Minnesota Department of Health (MDH)
Food Safety Partnership (FSP) and
Partnership and Workforce Development Unit (PWDU)
QUARTERLY UPDATE
Volume 6, Issue 3, July 2012
SECTION HEADINGS
Training Resources ….……….…..….….…………….….. 1-2
Program Evaluators’ Update …………..………….….. 3
Tip of the Quarter ….......................................... 3
Bug of the Quarter ……………………………………….... 4-5
Web and Written Resources……………………..…..
6-7
Climate Change Corner …….…………….……….......… 7
Healthy Swimming Update ………………………......... 8
Food and Food Safety Matters……….…..….……….. 9
In The News……………………………………………..……… 9
Germ City Available During the Fair………..……… 9
Go Figure ………………………………………………..……… 9
PWDU Staff Contact Information...................... 10
NOTE FROM THE EDITOR
TRAINING RESOURCES
2012-2013 Training Calendar
Date
Org.
10:00 a.m. to 12:00 noon
Aug 15
FSP+
Sep
27-28
MDH
Thank you for helping me to learn about food safety.
Thank you for working with me on the Food Safety
Partnership and its Steering Committee. Thank you for
your willingness to go above and beyond what you
must do to assist with years-long workgroups,
quarterly conferences, and daily questions, all in
pursuit of a healthier environment for us all.
I am moving on to a position as the Minnesota Fish
Advisory outreach coordinator. I hope to spend my
last several years in Public Health learning new things,
and meeting people whom I will enjoy as much as
I have enjoyed working with you.
Juice and Cider Making, Katherine
Simon, MDA and Fish and Wild Game
Donations, Levi Muhl, MDA
Reduced Oxygen Packaging (ROP)
Workshop. Details TBA
9:30 a.m. to 1:00 p.m.
Oct 3
FSP
Oct 4
MEHA
Fall Education Conference, Walker,
MN, www.mehaonline.org/events
Dec
FSP+
Agenda TBA
Feb
FSP
Apr
FSP+
Jun
FSP
Aug
FSP+
Oct
FSP
Agenda: Epidemiology report, other
agenda items To Be Announced (TBA)
All Day
Dear Friends and Colleagues,
This will be my last PWDU Newsletter. I am grateful
for this opportunity to thank everyone I have worked
with during the last five years.
Topic / Contact
9:30 a.m. to 1:00 p.m.
Agenda TBA
Agenda TBA
9:30 a.m. to 1:00 p.m.
Agenda TBA
Agenda TBA
9:30 a.m. to 1:00 p.m.
Agenda TBA
See Training and Program Evaluation Calendar at:
health.state.mn.us/divs/eh/food/pwdu/training.html
Best to all, Deborah
PWDU Quarterly Newsletter
Page 1 of 11
TRAINING, CONTINUED
New Web Based Courses from FDA’s ORA U
MN Food Safety Partnership Video-Conference
http://www.fda.gov/Training/ForStateLocalTribalRegu
lators/ucm120925.htm
The last Food Safety Partnership (FSP) videoconference was held on June 6, 2012.
An archive video can be viewed online at
mms://stream2.video.state.mn.us/mdhvc/foodsafety
prtnrshp060612.wmv
See past FSP presentations and materials at
www.health.state.mn.us/divs/eh/food/pwdu/fsp/.
The next FSP video-conference will be held from 9:30
a.m. to 1:00 p.m. on Wednesday, October 3, 2012.
The U.S. Food and Drug
Administration (FDA)
announced in late June
that there are several new
ORA U courses available online. Also, the ORA Risk
Management Course – formerly delivered by CD - is
now available as a web-based course.
New online are:
•
ORA Risk Management
For CEUs or site information, contact Jennifer Rief,
651-201-4508, [email protected].
•
Pest Control in Food Establishments
•
Plumbing Controls for Commercial Food
Establishments
FSP-Plus Training, August 15, 2012
•
The August 15 FSP-Plus video-conference will feature
presentations by two Minnesota Department of
Agriculture staff members.
