Minnesota Department of Health (MDH),
Food Safety Partnership (FSP) and
PWDU Quarterly Update
Volume 7, Issue 1, January 2013
Training Calendar
Inside this Issue
Happy New Year from PWDU! ........................................ 1
Training Calendar ............................................................ 1
Date
Org.
Details
Jan 31
MEHA
Winter MEHA Conference
U of M Continuing Education
Center, University of Minnesota St. Paul Campus
Tip of the Quarter ............................................................ 2
Bug of the Quarter: Mystery Outbreak! ........................... 3
Healthy Swimming Update .............................................. 4
http://www.mehaonline.org/sites/
default/files/meha/images/2012%
20Winter%20Agenda.pdf
Training Events ............................................................... 5
P.E.P. Talk: Program Evaluation Pointers ...................... 5
Feb 6
Farm to Cafeteria Workshops 2.0 ................................... 6
MDH/
FPLS
8:30 a.m. to 9:30 a.m.
FSP
9:45 a.m. to 1:00 p.m.
Climate Change Corner .................................................. 7
In the News ..................................................................... 7
Ice Bars ........................................................................... 9
Feb 6
PWDU Staff Contact Information .................................... 9
Regulators’ Breakfast: Topics
vary. Regulators may submit
questions to
[email protected].
Agenda: Food Code Update;
Seasonal Temp Fact Sheet;
Mechanically Tenderized Meats;
Epidemiology report
Happy New Year from PWDU!
With this issue of the Quarterly Update, we welcome
three new members in our unit. Denise Schumacher, Jim
Topie and I are collaborating on communications and
training. Please contact us with feedback and
suggestions.
In each issue of the Update,
look for P.E.P. Talks (Program
Evaluation Pointers), a
Healthy Swimming Update,
the Climate Change Corner and more.
In this issue, test your FBI-sleuthing skills with a Mystery
Outbreak! and learn about fermentation in the Tip of the
Quarter. Watch coming issues for a fishy news item from
former editor Deborah Durkin, too.
Mar 6
Apr 3
Apr 3
MDH/
FPLS
Regulators’ Breakfast
MDH/
FPLS
Regulators’ Breakfast
FSP+
9:45 a.m. to 1:00 p.m.
8:30 a.m. to 10:00 a.m.
8:30 a.m. to 9:30 a.m.
Agenda TBA
Apr 12
MDH/I
DEPC
Healthy Swimming Workshop
Rochester
Time and location TBA
Happy Reading, Sarah
1
Date
Org.
Details
Apr 19
MDH/I
DEPC
Healthy Swimming Workshop
Tip of the Quarter
What is Fermentation?
St. Cloud
Fermentation is the breakdown of sugars,
carbohydrates, protein and fats by microorganisms
under both aerobic and anaerobic conditions. The
purpose of fermentation is to reduce pH to below 4.6
(use 2009 FDA Food Code interaction tables to
determine product-specific pH requirements) and inhibit
harmful bacteria as well as bacteria that cause spoilage.
Fermentation of foods involves adding components such
as starter cultures, sugar and/or salt to help with the
fermentation process. The major types of fermentation
include alcoholic fermentation, lactic and acetic acid
fermentation and mixed fermentation.
Time and location TBA
May 8
May 8-10
MDH/
FPLS
Regulators’ Breakfast
MEHA
Spring MEHA Conference
8:30 a.m. to 10:00 a.m.
Ruttger’s Bay Lake Lodge
Jun 5
Jun 5
MDH/
FPLS
Regulators’ Breakfast
FSP
9:45 a.m. to 1:00 p.m.
8:30 a.m. to 9:30 a.m.
Agenda TBA
Jul 9-11
NEHA
NEHA AEC Washington, D.C.
Jul 10
MDH/
FPLS
Regulators’ Breakfast
MDH/
FPLS
Regulators’ Breakfast
FSP+
9:45 a.m. to 1:00 p.m.
Aug 7
Aug 7
Alcoholic Fermentation
This process involves yeasts or
bacteria converting sugar, in
the absence of oxygen, into
CO2 and ethanol. Alcoholic
fermentation is used as a way
to preserve perishable foods
such as fruits, and high sugar
or starchy foods.
