Minnesota Department of Health (MDH), Food Safety Partnership (FSP) and PWDU Quarterly Update November 2015 2015 Training Calendar In this issue Note From the Editor....................................................... 1 2015 Training Calendar................................................... 1 Date Org. Details Oct 7. – 9 MDH/ SCHSAC Community Health Conference Cragun’s Conference Center Brainerd, MN Including “Poo Fighters” presentation (norovirus) developed by FPLS, presented by St. PaulRamsey County EH Oct. 8 – 9 Iowa EHA NEHA Region 4 Environmental Health Conference Waterloo, IA Including “Poo Fighters” presentations (Shigella and hepatitis A) presented by PWDU Oct. 16 St. Louis County St. Louis County HHS Conference DECC Duluth, MN Including “Poo Fighters” presentation (norovirus) developed by FPLS, presented by PWDU Dec. 2 MDH/FPLS Regulators’ Breakfast 8:30 a.m. to 10:00 a.m. Dec. 2 MDH/FPLS/ FSP+ FSP 10:15 a.m. to 1:00 p.m. Plan Review for Retail Food Establishments MDH and MDA Plan Review Cadres, plus representatives of local public health and industry Training Events................................................................ 2 Healthy Swimming Update.............................................. 4 Bug of the Quarter........................................................... 5 Tip of the Quarter............................................................ 6 Emergency Preparedness............................................... 8 Rule Revision................................................................ 10 Partnership and Workforce Development Unit Staff Contact Information.....................................................................11 Note From the Editor Priorities Most of us spend too much time on what is urgent and not enough time on what is important. –Steven R. Covey While putting together this issue of the Update, I was struck by the variety of topics covered in the articles. And by an underlying theme: preparation. As environmental health professionals, an important part of our work is to build and support a system that is both robust and nimble. We provide science-based regulation and training for food safety and related environmental health concerns. We educate. We prepare. We respond. Thanks for the time you spend on “what is important.” Sarah and the PWDU team 1 Training Events Food Safety Partnership – Plus Food Safety Partnership – Plus (FSP+) events are opportunities for the regulatory community, industry and consumers to meet and learn about current issues impacting various environmental health issues. FSP Videoconferences The Food Safety Partnership (FSP) is a consortium of environmental health professionals, industry partners, and other stakeholders, founded in 2001. FSP members work together to protect public health in the area of food safety. Great River Energy Field Trip On August 11, 2105, FSP members gathered for a field trip to learn more about renewable energy in Minnesota.. The group toured Great River Energy’s Elk River Energy Recovery Station and Elk River Resource Processing Plant. For registration details or site information, contact Jennifer Rief at 651-201-4508, [email protected]. Our tour began with a presentation by Tim Steinbeck, Director of the Resource Recovery Project. From left: Patrick Kuisle (Hennepin Co.), See Lee (MDH), Peggy Spadafore (MDH), Lea Lakes (MDH), Diane Olson (MDH), Aaron Gertz (MDH), Solveig Wilmot (City of Edina), Lee Renneke (City of Edina), Sue Goepfert (Anoka Co.), Not pictured: Jennifer Rief (MDH), Sarah Leach (MDH) Municipal solid waste in the receiving floor at the Elk River Resource Processing Plant, above. Great River Energy employees monitor all phases of resource recovery and energy production with modern control equipment, above. The Elk River Resource Recovery Station has a long history of power generation, as can be seen these images of a generator (l), history display (c) and monitoring equipment (r). 2 Regulators’ Breakfast We watched a video showing the process, and then had a lively discussion. You can view the video at the Elk River Resource Processing Plant website (http:// www.greatriverenergy.com/makingelectricity/biomass/ elkriverresourceprocessingplant.html). The purpose of the Regulators’ Breakfast is to establish a forum that will contribute to statewide uniformity and consistency among regulatory staff and management (local agency and MDH) in the interpretation and application of statutes, rules and procedures. This event is for regulatory agencies. Contact Sarah Leach (sarah. [email protected]; 651-201-4509) for more information. After donning hard hats and safety glasses, our group followed Tim on a tour of the recovery station, where municipal solid waste from Anoka, Hennepin and Sherburne counties is collected daily and processed into refuse-derived fuel. At this facility, employees manage a multi-step process to remove recyclables and grind the refuse to prepare it for use as fuel. A