Minnesota Department of Health (MDH) Food Safety Partnership (FSP) and Partnership and Workforce Development Unit (PWDU) QUARTERLY UPDATE Volume 5, Issue 1, January 2011 NEW: TRAINING EVENTS CALENDAR SECTION HEADINGS 2011 FSP, MEHA Calendar…………………... 1 “Bug of the Quarter” …..…………………......… 2-3 Training Resources ...….…….……….……….. 3-4 Web and Written Resources ………………….. 4-5 Food and Food Safety Matters …..….……..… 6 Rules and Legislation…………………………… 7 MDH and the Minnesota Environmental Health Association (MEHA) are working together to coordinate their training offerings. This calendar of FSP and MEHA events is posted on the MDH website, http://www.health.state.mn.us/divs/eh/food/pwdu/fsp/201 1calendar.pdf, and will be regularly updated there and in this newsletter. We will add other pertinent, local (Minnesota) events at the request of FSP members. Climate Change Corner………………………… 8 Environmental Odds and Ends ……………….. PWDU Staff Contact Information .................…. 8 SEASON’S GREETINGS And best wishes for this New Year to all our Food Safety Partnership and Environmental Health friends and partners throughout Minnesota. Please let us know how the Partnership and Workforce Development Unit can help you in 2011. Deborah 2011 Training Events Calendar 8 Date Provider Topics Jan 27 8:30-4 pm MEHA Pools, vector borne disease, body art, raw milk, food safety trends, contaminants of emerging concern Feb 2 9:30-1pm FSP Epidemiology report, uneviscerated fish, post-disaster response Mar MDH Drinking Water Protection Training Apr 5 10 -12 FSP+ Seafood HACCP and sushi Apr 13 8:30-4pm MDH Certified Food Managers Workshop May 4-6 MEHA TBA Jun 8 9:30-1pm FSP Epidemiology report, local foods in schools, resale of meat products Aug 10 -12 FSP+ TBA Sep MEHA/ NEHA TBA Oct 5 9:30-1pm FSP TBA FSP+ TBA Jul Nov Dec 10 -12 PWDU Quarterly Newsletter Page 1 of 8 2011 Estimates BUG of THE QUARTER CDC 2011 Estimates of Foodborne Illness in the United States Differences between 2011 and 1999 Estimates The revised estimates, in two articles by Scallen et al., were published online in December 2010 and appear in the January 2011 issue of Emerging Infectious Disease. CDC has had access to better data sources over the past decade than were available to Mead et al. Dubbed, “Sons of Mead,” the work provides a new mantra: 47.8 million foodborne illnesses, 127,839 hospitalizations, and 3,037 deaths each year. This is roughly equivalent to one in six Americans becoming ill from contaminated food each year. In about 80 percent of cases, the pathogen is never determined. Scallan et al. have used more sophisticated methods to model for uncertainty. Most Commonly Identified, Most Deadly CDC 2011 estimates of illnesses, hospitalizations, and deaths from foodborne diseases in the United States are more accurate than those published in 1999. These differences mean there is no strict side-by-side comparison that can be made between the two sets of estimates. http://cdc.gov/foodborneburden/differences-in-estimates.html Of the 9.4 million illnesses for which (one of 31) pathogens are identified, 5.5 million (59 percent) are caused by viruses, 3.6 million (39 percent) by bacteria, and 0.2 million (2 percent) by parasites. For more than a decade, presentations and articles about foodborne illness have shared a standard introduction: CDC estimates that about 76 million cases Ninety-percent of those 9.4 million illnesses are caused by seven of the 31 pathogens: Salmonella, Norovirus, Campylobacter, Toxoplasma gondii, E.coli O157:H7, Listeria monocytogenes, and Clostridium perfringens. of foodborne illness, resulting in 325,000 hospitalizations and 5,000 deaths occur each year in the United States. Norovirus is the most commonly identified; Samonella infections result in most deaths; Listeria is the most virulent, resulting in death in 16 percent of cases. 1999 Estimates Since the Centers for Disease Control (CDC) released this work in 1999, these estimates of the illness caused by foodborne pathogens have inspired our efforts to create a safer food system and have described the impact of foodborne illness in the U.S. - one in four Americans were said to suffer the effects of foodborne illness every year. Now, CDC has revised the Mead et al. 1999 estimates using improved statistical methods and a somewhat different definition of acute gastrointestinal illness. Of 47.8 million (est.) foodborne illnesses each year, 20 percent (9.4 million) are from 31 known pathogens. The causes of 80 percent of those foodborne illnesses (38.4 million) are unknown. 