EHA Group Food Safety and Epidemiology Blog

COVID-19 Holiday Season Safety Guide

The 2020 holiday season brings unique challenges never before seen. Faced with a pandemic, we are encouraged to limit gatherings to immediate family only. The Centers for Disease Control and Prevention (CDC) has published recommendations to help curb the spread of COVID-19. 

Small household gatherings are contributing to the spread of COVID-19. The CDC recommends limiting gatherings to immediate household members only. This means the people that live in your household on a day-to-day basis, which may include roommates. When non-household members travel to see you and visit bus stations and airports, they increase the risk of spreading COVID-19. Likewise, crowded shopping areas are strongly discouraged.

The CDC has made these recommendations: 

• Celebrate remotely with Face Time, Zoom or Skype. 
• Host outdoor, rather than indoor, gatherings as much as possible if the weather permits. 
• Check the COVID-19 infection rates in areas where attendees live because it is possible certain areas should be excluded. 
• Avoid holding gatherings in crowded, poorly ventilated spaces. Ensure that 6-feet distancing can be obtained in the space provided. 
• Increase ventilation by opening windows and doors if possible. Use portable HEPA filters in each room if you can. 
• Ensure guests are seated with physical distancing in mind. Use more tables and less chairs. 
• Avoid singing or shouting, especially indoors. Keep music volume low to avoid needing to shout. 

In addition to avoid spreading COVID-19, it is important we practice good food safety practices to avoid spreading a foodborne illness. The following steps will help you handle food safely while navigating this pandemic. 

Thaw turkey completely in the refrigerator before cooking. This may take three days depending on the size of your bird. Alternatively, you can put your food under cold running water no greater than 70°F. Compared to a 40°F refrigerator, this will speed up the process. Never place food on the counter to thaw as bacteria can grow on the turkey and even double every 20 minutes under the right conditions.  

Handle raw turkey (or other meats) carefully. Wash hands, knives and cutting boards thoroughly immediately after use. The juices of raw meat or poultry can contaminate hands or utensils if not properly washed. Never wash a packaged turkey either, the splashing can cross-contaminate nearby surfaces. Wash hands after touching any raw turkey for 20 seconds. Do not substitute hand sanitizer for proper handwashing. 

Cook stuffing separately from turkey in a casserole dish (optional). There is no minimum cooking temperature for stuffing provided it is free of meat or turkey. Set the oven to at least 325°F and cook the turkey to a minimum of 165°F using a stem thermometer. Check multiple areas of the turkey, insert the thermometer completely into the center. Do not rely on a “pop-up” indicator which some turkeys are equipped with. Follow the directions printed on the turkey which likely indicate oven temperature and time to cook based on weight. For large birds, this may take three hours.  

Leftovers should be immediately cut into smaller pieces and refrigerated. The bacteria Clostridium perfringens grows in cooked foods left at room temperature. These bacteria are most commonly diagnosed around the holiday season (November and December) for this reason. Breaking the turkey up into smaller portions and using the freezer are excellent ways to speed up the cooling process. Keep turkey refrigerated for no more than seven days and then discard it. The less time the better, consider freezing cooked turkey. 

Dr. Kramer of EHA Consulting Group speaks to NBC Los Angeles about swimming pool safety

Dr. Melvin Kramer of EHA Consulting Group, Inc. spoke to NBC Los Angeles about swimming pool safety:

"We do have some very serious diseases to certain people that are transmissible through mainly swimming pools and to a lesser extent spas. And that's why the health department inspections are very, very important," said Dr. Mel Kramer, an environmental and disease epidemiologist and former director of environmental health in the city of Baltimore. "We tell people, don't swallow water, to the best of your ability, don't."

Kramer said a multi-point inspection is only a snapshot of the conditions at the time the water is tested. But other days might be different.

"The day before it could be a real health hazard, the day after it could be a lot different," Kramer said.

Dr. Kramer added:

"Just because it’s a fancy club or an expensive hotel doesn't mean it's 100 percent safe," Kramer said.

Kramer said everyone shares the responsibility for keeping pools clean, but swimmers should keep in mind the territory they're entering.

"When you jump into that pool, remember it is probably one of the few places you will ever go where you will put your face where other people put their bottom," Kramer said.

 You can read the full article on nbclosangeles.com.

FDA Investigating Outbreak of Cyclosporiasis in Iowa and Nebraska

Contaminated salad mix has been linked to a cyclosporiasis outbreak in Iowa and Nebraska:

On July 30, 2013, the states of Iowa¹ <image001.png> ² and Nebraska³ announced that their analysis indicated that the outbreak in those states was linked to a salad mix. In follow-up to that announcement, the U.S. Food and Drug Administration is providing an update on its investigation.

