Peterson-Vangsness.]
Page 4
PWDU Quarterly Update
On Safer Pools and Beef in Schools
PENDING POOL LEGISLATION
The injury of a six-year-old in a
metro-area swimming pool last
summer, as well as previous injuries and deaths related to faulty or
missing pool drain covers, has inspired pool safety legislation at the
state and federal levels.
The United States
Congress passed a
pool safety bill in
December 2007
requiring improvements to drain
systems in existing
pools, as well as
new standards for pools built after
January 1, 2009. The federal law
includes some grant money to support compliance at the state level.
The proposed Minnesota legislation
is somewhat more stringent. Two of
the proposed changes are: (1) the
expansion of public pool licensure
to include “any pool other than a
private residential pool that is open
to the public ...”. This includes
pools at apartment complexes and
other locations that were not previously licensed; and (2) the proposal
that a dual suction outlet system be
required in all public pools.
There has been broad, public, and
legislative support for changes that
would prevent future injuries in
pools. However, some legislators
expressed concern that pools
operated by both public entities and
private organizations would have to
be closed because of the costs of
the upgrades required by this bill.
House Files 3812 and 3381, and
Senate File 2833 can be found at:
http://www.leg.state.mn.us/leg/le
gis.asp
CHANGES to CDC GUIDANCE on
FECAL ACCIDENTS in POOLS
The Centers for Disease Control
issued an alert on February 1, 2008
regarding changes to the guidance
for responding to fecal accidents in
swimming pools.
Based on new data, Cryptosporidium was found to be
more resistant than previously thought to chlorine disinfection when the pH was
raised to 7.5. As a result of
these findings, new guidance
for diarrheal events says to:
“Raise the free chlorine concentration to 20 ppm (mg/L); maintain the water’s pH between 7.2 and
7.5; and temperature at about 77F.
The chlorine and pH should remain
at these levels for at least 12.75
hours (changed from 8.0 hours previously) to achieve the CT inactivation value** of 15,300.”
**[The CT inactivation value is the
concentration (C) of free chlorine in
ppm multiplied by time (T) in minutes (CT value = C x T ).]
These new guidelines, and information for pool managers who wish to
use a lower chlorine concentration
or inactivation time, are posted on
the Healthy Swimming website at:
http://www.cdc.gov/healthyswim
ming/pdf/Fecal_Accident_Respons
e_Recommendations_for_Pool_Staff
.pdf.
Also, please note that Recreational
Water Illness (RWI) Prevention
Week is scheduled for May 19-25,
2008. CDC asks us all to visit the
Healthy Swimming website after
April 1, 2008 for updated prevention
tools in this year's Health Promotion
Toolkit.
SCHOOL BEEF RECALL
In mid-February, the U.S. Department of Agriculture announced the
largest beef recall in U.S. history—
143 million pounds of frozen beef
from a California slaughterhouse.
The recall affected frozen beef
dating from February 1, 2006 from
the Westland/Hallmark Meat Co.,
which supplies meat to the federal
school lunch program and to some
major fast-food chains.
While about 80 percent of the product shipped to Minnesota schools
had already been consumed, there
were more than 100 school districts
still holding recalled beef.
Unfortunately, USDA did not use
traditional lines of communication
to notify local agencies that they
would be required to oversee the
destruction of the product. As agencies started to receive calls from
schools, MDH and local agencies
had to work quickly to coordinate
efforts and respond accordingly.
USDA has
classified
this as a
Class II
recall,
inferring
that there
is little risk
to public
health. Due to the product being
supplied to the School Lunch Program, this has been a sensitive issue on many levels.
The legal proceedings for Westland/Hallmark are still on-going.
Reports indicate that the plant,
employing approximately 220
people, will not re-open.
Page 5
PWDU Quarterly Update
On Public Entertainment
FREEDOM to BREATHE
A brief history of the Freedom to
Breathe legislation, which came into
effect in Minnesota on October 1,
2007, can be summarized in a few
headlines:
Minnesota Lawmakers Pass
Smoking Ban
(Washington Post,
5/12/2007);
Day One: No
Huffs, Fumes
or Butts (Star Tribune, 9/30/2007);
been supportive, though some
smokers are displeased that the
new restrictions have impinged on
their freedom to smoke in public
places, and some bar owners report
significant business losses.
A presumed loophole in the law—
the exemption of the ban for actors
in a theatrical performance—briefly
resulted in a departure from otherwise lawful compliance, in an unknown number of establishments
statewide.
Theater nights in bars,
with smoking patrons
as “actors” were the
brainchild of a
Minnesota attorney-intights who expressed
sympathy for bar
owners suffering
under the ban.
Health Officials Say Freedom to
Breathe Going Smoothly, (MDH
press release, Nov 6, 2007);
Theater of the Absurd: Minnesota
Bars Thwart Smoking Ban by
Declaring Everyone An Actor
(Associated Press, 3/7/2008);
Curtain May Fall on Faux Theater
(USA Today, 3/8/2008).
In the November 7, 2007 press
release from MDH, Commissioner
Sanne Magnan was quoted as saying that implementation of the new
indoor smoking ban was proceeding smoothly. She said that the
department was helping to ensure
compliance by providing information
to facility operators who had questions about the law, and that MDH
had notified 31 businesses that they
were not yet in compliance.
