Simmons College

H1N1 Swine Influenza (Flu)

October 31, 2009

As of October 2009, the Centers for Disease Control reported that most of the flu viruses causing illness are identified as being H1N1 (swine) influenza A. The number of flu-like illness being reported throughout the United States is extremely high for the month of October. There is further concern because young people, pregnant women, and people with asthma or chronic conditions are experiencing severe illness; and pediatric deaths from H1N1 are very high. The current H1N1 virus remains susceptible to the H1N1 immunization as well as the antiviral drugs oseltamivir and zanimivir. Though shipments of H1N1 flu vaccine began in early October, production is slower than expected. The CDC, however, expects that the H1N1 flu vaccine - both in nasal mist and injection form - will become more widely available by early November.

Because the seasonal flu vaccine prepared for fall/winter 2009 is unlikely to protect against novel H1N1 influenza, certain at-risk populations are recommended to receive the H1N1 vaccine in addition to the seasonal flu vaccine.

CDC recommends novel H1N1 vaccine for the following at-risk populations FIRST:

• Pregnant women
• Household contacts and caregivers for children younger than 6 months of age
• Healthcare and emergency medical services personnel
• Children ages 6 months through 4 years of age
• Young people ages 5 through 18 with chronic medical conditions

The H1N1 flu vaccine is also recommended for:

• All persons ages 6 months to 24 years of age
• Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza

Where can you get your H1N1 immunization?

Each state decides who will administer the H1N1 vaccine: public health clinics, schools, hospitals, or private physicians. To find where to go for your H1N1 vaccine, you can:

• Check the website www.flu.gov and click on your state
• Or, call your physician's office; they should know what your state's policy on immunization will be

Important points about the H1N1 immunization:

• People with egg allergies should consult with their physician before receiving the H1N1 immunization the vaccine may trigger an allergic reaction
• People who had influenza-like illness since the Spring of 2009 can receive the H1N1 immunization, even if they may have had H1N1 flu illness. Check with your physician
• Children under the age of 10 are recommended to have 2 doses of H1N1 vaccine in addition to a seasonal flu shot. If they have never received a seasonal flu shot, then they will need 2 doses of seasonal flu vaccine. Check with your pediatrician
• Children younger than 6 months cannot receive the seasonal or H1N1 flu vaccine
• If you need both the seasonal and H1N1 flu shots, you can have them at the same time in the following combinations:
  • inactivated seasonal + inactivated H1N1
  • inactivated seasonal + live attenuated H1N1
  • live attenuated seasonal + inactivated H1N1

Chart Comparing Cold, Seasonal Flu, and H1N1 Symptoms:

Download the chart Cold, Seasonal Flu, Or H1N1?

An informative Question and Answer web page about H1N1 and its vaccine can be found: http://www.nytimes.com/2009/10/10/health/10primer.html?scp=1&sq=as%20flu%20vaccine%20arrives%20for%20the%20season%20some%20questions%20and%20answers&st=cse

What You Can Do to Stay Healthy

There are everyday actions people can take to stay healthy:

• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
• Avoid touching your eyes, nose or mouth. Germs spread that way.
• Try to avoid close contact with sick people.

Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people. If you are sick with a flu-like illness, CDC recommends that you stay home from work or school until you are fever-free for 24 hours; also, limit contact with others to keep from infecting them.

The CDC recommendations for and information about H1N1 vaccine is likely to change. For the latest updates, visit :http://www.cdc.gov/h1n1flu/

World Health Organization (WHO) Disease Outbreak News: http://www.who.int/csr/don/en/

Guidelines on Cleaning to Reduce the Risk of Transmission of H1N1 Flu for Cleaning, Janitorial, and Maintenance Staff

August 9, 2009

The H1N1 (swine) flu is a new variant of influenza type A that appeared in Mexico in the Spring of 2009 and quickly spread across the world. Most people do not have immunity to this flu virus, and it can be transmitted from person to person. Cleaning, janitorial, and maintenance staff are on the front line in reducing the spread of H1N1, especially since it will likely remain a threat during the Fall-Winter influenza season. To learn about the current cleaning guidelines for H1N1, download the document: Professional Cleaning for H1N1.