National Shellfish Sanitation Program
Overview
•
Shellfish Growing Areas
•
Shellfish Plant Sanitation
Katherine Simon will speak about food safety and
regulatory requirements related to Fruit Juice and
Cider Making. Levi Muhl will address the same aspects
of Fish and Wild Game Donations.
FPS-Plus is scheduled from 10:00 a.m. until 12:00
noon. The workshop will originate from the
MDA/MDH Freemen Office Building in Saint Paul and
be available at the usual FSP video-conference sites.
Watch for an email with site locations and other
details in mid- to late July. Anyone with an interest in
these topics is welcome.
Reduced Oxygen Packaging Training,
September 27-28, 2012
The September 27 and 28, 2012 event will be a dayand-a-half Reduced Oxygen Packaging HACCP
Workshop, presented by Dr. Brian Nummer of Utah
State University.
The workshop will be held at the MDA/MDH Freeman
Office Building in St. Paul. There is room for 60
participants and there will be a small fee.
Watch for an email coming soon with more
information regarding this invitation-only event for
regulatory staff.
PWDU Quarterly Newsletter
In the planning and development stages:
•
Communication skills for regulators (oral) –
expected soon
•
Pasteurization and food labeling - expected to
be online in September or October
Other online courses (accessible to all):
•
•
•
ALERT: Food Defense Awareness
Basics of Auditing for Regulators MP1050
CARVER + Shock Software Tool
The CARVER + Shock Vulnerability Assessment
Tool can be used to assess vulnerabilities within
a food production system or infrastructure.
Computer-Based Case Study: "Salmonella in the
Caribbean"
•
•
•
•
Introduction to the Food Emergency
Response Network (FERN)
Introduction to Food Security Awareness
FD251A3
June 28, 2010 Integrated Food Safety
System Webinar
Tour of FDA
For information on registration and web-based
courses, see
www.fda.gov/Training/ForStateLocalTribalRegulators/
ucm120939.htm
Page 2 of 11
PROGRAM EVALUATORS’ UPDATE
TIP OF THE QUARTER
Risk Categories and Self-Assessment
What is Reduced Oxygen Packaging?
Two reminders from the Program Evaluation Team:
Reduced Oxygen Packaging includes the following
processes:
(1) Risk Category Assignment: Be sure to review the
risk categories for your establishments, especially
those facilities that have a swimming pool (such as a
hotel). Refer to MN Statute 157.20, which specifies
that:
lodging establishment, or resort that:
"High-risk
establishment
means a
public pool, or
any food and
beverage
service
establishment,
hotel, motel,
(1) serves potentially hazardous foods that require
extensive processing on the premises, including
manual handling, cooling, reheating, or holding for
service;
(2) prepares foods several hours or days before
service;
(3) serves menu items that epidemiologic experience
has demonstrated to be common vehicles of foodborne illness;
(4) has a public swimming pool; or
(5) draws its drinking water from a surface water
supply.”
What this means: If a hotel in your jurisdiction has a
swimming pool and it serves a continental breakfast,
the pool, lodging AND FOOD all need to be
categorized high risk.
If these establishments have been categorized
incorrectly, it will affect the frequency calculation
during your evaluation.
(2) Preparation for Your Evaluation: When
completing your program self-assessment, you are
welcome to use the MDH spreadsheet and formulas
that MDH evaluation staff use to calculate frequency.
Contact Angie ([email protected]), Kim
([email protected]) or Michelle
([email protected]) if you would like the
spreadsheet sent to you.
PWDU Quarterly Newsletter
Vacuum Packaging: Air is removed from a package of
food; the package is hermetically sealed so that a
vacuum remains in the package. This is typically done
for portioning and storage.
Modified Atmospheric Packaging (MAP): The
atmosphere of the package of food is modified so that
the composition is different from air. Oxygen may be
totally replaced or the proportion of another gas such
as CO2 or Nitrogen may be increased. Over time, the
atmosphere may change due to the permeability of
the packaging or the respiration of the food.
Controlled Atmospheric Packaging (CAP): The
atmosphere of a package of food is modified so that
the composition is different from air. The atmosphere
will remain controlled until the package is opened. It is
maintained by using oxygen scavengers or absorbents,
or a combination of total replacement of oxygen, nonrespiring food, and impermeable packaging.