8:30 a.m. to 10:00 a.m.
8:30 a.m. to 9:30 a.m.
Agenda TBA
Sept 11
Week of
Sept 23
MDH/
FPLS
Regulators’ Breakfast
NEHA
NEHA Regional Workshop
Examples: Wine, Beer
Lactic and Acetic Acid Fermentation
8:30 a.m. to 10:00 a.m.
Lactic acid and acetic acid
fermentation occur when
microorganisms ferment simple
sugars such as glucose, sucrose
or fructose in the absence of air,
and produce lactic acid and other
acids. These acids reduce pH and
LaCrosse, WI Radisson
Agenda and dates TBA
Oct 2
Oct 2
MDH/
FPLS
Regulators’ Breakfast
FSP
9:45 a.m. to 1:00 p.m.
8:30 a.m. to 9:30 a.m.
preserve the food.
Agenda TBA tentative: Juice
HACCP, Wild Game
Nov 6
Dec 4
Dec 4
MDH/
FPLS
Regulators’ Breakfast
MDH/
FPLS
Regulators’ Breakfast
FSP+
9:45 a.m. to 1:00 p.m.
Examples: Sauerkraut, Kimchi, Pickles, Yogurt,
Vinegar
Mixed Fermentation
8:30 a.m. to 10:00 a.m.
Mixed fermentation involves the use of
different types of microorganisms such
as bacteria, yeasts and molds in a
specific sequence.
8:30 a.m. to 9:30 a.m.
Agenda TBA
2
cream. Early in the morning on December 14, they woke
with intense vomiting and diarrhea.
Example: Kefir
Food Safety Concerns
What do you think caused these illnesses?
Bacterial hazards associated with fermentation include:
Clostridium botulinum, Staphylococcus aureus,
Salmonella, Listeria monocytogenes, Shigella, and
pathogenic E. coli.
Looking Deeper
Let’s take a look at what’s been happening inside the
restaurant in the last few days. This restaurant is always
busy, but especially at this time of year. Three regular
employees have recently left, leaving the remaining
staff to put in extra hours.
Fermentation reduces pH to below 4.6 and inhibits
harmful bacteria.
Safe Fermentation of Foods
Safe and successful fermentation of foods can be
accomplished by addressing several factors. Here are
some examples of controls:
•
•
•
Anthony is a line cook. His son was sent home from
school on December 10 after vomiting. The next day,
Anthony didn’t feel great, but went to work anyway.
The manager has told several cooks that they can’t take
time off until he hires more people.
Lactic and/or Acetic Acid Fermentation-Must
have a rapid drop in pH to required level.
Alcoholic Fermentation- Rapid production of
large amounts of carbon dioxide in the
fermentation vessel and the rapid production of
ethanol inhibit harmful bacteria.
Mixed fermentation: Mixed fermentations of
beans, tubers, grains and fish often rely on high
salt concentrations (>13%) to inhibit harmful
bacteria.
Anthony is responsible for receiving, washing and
cutting produce, and for cooking and cooling chicken
breasts for enchiladas. During the lunch and dinner
rushes, Anthony cooks and plates orders. In this small
kitchen, the employees often have a hard time finding
enough space in the walk-in cooler for the large
containers of refried beans, cooked and raw meats, and
fresh produce.
Bug of the Quarter: Mystery Outbreak!
After the beans are cooked and mashed every evening,
employees need to stack the large plastic tubs of beans
three deep on the walk-in shelves.
Mystery Illness
On December 15, Sarah called
the health department to
complain that she, her husband
and their three daughters all
had watery diarrhea. They had
eaten chicken tacos, chips, salsa
and refried beans for lunch at a
popular restaurant the day before. By dinnertime, they
were fighting for the one bathroom in their house.
Did this information change your mind about the cause
of illness?
The Solution
If you guessed that this was both a norovirus outbreak
AND a Clostridium perfringens outbreak, you are
CORRECT! An ill foodworker transmitted norovirus and
improper cooling of meats and beans allowed
Clostridium perfringens to multiply to unsafe levels.