Congress Considering Food Safety Bill

June 13, 2009

In the last few years, the US has suffered a number of recalls and outbreaks of foodborne illness from contaminated food products. New legislation to improve the safety of food was introduced in congress on June 8, 2009. Named the Food Safety Enhancement Act, the bill would amend the Food, Drug, and Cosmetic Act and aims to strengthen the Food and Drug Administration's (FDA) authority to oversee food safety. Some of the bill's stipulations include:

• Requiring more frequent inspections of food processing facilities by the FDA. (Currently some plants may only be inspected every 10 years.)

• Requiring food companies to develop and manage food safety programs.

• Giving the FDA the authority to order companies to recall potentially contaminated food.

The FDA commissioner Dr. Margaret A. Hamburg has testified to congress in support of the Food Safety Enhancement Act. Read her comments online at: http://www.fda.gov/NewsEvents/Testimony/ucm164186.htm.

The Food Safety Enhancement Act can be viewed in its entirety at: http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111congbills&docid=f:h759ih.txt.pdf . This may not be the final version of the bill, since amendments are frequently added by legislators.

The Center for Science in the Public Interest (CSPI) is following the course of this bill through congress closely and can assist consumers in contacting their congressperson. Visit the CSPI website at: http://www.cspinet.org, click on the June 3, 2009 article, and find the Safe Food Coalition icon.

Peanut-Containing Product Recall

June 12, 2009

Recall of Peanut-Containing Products

February 4, 2009

A combination of epidemiological analysis and laboratory testing by state officials in Minnesota and Connecticut, the Food and Drug Administration (FDA), and the Centers for Disease Control and Prevention (CDC) have enabled FDA to confirm that the sources of the outbreak of illnesses caused by Salmonella Typhimurium are peanut butter and peanut paste produced by the Peanut Corporation of America (PCA) at its Blakely, Georgia processing plant.

Peanut butter is sold by PCA in bulk containers ranging in size from five (5) to 1,700 pounds. The peanut paste is sold in sizes ranging from 35-pound containers to product sold by the tanker container. Neither of these products is sold directly to consumers. However, through its investigation, FDA has determined that PCA distributed potentially contaminated product to more than 100 consignee firms, for use as an ingredient in hundreds of different products, such as cookies, crackers, cereal, candy and ice cream. FDA initiated an inspection of PCA's Blakely plant on January 9 shortly after learning that this firm might be linked to the ongoing Salmonella outbreak. FDA finished its inspection on January 27. A list of problems observed by FDA investigators during their inspection is available at this link: http://www.fda.gov/ora/frequent/default.htm. This list is not a final agency determination regarding compliance. The deficiencies observed indicate that the plant was not compliant with Current Good Manufacturing Practices required by the FDA. These deficiencies are related to cleaning programs and procedures as well as failure to implement steps to mitigate Salmonella contamination in the facility.

On January 28, PCA issued an expanded voluntary recall of all peanuts and peanut products processed in its Blakely, Georgia facility since January 1, 2007. The expanded recall includes all peanuts (dry and oil roasted), granulated peanuts, peanut meal, peanut butter and peanut paste. All of the recalled peanuts and peanut products were made only at the company's Blakely, Georgia facility.

On January 30, FDA confirmed that FDA's Office of Criminal Investigations is involved in a Justice Department investigation of PCA.

FDA has been working with the company and purchasers of PCA's peanut butter and peanut paste to identify affected products and facilitate their removal from the market. FDA and state officials have visited in excess of 1,000 firms who purchased PCA products. Now, the same type of work is continuing and includes the additional products in the expanded recall.

Companies nationwide that received product made by PCA have issued voluntary recalls of their products. As FDA gathers additional information about these products, the list of recalled products is expected to expand. FDA has created a searchable database for these products, which can be found at: http://www.accessdata.fda.gov/scripts/peanutbutterrecall/index.cfm.