Cook-Chill: Cooked food is hot filled into impermeable
bags. Then the bags are sealed, rapidly chilled, and
refrigerated.
Sous Vide:
Raw or
partially
cooked food is
placed into a
hermetically
sealed,
impermeable
bag, cooked in
the bag
(usually in a
water bath). Then the bag is rapidly chilled and
refrigerated.
Under the Minnesota Food Code, ALL types of
Reduced Oxygen Packaging require a HACCP plan.
Certain processes may require a variance. Refer to
4626.0415 and 4626.0420.
MDH is working on further guidance for these
processes. Please mark your calendars for the
upcoming ROP/HACCP workshop to be held at the
Freeman Building September 27-28.
Page 3 of 11
BUG OF THE QUARTER
Shigella, Shigellosis (Dysentery)
Shigellosis is an intestinal infection caused by Shigella
bacteria. There are four species of Shigella: Shigella
dysenteriae, S. flexneri, S. boydii, and S. sonnei.
S. dysenteriae is the agent of epidemic dysentery;
while the milder S. sonnei is most common in the
United States.
Transmission
Transmission is fecal-oral, either by person-to-person
contact, or through food, water or objects that have
been contaminated with human feces. With a low
infectious dose of 10-100 organisms, Shigella is spread
very easily. Outbreaks have been traced to
contaminated produce and other foods, contaminated
drinking water, swimming in contaminated water, and
sexual contact between men. In the U.S., S. sonnei
outbreaks among young children in daycare settings
are very common.
Children between two and four years of age are most
likely to get shigellosis. Infants, the elderly, and the
infirm are likely to have the most severe cases.
Symptoms
Symptoms of shigellosis typically appear 1-3 days after
exposure. Symptoms range from mild to severe and
usually last 4-7 days. Symptoms include diarrhea –
often watery or bloody, fever, stomach cramps, and
nausea. Some people with shigellosis will not have
symptoms but will nevertheless carry the pathogen in
their feces.
Diagnosis and Treatment
Shigellosis is confirmed through culture of a stool
specimen or rectal swab. Infections usually will resolve
within 4-7 days without any treatment except
replacement of lost fluids. Complications can include
dehydration or, with S. dysenteriae infection,
hemolytic uremic syndrome (HUS).
Small children may need to be given an oral
rehydrating solution such as Pedialyte. With severe
infections, and for infants, older adults and people
with compromised immune systems, antibiotics and
intravenous fluids may be necessary. The primary
indications for antibiotic treatment are to shorten
duration of illness or eliminate bacteria in the stool to
prevent transmission.
PWDU Quarterly Newsletter
Antibiotic Resistance
Many strains of Shigella are becoming resistant to
antibiotics. The National Antimicrobial Resistance
Monitoring System (NARMS) 2010 annual report
(www.cdc.gov/narms/pdf/2010-annual-reportnarms.pdf) showed that 36.4 percent of Shigella
isolates were resistant to at least three of the eight
antimicrobial drug classes that were tested.
Prevention
Simple precautions can help to prevent shigellosis:
•
Wash hands thoroughly after using the
bathroom and changing diapers, and before
handling or eating food.
• Supervise small children when they wash their
hands.
• Dispose of soiled diapers properly, and disinfect
diaper-changing areas after use.
• Don't prepare food for others if you have
diarrhea; keep children with diarrhea home
from child care, play groups or school.
• Avoid swallowing lake or pool water while
swimming.
• When you have diarrhea, avoid swimming or
sharing baths with others.
Epidemiology
Worldwide: Shigella is estimated to cause 80 to 165
million cases and 600,000 deaths annually. Secondary
attack rates in households have been shown to be as
high as 40%. Shigellosis is more common and serious
in the developing world than in the U.S. Fatality rates
of Shigellosis epidemics in developing countries can be
five to 15 percent.
United States: An estimated 18,000 cases of shigellosis
occur annually in the United States. A FoodNet study
found that approximately 26% of U.S. residents with
sporadic shigellosis reported international travel in the
week before symptom onset. Approximately twothirds of U.S. cases are children under the age of 10.