Another call came in that same day. Kim and her friend
Nicole had met for dinner at the same popular
restaurant a few days earlier, on December 12. Kim and
Nicole both had the taco salad, chips, salsa and fried ice
It isn’t often that one restaurant is responsible for two
different foodborne illness outbreaks in the same week,
but with improper food safety practices, this has
happened in the past.
3
This story is based on a real
situation from a Minnesota
foodborne illness outbreak.
Healthy Swimming Update
Pathogen Resources
A record number of 11 recreational water outbreaks
were identified in Minnesota 2012. The outbreaks took
place at a wide variety of settings, including
pools/waterparks (5), spa pools (2), splash pads (2), a
lake (1), and a swim pond (1). The 11 outbreaks were
responsible for almost 200 documented illnesses. The
majority (82%) of the outbreaks were due to the chlorineresistant parasite Cryptosporidium.
2012 Statistics
Norovirus Fact Sheet for
Foodhandleers (CDC):
http://www.cdc.gov/norovirus/downloads/foodhandler
s.pdf
Norovirus Home Page (CDC):
http://www.cdc.gov/norovirus/resources.html
Lessons Learned
Clostridium perfringens web page (CDC):
http://www.cdc.gov/foodborneburden/clostridiumperfringens.html
Norovirus
Clostridium
perfringens
Incubation
12 to 48 hours
(typically 24 to 48)
6 to 24 hours
(typically 8 to
12)
Duration
Less than 24 to 60
hours
Less than 24
hours
Acute-onset
vomiting, non-bloody
diarrhea, cramps,
aches, low grade
fever
Abdominal
cramping and
watery
diarrhea
Uncooked food
(requiring hand
contact), water,
person-to-person,
environment/fomites
TimeTemperature
abused beef,
poultry,
gravies, stews,
beans
Supportive
Supportive
Symptoms
Risk Factors &
Transmission
Treatment
Several important lessons can be learned from the 2012
waterborne outbreaks, including:
People are continuing to swim while ill with diarrhea,
including pool staff. Educate staff and patrons on the
importance of not swimming when they have diarrhea.
Cryptosporidium can survive for days in properly
maintained pools. However, improper disinfection can
lead to a protracted amount of time during which users
are at risk of becoming infected.
Additional treatment devices (e.g., UV) to kill
Cryptosporidium are only effective if they are properly
maintained.
Upcoming Training
Since swimmers share the water – and the germs in it –
with every person who enters the pool, spa pool, lake, or
splash pad, the best way to prevent recreational water
illnesses is to keep germs out of the water in the first
place. The annual Healthy Swimming Workshops will be
offered this spring for aquatic personnel interested in
learning more about promoting healthy swimming at their
venues. Workshops this year are tentatively scheduled
to be held in Rochester on April 12 and St. Cloud on
April 19; additional information will be available in early
spring. For more information, contact Trisha Robinson at
[email protected].
4
Training Events
Regulators’ Breakfast
FSP Videoconferences
The purpose of the Regulators’ Breakfast is to establish
a forum that will contribute to statewide uniformity and
consistency amongst regulatory staff (local agency and
MDH) in the interpretation and application of statues,
rules and procedures. This event is for regulatory staff.
Contact Sarah Leach for more information
[email protected], 651-201-4509.
The last Food Safety Partnership (FSP) videoconference
was held on June 6, 2012.
View the archive online at
mms://stream2.video.state.mn.us/mdhvc/foodsafetyprtne
rshp060612.wmv.
NEHA Regional Conference
See past FSP presentations and materials at
www.health.state.mn.us/divs.eh/food/pwdu/fsp/.
The NEHA Region 4 Conference will be held in
LaCrosse, WI the week of September 23, 2013. Watch
the MEHA and NEHA websites for details.
The next FSP videoconference will be held from 9:45
a.m. to 1:00 p.m. on Wednesday February 6, 2013.
P.E.P. Talk: Program Evaluation
Pointers
You’ll want to make sure to attend at one of the 14 sites
throughout the
state, or stream
the presentation to
hear about risks
associated with
mechanically tenderized meat products. Jim Topie
(MDH) and Carissa Nath (AURI) will be teaming up to
bring you a wealth of timely information.