31 Known Pathogens Unknown Pathogens PWDU Quarterly Newsletter Selected Pathogens Illnesses (est.) Deaths (est.) Norovirus 5,461,731 149 Salmonella 1,027,561 378 C. perfringens 965,958 26 Campylobacter 845,024 76 T. gondii 86,686 327 E. Coli O157 63,176 20 1,591 255 Listeria Can We Compare the 1999 and 2011 Estimates? For a number of reasons, the two data sets are not comparable. Two specific reasons are that the researchers used a more restrictive definition of gastroenteritis in their calculations; and that the new estimates represent only illnesses caused by food eaten in the United States. The 1999 estimates included illnesses acquired from food eaten in other countries. An editorial accompanying the two Scallen et al. articles states that, “The methods, underlying assumptions, and parameter estimates used to generate these new numbers differ sufficiently from those used ≈11 years ago to preclude comparisons.” Page 2 of 8 BUG of THE QUARTER, continued TRAINING RESOURCES, MINNESOTA Is Food Any Safer Now Than It Was in 1999? MEHA Winter Conference CDC says that the best answer to that question comes from FoodNet annual data on actual cases of laboratory-diagnosed (mainly foodborne) bacterial and parasitic pathogens. FoodNet data show a drop in the numbers of infections with most major bacterial foodborne pathogens after new USDA regulations were implemented in 1995, followed by a leveling off of incidence in the following years. The exception to this rule is Vibrio spp. which is increasing, perhaps due to climate-related changes in water temperatures. The Minnesota Environmental Health Association (MEHA) Winter Conference will be held on Thursday, January 27, 2011 at the Hampton Inn in Shoreview. Conference hours are 8:30 a.m. to 4:00 p.m., with registration and breakfast from 7:45 to 8:30 a.m. Summing It All Up For more information: CDC summarizes, “…with the exception of Vibrio spp., things don't seem to be getting worse; however, after the initial decline since the USDA regulatory changes in 1995, one does not see evidence of sustained improvement. “ http://www.mehaonline.org/winterconference.htm And in the New York Times, “The federal government on Wednesday significantly cut its estimate of how many Americans get sick every year from tainted food. But that does not mean that food poisoning is declining or that farms and factories are producing safer food. Instead, officials said, the government's researchers are just getting better at calculating how much foodborne illness is out there.” References Morris, JG Jr. How Safe Is Our Food? Emerg Infect Dis. [serial on the Internet]. 2011 Jan [date cited]. http://www.cdc.gov/eid/content/17/1/126.htm MEHA Food Safety Partnership Video-Conferences The most recent Food Safety Partnership (FSP) video-conference was held on Tuesday, October 5, 2010. The archive can be viewed at: mms://stream2.video.state.mn.us/MDH/foodsafety100510 .wmv To suggest a future FSP topic, contact Deborah Durkin (651-201-4509, [email protected]). For CEUs, contact Maggie Edwards (651-201-4506, [email protected]). FSP meetings in 2011 will be held on February 2, June 8 and October 5, 2011. See past FSP presentations at: http://www.health.state.mn.us/divs/eh/food/pwdu/fsp/ind ex.html. FSP-Plus Short Sessions Scallan E, Hoekstra RM, Angulo FJ, Tauxe RV, Widdowson M-A, Roy SL, et al. Foodborne illness acquired in the United States--major pathogens. Emerg Infect Dis. 2011 Jan; and Epub ahead of print: http://www.cdc.gov/EID/content/17/1/pdfs/091101p1.pdf The next FSP-Plus training will be held on Tuesday, April 5 from 10:00 a.m. to 12:00 noon. FDA, MDH and MDA will provide training on HACCP and sushi. Scallan E, Griffin PM, Angulo FJ, Tauxe RV, Hoekstra RM. Foodborne illness acquired in the United States-unspecified agents. Emerg Infect Dis. 2011 Jan; [Epub ahead of print] The training will be available at the usual FSP videoconference sites and through web streaming. More information will be sent by email in the coming weeks. Mead PS, Slutsker L, Dietz V, McCaig LF, Bresee JS, Shapiro C, et al. Food-related illness and death in the United States. Emerg Infect Dis. 1999;5:607-24. PubMed DOI: 10.3201/eid0505.990502 Neuman, William, New York Times, December 15, 2010, http://www.nytimes.com/2010/12/16/business/16illness. html?