Minnesota: In April 2012, MDH sent an email to state
and environmental health staff warning them that
MDH is seeing an increase in the number of Shigella
cases statewide. There have been more than 100
cases of Shigellosis identified so far in 2012. The total
number of cases in 2011 was 87; with most of those
cases residing in the metro area. There have also been
five identified outbreaks in childcare centers this year
in Minnesota. MDH expects to see an increase in cases
as the summer progresses.
Page 4 of 11
Shigella, Shigellosis, Continued
The figure below shows Minnesota Shigella data from
1997 through 2011. MDH epidemiologists do not
expect 2012 cases to reach the levels of 2000 or 2001
but do expect numbers similar to those in 2007-2008.
Reported Cases of Shigella Infection,
Minnesota, 1997-2011
Number of Cases
1000
Implications for the Field
When doing inspections at child care facilities and
schools, please stress the importance of handwashing,
employee (and child) illness restrictions/exclusions,
and the need to report when employees are ill.
There are special restrictions for children diagnosed
with a Shigella infection who attend daycare. They
must be excluded until they are symptom-free and
they have been on antibiotic treatment for 24 hours
or have had two stools test negative for Shigella.
Resources
800
MDH Shigellosis (Shigella) Website
600
www.health.state.mn.us/divs/idepc/diseases/shigello
sis/index.html
400
Hennepin County Infectious Diseases in Childcare
Settings and Schools Manual
200
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
0
NOTE: This increase in Shigella
cases has prompted the MDH
Infectious Disease Epidemiology,
Prevention and Control (IDEPC)
Division to prepare a postcard
(text below) that will be sent to
roughly 12,000 Minnesota
daycare centers this summer.
State and local program staff may receive calls from
daycare centers who have received this information.
http://hennepin.us/childcaremanual
Shigella Parent Fact Sheet
http://hennepin.us/files/HennepinUS/HSPHD/Public%
20Health%20Protection/Epidemiology/Daycare%20M
anual/1640_shigella%20parent.pdf
Shigella Technical Fact Sheet
http://hennepin.us/files/HennepinUS/HSPHD/Public%
20Health%20Protection/Epidemiology/Daycare%20M
anual/1635_s6SHIGELLA.pdf
Cleaning, Sanitizing and Disinfection in day cares:
http://hennepin.us/files/HennepinUS/HSPHD/Public%
20Health%20Protection/Epidemiology/Daycare%20M
anual/1085_s2aclean.pdf
Postcard from MDH to Minnesota Daycares – To Be Mailed July 2012
Symptoms of Shigella infection (shigellosis): diarrhea that may be watery or bloody, stomach cramps, fever,
and sometimes vomiting. Other germs like E. coli O157:H7 cause similar symptoms and can cause severe
complications. Shigella and other diarrheal illnesses can be spread from one person to another when objects,
like food or toys, are contaminated with feces and are put in the mouth.
Help prevent illness from spreading at daycare:
1. Follow strict illness exclusion policies: children with diarrhea, vomiting or fever need to stay home until
recovered. Children diagnosed with Shigella infection must also be on antibiotic treatment for 24 hours or have
two stools test negative for Shigella before returning to daycare. Special restrictions also apply for several other
diarrheal diseases (see web links below).
2. Wash hands well with soap and water for 20 seconds, especially after handling diapers, before preparing
food, and before eating.
3. Clean and sanitize surfaces and toys regularly.
For more information about Shigella and about diarrheal illnesses at daycare:
http://www.health.state.mn.us/shigella, http://hennepin.us/childcaremanual or call 651-201-5414.
PWDU Quarterly Newsletter
Page 5 of 11
WEB AND WRITTEN RESOURCES
MDH Climate Change Resources
www.health.state.mn.us/divs/climatechange/
The MDH climate change website is divided into four
topic areas: (1) Climate Change 101, (2) Vector-Borne
Diseases, (3) Extreme Heat Events, and (4) Planning
Tools and Data.
New material on the website includes the Extreme
Heat Toolkit at
http://www.health.state.mn.us/divs/climatechange/e
xtremeheat.html
Assessment of
Health and Climate
Preparedness –
Final Report of the
SCHSAC Climate
Change Adaptation
Workgroup May
2012 is another
new addition to
the MDH website.