Product recalls include some pet food products that contain peanut paste that was made by PCA. While the risk of animals contracting salmonellosis is minimal, there is risk to humans from handling these products. It is important for people to wash their hands—and make sure children wash their hands—before and, especially, after feeding treats to pets. Further information for consumers is located in the Frequently Asked Questions section located on this web site. The pet food products are also included in the searchable data base of recalled products.

Major national brands of jarred peanut butter found in grocery stores are not affected by the PCA recall.

FDA and CDC recommendations for consumers include:

Consumers are urged to check FDA's web site to determine which products have been recalled and will be recalled in the coming days.

Any product that is on the recall list should be disposed of in a safe manner. Consumers are also urged to wash their hands after handling potentially contaminated products.

If consumers are unsure whether a peanut-containing product is potentially contaminated, they should avoid consuming it or feeding it to their pet until they obtain more information regarding the product.

Persons who think they may have become ill from eating peanut products are advised to consult their health care providers.

For Retailers

Stop selling recalled products.

For Directors of Institutions and Food Service Establishments

Ensure that they are not serving recalled products.

For Manufacturers

Inform consumers about whether their products could contain peanuts or peanut products from the Peanut Corporation of America (PCA). If a manufacturer knows its products do not contain peanuts or peanut products from PCA, it may wish to provide this information to consumers. For specific guidance: Guidance for Industry: Product Recalls, Including Removals and Corrections

The FDA will closely monitor these events by continuing to work with the firms on the details of their actions, conducting follow-up audits and inspections, monitoring the progress of the firms' actions, working with state and local regulatory authorities, and notifying our foreign regulatory counterparts of products that have now been confirmed as having been distributed internationally.

Ongoing Investigation

FDA has collaborated with the Centers for Disease Control and Prevention (CDC) and public health officials in various states to investigate the multi-state outbreak of human infections due to Salmonella Typhimurium. An epidemiological investigation by the Minnesota Department of Health isolated and tested subsamples from an open five-pound container of King Nut peanut butter obtained at a nursing home where three patients were sickened by the outbreak strain of Salmonella Typhimurium. The Minnesota Health officials found the peanut butter contained the same strain of Salmonella Typhimurium associated with the illnesses linked to the outbreak.

Because it is always possible that the open container was contaminated by someone or something else in the environment, the FDA and the states began testing unopened containers of the same brand of peanut butter. King Nut distributes peanut butter manufactured by the PCA to institutional facilities, food service industries, and private label food companies in several states.

On January 19, 2009, testing by the Connecticut Department of Health of an unopened container of King Nut peanut butter showed that it too contained the same strain of Salmonella Typhimurium associated with illnesses linked to the outbreak. The fact that the Salmonella Typhimurium was confirmed in an unopened container of peanut butter indicates that peanut butter originating from the processing plant was contaminated. FDA has initiated inspections at the direct consignees of PCA and King Nut and continues to follow the distribution points for products.

The FDA has no evidence to suggest that the Salmonella Typhimurium contamination originated with any manufacturing facility other than PCA. The PCA facility in Blakely, Georgia is not operating at this time and the company has recalled all peanuts and peanut products produced there from January 1, 2007, to the present.

The FDA and food manufacturers are working to identify products that may be affected, and to track the ingredient supply chain of those products to facilitate their removal from the marketplace.

Melamine-Contamination Event, China

September 1, 2008

World Health Organization (WHO)

Description of the event

More than 54 000 infants and young children have sought treatment for urinary problems, possible renal tube blockages and possible kidney stones related to the melamine contamination of infant formula and related dairy products. Three deaths among infants have been confirmed, more than 14 000 infants have been hospitalized and a little less than 13 000 remain so. Kidney stones in infants are very rare.

While the exact onset date of illness resulting from contamination and the beginning of the contamination itself remain unknown, a manufacturer (Sanlu) received a complaint of illness in March 2008.