_r=2&ref=food_safety PWDU Quarterly Newsletter Topics have not been chosen for FSP-Plus sessions in August and December 2011. For more information, or to suggest training topics, contact Michelle Messer (651-201-3657, [email protected]). Page 3 of 8 TRAINING RESOURCES, NATION-WIDE Two Opportunities: International Food Protection Training Institute (IFPTI) IFPTI Seeking Applicants for 2011 Fellowship in Food Protection Program IFTPI is accepting applications for the 2011 cohort of the “Applied Science, Law, and Policy: Fellowship in Food Protection” program. The program is designed to provide future leaders from the state, local, tribal and territorial food protection community with a professional development experience focused on critical thinking, problem solving and decision making. Three week-long training sessions will be held at IFPTI in Battle Creek, Michigan over the year beginning August 2011. Course topics are: 1) Law, 2) Policies, Strategies and Tools, 3) Labeling, 4) Evolving Science of Food Protection, 5) Food Systems Control, and 6) Prevention, Intervention and Response. Program overview and applications are available at http://ifpti.org/fellowship_food_protection.cfm. The application deadline is March 1, 2011. Food Safety Instructors Wanted! The Association of Food and Drug Officials (AFDO) and IFPTI have begun an effort to identify qualified instructors for food protection training courses. This includes current or former employees of agencies, industry, or academia having expertise in food protection. Content areas of expertise include food, dairy, feed, produce, laboratory, epidemiology, shellfish, meat, egg, or any other related areas. Interested parties can complete an "Instructor Assessment Preference" form at: http://ifpti.org/blogs/assets/content//IFPTI2010040v2_distributed_0001.pdf. Applicants may be contacted about attending instructor training, auditing course deliveries, performing actual training, or assisting on course and curriculum development activities. IFPTI reimburses all program-related travel expenses including airfare, hotel and meals for fellowship participants, instructors, and course attendees. More information on the fellowship and IFPTI course schedule is available at: http://www.ifpti.org. PWDU Quarterly Newsletter Centers for Disease Control (CDC) National Center for Environmental Health (NCEH) Summer 2011 Program in Environmental Health CDC’s National Center for Environmental Health (NCEH) is offering a 10-week summer internship program for students majoring in Environmental Health. From June 8 to August 12, 2011, selected interns will be introduced to federal, state and local environmental health activities through project work, site visits, field assignments and relationships with CDC staff. Interns will be based in Atlanta and will receive a weekly stipend of $750 to cover living expenses. Applications and more information are available at http://www.cdc.gov/nceh/ehs/supeh. WEB AND WRITTEN RESOURCES: EMPLOYEE ILLNESS FDA Food Employee Reporting Agreement We are all familiar with the gap between education and behavioral change (think smoking, handwashing, seatbelts). One example of this gap can be found in the area of food worker illness. Regulatory staff provide employee illness materials and education; food establishments hang the materials on their walls; and norovirus continues to make more people ill than any other foodborne pathogen. FDA believes that active and consistent use of their Food Employee Reporting Agreement will help to reduce the risk of foodborne illness from ill food workers. That form is now available in six languages, English, Chinese, Hindi, Korean, Russian, Spanish, and Vietnamese. The Agreement can be found at: http://www.fda.gov/Food/FoodSafety/RetailFoodProtecti on/IndustryandRegulatoryAssistanceandTrainingResour ces/ucm113827.htm Page 4 of 8 Connecticut Department of Health: Using the Reporting Agreement in an Employee Illness Program http://www.ct.gov/dph/cwp/view.asp?a=3140&q=447464 Connecticut Ill Food Worker Campaign As part of a 2009 EHSNet-funded campaign to decrease the occurrence of restaurant-associated norovirus outbreaks, the Connecticut Department of Health created posters and other employee illness materials that were to be delivered - with education – to food establishments in