A Few Notes about
Standardization
The purpose of
standardization is to
promote uniformity,
consistency and
quality inspections in
accordance with the
Food and Drug
Administration
Recommended National Retail Food Regulatory
Program Standard No.2 (Trained Regulatory Staff). This
includes the ability to accurately cite the provisions of the
MN Food Code, focusing on Public Health Interventions
and foodborne illness risk factors, and applying a
HACCP-based inspectional approach.
For CEUs or site information, contact Tracie Zerwas,
651-201-5402, [email protected].
FSP+ Videoconferences
Food Safety Partnership
Plus (FSP+)
videoconferences are
opportunities for the
regulatory community,
industry and consumers to
meet and learn about
current issues impacting
various environmental
health issues.
MDH has three FDA Standardized Food Safety
Inspection Officers in PWDU that standardize
government inspectors. The current goal is for the MDH
Standards to standardize one person at each delegated
agency and MDH district office. That standardized
person is then expected to train and standardize the
remaining staff in that agency or office.
Three FSP+ events are planned for 2013. Watch for
details in future issues and by viewing the PWDU
training calendar at
http://www.health.state.n.us/divs/eh/food/pwdu/training.h
tml.
Standardization is validation of the individual
candidates’ high level of knowledge, understanding
and application of food safety principles.
Standardization is not basic training.
5
Who is invited:
During standardization, with minimal assistance from the
MDH Standard, the candidate must be able to:

Demonstrate knowledge of the MN Food
Code and be able to interpret and apply the
code provisions

Apply a risk-based inspectional approach by
focusing on practices that are reflective of
the Public Health Interventions and that
address risk factors known to contribute to
foodborne illness


When and Where:
Thursday, February 14th, 10-3:15pm – Gustavus
Adolphus Lutheran Church, Saint Paul
Prepare flow charts for a: “no cook step”, a
“cook serve”, and a “complex food process”
and identify the hazards, critical control
points, and critical limits
Thursday, February 28th, 2-7:15pm – Christ the King
Lutheran Church, Bloomington
What to expect at each Farm to Cafeteria
Workshop:
Recognize when a HACCP plan is required
and verify compliance with an existing
HACCP plan

Develop a Risk Control Plan

Properly use and calibrate inspection
equipment essential for monitoring and
verification of the code requirements

School food service professionals, school administrators,
institutional buyers/wholesalers, farmers, growers,
Statewide Health Improvement Program coordinators,
parents and guardians of metro-area school children,
and other community partners!
•
•
•
•
Effectively communicate with the person-incharge and explain significant inspection
findings in a way that can be understood,
accepted and acted upon.
•
•
Please be aware that the MDH Standards’ schedules are
very full, so they may not be able to accommodate a
standardization request right away. They are keeping a
waiting list of individuals that wish to become
standardized. For questions, or to apply, contact Angie
Cyr, Michelle Messer, or Kim Carlton.
Farm to Cafeteria Workshops 2.0
Join us on February 14th or 28th to build and
strengthen Farm to School!
The organizations, Renewing the Countryside and the
University of Minnesota Extension, are hosting two
identical Farm to Cafeteria workshops in the Twin Cities
metro area in February, 2013. The 2013 workshops are
intended to help build skills and work toward breaking
down barriers to Farm to School.
•
6
Informative and interactive training sessions on
the following topics:
Post-harvest handling and on-farm food safety
Navigating Farm to School contracts between
growers and school food service
How to generate and maintain school and
community support for Farm to School
Overview of the new National School Lunch
Program regulations and the Fresh Fruit and
Vegetable Program
Tips for parents and community members on
Farm to School promotion
• A chance to
network with school
food service directors,
institutional food
buyers, producers, and
more!
• A chance to
share your thoughts on
Farm to School
challenges and
opportunities.
