Minnesota Department of Health (MDH)
Food Safety Partnership (FSP) and
Partnership and Workforce Development Unit (PWDU)
Volume 5, Issue 4, October 2011
Cooking Safely for a Crowd Workshop ……...
1
HELP TO PROMOTE THIS GIFT TO
YOUR COMMUNITY ORGANIZATIONS !
Other Training Resources ….…….….………..
2
Cooking Safely for a Crowd Workshop
SECTION HEADINGS
Web and Written Resources……….….……….. 2-3
Handwashing News …………………………….. 3
Plan Review Too: Tankless Water Heaters ..... 4
Food and Food Safety Matters …..….……..…
4
Special Report: Rapid Inspection Changes …
5-6
Environmental Odds & Ends ………………….
6
Bug of the Quarter …..…………………......…
7
Germ City Thank You……………………...…..
8
PWDU Staff Contact Information ..................
8
NOTE from PWDU:
Please help MDH and University of Minnesota
Extension to publicize this workshop being provided at
no cost for people who cook and serve food for groups.
Workshop Details and Registration
Date and Time: October 18, 2011, 1:00 to 4:00 p.m.
Locations: Video-conference centers throughout MN
Registration and Site Info: http://z.umn.edu/csfc
A Certificate of Attendance from this workshop is one
way to satisfy the requirement for a trained volunteer
as stated in Minnesota Statutes 157.22, as amended
during the 2011 legislative session (See guidance
document on these changes at
http://www.health.state.mn.us/foodsafety/away/groupsf
aithex.pdf)
Workshop instructors will be University of Minnesota
Extension Food Safety Educators and staff from MDH.
The Agenda includes information about:
Dear Colleagues,
This issue is the last of Volume 5, marking five years of
PWDU quarterly newsletters. Best wishes to you all,
have a food-safe fall, and don’t forget to water your
trees before the first deep freeze.
Foodborne illness: causes, concerns and past
outbreaks at community events
Planning for a large food event
Purchasing, storing, and preparing foods safely
Kitchen and personal hygiene
Preventing cross-contamination
Times and temperatures
Thawing, heating and reheating
Cooling, holding and serving safe food
New legal requirements for unlicensed kitchens
If you would like an informational flyer for this event,
email Deborah ([email protected])..
Deborah
PWDU Quarterly Newsletter
Page 1 of 8
TRAINING RESOURCES, MINNESOTA
WEB AND WRITTEN RESO URCES
Training Events Calendar
St. Paul-Ramsey County
October 2011 through June 2012
Date
Oct 5
9:30-1pm
Oct 18
1-4:00pm
Org.
Topic (Contact)
FSP
Epidemiology report; EHS-Net
Study results; Meat rules and
regulations
http://www.co.ramsey.mn.us/NR/rdonlyres/EFFEDF3A8D58-4804-BF637C516918A725/24482/thought_for_food_summer_201
1.pdf
[email protected]
What Do Restaurant Patrons Want…?
Cooking Safely for a Crowd
Video-Conference Workshop
Shari Schmidt, 1-888-241-4591 or
[email protected]
The latest issue of the St-Paul Ramsey County
newsletter for food establishments, thought for food,
features a report on a recent survey assessing the
needs and preferences of 600+ restaurant goers in
Ramsey County.
FDA Course: Risk-Based
Inspection Methods at Retail
(More info to follow in October)
Though survey respondents showed little interest in
menu labeling for fat, calorie and sodium content, they
did express interest in having fresh fruits and
vegetables on the menu. Coupled with this preference
was a desire for the option to buy smaller portions.
MDH/
UMN
Nov
Dec 13
and 14
FDA
Winter Conference
Jan
MEHA
(More info to follow. See:
http://www.mehaonline.org/events
Feb 1
9:30-1pm
thought for food Quarterly News
FSP
Agenda To Be Announced
Apr
FSP+
Date & Topic To Be Announced
May 2-4
MEHA
Ruttger's Bay Lake Lodge
June 6
9:30-1pm
FSP
Agenda To Be Announced
Mar
Food Safety Partnership Video-Conferences
The next Food Safety Partnership (FSP) videoconference will be held on Wednesday, October 5.