highlight for tour participants was watching the crane operator remove large items before the grinding step. The next Regulators’ Breakfast will be held Wednesday, December 2, 2015, 8:30 a.m. – 10:00 a.m. (just prior to the FSP+ videoconference). Food Safety Classroom Training The second stop on our field trip was the Elk River Resource Processing Plant, just up the road from the Resource Recovery Station. The plant has been in operation for over 60 years! We were able to see vintage generators and out-of-use computer monitoring equipment as well as the current control room. Even though the plant was off-line for routine maintenance during our visit, Tim provided a wealth of information about the amount of fuel used and energy produced, how control systems work and the ways ash is scrubbed. Minnesota Department of Health, Food, Pools, and Lodging Services Section (MDH FPLS) has developed and provides Food Safety Classroom Training sessions on a regular basis to inspection and management staff from MDH and local delegated health agencies. This training is provided to advance knowledge, encourage standard procedures and promote uniformity between inspection staff. It is considered “Core” training and topics covered include: • FDA and Minnesota food codes; statutes, rules and regulations Thanks to all who participated, and in particular to Tim Steinbeck and Brenda Geisler from Great River Energy for making the tour a successful educational event. • Proper equipment use (e.g., thermocouples and pH meters) • Effective communication and report writing • Risk-based inspections Over the six days of classroom training, we build upon the learning. The last day we take what has been learned and in teams, document a complex flow chart, identify hazards and CCPs, determine applicable MN food code rules, practice demonstration of knowledge in relation to the food identified in the flow chart and write a risk control plan using the examples provided. Training sessions are scheduled for January 13 - 15 and February 10 - 12, 2016. Contact Jim Topie (james.topie@ state.mn.us; 218-302-6154) to reserve a spot for yourself or other staff from your agency or for information about future sessions. December 2, 2015 FSP+ – Plan Review Videoconference The final FSP+ event this year will be a videoconference on December 2, 2015 (10:15 a.m. to 1:00 p.m.). Plan review for retail food establishments will be the general topic. The agenda for this event is available at the Food Safety Partnership website (http://www.health.state.mn.us/divs/eh/ food/pwdu/fsp/index.html). All training takes place at the MDH Freeman Building in St. Paul. 3 Poo Fighters 2015 Tour Food safety education has hit the road this year with a multi-state Poo Fighters tour. The Poo Fighters training modules were developed for the annual workshop for instructors of certified food manager (CFM) courses. The workshop committee, including staff from state and local regulatory agencies as well as U of MN Extension and private industry, developed training modules focusing on the five reportable pathogens: • Norovirus (not reportable in Minnesota) Poo Fighters Sarah Leach and Jim Topie (MDH Food, Pools, and Lodging Services) at the National Environmental Health Association Region 4 conference in Waterloo, Iowa. • E. coli O157:H7 • Salmonella spp. Healthy Swimming Update • Shigella spp. • Hepatitis A Swimming and Diapers After a sold out show at the CFM workshop (April 2015), Poo Fighters booked dates in St. Cloud (Minnesota School Nutrition Association Annual Conference, August 2015), Brainerd (Community Health Conference, October 2015), Waterloo, Iowa (National Environmental Health Association Region 4, October 2015), Duluth (St. Louis County Health and Human Services, October 2015), and Bloomington (Association of Correctional Food Service Affiliates Annual International Conference, August 2016). This past summer, the Minnesota Department of Health investigated a waterborne outbreak of norovirus gastroenteritis associated with a boating group that swam in the Mississippi River. Ultimately, the water was determined to be contaminated by a young, diapered child who had onset of vomiting 2 days prior to the outing. The child spent the afternoon on the boat, but the child’s parent reported he did not change any diapers during that time. Swim diapers are not leak proof and do not keep germs from contaminating the water. Attendees acquire resources and skills for educating colleagues and the public on the topics of foodborne illness (FBI) reporting and investigation in Minnesota. Sessions improve knowledge of foodborne illness and dispel myths about transmission. The presentations use real-life examples from familiar settings to bring scientific facts and regulatory requirements to life. This outbreak highlights the importance of excluding ill individuals from swimming activities even if they are wearing swim diapers or swim pants. Swim diapers and swim pants can give parents