MDH Environmental Health Division scientist, Kristin
Raab initiated this project through the State
Community Health Services Advisory Committee
(SCHSAC) with funds from the Centers for Disease
Control. The final report can be found at
www.health.state.mn.us/divs/cfh/ophp/system/schsa
c/reports/docs/2012climatefinalreport.pdf.
New CDC Norovirus Website
www.cdc.gov/norovirus/
The CDC Norovirus website has been updated. The
following memo is from CDC’s Division of Viral
Diseases:
“Learn about norovirus illness, its symptoms, how it
spreads, and ways to help prevent it. Check out
sections targeted for food handlers, healthcare
providers, public health professionals, and
laboratorians. Keep up-to-date on surveillance trends
and outbreaks of norovirus illness. Use the website to
access scientific articles, guidelines, factsheets,
podcasts, and other educational resources.”
The website includes:
•
•
Surveillance for Norovirus Outbreaks
Prevent the Spread of Norovirus
PWDU Quarterly Newsletter
Extension Newsletter/Website: Home Food
Preservation, June 2012
www1.extension.umn.edu/food-safety/home-foodpreservation-newsletter/
From our colleagues at UMN Extension:
“Strawberries are ready for preserving, asparagus to
be pickled, mint to be dried--let the 2012 food
preservation season begin! The June 2012 issue of the
Home Food Preservation Newsletter is online now.
Check it out!”
FDA Food Safety for Moms-To-Be: Safe Eats Eating Out & Bringing In
http://www.fda.gov/food/resourcesforyou/healthedu
cators/ucm082539.htm
This FDA website warns that pregnant woman must be
especially careful about the food they eat. The page
highlights a list of foods to avoid:
•
•
•
•
Swordfish, tilefish, king mackerel, and shark
Raw sprouts of any kind
Juice by the glass (unpasteurized)
Foods that may contain raw or undercooked,
unpasteurized eggs
Also of Interest on the Web
Antimicrobial Use: Urinary levels of triclosan and
parabens are associated with aeroallergen and food
sensitization. Savage JH, Matsui EC, Wood RA and Keet
CA, Journal Allergy and Immunology (Online) June
2012.
www.sciencedirect.com/science/article/pii/S0091674
912007798
Baby Chicks: CDC: Poultry-linked Salmonella outbreak
lasted 8 years. Robert Roos, CIDRAP News, May 31,
2012 www.cidrap.umn.edu/cidrap/content/fs/fooddisease/news/may3112chicks.html
FOODNET : Foodborne Diseases Active Surveillance Network
(FoodNet) in 2012: A Foundation for Food Safety in the
United States. Scallan E and Mahon BE, Clinical Infectious
Diseases, Volume 54, Issue suppl 5, May 2012.
http://cid.oxfordjournals.org/content/54/suppl_5/S381.full.
pdf+html
Page 6 of 11
..On the Web, Continued
CLIMATE CHANGE CORNER
From Rover to You: Notes from
the Field: Human Salmonella
Infantis Infections Linked to Dry
Dog Food — United States and
Canada, 2012. CDC, MMWR,
2012-03-30.
ECDC: Potential Impacts of Climate Change on
Food- and Waterborne Disease
www.cdc.gov/mmwr/preview/mmwrhtml/mm6123a4.htm?
s_cid=mm6123a4_w
In late March, the European Centre for Disease
Prevention and Control (ECDC) published their
technical report, Assessing the potential impacts of
climate change on food- and waterborne diseases in
Europe.
Norovirus: Persistence and transferability of
Noroviruses on and between common surfaces and
foods. Escudero BI, Rawsthorne H, Gensel C, Jaykus LA,
Journal of Food Protection, Volume 75, Number 5,
May 2012.
www.ingentaconnect.com/content/iafp/jfp/2012/000
00075/00000005/art00016
Post-infectious gastrointestinal disorders following
norovirus outbreaks. Porter CK, et al, Clinical Infectious
Diseases, online June 19, 2012.
http://cid.oxfordjournals.org/content/early/2012/06/
19/cid.cis576.full.pdf+html?sid=3d022e08-1774-4b97ab60-856e0932f4cf
Sapovirus: Sapovirus Outbreaks in Long-Term Care
Facilities, Oregon and Minnesota, USA, 2002–2009.