The meeting can be live-streamed at:
http://www.health.state.mn.us/divs/eh/food/pwdu/livestr
eam/survey.cfm. The archive will be available for three
months at:
mms://stream2.video.state.mn.us/MDH/FoodSafety100
511.wmv
To suggest a future FSP topic, contact Deborah Durkin
(651-201-4509, [email protected]). For
CEUs or site information, contact Maggie Edwards
(651-201-4506, [email protected]).
See past FSP presentations and materials at:
http://www.health.state.mn.us/divs/eh/food/pwdu/fsp/.
PWDU Quarterly Newsletter
thought for food offers training tips for food service
staff and information about health issues in the food
service industry. Anyone can subscribe to the
newsletter at:
https://public.govdelivery.com/accounts/MNRAMSEY/s
ubscriber/new?topic_id=MNRAMSEY_21
http://harvestfoodservice.com/wpcontent/uploads/2011/07/HARVEST-v1_i2_low_res.pdf
Harvest Foodservice Journal: Vol. 1, Issue 2
The journal is dedicated to, “connecting sustainable
food systems with the foodservice industry.”
This issue features a story about the Minnesota Food
Association’s Big River Farms Training Program. Big
River trains immigrant farmers in sound business
practices and organic farming methods. In the second
or third year of their program participation, Big River
helps the new farmers to develop markets for their
produce. Between 700 and 800 people have
completed the program since its inception in 1998.
Data are not yet available on all program graduates but
each of the graduates since 2007 has continued
farming. About one-third of those recent graduates are
running their own crop sharing programs.
Page 2 of 8
National Food Safety Education Month:
Lessons Learned From the Health Inspection
http://www.servsafe.com/nfsem/all.aspx
The theme of this year’s National Food Safety
Education Month is “lessons Learned from the Health
Inspection.”
University of Minnesota Extension
New Food Safety Website
http://www1.extension.umn.edu/food-safety/
Suzanne Driessen and Extension staff have recently
completed a major overhaul of the Extension food
safety website. The website supplies materials,
factsheets, videos and links to information in four major
areas: “preserving and preparing,” “sanitation and
illness,” “courses and certification,” and “for the food
service industry.”
HANDWASHING NEWS
Hands-Free Faucets Harbor More Bacteria
Materials include five lessons with quizzes, answer
guides and supporting posters. All materials are in
English and Spanish. Archived materials are at:
http://www.servsafe.com/nfsem/archives.aspx.
FDA Employee Health and Personal Hygiene
Interactive Resource Disk
http://www.fda.gov/Food/FoodSafety/RetailFoodProtect
ion/ucm266434.htm
The FDA Employee Health and Personal Hygiene
Interactive Resource Disk was developed to assist
retail food establishments in preventing sick food
employees or conditional employees from working with
food in the retail food establishment setting.
The disk contains an Employee Health Interactive Tool
and resource documents such as the FDA Food Code,
and Oral Culture Learner Educational Materials related
to employee health and personal hygiene.
The Employee Health
Interactive Tool can be
used to quickly determine
the appropriate course of
action to take when
dealing with a sick
employee. The interactive
tool helps food
establishment managers
to decide what steps to
take when an employee is ill, including whether to
notify public health, and whether the employee should
be sent home.
The Resource Disk can be downloaded at the address
above.
PWDU Quarterly Newsletter
http://bodyodd.msnbc.msn.com/_news/2011/03/31/637
7936-automatic-faucets-germier-than-the-oldfashioned-kind-study-shows
A study of newly installed,
hands-free faucets at the
Johns Hopkins Hospital
showed that they were
more likely to be
contaminated with
bacteria than the old
fashioned faucets with handles for hot and cold water.