and aquatics staff a false sense of security regarding fecal contamination. Like older children and adults, diapered children who have diarrhea should NOT go swimming! Each 60-minute module is tied together by a band tour theme with the following components: • The Band – human and economic burden, pathogen biology, symptoms, treatment Key facts about swim diapers: • Event Staff – foodborne illness risk factors, person in charge/certified food manager roles • Poo Fighters Diarrhea & Vomit Tour – foodborne illness hotline, number of outbreaks • Swim diapers are designed to contain solid waste not diarrhea. • Classic Hits – historic or well-known outbreaks • Swim diapers do not prevent diarrhea-causing germs like norovirus and Cryptosporidium from leaking into the water. • New Releases – recent outbreaks • Summary, Q & A – review and extend learning, selfcorrect and discuss quiz Contact Sarah Leach ([email protected]; 651-2014509) if you would like Poo Fighters to play your town. • Swim diapers are not a replacement for frequent diaper changing. 4 Bug of the Quarter • 1 acquired in a laboratory setting Brucella Species Six cases of brucellosis in Minnesota were Brucella suis (associated with pigs): What is brucellosis? Brucellosis is a disease, caused by bacteria, which affects many different kinds of animals – including sheep, goats, cattle, elk, pigs, camels and dogs. However, it can also cause disease in humans. • 6 exposed through animal contact such as working at a slaughtering facility in the past or hunting feral swine • 1 foodborne such as preparing infected meat from feral pigs One Minnesota case was Brucella canis (associated with dogs): • Exposed to infected dogs How do people get brucellosis? People with brucellosis may develop fever, sweats, headaches, back pains, and physical weakness. Complications of infection can occur and can involve the bones and joints, heart, liver, and reproductive organs. Symptoms can appear anywhere from five days to several months after exposure. People can be infected with brucellosis bacteria by: • Eating or drinking something that’s been contaminated with the bacteria • Mucus membrane contact with the bacteria, or through breaks in the skin • Inhaling the bacteria, such as in a laboratory setting The most common way that people get the disease is by drinking or eating unpasteurized, contaminated milk or cheese. You can also get it by breathing in the bacteria. That happens less often, but it can be a hazard for people in some kinds of jobs – people who work in labs or slaughterhouses, for example. Infected wounds can be a problem for veterinarians, slaughterhouse workers, or hunters. Hunters can get it by preparing food that is contaminated with brucellosis bacteria, or eating undercooked wild game. Human cases of brucellosis are uncommon, with only about 100 cases a year reported in the U.S. Although brucellosis can make you very sick, it is rarely fatal. Brucellosis has been eradicated from domestic livestock herds in the U.S. although feral swine populations in the southern U.S. continue to be a problem. Most cases of brucellosis in the U.S. likely acquired their infection in a foreign country, or consumed dairy products produced in a foreign country where Brucella is common. There were 23 confirmed cases of brucellosis reported in Minnesota from 1995 through 2014. From January through August of this year (2015), there have been four cases reported in Minnesota. Of the 16 cases of brucellosis in Minnesota with exposure information, 12 were Brucella melitensis (associated with sheep, goats, camels, and cattle): • 8 likely exposed through drinking raw cow, camel, or goat milk, or eating unpasteurized cheeses 5 Tip of the Quarter Can brucellosis be treated? Catering Brucellosis can be treated with antibiotics – but it can take a long time, and treatment can be difficult. Depending on the severity of the illness – and when treatment is begun – it can take anywhere from a few weeks to a few months to recover. Every day, Minnesota food establishments provide food service at events such as weddings, graduation parties or business conferences. The challenges of safely preparing, storing, and transporting large volumes of food typically associated with catered events present increased food safety risks. This fact sheet highlights important requirements and safety considerations for food establishment operators who want to cater in Minnesota. Can brucellosis be prevented? There is no vaccine available for brucellosis. However, you can reduce your risk if you avoid eating or drinking unpasteurized milk, cheese and ice cream. Hunters should wear rubber gloves when field dressing animals and when preparing the meat. Licensing Food establishments that prepare food under contract in support of an event such as a reception, party, luncheon, conference, ceremony or trade show must be licensed. All caterers operating in Minnesota, including those based in neighboring states, must