The FDA traceback investigation has confirmed that the salad mix identified by Iowa and Nebraska as being linked to the outbreak of cyclosporiasis in those states was supplied to restaurants in those states by Taylor Farms de Mexico, S. de R.L. de C.V., a processor of foodservice salads.   The FDA traceback investigation found  that illness clusters at restaurants were traced to a common supplier,  Taylor Farms de Mexico, S. de R.L. de C.V. The restaurants in Iowa and Nebraska include Olive Garden and Red Lobster, both of which are owned by Darden Restaurants.

FDA’s investigation has not implicated consumer packages sold in grocery stores.

For more information, read EHA Consulting Group's analysis and update on the cyclospora outbreak.

Surveying the 161 Bacterial Families That Live on Your Fruits and Vegetables

We wanted to share this article from Smithsonian Magazine's science blog, about the bacteria that lives on the fruits and vegatables you eat:

For the first time, researchers have sampled and sequenced the DNA of the hundreds of varieties of bacteria that harmlessly live on the produce you buy at the grocery store. Their study, published today in PLOS ONE, revealed 17 to 161 families of bacteria on each of the fruits and vegetables they tested, with grapes, peaches and sprouts hosting the largest diversity of bacteria.

The researchers—Jonathan Leff and Noah Fierer of the University of Colorado, Boulder—studied 11 types of produce in total: apples, grapes, lettuce, mushrooms, peaches, bell peppers, spinach, strawberries, tomatoes, alfalfa sprouts and mung bean sprouts. For each fruit or vegetable, they swabbed the surface, isolated the DNA from the swab, sequenced the DNA and analyzed which bacterial family it fell into.

California Cow with BSE (Mad Cow Disease) Does Not Pose a Threat to the Food Supply

On April 24th, 2012, it was announced that the fourth U. S. cow tested positive for BSE. In truth, the first U. S. cow, which was imported from Canada, had “typical” BSE, which was identified in the United Kingdom and has been present in both Europe and Japan, and to a lesser extent in Canada.

The two previous U. S. cattle were actually atypical, as was the one identified this week. Although scientifically less is known about the etiology or causation of atypical BSE, what is known is it is not acquired the same way as the typical BSE (from consuming infected feed containing the brain or other Specified Risk Materials from an infected animal), nor does it seem to present the same danger, even if consumed.

No animal slaughtered in the United States for human or animal feed can contain Specified Risk Material, which is where the prion (not bacteria or virus) can be found. This includes the brain, the tonsils, and parts of the intestine, as well as the spinal cord. This fourth cow from California was found during the routine surveillance of USDA, APHIS (Animal Plant and Health Service).

This cow was presented for slaughter in an ambulatory fashion (not a “downer”) and was to be incorporated in pet food, but again, none of the Specified Risk Materials would have been included in the pet foods. There is no evidence that non-ruminant animals actually get BSE; however, there are quite a few ruminants that humans consume other than cattle - including buffalo, sheep, goat, and elk.

The human form of BSE is new variant Creutzfeldt-Jakob Disease (vCJD), which is highly and actively looked for in the United States through a variety of modalities, including biological materials sent to the National Prion Disease Surveillance Center in Cleveland, Ohio. Since they started actively looking for vCJD, which would have been from cow, three cases in the United States were identified with none having their exposure to U. S. beef. Their risk factors were two from the United Kingdom and one from Saudi Arabia, who most likely had exposure in the UK and/or the EU.

The U. S. has worked very hard to try to assure not only it’s citizens, but also its trading partners around the world, that due to excellent decision making in the 1980’s with regard to the importation of cattle and bone meal, as well as later on in the discontinuation of feeding any of the Specified Risk Materials to cattle or other food animals and embarking on an intensive surveillance program, that the United States, in effect, is free from BSE and should not be worrisome to the American consumer nor our trading partners around the world.

The bottom line is that this cow does not pose a food safety issue. One can only hope that the news media will not make more out of this and, if they want to increase food safety awareness and prevent foodborne diseases, they will do stories on cooking ground beef to 160 degrees Fahrenheit, poultry to 165 degrees Fahrenheit and don’t cross-contaminate between raw and ready-to-eat burgers or poultry and, of course, frequent handwashing.

Pink Slime Poses no Food Safety Risk

Pink slime has become a pejorative word for some ground beef mixes that have included taking beef trimmings, often times that are very close to the bone, and treated with ammonia or citric acid to create a leaner and more cost-effective component of some ground beef. 

There has never been a question, in terms of food safety, yet due to the media and consumer fire storm that has erupted due to the psychological “yuck” factor, many retailers, both at the food service and supermarket levels, have retreated from using it, which according to the American Meat Institute, will require an additional 1.5 million cattle to be slaughtered to make up the difference in harvesting this otherwise wholesome protein from already slaughtered animals. 