The study revealed Legionella growing in 50 percent of
cultured water samples from 20 electronic-eye faucets
in or near patient rooms on three different inpatient
units, but in only 15 percent of water cultures from 20
manual faucets in the same areas.
The new faucets cut daily water
consumption at the hospital by
well over 50 percent but the
hospital is replacing them with
hand-operated faucets. Manual
faucets have also been ordered
for new clinic facilities under
construction.
Johns Hopkins, like other
hospitals, treats publically supplied water with chlorine
dioxide or other methods to keep Legionella levels low.
The original purpose of the study was to test how often
and for how long treated water needed to be flushed
through the hospital’s system to keep Legionella and
any other bacteria at nearly undetectable levels
Researchers believe that hospital water disinfection
methods did not work effectively on the complex valve
components of the newer faucets.
Page 3 of 8
PLAN REVIEW TOO
FOOD and FOOD SAFETY MATTERS
Tankless Water Heaters
A Reminder from CDC
By MDH EHS Plan Review Staff
One in six Americans get a foodborne illness each
year; 3,000 die from those illnesses.
Tankless water heater installations in foodservice
facilities are increasing. They are gaining popularity
due to their space saving and energy saving
capabilities. Plan review is not necessary when the
installation of a tankless heater is the only systems
change. However, a plumbing permit may be required.
Check with your plumbing authority before installation.
Tankless units are different from a normal water heater
in that they are not maintenance free. Tankless heaters
require ongoing maintenance and cleaning in order to
operate properly. If a heater is not cleaned when the
alarm sounds, it will stop operating, and no hot water
will be available for the food facility. Monitoring of these
machines is mandatory, and maintenance charts
should be evaluated during routine inspections.
When evaluating
the purchase of a
tankless water
heater, consider
the following:
Will one heater be enough? Contact the
manufacturer for adequate sizing and installation
of these units. Multiple tankless water heaters
can be installed.
The units must have either an audible or visual
alarm. They must be checked frequently in order
to determine when descaling is needed.
The units must be NSF approved to Standard #5
or equivalent.
A water softener is recommended when the
water hardness is over 9 grains.
A maintenance schedule must be kept and
available for review by the inspecting Sanitarian.
All other local codes and permits must be met
prior to installation.
The sanitarian should ask about the cleaning
and descaling procedures used. Refer to the
manufacturer’s specifications for specific
descaling procedures for each specific unit.
If you have any questions regarding tankless hot water
heaters or other plan review issues, please contact one
of the plan review staff: Pamela Steinbach, 651-2015634; Charlotte Morgan, 651-201-3988 or Barbara
Krech, 651-201-5244.
PWDU Quarterly Newsletter
Overall
-- 48 million illnesses
-- 128,000 hospitalizations
-- 3,000 fatalities
31 Known Pathogens
-- 9.4 million illnesses
-- 56,000 hospitalizations
-- 1,350 fatalities
Unknown Agents
-- 38.4 million illnesses
Norovirus
is the most common
cause of illness,
accounting for 49
percent of
outbreaks and 46
percent of illnesses
-- 71,800 hospitalizations
-- 1,700 fatalities
http://cdc.gov/mmwr/preview/mmwrhtml/mm6022a5.htm
Six Non-O157 STECs Declared Adulterants
As of September 13, 2011, six additional Shigatoxinproducing E. coli strains will join E. coli O157:H7 on the
list of Adulterants within the Federal Meat Inspection
Act. These bacteria are not allowed in ground beef,
trim, and blade tenderized steaks in the United States.
Meat discovered to be contaminated with the “Big
Seven” must be destroyed or diverted for use in
cooked products where bacteria are killed by heating.
Minnesota Data:
In a Minnesota study by Hedican, et al looking at nonO157 cases from 2000 to 2006, the number and
proportion of STEC cases identified each year in
Minnesota increased from 2004 to 2006.