operate in compliance with the Minnesota food code. Resources • Eurasian Swine: Early Detection Species, Minnesota Department of Natural Resources (http://www.dnr.state.mn.us/invasives/ terrestrialanimals/eurasianswine.html) Food establishments in Minnesota are licensed by a variety of different agencies. The establishment’s location and menu determine which agency will issue the license. To find out which agency will issue a license, see the Licensing website. Contact the agency that issues the license for the establishment for more information about how the Minnesota food code applies to your establishment. • Feral Pig Hunting, Wisconsin Department of Natural Resources (http://dnr.wi.gov/topic/hunt/ feralpig.html) • Brucellosis, U.S. Centers for Disease Control and Prevention (http://www.cdc.gov/brucellosis/) • Brucellosis Disease Information, USDA Animal and Plant Health Inspection Service (https://www.aphis. usda.gov/wps/portal/aphis/ourfocus/animalhealth/ sa_animal_disease_information/sa_cattle_health/ sa_brucellosis/ct_brucellosis_disease_information/) Other ordinances, such as, zoning, building, and liquor may apply. Certification Minnesota food code requires one full-time Minnesota certified food manager (CFM) in most food establishments. To find out more about CFM requirements, training and certification see the Minnesota Certified Food Manager (CFM) website. Menu, food flow and equipment Menu and food flow determine the type of equipment required and whether the operation can be approved. Menu changes may affect equipment requirements. 6 • Avoid the temperature danger zone (between 41°F and 140°F). Food flow includes all receiving, storage, preparation and service steps. • Properly store food and wash, rinse, and sanitize food-contact surfaces. Food must be adequately protected when transported, stored or displayed to prevent cross-contamination or contamination by dust, insects or other sources. Food grade containers capable of maintaining food at safe temperatures in a sanitary manner are required for delivery or catering. Food, equipment and vehicles must be kept clean. The Food Business Fact Sheets website provides more information about Minnesota food code requirements, such as employee personal hygiene, temperature and time requirements for foods, serving locally grown produce in food facilities, cooling potentially hazardous foods, and safe operation of a food establishment. Keeping food safe Frequently asked questions A caterer is responsible for maintaining control and ensuring the safety of the food from receiving to service. Can more than one business operate out of the same location? When food is being prepared for a catering event, the following can increase the risk of a foodborne illness outbreak: Yes. Any facility used for catering operations must meet construction standards appropriate to the menu and volume of food prepared in that kitchen. Each operator in a shared space must obtain a license to operate at that location. • Poor employee health and hygiene Can caterers cook and assemble food on site at contracted events? • Improper cooking temperatures and times • Food from unsafe sources Yes. Foods may be cooked and assembled on site when control measures are followed to reduce the risk of foodborne illness. Each catering business is unique and operators should discuss menu and food flow, volume and timing, equipment, cleaning and sanitizing, and utilities with their inspector to determine specific requirements. • Improper hot and cold holding temperatures and times • Cross contamination and contaminated equipment Some effective control measures to reduce the risk of foodborne illness are: Are there additional requirements a caterer needs to consider? • Exclude ill employees, wash hands properly, and limit bare hand contact with food. Yes. Caterers must meet safe operation requirements including water supply, sewage disposal, and utilities. Before providing food catering services contact your inspector or licensing agency for plan review requirements. • Cook raw animal foods to at least the minimum temperatures and times. • Verify food source and evaluate received foods for temperature abuse, cross-contamination and labeling. MDH or the agency issuing the license must approve food service plans before new construction or remodeling begins. MDH plan review resources are available at the Plan Review website. 