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. 

FDA Recall of Hand Sanitizer

The FDA advises consumers not to use any hand sanitizer manufactured by Eskbiochem SA de CV in Mexico, due to the potential presence of methanol (wood alcohol), a substance that can be toxic when absorbed through the skin or ingested. FDA has identified the following products manufactured by Eskbiochem:

• All-Clean Hand Sanitizer (NDC: 74589-002-01)
• Esk Biochem Hand Sanitizer (NDC: 74589-007-01)
• CleanCare NoGerm Advanced Hand Sanitizer 75% Alcohol (NDC: 74589-008-04)
• Lavar 70 Gel Hand Sanitizer (NDC: 74589-006-01)
• The Good Gel Antibacterial Gel Hand Sanitizer (NDC: 74589-010-10)
• CleanCare NoGerm Advanced Hand Sanitizer 80% Alcohol (NDC: 74589-005-03)
• CleanCare NoGerm Advanced Hand Sanitizer 75% Alcohol (NDC: 74589-009-01)
• CleanCare NoGerm Advanced Hand Sanitizer 80% Alcohol (NDC: 74589-003-01)
• Saniderm Advanced Hand Sanitizer (NDC: 74589-001-01)

FDA tested samples of Lavar Gel and CleanCare No Germ. Lavar Gel contains 81 percent (v/v) methanol and no ethyl alcohol, and CleanCare No Germ contains 28 percent (v/v) methanol. Methanol is not an acceptable ingredient for hand sanitizers and should not be used due to its toxic effects.

Consumers who have been exposed to hand sanitizer containing methanol should seek immediate treatment, which is critical for potential reversal of toxic effects of methanol poisoning. Substantial methanol exposure can result in nausea, vomiting, headache, blurred vision, permanent blindness, seizures, coma, permanent damage to the nervous system or death. Although all persons using these products on their hands are at risk, young children who accidentally ingest these products and adolescents and adults who drink these products as an alcohol (ethanol) substitute, are most at risk for methanol poisoning.

On June 17, 2020, FDA contacted Eskbiochem to recommend the company remove its hand sanitizer products from the market due to the risks associated with methanol poisoning. To date, the company has not taken action to remove these potentially dangerous products from the market.

Therefore, FDA recommends consumers stop using these hand sanitizers and dispose of them immediately in appropriate hazardous waste containers. Do not flush or pour these products down the drain.

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.

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.

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