their state. Two of the tools that regulators hoped would move their establishments through the steps to behavioral change (Knowledge, Approval, Intention, Practice) were the FDA Reporting Agreement and their own document, “Talking Points for Inspectors” to be used as part of the educational process. The talking points list the following items that food workers should be able to answer: Do you have an Employee Health or Sick Leave Policy? If yes, are workers aware of the policy and is it available in written format? Do you require food workers to report illnesses, symptoms, and exposures? Have workers signed a Reporting Agreement? What are the reporting requirements for food worker and managers? Are the reporting requirements explained to all employees? What history of exposure is a food worker or conditional employee required to report? If a food worker calls in sick, does the person-incharge ask why? Do they ask what symptoms the worker is experiencing? If a food worker reports vomiting, diarrhea or has been diagnosed with a pathogen known to be transmitted via food or workers, what questions are asked of the food employee? What symptoms would require exclusion of a food employee from the establishment? Who does the establishment notify when a food worker reports vomiting, diarrhea or a diagnosis with one of the pathogens of concern? If a food worker reports a gastrointestinal symptom, what criteria are used to allow the employee to return to work? PWDU Quarterly Newsletter (And one more time) FDA Oral Culture Learners Posters and MDH Employee Illness Materials FDA Posters Recognizing that many food workers do not read English, and that many of them are culturally oral learners, FDA has created a series of posters (in English, Hindi, Korean, Russian, Chinese, Spanish, and Vietnamese) to teach the importance of following proper food safety practices. http://www.fda.gov/Food/FoodSafety/RetailFoodProtect ion/IndustryandRegulatoryAssistanceandTrainingResour ces/ucm212661.htm MDH Food Worker Illness Materials MDH food worker illness awareness materials can be downloaded from the MDH website. Local jurisdictions and other partners may request the materials in word format, so that they can be revised to include local contact information. http://www.health.state.mn.us/foodsafety/dwi/index.html Postscript: “Serving While Sick” http://www.rocunited.org/news/20100927-serving-while-sickreport-reveals-need-paid-sick-days On September 30, 2010, Restaurant Opportunities Centers United (ROC), a restaurant workers' advocacy group, released "Serving While Sick,” a study of health conditions among restaurant workers based on more than 4,300 surveys nationwide. Among those surveyed, 90 percent of workers said that they do not receive paid sick days; 90 percent reported not having health insurance through their employers; and 63 percent reported working while sick. A representative of the National Restaurant Association said the report presents a, “distorted image of the restaurant industry and its employees while pushing ROC's agenda." Page 5 of 8 FOOD AND FOOD SAFETY NEWS Food Security Awareness Homeland Security Food and Agriculture Sector Councils “If You See Something, Say Something” http://ag.utah.gov/divisions/animal/images/SeeSaySomet hing.pdf On December 17, a letter and poster were sent to “Food Service and Retail Industry Private Sector Partners” encouraging facility managers to educate staff about indicators of suspicious activity, and how to respond, if they observe a threat to food security. FDA “ALERT” and “FIRST” http://www.fda.gov/Food/FoodDefense/Training/ALERT/d efault.htm http://www.fda.gov/Food/FoodDefense/Training/ucm1350 38.htm Food operations and food regulators may already be familiar with two recent food defense initiatives from FDA. "ALERT" and "FIRST" address food defense measures that industry can take or implement into their processes, whether retail or manufacturing. According to FDA, the ALERT initiative is intended to raise the awareness of state and local government agency and industry representatives regarding food defense issues and preparedness. It applies to all aspects of the farm-to-table supply chain. ALERT identifies five key points that industry and businesses can use to decrease the risk of intentional food contamination at their facility: Assure, Look, Employees, Report, Threat) Employees FIRST (Follow