Of 206 STEC-only cases, 108 (52 percent) involved nonO157 serotypes and 98 (48 percent) involved O157.
Five serotypes represented 74 percent of the non-O157
isolates: O26, O45, O102, O111, and O145. Four of the
newly declared adulterants are included in this group.
E. coli O157 was declared an adulterant in 1994; O157
illnesses are now half of what they were a decade ago.
Though the new law is considered a victory by food
safety advocates, all agree that testing alone will not
guarantee a safe food supply but must be part of a
comprehensive strategy involving all parties - from
farm to fork.
Page 4 of 8
My Pyramid, My Plate, Healthy Eating Plate
The U.S. Department of
Agriculture (USDA) published
its first dietary guidance in
1894, but the now familiar
food pyramid was created in
the 1960s due to concern
over an increase in heart
disease among Americans.
The original pyramid - and those that succeeded it were replaced by USDA this summer with MyPlate,
whose improved design reflects current thinking about
the proper
balance of foods
in a healthy diet.
Unlike the
pyramid which
has always
rested on a
foundation of
carbohydrates,
MyPlate is halffull of fruits and
vegetables.
(http://www.choosemyplate.gov/)
Harvard University faculty soon announced their
iteration - Healthy Eating Plate. This plate says its
creators, “fixes the flaws in USDA's MyPlate” by
including advice about good and bad choices in each
category. For example, the “grains” section of MyPlate
is replaced with “whole grains” and includes the text,
“Eat whole grains like brown rice, whole-wheat bread
…. Limit refined grains like white rice and white bread.”
The
Harvard
University
website
says its
plate is,
“based on
the most
up-to-date
nutritional
research,
and it is
not influenced by the food industry or agricultural
policy.”
(http://www.hsph.harvard.edu/nutritionsource/files/healt
hy-eating-plate.pdf)
PWDU Quarterly Newsletter
Seattle Signs on To Mandatory Sick Leave
http://www.cidrap.umn.edu/cidrap/content/influenza/biz
-plan/news/sep2611newsscan.html
On September 23, Seattle Mayor Mike McGinn signed
legislation ensuring paid sick leave in all Seattle
companies with more than four workers. The law takes
effect in September 2012. Seattle is the third US city,
joining Washington, D.C., and San Francisco, to pass
sick leave legislation. In July, Connecticut became the
first state to pass similar legislation.
SPECIAL REPORT
Changes Ahead for Users of MDH’s Rapid
Inspection Software
By Jennifer Miller, MDH Information and Data
Management Unit
MDH is in the beginning stages of a project to develop
a new web based Electronic Field Inspection System
(EFIS) that will eventually replace the Rapid Inspection
(RI) software that is currently used to store, organize,
and retrieve information pertaining to inspections of
food, beverage, and lodging establishments; public
pools and related facilities; youth camps; manufactured
home parks and recreational camping areas.
To start a dialogue with local partners currently using
RI software about the changes that lie ahead, MDH
hosted a series of EFIS Regional Meetings during the
month of June 2011. Representatives from 21 local
partner agencies that use the current RI system
attended the meetings. Participants included local
program managers, inspection staff, and IT staff.
The regional meetings provided MDH staff with the
opportunity to respond to questions regarding the new
EFIS, to gather input from local partners regarding the
design of the new EFIS, and to talk about how we
envision we will transition from the RI system to EFIS.
Overall, there were few concerns expressed about the
new system, and several suggestions / ideas were
shared that will be helpful to the EFIS project team.
Probably the most commonly expressed concern
pertained to internet connectivity issues. To address
this concern, at least initially, MDH has purchased
wireless cards that will be used to identify areas within
the state where wireless internet connectivity is
unavailable and/or areas where transmission speeds
are slow. (continued, next page)
Page 5 of 8
Rapid Inspection Special Report, continued
EH ODDS and ENDS
What prompted MDH to begin to work on
inspection system changes?