The process that they use to recover the additional lean meat is that they heat the meat on the bone, or trimmings, to approximately 100 degrees, spin them in a centrifugal spinner, and the lean beef easily separates from the fat.  It is then treated with ammonium hydroxide or citric acid as an intervention to prevent bacterial problems from organisms such as Salmonella and E. coli O157:H7. 

The important bottom line with this “pink slime” debacle, is that there is no food safety risk and, in fact, this is a safe product and uses as much of our resource of cattle as possible.  There is no question that there definitely can be a “yuck” factor, especially when styled the way it has in both the media, and especially the social media. 

Clearly, when you have the Secretary of Agriculture and the consumer advocate group, Center for Science, in the public interest on the same page and there has been no evidence of any illness, there is no food safety issue. 

The USDA’s deputy secretary for food safety, Dr. Elizabeth Hagen, states that the real issue is transparency in labeling, which clearly can be easily corrected and, again, it is always the consumer who has the ultimate right to purchase or not for their consumption.

Reducing the Risk of Salmonella in Retail Establishments

I posted this comment on Salmonella on an international listserv sponsored by the International Society for Infectious Diseases at Harvard University:

As someone who has investigated egg-associated outbreaks since the 1980s, there is a component that seems not to be transmitted either by the popular media or even through professional communication. The risk of getting an egg infected with _Salmonella_ Enteritidis (SE) is approximately 1 in 20,000.

The reason why we see restaurants now as in previous times being associated with outbreaks is they tend to pool many dozens of eggs, thermally abuse them over 41 deg F [5 deg C] increasing the number of organisms, then they either fail to cook whatever the product is to 155 deg F [68 deg C] or above, or cross-contaminate the raw egg with ready-to-eat foods.

Clearly, SE is a preventable disease if retail establishments follow the food code that is in their jurisdiction. Outbreaks of SE have been attributed in the past to hard-boiled eggs (obviously not boiled enough), raw egg products in Caesar salads, mousses, and eggnog as well as in cooked dishes such as quiches, lasagna, Monte Cristo sandwiches, and the like. The egg industry actually reduced the risk and many retail establishments eliminated utilizing raw, shell eggs and went to pasteurized eggs for both raw and fully cooked egg dishes.

-Dr. Melvin Kramer

New York City Restaurateurs ’ Dilemma – The New ABC Grading System is Effective July 1, 2010

New York City is following in the footsteps of Los Angeles County. In July 2010, The New York City Department of Health is planning on rolling out its new A, B, C Letter Grading System to score restaurants in the city on their food safety program which includes food protection, employee health and hygiene, physical cleanliness, as well as pest control.

But restaurateurs, have no fear, this is no big deal! Los Angeles has been giving letter grades to restaurants for over 12 years. The program not only increased compliance with the food safety regulations and laws within Los Angeles County restaurants, it also resulted in a decrease in the number of food-borne disease related hospitalizations drastically since the program was started (http://www.cspinet.org/dirtydining/HospitalizationsStudy.pdf).

Response to Bites

I note with interest the lead story of Monday, March 1, 2010 that “Food safety audits never enough”. There is no question that a simple food safety audit is not the ‘be all and end all’ in assuring food safety, whether at the retail, processing, manufacturing, or farm level.

However, to broad stroke the worthlessness of food safety audits is, in my opinion, a grave error. There is no question that over the past several years some high profile recalls and outbreaks, including outbreaks associated with deaths, have occurred in facilities that have had third-party audits.

The questions should be, “Who is the auditor?”, “What are the auditor’s credentials?” and “What is the motivation of the auditing firm that is conducting the audit?” Specifically, having auditors that do not have minimum credentialing of a Registered Sanitarian or Registered Environmental Health Specialist (R.S./ R.E.H.S.) is clearly the beginning of a recipe for failure.

Some of the national auditing firms that have teams of auditors who post on their websites that the minimum requirements are a high school diploma or equivalent and five to ten years of experience in a food plant clearly do not meet any credentialing standards that I would want to have as an auditor. Individuals who possess the correct credentials of the R.S./R.E.H.S. require a Bachelors Degree with 30 credits in the sciences, training, experience, and passing a state or national examination.

Third-Party Audits: EHA Consulting Group Releases Comments on Food Safety Consultant Auditors ' Qualifications and Competencies

February 11, 2009 -- EHA Consulting Group, which has over 25 years of experience providing food safety consulting, released comments today about the qualifications and competencies of food safety auditors.

The potential for under-qualified and lack of third party audits by many of the processors who purchased the recently recalled Salmonella contaminated peanut butter and peanut product may have had an impact on the number of cases of Salmonellosis and deaths according to EHA's President, Dr. Melvin N. Kramer.

Salmonella typhimurium has been reported in 600 cases across 44 states and Canada, and attributed to peanut butter incorporated into a plethora of food products. These cases have resulted in eight deaths. This outbreak is an embarrassment to the U.S. Food and Drug Administration (FDA), state regulators in Georgia, and industry.