Chinese media reported at the beginning of September that Sanlu brand infant formula produced by Hebei-based Sanlu Group was contaminated with melamine. Sanlu's powdered infant formula is widely consumed by infants across China because the product is relatively affordable compared to others.

Following inspections conducted by China's national inspection agency, at least 22 dairy manufacturers across the country were found to have melamine in some of their products.

Two companies, Guangdong Yashili and Qingdao Suokang, exported their products to Bangladesh, Burundi, Myanmar, Gabon and Yemen. While contamination in those exported products remains unconfirmed, a recall has been ordered from China.

Other countries, however, have also reported finding melamine in dairy products manufactured in China.

So far, contamination has also been found in liquid milk, frozen yogurt dessert and in coffee drink. All these products were most probably manufactured using ingredients made from melamine contaminated milk.

In 2007, melamine was found in pet feed manufactured in China and exported to the United States of America, and caused the death of a large number of dogs and cats due to kidney failure.

Melamine contamination

Presentation of melamine

Melamine is a chemical compound that has a number of industrial uses, including the production of laminates, glues, dinnerware, adhesives, molding compounds, coatings and flame retardants. Melamine is a name used both for the chemical and for the plastic made from it. In this event, all references are to the chemical. There are no approved direct food uses for melamine, nor are there any recommendations in the Codex Alimentarius. Melamine is illegally added to inflate the apparent protein content of food products. Because it is high in nitrogen, the addition of melamine to a food artificially increases the apparent protein content as measured with standard tests.

Source of the contamination

In this event, contamination appears to have happened as fraudulent contamination in primary production. Chinese government officials have pinpointed milk collecting stations as the sites where the melamine was added. According to Sanlu, contaminated milk was used in the manufacture of powdered infant formula processed before 6 August 2008 and the tainted milk powder has also been used in the manufacture of a number of other products.

Contamination levels

There are a total of 175 infant formula manufacturers across China, of which 66 have halted production and the remaining 109 manufacturers have undergone inspection due to the current events of melamine contamination. The inspections' results presented by the Administration of Quality Supervision, Inspection and Quarantine (AQSIQ) show evidence of the presence of melamine. Out of 491 batches tested, 69 of them, produced by 22 companies, tested positive for Melamine.

According to the State Council of China, the levels found in the batches ranged between 0.09 mg/kg and 619 mg/kg. Batches from the company Shijiangzhuang Sanlu Co. contained the highest levels, up to 2563 mg/kg.

Toxicology of melamine

Based on the previous incidents of melamine contaminated pet food and the development of kidney stones and subsequent acute kidney failure in cats and dogs, it appears that melamine and its structural analogues, such as cyanuric acid, may act together to form crystals. This crystal formation occurs at very high-dose levels and is a threshold and concentration dependent phenomenon, which would not be relevant at low levels of exposure (US FDA/CFSAN Interim Melamine and Analogues safety/risk assessment http://www.cfsan.fda.gov/~dms/melamra.html).

Exposure

Consumer exposure to melamine is considered to be low, but may occur through the extraction of melamine from compression moulds by acidic foods, such as lemon or orange juice or curdled milk, at high temperature. Taking into account these sources the estimated oral uptake of melamine is around 0.007 mg melamine/kg/day (OECD 1998).

Toxicity of melamine

Melamine is not metabolized and is rapidly eliminated in the urine. No human data could be found on the oral toxicity of melamine but there are data from animal studies. These show the compound to have a low acute toxicity, with an oral LD50 in the rat of 3161 mg/kg body weight. In animal feeding studies, high doses of melamine have an effect on the urinary bladder, in particular causing inflammation, the formation of bladder stones and crystals in the urine. Analysis of the bladder stones has shown that these are a mixture of melamine, protein, uric acid and phosphate. Animal studies have generally not shown any renal toxicity or the formation of kidney stones.