Acute Illnesses Associated with Insecticides
Used to Control Bed Bugs - Seven States,
2003-2010
One of the main reasons we initiated discussion and
decided to begin work on inspection system changes is
the fact that the Minnesota Departments of Health and
Agriculture are in the process of amending the
Minnesota Food Code, Minnesota Rules, Chapter
4626.
The current RI software will be modified so as to be in
compliance with the new MN Food Code once it is
amended. If EFIS is not ready for release by the time
the MN Food Code is promulgated (which is likely to be
the case), then the modified version of RI will be
deployed for use until EFIS is released. Should local
partners wish to continue to use the modified version of
RI rather than EFIS, they are welcome to do so,
however once EFIS is released, support of RI will
eventually be discontinued.
Why is a new inspection system needed rather
than just a modification of the current system?
The Rapid Inspection software that is currently used is
a Visual FoxPro application and database. Visual
FoxPro is no longer supported by Microsoft and may
not be compatible with future releases of Windows.
Therefore, MDH will be moving the existing system to
an Oracle database, and redesign the system to
assure that it is programmed in a language that is in
conformance with MDH information technology
standards. The new EFIS system will meet these
programming and technology standards, and will be a
system designed to run from any type of computer
running the most popular web browsers (Explorer,
Firefox, and Safari).
When will the new EFIS be released?
EFIS will not be released until all inspection modules
(including those pertaining to food, beverage, and
lodging; public pools and related facilities; youth
camps; manufactured home parks and recreational
camping areas) have been designed, developed, and
tested. The project, which is in the very early stages of
development, is likely to take at least 24 months to
complete, meaning that EFIS will probably not be
released until sometime after September 30, 2013.
Where can I learn more about the new EFIS?
For more information about EFIS, please see:
http://www.health.state.mn.us/divs/eh/local/foodinspect
/efis.html
PWDU Quarterly Newsletter
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6037
a1.htm
On September 23, CDC’s Mortality and Morbidity
Weekly Report included an article on a seven state
review of illnesses associated with use of insecticides
used to control bed bugs.
The data – collected from a passive surveillance
system – does not represent the true number of cases
but according to the report, exposure to insecticides
used to control bedbugs led to one death and 111
illnesses between 2003 and 2010.
The most common causes of illness were overuse of
insecticides, failure to wash or change bedding that
had been treated with insecticide, and failure to
adequately warn others that insecticide had been used.
The 111 illnesses were reported in seven states:
California, Florida, Michigan, North Carolina, New
York, Texas, and Washington. More than half of the
illnesses occurred in New York. Nearly three quarters
of the cases occurred between 2008 and 2010.
Authors said that the number of reported illnesses
"does not suggest a large public health burden." The
problem, they said, could escalate if the growing bed
bug problem is not adequately and properly controlled
using integrated pest management (IPM) practices.
Food Safety Professionals Dismayed:
Please NOT the Bacon, Said One
http://www.montrealgazette.com/health/Canadian+bac
on+recalled+over+listeria+fears/5251682/story.html
Bacon-loving food
safety professionals
from the Minnesota
Department of Health
were disheartened to
learn in August that
hundreds of thousands
of pounds of Canadian
bacon had been recalled due to fears of listeria
contamination. “Shut down the government if you
must,” said one, “but please don’t take my bacon.”
Page 6 of 8
BUG OF THE QUARTER
Guillain-Barré Syndrome associated with
Campylobacter jejuni Infection
Campylobacter (C. jejuni) is one of the most common
causes of diarrheal illness in the United States. An
estimated 2.4 million people in the U.S. are affected by
campylobacteriosis each year.
Most people who get campylobacteriosis recover
completely within two to five days. In rare cases,
Campylobacter infection results in long-term
consequences. Among the possible consequences of
campylobacteriosis are temporary arthritis, carditis,
and Guillain-Barré syndrome (GBS).
Approximately, one in every 1,000 reported
Campylobacter illnesses leads to Guillain-Barré
syndrome. As many as 40% of GBS cases in this
country may be triggered by campylobacteriosis.