Lee LE, Cebelinski EA, Fuller C, Keene WE, Smith K,
Vinjé J, et al. Emerg Infect Dis [Internet]. 2012 May.
http://dx.doi.org/10.3201/eid1805.111843
Workforce: Curtailed Funds Continue to Hurt Local
Public Health. Mary Rothschild, Food Safety News,
May 24, 2012
http://www.foodsafetynews.com/2012/05/budgetconstraints-continue-to-hurt-local-public-health/
The Epidemiology Workforce in State and Local Health
Departments — United States, 2010. CDC, MMWR,
2012-03-30.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm
6112a2.htm
Understanding EH: People, Polar Bears, and the
Potato Salad: Mapping the Mapping the Gaps
Between Expert and Public Understandings of
Environmental Health, Eric H. Lindland and Nathaniel
Kendall-Taylor, September 2011
www.frameworksinstitute.org/assets/files/eh_mtg_fin
al.pdf
PWDU Quarterly Newsletter
http://ecdc.europa.eu/en/publications/Publications/1
203-TER-Potential-impacts-climate-change-foodwater-borne-diseases.pdf
Report authors studied hundreds of peer-reviewed
publications in English and German looking at key
factors linking the viability of six common food- and
waterborne pathogens to variables such as heavy
rainfall events, air and water temperature, changes in
air temperature, seasonality, and precipitation.
Below, the six pathogens chosen for study are plotted
according to strength of their association with
climatic variables and according to relative public
health risk.
High
Vibrio
Crypto
Salmonella
Campylobacter
Med
Listeria
Norovirus
Low
Low
Medium
High
Severity of consequences for society/risk group
Campylobacter and Salmonella were most strongly
associated with air temperature. Campylobacter is
also strongly associated with seasonality. Researchers
believe that foodborne outbreaks associated with
these pathogens can be moderated by public health
measures.
The study strengthens earlier findings showing Vibrio
infections increasing with longer summers and
warmer water. Authors note that there are still very
few Vibrio infections.
Although each of the six pathogens showed some kind
of relationship to the variables studied, neither
Listeria nor Norovirus showed strong association with
climate change.
Page 7 of 11
FOOD AND FOOD SAFETY
Testing for Non-O157 STEC in Beef
www.cbsnews.com/8301-204_162-57446380/fedsexpand-e-coli-testing-in-meat/
On June 4, 2012, the USDA Food Safety and Inspection
Service (FSIS) began testing meat trimmings for six
additional Shiga toxin-producing E. coli (STEC).
As of that date, any raw, non-intact beef products or
components contaminated with non-O157 STECs O26,
O45, O103, O111, O121, and O145, will be legally
considered adulterated. E. coli O157:H7 has been
considered a beef adulterant for 18 years.
FSIS notes that the new testing policy is not meant to
solve the problem of meat contamination but to help
regulators determine to what degree the industry is
controlling the pathogens.
"FSIS acknowledges that the best approach to
reducing STEC contamination lies not in
comprehensive end-product testing but in the
development and implementation of science-based
preventive controls, with end-product testing to verify
process control," read the notice.
FSIS also pointed to a report from the Centers for
Disease Control and Prevention (CDC) saying that nonO157 STEC "pose a significant public health burden in
the United States." to support the agency's position.
The document added that, "FSIS and the CDC believe
that there are more unreported and unconfirmed
illnesses associated with the specified non-O157 STECs
than with E. coli O157:H7."
Notice from AFDO: Cottage Foods Guidance
www.afdo.org/resources/temp/Cottage_Foods_013.p
df
“AFDO is pleased to announce the completion and
availability of the document, “Cottage Foods
Regulatory Guidance for Best Practices.”
The document was developed for state and local food
safety regulators to provide guidance on the
management of food safety issues with cottage food
operations. AFDO’s Food Committee, consisting of
food protection officials from around the country,
produced the guidance document for this type of food
establishment, which is generally monitored in a very
limited fashion by government regulatory agencies.