Carcinogenicity

The International Agency for Research on Cancer (IARC) has concluded that there is sufficient evidence in experimental animals for the carcinogenicity of melamine under conditions in which it produces bladder stones. There is inadequate evidence for carcinogenicity in humans.

Role of melamine in the formation of kidney stones

Animal data have not shown that melamine alone causes renal failure or the formation of kidney stones. Evidence from an earlier outbreak of acute renal failure in cats and dogs associated with contaminated pet food suggests that a combination of melamine and cyanuric acid does cause renal toxicity. Both of these compounds were found in the pet food together with other triazine compounds. Subsequent experimental studies in animals have shown that when they are fed a mixture of melamine and cyanuric acid this causes the formation of crystals in the tubules of the kidneys, eventually blocking them and causing renal damage and renal failure. The source of the cyanuric acid in the pet food was unknown but it may have been present as a contaminant of the melamine that had been illegally added to wheat gluten used in formulating the petfood. In the current event in China, the presence of cyanuric acid has not yet been confirmed.

Health-based Guidance Values

Following the petfood incident in 2007 described above, several authorities have preformed preliminary risk assessments.

The US FDA has published an interim safety/risk assessment on melamine and structural analogues and has established for melamine a tolerable daily intake TDI of 0.63 mg per kg of body weight per day.

The European Food Safety Authority has published a provisional statement and recommended to apply a TDI of 0.5 mg per kg of body weight per day as tolerable intake value for melamine.

Epidemiology and treatment

Suggested surveillance case definition

Identification of possible cases related to the consumption of melamine-contaminated products from China

Member States should be aware of the possible distribution of the contaminated products either through formal or informal channels, because of the large quantities involved and the seriousness of the public health consequences of this event. The period of production of contaminated product is uncertain and the incriminated raw material and products may have been exported as infant formula or other milk containing products to other Member States. Therefore WHO is suggesting this surveillance case definition to Member States to increase their awareness of signs that their population may be affected.

Clinical description

The following symptoms have been observed in infants affected by the melamine-contaminated infant formula in China:

Unexplained crying in infants, especially when urinating, possible vomiting Macroscopic or microscopic haematuria Acute obstructive renal failure: oliguria or anuria Stones discharged while passing urine. For example, a baby boy with urethral obstruction with stones normally has dysuria High blood pressure, edema, painful when knocked on kidney area

WHO experts believe an additional symptom may be unexplained fever arising from urinary tract infections/bacteraemia secondary to urine stasis resulting from obstruction.

Surveillance case definition

A case is defined as an infant with kidney stones or other kidney problems (e.g. anuria, renal failure) having consumed powdered infant formula produced in China before 6 August 2008, and where other potential causes of kidney stones have been excluded by differential diagnosis.

Treatment

The World Health Organization has agreed to circulate the information contained herein regarding the treatment plan that is being implemented in China by the Ministry of Health. The information below does not reflect the rules, regulations, policies and guidelines of the World Health Organization.

The following regimen has been issued by the Ministry of Health, China.

Clinical manifestations

Unexplained crying, especially when urinating, possible vomiting Macroscopic or microscopic haematuria Acute obstructive renal failure: oliguria or anuria Stones discharged while passing urine. For example, a baby boy with urethral obstruction with stones normally has dysuria High blood pressure, edema, painful when knocked on kidney area

Key diagnostic criteria

Been fed with melamine-contaminated infant milk formula Having one or more of the above clinical manifestations Laboratory test results: routine urine tests with macroscopic or microscopic haematuria; blood biochemistry; liver and kidney function tests; urine calcium/creatinine ratio (usually normal); urinary red blood cell morphology shows normal morphology of red blood cells (not glomerular haematuria); parathyroid hormone test (usually normal). Imaging examination: preferably ultrasound B exam of urinary system. If necessary, abdominal CT scan and intravenous urography (not to be used in case of anuria or renal failure). Kidney radionuclide scans can be used where available to evaluate renal function. Ultrasound examination features: General features: bilateral renal enlargement; increased echo on solid tissue; normal parenchyma thickness; slight pyelectasia and calicectasis; blunt renal calyx. If the obstruction locates in the ureter, then the ureter above the obstruction point dilates. Some cases have edema with perinephric fat and soft tissue around the ureter. As the disease develops, the renal pelvis and ureter wall may have secondary edema. A few cases have ascites. Stone features: most stones affect the collecting system and ureters on both sides. Ureteral stones are mostly at pelviureteral junction, the part where the ureter passes across iliac artery, and ureter-bladder junction. Stones stay collectively, covering massive areas. Lighter echo in the background. Most stones are different from the calcium oxalate stones. Urinary tract is mostly completely obstructed by the stones.