• A locally
sourced meal featuring
Farm to School recipes served by local districts
Resource tables with information on Food
Safety, School Gardens, Farm to School
Documentary, Food and Nutrition Education,
Salad Bars, Local Food Marketing, the
Minnesota Institute of Sustainable Agriculture,
Minnesota Grown, the Institute for Agriculture
and Trade Policy, and more!
importance of water in Minnesota, the public health
issues related to climate change and water, and public
health strategies to prevent injury and illness due to
changing water conditions. View this module here:
http://www.health.state.mn.us/divs/climatechange/wa
ter.html
Cost:
$20 (CEU’s will be available for food service personnel)
See the event website for workshop details and
registration information and join the event on Facebook
(Feb 14 or Feb 28)! Feel free to contact Molly Turnquist
<[email protected]> with any questions.
Air Quality, Climate Change and Public Health. This
training module provides an overview
of the observed climate changes in
Minnesota, the public health issues
related to climate change and air
quality, and public health strategies
to mitigate and adapt to climate change to reduce the
health impacts. View this module here:
http://www.health.state.mn.us/divs/climatechange/air.ht
ml
We hope to see you there!
Climate Change Corner
Climate Change and Human Health Training Tools
Climate Change and Public Health 101; Water
Quality and Quantity, Climate Change and Public
Health; and Air Quality, Climate Change and Public
Health are the latest training tools from the Minnesota
Climate and Health Program in MDH’s Environmental
Health Division. Recently released, they join another
training module, Extreme Heat Events, Climate
Change and Public Health. The modules are free and
can be used as an educational tool for interested
individuals or as a “train the trainer” for presenters. Each
training is approximately one hour long and is available
to download as a fully scripted PowerPoint document.
Module descriptions follow with their links.
Extreme Heat Events, Climate Change and Public
Health. This module provides an overview of extreme
heat events and the public health
impacts of heat. The module also
discusses strategies for individuals to
stay cool and for local health
departments to protect their
communities during heat events. View this module here:
http://www.health.state.mn.us/divs/climatechange/extre
meheat.html
This information regarding the most likely climate
changes in Minnesota and their potential impacts on
public health, compiled from many local and state
partners, is possible through funding from the Centers
for Disease Control and Prevention (CDC).
Current climate change training modules:
Climate Change and Public Health
101. This module provides an
overview of the observed climate
changes in Minnesota and discusses
the potential human health impacts
of climate change. The module provides
communication, mitigation, and adaptation strategies
that public health and local government can employ to
prevent climate-related illness, injury, or death. View this
module here:
http://www.health.state.mn.us/divs/climatechange/climat
e101.html
In the News
Locally Caught
Fish
Chef Evan Mallett
owns Black Trumpet
Bistro in Portsmouth,
NH. In November
2012 he published
an article discussing
the considerations
Water Quality and Quantity, Climate Change and
Public Health. This training module
provides an overview of the
7
he and other restaurateurs deal with when deciding what
seafood to offer, and how to source it.
slicers should be removed from service until
repaired or replaced.
Commercial Deli Slicer Inspection Tips for Food
Safety Professionals (English PDF)
Read the full blog post here:
http://chefscollaborative.org/2012/11/20/grandpa-whatsa-cod/.
If deli slicers are not properly cleaned and sanitized on a
regular basis, food soils and disease-causing
microorganisms can accumulate on slicer surfaces and
result in food contamination. These machines have a
long life in retail and foodservice establishments, and
over time they may become difficult or impossible to
properly clean and sanitize. Routine professional
maintenance of all deli slicers is critical to preventing
these machines from becoming a significant food safety
hazard.
Energy Conservation Awareness in Hennepin
County
The December 2012 issue
of NEHA’s Journal of
Environmental Health
included Energy
Conservation Awareness
and Practice in
Restaurants of Hennepin
County, Minnesota by
Jack Brondum and Susan
Palchik of the Hennepin County Human Services and
Public Health Department.
Outbreaks of foodborne illness resulting in serious
illnesses and hospitalizations have been linked to food
that has become
contaminated
during contact
with deli slicers.
FDA continues to
work closely with
state and local
governments
and operators of
restaurants,
grocery stores
and other food
establishments to prevent illness from contaminated
food. FDA is working with stakeholders to develop
enhanced minimum standards for the design and
construction of new deli slicers and to ensure that proper
cleaning and maintenance instructions are provided with
each machine.