7 ECHO Resources • Licensing (http://www.health.state.mn.us/divs/eh/ food/license/index.html) • Caterer’s Permit with Alcohol, Minnesota Department of Public Safety (http:// mn.gov/elicense/licenses/licensedetail. jsp?URI=tcm:29-2728&CT_URI=tcm:27-117-32) • Minnesota Certified Food Manager (CFM) (http:// www.health.state.mn.us/divs/eh/food/cfm/index.html) • Food Business Fact Sheets (http://www.health.state. mn.us/divs/eh/food/fs/index.html) • Plan Review (http://www.health.state.mn.us/divs/eh/ food/license/planreview.html) • Food Business Safety (http://www.health.state.mn.us/ divs/eh/food/) Emergency Information for Community Members In an emergency, ECHO (http://www.echominnesota. org/in-an-emergency/community-members) will work with public officials to provide you and your family with the information that you need to stay healthy and safe in multiple languages. In the event of a public health or safety crisis: • Call ECHO Phone: ECHO Phone (1-888-883-8831 toll free within Minnesota) will provide background on the situation as well as instructions on how to stay safe and where to go for more information. ECHO Phone will be updated as needed, so be sure to call back frequently. Emergency Preparedness Before Winter Storms and Extreme Cold • Log on to ECHO Web: Our home page will have updated information on the situation and additional resources. ECHO Web will be updated as the situation changes, so be sure to check back for the most recent information. Winter is right around the corner. Before the first winter storm strikes consider the following supplies: • Emergency kit supplies for your home and vehicle. • Tune in to Public Radio: ECHO’s partners in local public radio stations across the state will broadcast emergency messages in multiple languages. Tune in to your local public radio station for situation updates and where to go for more information. • Purchasing a NOAA Weather Radio to hear the latest alerts and warnings. • Download free smart phone apps from FEMA and the American Red Cross to find shelters, first aid information and to find assistance for recovery. • Watch ECHO TV: on Twin Cities Public Television and local public access cable stations. During a major statewide emergency, information in multiple languages will broadcast so that you and your family know what to do to stay healthy and safe. • Check heat source supply. Winter storms can range from a light snow over a few hours to a blinding blizzard. Extreme low temperatures, ice, and strong winds increase the likelihood of taking out power. Storms have the potential to last for several days. Your family might not be together when a winter storm hits, so it is important to make a Family Communication Plan ahead of time. And always listen to the instructions of public health and safety officials – they are here to help you. For more information visit America’s PrepareAthon! (http:// www.community.fema.gov/). • Winter Storms and Extreme Cold (http://www.ready. gov/winter-weather) • Winter Weather (http://emergency.cdc.gov/disasters/ winter/index.asp) • Preparedness Content for Social Media (http://www. cdc.gov/phpr/postcards.htm) 8 10 Ways to Build Resilience Here are some tips from the American Red Cross (http://www.redcross.org/) and American Psychological Association (http://www.apa.org/) to build your resilience and be prepared for an emergency or natural disaster. 1 Good relationships with close family members, friends or others are important. Accepting help and support from those who care about you and will listen to you strengthens resilience. Some people find that being active in civic groups, faith-based organizations, or other local groups provides social support and can help with reclaiming hope. Assisting others in their time of need also can benefit the helper. You can’t change the fact that highly stressful events happen, but you can change how you interpret and respond to these events. Try looking beyond the present to how future circumstances may be a little better. Note any subtle ways in which you might already feel somewhat better as you deal with difficult situations. Accept that change is a part of living Move toward your goals Develop some realistic goals. Do something regularly — even if it seems like a small accomplishment — that enables you to move toward your goals. Instead of focusing on tasks that seem unachievable, ask yourself, “What’s one thing I know I can accomplish today that helps me move in the direction I want to go?” 5 Nurture a positive view of yourself 8 Keep things in perspective 9 Maintain a hopeful outlook Even when facing very painful events, try to consider the stressful situation in a broader context and keep a longterm perspective. Avoid blowing the event out of proportion. An optimistic outlook enables you to expect that good things will happen in your life. Try visualizing what you want, rather than worrying about what you fear. 10 Certain goals may no longer be attainable as a result of adverse situations. Accepting circumstances that cannot be changed can help you focus on circumstances that you can alter. 