Differential diagnosis

Haematuria differentiation: need to rule out glomerular haematuria. Stone differentiation: the stones are normally radiolucent and have a negative image on urinary tract x-ray. This feature differentiates the stones from those of radiopaque stones of calcium oxalate and calcium phosphate. Differentiation of acute renal failure: need to rule out pre-renal and renal failure.

Clinical treatment

Immediately stop using melamine-contaminated infant formula milk powder. Medical treatment: use infusion and urine alkalinization to dispel the stones. Correct the water, electrolyte and acid-base imbalance. Closely monitor routine urine tests, blood biochemistry, renal functions, ultrasound findings (with particular attention to the renal pelvis, ureter expansion, and the change of the stones in shape and location). If the stones are loose and sand-like, they are very likely to be passed out with urine. Treatment of complicated acute renal failure: priority should be given to the treatment of life-threatening complications such as hyperkalemia. Measures include the administration of sodium bicarbonate and insulin. If possible, blood dialysis and peritoneal dialysis can be used early. Surgical measures can be taken to remove the obstruction if necessary. Surgical treatment: if medical treatment is not effective, and hydrocele and kidney damage present, or blood dialysis and peritoneal dialysis are not available in case of renal failure, surgical methods can be considered to remove the obstruction. Stones can be removed by different methods including cystoscope retrograde intubation into the ureter, percutaneous kidney drainage, surgical removal and percutaneous kidney stone removal. Extracorporeal shock wave lithotripter (ESWL) is greatly limited in its application, because the stones are loose and mainly composed of urate, and the patients are infants.

Follow-up

Once the urinary obstruction is relieved, and the general condition and renal function and urination are back to normal, the children can be discharged.

Key issues to follow-up

Urine routine tests; ultrasound of urinary system; renal function tests; IVP (intravenous pyelogram) if necessary.

Actions taken by INFOSAN

INFOSAN is working directly with Ministry of Health (MoH), China in collaboration with the WHO Country Office in China. Through the INFOSAN Emergency surveillance system, WHO has learned of the contamination of infant formula with melamine and requested further information about the event on the 11 September 2008. MoH confirmed on 12 September 2008 that incriminated products from the Sanlu Company had not been exported and provided WHO with a description of the development of the event. Through further interaction between INFOSAN and MoH the issue of potential other use of the contaminated milk powder as well as parallel (illegal) distribution of contaminated milk powder was raised. An INFOSAN alert was subsequently distributed to the entire network on the 16 September 2008 alerting members of the event and of the possibility of contaminated products finding their way to other markets.

INFOSAN has several times during the past week, kept the entire network informed of developments in relation to this event as well as additional information on other products being found contaminated, information about the toxicity of the melamine and other information to help Member States better understand and assess the potential risks associated with melamine contaminated products.

The Chinese authorities, in their on-going investigation, discovered that 2 producers found to have products contaminated with melamine had exports going to five countries, INFOSAN informed these five countries of the situation.

To print this article:

• Melamine-Contamination Event, China, September 2008 (PDF)

For more information on melamine, contamination, and recalled products:

• World Health Organization (WHO), www.who.int/en
• U.S. Food and Drug Administration, www.fda.gov
• Questions and Answers on Melamine (PDF)
• FDA Detects Melamine Contamination in Flavored Drink

USDA CONSUMER ALERT: Keeping Food Safe During an Emergency

June 19, 2008

The U.S. Department of Agriculture is providing recommendations to those affected by severe weather and flooding in the Midwest. USDA is hopeful that this information will help minimize the potential for foodborne illnesses due to power outages and other problems that are often associated with severe weather events.