Find abstracts of this and other articles at the NEHA
website:
http://www.neha.org/JEH/2012_abstracts.htm#Energy
Conservation Awareness and Practice in Restaurants of
Hennepin County, Minnesota.
New FDA Materials on Sanitation Concerns with
Commercial Deli Slicers
As part of an initiative to improve food safety practices in
retail and foodservice establishments, FDA has
developed a poster and flyer designed to raise
awareness of sanitation concerns with commercial deli
slicers commonly used to slice meats, cheeses and
produce in food stores, delis, restaurants and other
foodservice establishments:
•
•
FDA encourages consumers to ask store and restaurant
management about the procedures they follow to ensure
their deli slicers are properly cleaned and maintained.
The poster, targeted to operators of food
establishments and their front line food
employees, is suitable for posting near deli
slicers, and explains the importance of proper
slicer maintenance and highlights examples of
hard-to-clean problem areas on deli slicers.
Keep Commercial Deli Slicers Safe1 (English
PDF) (Spanish PDF)
The flyer, targeted to food safety professionals,
offers tips to ensure deli slicers are being
properly cleaned and maintained and when
The new poster and flyer are available in both English
and Spanish at no charge and can be ordered at:
http://www.fda.gov/downloads/Food/ResourcesForYou/U
CM222258.pdf.
For orders greater than 500, contact Shirley Turpin at
[email protected].
8
Ice Bars
a roof to shelter the operation from the elements and
potential contamination, before a license is issued.
Because conventional plumbing would freeze, approved
temporary handwashing sinks are used in the ice bar
service area.
A Cool Hangout
Minnesota is noted for its hardy citizens who greatly
enjoy our varied seasons. We have outside summer
activities that have spilled over to wintertime. There is
the Holidazzle parade, frozen turkey bowling, lake ice
golf outings,
winter carnivals,
numerous
frolic-in-the-snow
festivals and
curling of rocks. In
addition, there
are creative ways
to enjoy certain
beverages at
some food
service and
lodging
establishments.
These are stands that customers like to patronize for
that real “up north” wintertime experience that are very
seasonal and are rock solid: ice bars.
Ice bar operations are not limited by freezing; frigid
temperatures simply help to build the ambiance. Ice bars
provide ice sculptures, blue ice lighting, slabs of ice
made into serving bars and ice seating. One unique
feature is that some have added actual ice shot glasses.
This does not mean the consumable ice is cut from a
lake as our ancestors may have previously done. The
perspective of environmental and public health has been
added with the recognition that ice contacting water or
beverages is actually a food. These ice shot glasses are
safely produced in the establishment’s permanent
location by freezing potable water in specially formed ice
trays. Ice shot glasses are used for single service by ice
bar patrons.
Ice bars are regulated by the Minnesota Department of
Health as Seasonal Temporary Food Establishments.
Currently, three ice bars associated with regular
establishments are licensed by MDH. (Others may also
be licensed by local health departments.) The bar must
meet several construction requirements, such as having
You can learn more about requirements for Seasonal
Temporary Food Stands, including ice bars, here:
http://www.health.state.mn.us/divs/eh/food/license/temps
eason.html.
Partnership and Workforce Development Unit Staff Contact Information
Angie Cyr, acting PWDU supervisor
[email protected]
651-201-4843
Kim Carlton, training, program evaluation, standardization
[email protected]
651-201-4511
Nicole Koktavy, epidemiologist, EHS-Net coordinator
[email protected]
651-201-4075
Sarah Leach, newsletter, training, food safety outreach
[email protected]
651-201-4509
Lynne Markus, emergency response, climate change
[email protected]
651-201-4498
Michelle Messer, training, program evaluation, standardization
[email protected]
651 201-3657
Jennifer Rief, administrative support
[email protected]
651-201-4508
Denise Schumacher, web, communications
[email protected]
507-537-7162
Jim Topie, training, communications
[email protected]
218-302-6154
Division of Environmental Health
Food, Pools, and Lodging Services Section
P. O. Box 64975
St. Paul MN, 55164-0975
651-201-4500 or 1-888-345-0823
9