procedures, Inspect, Recognize, Secure ingredients, Tell management) provides front-line food industry workers with information about the risk of intentional food contamination and the actions they can take to identify and reduce these risks. Raw Milk Decision On December 22, 2010, in a ruling based on ten days of testimony, a state judge rejected Michael Hartman’s denial of responsibility for an outbreak of illness linked to raw milk that he produced and sold. Mr. Hartman’s attorney said that the litigation is far from over. PWDU Quarterly Newsletter Uneviscerated Fish Heads Up Last April, Minnesota Department of Agriculture staff seized more than 400 pounds of uneviscerated fish at ethnic grocery stores in the Twin Cities. Since then, there have been several unevicerated fish recalls nationwide, and more of these products spotted in Minnesota establishments by MDA and MDH staff. Both agencies warn consumers and inspectors to watch for these potentially dangerous products. Uneviscerated fish are typically dried, salted and often smoked. The sale of un-eviscerated fish is prohibited because Clostridium botulinum spores are more likely to be concentrated in the viscera than any other portion of the fish. Uneviscerated fish has been linked to outbreaks of botulism poisoning. 2010 Meat and Poultry Recalls 2010 Meat & Poultry Recalls: Over 27 Million lbs. Marler Clark’s Food Safety News reported on December 15, 2010 that more than 27 million pounds of meat and poultry (or about seven ounces for every school-aged child in the U.S. ) were recalled in 2010 by processors regulated by USDA's Food Safety and Inspection Service (FSIS). Salmonella was the pathogen identified in the recalls of 3.2 million pounds of the 5.9 million pounds of meat and poultry recalled for bacterial contamination. There were 11 meat and poultry recalls during 2010 for E. coli contamination, totaling 2.3 million pounds of meat. Meat and Poultry Labeling Beginning January 1, 2012, U.S. meat purchasers must be provided with nutritional facts about 40 commonly purchased cuts of meat and poultry. Ground and chopped meats must be labeled. Whole cuts may either be labeled, or the seller may provide information at the point of sale. The new labels will include information on calories, fats, cholesterol, and protein. Note: Under most circumstances, the new rule does not apply to ground and chopped meat processed by businesses with a single facility producing less than 100,000 of pounds annually, or to products intended for further processing or export. Page 6 of 8 RULES AND LEGISLATION U.S. Senate Bill 510: Federal Food and Drug Administration Food Safety Modernization Act Passed twice by the Senate (due to a misstep in the legislative process) and once by the House, the FDA Food Safety Modernization Act is expected to be signed by President Obama on January 4, 2011. The 1.4 billion dollar bill expands the authority of the Food and Drug Administration (FDA) over approximately 80 percent of the food supply. Meat, poultry and dairy – regulated by the U.S. Department of Agriculture – are not affected. The bill is intended to shift the focus of FDA’s regulatory efforts from reaction to prevention of foodborne illness. The inclusion of the “tester Ammendment” was one of the concessions that made passage of the bill possible. Tester stipulates that food producers with less than $500,000 in annual sales will not be subject to new federal requirements if they sell the majority of their food directly to consumers within the state, or within a 275-mile radius of where it was produced. As summarized by the Huffington Post, the following are among the key provisions of the bill: FDA may suspend a food production facility if a possible health risk is suspected. Food production facilities must alert the FDA, through writing, of all identified hazardous practices currently in place and their plans to implement preventive measures going forward. FDA may set nationwide standards for producing and harvesting fresh produce. FDA will publish updated safety guidelines for specific fruits, vegetables and designated highrisk produce which they define as raw agricultural commodities. The FDA, Department of Homeland Security and USDA will issue regulations that prevent food companies from knowingly including illegal additives, chemicals or other substances in their food products. Sources Bottemiller, H, “Food