"Severe weather events can mean power outages, floods, and other problems that can affect the safety of food,' said USDA Under Secretary for Food Safety Dr. Richard Raymond. "People living in areas subject to floods may cope by raising refrigerators or freezers off the floor, putting cement blocks under their corners. Even if you can't manage this, canned goods and other foods kept in a basement or low cabinets should be moved higher in the event of a flood."

Steps to follow to prepare for a possible weather emergency:

• Keep an appliance thermometer in the refrigerator and freezer. An appliance thermometer will indicate the temperature in the refrigerator and freezer in case of a power outage and help determine the safety of the food.
• Make sure the freezer is at 0 °F or below and the refrigerator is at 40 °F or below.
• Freeze containers of water for ice to help keep food cold in the freezer, refrigerator or coolers after the power is out.
• Freeze refrigerated items such as leftovers, milk and fresh meat and poultry that you may not need immediately — this helps keep them at a safe temperature longer.
• Plan ahead and know where dry ice and block ice can be purchased.
• Store food on shelves that will be safely out of the way of contaminated water in case of flooding.
• Have coolers on hand to keep refrigerator food cold if the power will be out for more than 4 hours. Purchase or make ice cubes and store in the freezer for use in the refrigerator or in a cooler. Freeze gel packs ahead of time for use in coolers.
• Group food together in the freezer — this helps the food stay cold longer.

Steps to follow after the weather emergency:

• Keep the refrigerator and freezer doors closed as much as possible to maintain the cold temperature.
• The refrigerator will keep food safely cold for about 4 hours if it is unopened. A full freezer will hold the temperature for approximately 48 hours (24 hours if it is half full) and the door remains closed.
• Discard refrigerated perishable food such as meat, poultry, fish, soft cheeses, milk, eggs, leftovers and deli items after 4 hours without power.
• Food may be safely refrozen if it still contains ice crystals or is at 40 °F or below when checked with a food thermometer.
• Never taste a food to determine its safety!
• Obtain dry or block ice to keep your refrigerator and freezer as cold as possible if the power is going to be out for a prolonged period of time. Fifty pounds of dry ice should hold an 18-cubic-foot full freezer for 2 days.
• If the power has been out for several days, check the temperature of the freezer with an appliance thermometer. If the appliance thermometer reads 40 °F or below, the food is safe to refreeze.
• If a thermometer has not been kept in the freezer, check each package of food to determine its safety. If the food still contains ice crystals, the food is safe.
• Drink only bottled water if flooding has occurred.
• Discard any food that is not in a waterproof container if there is any chance that it has come into contact with flood water. Discard wooden cutting boards, plastic utensils, baby bottle nipples and pacifiers.
• Undamaged, commercially prepared foods in all-metal cans and retort pouches (for example, flexible, shelf-stable juice or seafood pouches) can be saved.
• Thoroughly wash all metal pans, ceramic dishes and utensils that came in contact with flood water with hot soapy water and sanitize by boiling them in clean water or by immersing them for 15 minutes in a solution of 1 tablespoon of unscented, liquid chlorine bleach per gallon of drinking water.
• When in Doubt, Throw it Out!
• Food Safety During Power Outages: a Public Service Announcement (PSA), illustrates practical food safety recommendations for handling and consuming foods stored in refrigerators and freezers during, and after, a power outage.

 

Study Found Pre-packaged Spinach Advertised as "Ready-to-eat" is Actually Misleading

June 12, 2007

Eat your leafy greens. While nutritionists commonly suggest this, a recent study by two Simmons students looking at the cleanliness of bagged spinach has uncovered data that could have ramifications for future research as well as the entire produce industry.