4 7 Developing confidence in your ability to solve problems and trusting your instincts helps build resilience. Avoid seeing crises as insurmountable problems 3 Look for opportunities for self-discovery People often learn something about themselves and may find that they have grown in some respect as a result of their struggle with loss. Many people who have experienced tragedies and hardship have reported better relationships, greater sense of strength even while feeling vulnerable, increased sense of self-worth, a more developed spirituality and heightened appreciation for life. Make connections 2 6 Take decisive actions Act on adverse situations as much as you can. Take decisive actions, rather than detaching completely from problems and stresses and wishing they would just go away. 9 Take care of yourself Pay attention to your own needs and feelings. Engage in activities that you enjoy and find relaxing. Exercise regularly. Taking care of yourself helps to keep your mind and body primed to deal with situations that require resilience. Additional ways of strengthening resilience may be helpful. For example, some people write about their deepest thoughts and feelings related to trauma or other stressful events in their life. Meditation and spiritual practices help some people build connections and restore hope. October 11, 2015. Columbia, South Carolina. The Red Cross provides hot meals, snacks and water to residents affected by the South Carolina floods. Photo by Danuta Otfinowski/American Red Cross The key is to identify ways that are likely to work well for you as part of your own personal strategy for fostering resilience. Learning from your past: Some Questions to Ask Yourself Focusing on past experiences and sources of personal strength can help you learn about what strategies for building resilience might work for you. By exploring answers to the following questions about yourself and your reactions to challenging life events, you may discover how you can respond effectively to difficult situations in your life. Consider the following: • What kinds of events have been most stressful for me? • How have those events typically affected me? • Have I found it helpful to think of important people in my life when I am distressed? To whom have I reached out for support in working through a traumatic or stressful experience? • What have I learned about myself and my interactions with others during difficult times? • Has it been helpful for me to assist someone else going through a similar experience? • Have I been able to overcome obstacles, and if so, how? • What has helped make me feel more hopeful about the future? To view the most current available draft language, read more about the rule revision process, or provide a comment, visit the Minnesota Food Code Rule Revision website (http://www.health.state.mn.us/divs/eh/food/ code/2009revision/index.html). Pool code We will be requesting approval from the Governor’s Office to publish a “Notice of Intent to Adopt Rules without a Public Hearing” (Notice) in the State Register (http:// www.comm.media.state.mn.us/bookstore/mnbookstore. asp?page=register). Publication of the Notice will start a 30 day period for the public to comment on the proposed revisions. To view information about pool code revision, visit the Minnesota Pool Code Rule Revision website (http://www. health.state.mn.us/divs/eh/pools/rulerevision.html). Registered environmental health specialist/ sanitarian The FPLS manager is reviewing an internal draft of the proposed revisions to the REHS/RS rule. Once this review is completed, the draft rule revisions will be given to the Revisor for drafting into the correct format. For more information about Minnesota’s environmental health specialist/sanitarian registration, visit the Environmental Health Specialist/Sanitarian website (http:// www.health.state.mn.us/divs/eh/san/index.html). Contact Linda Prail ([email protected]; 651-201-5792) with questions about REHS/RS rule revision. Rule Revision Minnesota is currently in the process of revising the Minnesota food code, Minnesota Rules, chapter 4626, the Minnesota pool code, Minnesota Rules, part 4717.1750, and registered environmental health specialist/sanitarian rule, Minnesota Rules, parts 4695.2500 through 4695.3200. Look for more rulemaking updates in future issues. Food code Staff from the Food, Pools, and Lodging Services section in MDH have worked with the Office of the Revisor of Statutes to finish a complete version of the draft revised food code. A complete “Revisor” draft is now posted on the website. 10 Partnership and Workforce Development Unit Staff Contact Information Name Email Phone Steven Diaz, FPLS manager [email protected] 651-201-3983 Kim Carlton, PWDU supervisor, training, program evaluation, standardization [email protected] 651-201-4511 Nicole Hedeen, epidemiologist, EHS-Net coordinator [email protected] 651-201-4075 Sarah Leach, newsletter, communication, education [email protected] 651-201-4509 Michelle Messer, training, program evaluation, standardization [email protected] 651-201-3657 Jennifer Rief, administrative support [email protected] 651-201-4508 Denise Schumacher, communication, program evaluation [email protected] 507-476-4234 Jim Topie, training, program evaluation, standardization [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 11
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