PWDU Quarterly Newsletter
Cottage food operations are, in many cases,
unlicensed or unregistered, and the limited oversight
of these operations may present a gap in our current
food safety and security system in this country.
The scope of these guidelines is comparable to those
accepted practices currently recognized in several
states and represents a consensus opinion of AFDO
members. AFDO believes that adopting and
implementing these guidelines, where there is little or
no oversight of such activities, can eliminate a void in
the national goal of a seamless food safety and
security system.
The guidance
document sets
limitations on
what cottage
food
operations can
do and
identifies
specific foods
that may and may not be produced. The document
also contains a list of frequently asked questions and
answers.”
Korean Shellfish Removed from Market
MDH contacted their own inspection staff and that of
delegated agencies on May 25, 2012 (with an update
on May 29) notifying them that all South Korean
shellfish shippers had been removed from the
Interstate Shellfish Shippers Conference List.
This action was taken after an FDA evaluation that
found that the Korean Shellfish Sanitation Program did
not have adequate sanitation controls and that
shellfish produced in that country had a significant risk
of contamination with water-borne pathogens.
MDH requested that staff look for the following
products during routine inspections: oysters, clams,
and mussels, whole and roe-on scallops either
shucked or in the shell, fresh or frozen, whole or in
part, and canned and retorted products.
Products found were to be considered adulterated
and therefore embargoed and condemned.
More information about the recall can be found here:
http://www.fda.gov/Food/NewsEvents/ConstituentUp
dates/ucm304600.htm
Page 8 of 11
HEALTHY SWIMMING UPDATE
MDH Healthy Swimming Advice
From 2000 to 2010, 23 swimming pool outbreaks and
15 beach outbreaks were identified in Minnesota,
resulting in over 900 illnesses. The trend in recent
years is upward as indicated by the figure below.
Therefore, both prevention of feces in pools and
response to fecal incidents are critically (and equally)
important for pool operators and their patrons.
Prevention
In her presentation, Trisha recommended the
following preventive measures:
•
•
•
•
•
•
At the June 6, 2012 Food Safety Partnership meeting,
MDH Epidemiologist, Trisha Robinson reported on a
March 2012 outbreak of Cryptosporidiosis related to a
waterpark.
Investigation of this event revealed 97 cases and one
hospitalization among 227 waterpark users. Outbreak
conclusion: (1) An infectious pool user most likely
introduced the parasite into the pool, and (2)
Improperly maintained chlorine levels helped facilitate
the survival of the parasite in the pools, leading to a
protracted amount of time during which pool users
were at risk for becoming infected.
Trisha noted that Cryptosporidium is particularly
chlorine resistant compared with other pathogens and
that it can survive and be transmitted even in a
properly maintained pool.
Pathogen Inactivation Time for Chlorinated Water
Pathogen
Time
E. coli O157
<1 minute
Hepatitis A
~16 minutes
Giardia
~45 minutes
Cryptosporidium
~15,300 minutes (10.6 days)
PWDU Quarterly Newsletter
Add healthy swimming information to pool
websites with other pool information. Post that
information near the most often viewed details
such as hours of operation.
Add a message to your voicemail or automated
greeting. For example, on the recording
regarding pool hours, add: “To keep the pool
healthy for everyone, remember not to swim
when you have diarrhea.”
Train staff to routinely educate patrons.
Add healthy swimming messages to all print
material around the pool.
Post signs at the front desk, front door, locker
rooms.
Include the information in your rules for special
event guests.
Trisha also noted that the CDC
healthy swimming website at
www.healthyswimming.org
has a variety of posters
available for download, as
well as other educational and
informational materials
related to healthy swimming.
Response
Trisha advised attendees to review the CDC Fecal
Incident Response Recommendations for Pool Staff.
found at
www.cdc.gov/healthywater/pdf/swimming/pools/feca
l-incident-response-recommendations.pdf
These CDC recommendations were revised in 2008.
Based on new data, the CT (contact time) inactivation
value used in CDC fecal accident recommendations for
99.9% inactivation of Cryptosporidium was changed
from 9,600 mg-min/L to 15,300 mg-min/L. This change
translates into longer swimming pool closures to
ensure inactivation of Cryptosporidium.