Simmons College nutrition graduate student Diana Bruen and undergraduate biochemistry major Asja Asceric received a grant from the Society for Applied Microbiology and this past spring traveled to Wales, England, to attend a four-day Food Microbiology Conference. During the conference, the two young women gave a presentation of their spinach study.

While taking a microbiology class last year with Professor Elizabeth Scott, Bruen became interested in the bacteria levels present on "ready-to-eat" produce. In an effort to facilitate cross collaboration between departments, Bruen and Asceric conducted their independent study in the biology department on the amount of bacteria present in pre-packaged spinach.

With assistance from Scott, the Center for Hygiene and Health in Home and Community, and the biology department, the students began their research last September looking into spoilage bacteria and E.coli contamination on three types of spinach: "field washed" spinach that has only been rinsed and not packaged, "triple-washed," and "thoroughly washed" pre-packaged spinach.

During the course of several months, they conducted bi-weekly test samplings and culturings and found that - over the course of seven days - bacteria levels increased in all three types of spinach, including significant growth in the "thoroughly washed" brand.

The students found that pre-packaged spinach advertised as "ready-to-eat" is actually misleading, and that consumers should wash all types of spinach before consumption. Bruen and Asceric hope to see future studies exploring this topic to see if reducing bacterial counts by various washing techniques could increase the refrigerated shelf life of pre-packaged spinach.

Food Contamination - Play it Safe!

December 1, 2006

What to make of all the food scares and still keep eating safely!

The current rash of events related to contaminated foods is both confusing and scary for the consumer. For example, this past summer we had the ongoing story of spinach contaminated with E.coli O157. Then we had contaminated tomatoes. Now we hear that 80% of poultry is contaminated with Campylobacter.

So what is a consumer to do? First, let's get some perspective.

We have to know that all raw foods are contaminated with bacteria, and some of these are pathogens. In fact, we should assume that all raw meat and poultry is contaminated with pathogens such as Salmonella and Campylobacter, and handle it accordingly. Produce can also become contaminated with pathogens from the dirt and from contaminated water if it is used for irrigation and for washing the picked produce before it goes to market. This is really nothing new and there is no doubt that we will continue to hear about outbreaks of illness associated with contaminated raw foods. But, consumers can take steps to protect themselves, no matter what new food scares occur. The last line of defense against food poisoning is in understanding and employing simple, safe food handling practices at home, as follows:

• Wash hands thoroughly following contact with raw food, especially meat & poultry and their juices. If the juices leak out of the package and get on your hands at the store, use an alcohol gel to sanitize your hands.
• At home, store all meat and poultry in a container in the refrigerator (at less than 40 degrees F), so that the juices to not drip onto other foods.
• Refrigerate all green leaf salads.
• Clean and sanitize all surfaces that come into contact with meat and poultry, such as the cutting board and knife, so as to prevent cross-contamination to other foods. Use an EPA approved food -surface sanitizer or a bleach solution.
• Do not mop up juices with the kitchen sponge, because bacteria thrive in the sponge and can contaminate the next surface that is wiped. Use paper towels instead.
• Cook meat thoroughly to an internal temperature of at least 160 degrees F. Use an instant read meat thermometer to check.
• Do not put cooked meats back onto a dish that contained the raw meat.
• Thoroughly wash all fresh produce, including pre-packaged, pre-washed salads under running water.

In addition, some members of the family are especially vulnerable to the effects of food poisoning because of their immature or compromised immune systems. Individuals at higher risk include children under five and adults over 65, pregnant women, individuals with pre-existing medical conditions and those undergoing chemotherapy etc. These individuals should avoid all raw or undercooked foods of animal origin, including eggs. All fruit, vegetables and salads should be carefully rinsed under running water.

For more information on food borne illnesses go to www.cdc.gov.

Written by Liz Scott, Co-Director of the Simmons Center and co-author of How to Prevent Food Poisoning. A Practical Guide to Safe Cooking, Eating, and Food Handling (Scott/Sockett. 1998. Published by John Wiley & Sons).

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