Typically, GBS associated with C. jejuni follows one to
several weeks after symptoms of the initial infection
occur. Guillain-Barré affects the nerves of the body,
resulting in paralysis that lasts several weeks and
usually requires intensive care.
GBS is known to follow several other infections in
addition to C. jejuni, including cytomegalovirus,
influenza, Epstein-Barr virus, and Mycoplasma
pneumonia.
However, GBS associated with Campylobacter may be
more severe than other combinations of infection with
GBS. C. jejuni has been identified as a potential
predictor of poor outcome in persons suffering from
GBS. These patients may have a more severe
autoimmune response to GBS, and therefore greater
damage to the nerves. Some studies report that a
Campylobacter infection preceding GBS can increase
the mortality rate and the need for mechanical
ventilation.
The first case report of this association was published
in 1982 and others have followed. A 2007 study by
British researchers (Tam et al) indicated, “a far greater
excess risk of GBS among Campylobacter enteritis
patients than previously reported by retrospective
serological studies.”
Case Study
In June, 2011, the Arizona Department of Health
identified 4 cases of suspected GBS in an area
bordering Mexico. An increase in Campylobacter
diagnoses had also been noted in Arizona.
GBS patients generally recover within weeks to
months. There is an estimated mortality rate among
U.S. GBS patients of 2 to 3 percent. (Worldwide, 4 to
15 percent of GBS patents may die within the first year
after onset). Twenty percent of GBS cases may have
significant and lasting neurologic effects.
A bi-national case control study ultimately identified 26
cases of GBS with onset from May 4 to July 21, 2011. Of
these, 81 percent reported diarrheal illness a median of
11 days before onset of GBS.
Resources
Contaminated water is believed to be the cause of the
original Campylobacter outbreak.
Minnesota Department of Health
http://www.health.state.mn.us/divs/idepc/diseases/gb/
basics.html
Mayo Clinic
http://www.mayoclinic.com/health/guillain-barresyndrome/DS00413
Centers for Disease Control
http://www.cdc.gov/h1n1flu/vaccination/factsheet_gb
s.htm
http://www.cdc.gov/nczved/divisions/dfbmd/diseases/
campylobacter/
Tam et al, 2007
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1828628/
A Binational Outbreak of Campylobacter and GBS
http://www.dgepi.salud.gob.mx/2010/PDFS/SINAVE/RNS
2011/1_310811_BroteSGB.pdf
PWDU Quarterly Newsletter
GBS typically affects only about 1 in 100,000 people. This
cluster of cases (additional cases were identified in
nearby Wyoming) were far in excess of the number of
cases (4 to 6) expected annually in the area.
GBS is devastating in human terms; its cost can also
be expressed in financial terms. In 1997, staff from the
U.S. Department of Agriculture and others produced an
Agriculural Econimic Report, Estimated Annual Costs
of Campylobacter-Associated Guillain-Barré
Syndrome.
They said, “Of an estimated 2,628 to 9,575 new U.S.
cases with GBS annually, 526 to 3,830 are triggered by
infection with Campylobacter. Estimated total annual
costs of Campylobacter-associated GBS plus
previously estimated costs of campylobacteriosis add
to total annual costs from Campylobacter of $1.5 to
$8.0 billion (1995 dollars). Assuming 55-70 percent of
costs are attributable to foodborne sources … reducing
Campylobacter in food could prevent up to $5.6 billion
in costs annually.
Page 7 of 8
L AST W O R D : T H AN K Y O U !
198 Germ City volunteers staffed 288 three
hour shifts and helped more than 24,000 State
Fair goers wash their hands in 2011.
PARTNERSHIP AND WORK FORCE DEVELOPMENT UN IT 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, 651-387-6461
Amanda Krentz, Germ City Intern
[email protected]
651-201-5659
Lynne Markus, IARC, 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) Cyr, training, prog. evaluation, standardization
NOTE: [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