Safety Bill Heads to President’s Desk,”, Food Safety News, December 21, 2010, http://www.foodsafetynews.com/2010/12/food-safetybill-clear-final-hurdle-heads-for-presidents-desk/ Johnson, R. et al., “Food Safety in the 111th Congress: H.R. 2749 and S. 510Congressional Research Service,” November 16, 2010, http://agriculturelegislation.blogspot.com/2010/11/food-safety-in-111thcongress-hr-2749.html Jalonick, MC, “Food Safety Bill Passes Senate by Unanimous Consent,”, Huffington Post, December 19, 2010, http://www.huffingtonpost.com/2010/12/19/foodsafety-bill-passes-_n_798884.html Food Code Rulemaking FDA may directly issue a food recall, rather than arranging a voluntary recall. The next meeting of the Food Code Advisory Committee will be held on January 25, 2011. Companies that require re-inspection or recall may be subject to an FDA fee. Minutes of the Rulemaking Advisory Committee meeting can be found on the Rule Revision website at: FDA will be required to identify the most significant food threats and provide new sciencebased outlines and regulations for food production companies at least every two years. http://www.health.state.mn.us/divs/eh/food/code/2009rev ision/index.htm. FDA will establish offices in at least five foreign countries that export food to the United States in an effort to improve food oversight. FDA will gain expanded access to food production facility records. PWDU Quarterly Newsletter Food Code stream and archive addresses can be obtained by contacting Susan Peterson ([email protected]). Each meeting will also be recorded and available on DVDs. For more information about meetings, the rulemaking process, or the Advisory Committee, contact Food Code Rule Coordinator, Linda Prail ([email protected] or 651-201-5792.) Page 7 of 8 CLIMATE CHANGE CORNER ENVIRONMENTAL ODDS AND ENDS New View of Climate Change Skepticism Bed Bugs and the Law http://ehp03.niehs.nih.gov/article/fetchArticle.action;jses sionid=EAB372F541A883636A6E54AEF335E0F1?articleU RI=info:doi/10.1289/ehp.118-a536 http://www.publichealthlawnetwork.org/bed-bug-controland-legal-authority/ Centers for Disease Control (CDC) and Environmental Protection Agency (EPA) have called bed bugs a rapidly growing public health problem. The online journal, Public Health Law Network, refers us to the “Michigan Manual for the Prevention and Control of Bed Bugs,” which provides guidance for education about; identification, treatment and prevention of bed bugs, as well as potential legal interventions and relevant laws regarding housing, accommodations, consumer goods and use of pesticides. The Michigan work demonstrates what states without specific bed bug laws can do to control the problem. In the December 2010 issue of Environmental Health Perspectives, science writer, Charles Schmidt argues that the substantial agreement among climate change believers and skeptics in the scientific community gets lost in the rhetoric and political posturing surrounding this issue. NOTE: The Public Health Law Network connects and serves individuals and organizations committed to applying the law to improve public health. Join the Network at http://www.publichealthlawnetwork.org/. Rather, he says, the discussion among scientists has shifted to the causes of climate change, and the potential of various schemes to reverse warming. PARTNERSHIP AND WORKFORCE DEVELOPMENT UNIT STAFF CONTACTS April Bogard Supervisor, PWDU [email protected] 651-201-5076, 612-296-8118 Deborah Durkin, FSP, newsletter, food safety outreach [email protected] 651-201-4509, 651-295-5392 Maggie Edwards, administrative support [email protected] 651-201-4506 Nicole Koktavy, EHS-Net coordinator [email protected] 651-201-4075 Lynne Markus, emergency response, climate change [email protected] 651-201-4498 Michelle Messer, training, program evaluation, standardization [email protected] 651 201-3657, 651 775-6238 Michael Nordos, training, program evaluation, standardization [email protected] 651-201-4511, 651-775-6234 Angie Wheeler, training, program evaluation, standardization [email protected] 651-201-4843, 651-373-7381 MINNESOTA DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH Orville L. Freeman Building 625 North Robert Street Saint Paul, Minnesota 55155 PWDU Quarterly Newsletter http://www.health.state.mn.us/ehs http://www.health.state.mn.us/foodsafety Page 8 of 8
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