Julie Ring, director of Minnesota’s
Local Public Health Association,
said that local public health officials
had received very positive feedback
about Freedom to Breathe and that
they were reporting good compliance with the new laws.
These early indications of a successful transition have not been
disproven. Most Minnesotans have
After receiving legal advice,
including from the Minnesota
Attorney General’s Office, MDH
concluded that “theater nights” in
bars do not fall within the theatrical
production exemption of the Minnesota Clean Indoor Air Act.
A letter sent to all Minnesota establishments in early March warned
that establishments found in
violation may be subject to license
suspension or revocation, as well
as civil administrative penalties of
up to $10,000 per violation.
NAKED SUSHI
In February, 2008, MDH was asked
for an opinion regarding the legality
of another artistic endeavor.
A Minneapolis restaurant owner
announced his intention to offer a
night of “Naked Sushi.” This he
explained, was the marriage of culture and art. A practice that began
in Japan during the 1960s, naked
(or body) sushi employs the bodies
of attractive models as tables from
which sushi may be eaten.
Prior to the arrival of the diners, the
hair- and blemish-free model lies on
a table where he or she is decorated with strategically placed
flowers and banana leaves before
the sushi is arranged for service.
The models remain still and silent
while diners sip champagne and
use chopsticks to remove food from
their bodies.
After careful consideration, MDH
staff provided the opinion that the
practice did not conflict with Minnesota statute or rule. There would be
no bare-hand or skin contact of the
sushi, and the food would not remain out of refrigeration for more
than the time allowed in law.
Agency staff were not asked to
comment on their personal reactions to the use of naked humans
as serving platters.
Responding to the high-jinks, MDH
Commissioner Magnan said, “It is
time for the curtain to fall on these
theatrics so that employees, and all
Minnesotans, are protected from
secondhand smoke.”
For Freedom to Breathe info:
[www.health.state.mn.us/freedomtob
table
reathe.]
leg
Minnesota Department of Health
DIVISION OF ENVIRONMENTAL HEALTH
those meetings, several other workgroups were formed, including the Program Evaluation Workgroup and the Manual Writing
and Reviewing Groups. More than 75 staff members from MDH
and local agencies have been collaborating to make all of the
delegation-related products a success.
MDH staff are also working with our partners in St. Louis County
on the transition of their delegated program back to MDH. We
thank them for their support and cooperation during this transition. We have also been collaborating with University of Minnesota Extension Food Science Educators on several food safetyrelated projects. We look forward to more prosperous collaborations like these in the future.
Orville L. Freeman Building
625 North Robert Street
Saint Paul, Minnesota 55155
OUTBREAKS
http://www.health.state.mn.us/foodsafety
Note from April Bogard
Like all of you, the PWDU team has been busy for the past
couple of months! Some of the things we’ve been working on:
LEGISLATIVE ISSUES
The Legislature is in session and our staff have been busy
addressing the pool safety and inspection-related bills moving
through the House and Senate. We’ve also been watching the
“doggie dining” bill (HF 2423 and SF 2232), the rental lodging
study bill (HF 3356 and SF 3158), and several other bills, as
they move through the House and Senate.
PARTNERSHIPS
One year ago this month we started our Delegation Agreement
Advisory Council meetings and have made excellent progress
in completing the EHS Delegation Agreement. As a result of
For the fifth time since 1998, MDH and MDA have identified an
outbreak of Salmonellosis associated with raw, frozen, prebrowned chicken products. Kudos to the MDH Public Health Lab
and the Epidemiologists who continue to do great public health
work!
In the past several weeks, news outlets have been reporting that
Minnesota is the third most dangerous state for eating out in restaurants (due to the 55 confirmed foodborne outbreaks reported
in 2006). We think being at the top of this list is a good thing!
Minnesota has one of the most sophisticated and aggressive
foodborne surveillance and response systems in the country.
We thank our state and local partners for making the system
work like it should!
WELCOMES AND FAREWELLS
Cathy Odinot joined our PWDU team in late January.
We’re happy to have her and her extensive
knowledge of the industry side of the food
world.
Jim Feddema (EHS Supervisor, St. Cloud),
Clara Vanasperen (Licensing), and Doug
Mandy (Drinking Water) retired from MDH this
week. We’re sad to see them go, but wish
them much enjoyment in their retirement.
PWDU Staff Contact Information
Name
Got A Question?
Phone and Email
April Bogard
Supervisor, Partnership and Workforce Development Unit.
[email protected]
651-201-5076
Deborah Durkin
Food Safety Partnership, Food Safety Center, UPDATE,
Manual development, food safety education.
[email protected]
651-201-4509
Tony Georgeson
Rapid inspection software development, maintenance, and
training.
[email protected]
218-332-5167
Steve Klemm
Swimming pool construction, plan review, and inspections.
[email protected]
651-201-4503
Angela McGovern
Administrative support.
[email protected]
651-201-4506
Michael Nordos
Training, Evaluation Workgroup, program evaluation.
[email protected]
651-201-4511
Cathy Odinot
Training, Manual development, program evaluation.
[email protected]
651-201-4843