CDC warns pool operators to check existing guidelines
from local or state regulatory agencies before using
these recommendations, because CDC
recommendations do not replace existing state or
local regulations or guidelines.
Page 9 of 11
GERM CITY AVAILABLE FOR YOUR USE
Germ City Will Not Be at the State Fair in 2012
Due to time
and resource
issues, the
two MDH
Germ City
units will not
be attending
the State Fair
this summer.
Therefore, there are unexpected openings on the
Germ City schedule for two weeks during August and
early September, as well as some availability in July.
For those who are not familiar with Germ City,
Germ City is a science based, educational program to
improve the effectiveness and frequency of hand
washing in adults and children.
Germ City staff members apply GlitterBug lotion to
visitors’ hands; visitors enter Germ City to see
‘pretend germs’ under the black lights; they wash
their hands, and re-enter the Germ City unit to see
how well they washed.
Germ City units are loaned free of charge. Borrowers
will need to make arrangements to pick up and return
Germ City. MDH will assist with these arrangements
whenever possible.
For more information, see
http://www.health.state.mn.us/divs/eh/food/pwdu/fs
p/germcity/index.html. To reserve Germ City, contact
MDH at 651-201-4500.
GO FIGURE
Heart Attack at the Heart Attack Grill
In February and again in April 2012, customers at the
Heart Attack Grill in Las Vegas suffered heart attacks
while eating the 6,000 calorie, 1.5 pound burger called
the Triple Bypass - served by wait-staff in nurses’
uniforms.
It is unknown whether either customer was also
enjoying Flatliner Fries (deep fried in pure lard) or if
they had taken advantage of the free meal offer for
“patients” weighing
more than 350 pounds.
Owner Jon Basso
remarked after the first
heart attack, “I have
had warnings labels
since Day One…telling
people how bad our food is for you. I think that skirts
any liability we might have.” The Heart Attack Grill
does prominently display signs that read “This
Establishment is Bad for Your Health.”
PARTNERSHIP AND WORKFORCE DEVELOPMENT UNIT STAFF CONTACTS
April Bogard Supervisor, PWDU
[email protected]
651-201-5076
Angie (Wheeler) Cyr, training, program evaluation, standardization
[email protected]
651-201-4843
Kim Carlton, training, program evaluation, standardization
[email protected]
651-201-4511
Lynne Markus, IARC, emergency response, climate change
[email protected]
651-201-4498
Jennifer Reif, administrative support
[email protected]
651-201-4508
Michelle Messer, training, program evaluation, standardization
[email protected]
651 201-3657
Nicole Koktavy, epidemiologist, EHS-Net coordinator
[email protected]
651-201-4075
Minnesota Department of Health (MDH)
Division of Environmental Health
Orville L. Freeman Building
625 N. Robert Street, St. Paul MN, 55155
651-201-4500 or 1-888-345-0823
PWDU Quarterly Newsletter
Page 10 of 11
Symptoms of Shigella infection (shigellosis): diarrhea that may be watery or bloody, stomach cramps, fever, and
sometimes vomiting. Other germs like E. coli O157:H7 cause similar symptoms and can cause severe complications.
Shigella and other diarrheal illnesses can be spread from one person to another when objects, like food or toys, are
contaminated with feces and are put in the mouth.
Help prevent illness from spreading at daycare:
1. Follow strict illness exclusion policies: children with diarrhea, vomiting or fever need to stay home until recovered
Children diagnosed with Shigella infection must also be on antibiotic treatment for 24 hours or have two stools test
negative for Shigella before returning to daycare. Special restrictions also apply for several other diarrheal diseases
(see web links below).
2. Wash hands well with soap and water for 20 seconds, especially after handling diapers, before preparing food, and
before eating
3. Clean and sanitize surfaces and toys regularly
For more information about Shigella and about diarrheal illnesses at daycare:
http://www.health.state.mn.us/shigella http://hennepin.us/childcaremanual
or call 651-201-5414
PWDU Quarterly Newsletter
Page 11 of 11