Firefly owner John Simmons poses at his restaurant at 3824 Paradise Road in Las Vegas on Monday Nov. 18, 2013. (Bill Hughes/Las Vegas Review-Journal)
NC Safe Plates Module 6
Military hospital Emergency Department received 13 people with gastrointestinal illness Symptoms:
Nausea, vomiting, abdominal cramps or pain, diarrhea, headache
Symptoms appeared 2-3 hours after a lunch party
Everyone ate Perlo (a chicken, sausage, and rice dish)
What Happened?
Morbidity and Mortality Weekly, December 20, 2013, Vol.62, No.50
The Recipe• Frozen chicken thighs and sausage
defrosted in the microwave
• Defrosted chicken thighs cooked in stock pot of boiling water
• Thighs cooled, meat removed & placed back in stock pot
• Sausage cooked and added to the stock pot
The Recipe (continued)• Onions and other seasonings sautéed in
sausage oil & added to stock pot• Rice added to stock pot & cooked until all
water absorbed• COOKED PERLO PLACED IN UNHEATED OVEN
FOR APPROXIATELY 8 HOURS (OVERNIGHT)• PERLO TRANSFERRED TO SLOW COOKER &
REHEATED FOR 1 HOUR ON HIGH SETTING BEFORE TRANSPORT AND CONSUMPTION
Likely CauseFood contained Staphylococcus aureus Could have been handling cooked chicken or taste testing•Overnight storage of Perlo in oven (not refrigerated) allowed growth & toxin production•Rewarming in slow cooker would not destroy toxin (food in TDZ)
– May have increased toxin production
Learning Objectives• Describe best practices to reduce or eliminate
the risk of Staphylococcus toxin forming• Identify the symptoms and foods for Staph. • Explain the difference between a restricted
and excluded employee• List reasons for exclusion/restriction of
employee
Key Terms• Toxin – poison produced by microorganism• Heat stable toxin – not destroyed by cooking
(165oF)• Temperature Danger Zone (TDZ)- Above 41oF
and below 135oF • Excluded employee- can’t work in operation• Restricted employee- can’t work with or
around food• Reinstated employee- approved to work
Staphylococcus aureus – a bacteria• Termed “staph”• Common in the environment• Lives in humans and animals
– Present in nasal passages & throats– Hand or arm sores (especially pus)– Cough or sneeze
• Can be destroyed by proper cooking• Can produce toxin that is not destroyed by
cooking
Toxin• Can cause nausea, stomach cramps, vomiting, and
diarrhea• Symptoms usually last for a few hours to a day• Fast acting
– Causes symptoms within 1-7 hours after eating contaminated foods
– Controlled by good personal hygiene and avoid temperatures in temperature danger zone
Foods linked to Staph• Meat and meat products• Poultry and egg products• Salads (egg, tuna, chicken, potato, macaroni)• Bakery products (cream-filled pastries, cream
pies, chocolate éclairs)• Milk and dairy products• Any food product handled after cooking
Corrective Action/ Prevention• Main contributing factors:
– Poor food handling practices (human contamination)
– Inadequate refrigeration of foods
• Using clean food preparation, storage, & equipment surfaces
• Immediately cooling using proper techniques
Remember from before?• Temperature Danger Zone
– Store TCS food at or below 41oF – Hot hold at 135oF or above if stored for more than 2
hours
• Check temperature– Do you document it?
• Store food in small portions in shallow containers
Corrective Action / PreventionPersonal Hygiene
Staph is naturally present on our skin, around the mouth and nose.
Open sores and cuts are problematic• Proper hand washing for 20 seconds, no bare hand contact• Exclude employees with wounds on hands or arms (unless
covered)• Cover open wounds with appropriate bandages and gloves
FDA Food Code
Reinstate restricted employee if skin, infected cut, or boil is covered with :•Impermeable cover (finger cot or stall) and single use glove if it is on hand, finger, or wrist•An impermeable cover on the arm if infected wound or boil on arm•Dry, durable, tight fitting bandage on body
Corrective Action / PreventionPersonal Hygiene
Hand washing, glove useLimit bare hand contact (utensils)BathingClean uniforms and clothsJewelry- maybe plain wedding band Hair restraintProper taste testing practicesCough and sneeze
When Gloves are Required
• Handling ready to eat foods (except washing produce)
• Slash resistant gloves for carving/cutting• Change gloves between raw and RTE• Open cut or sore- remember regular hand
washing
Activity
Write down a list of best practices to minimize the risk of staphylococcus aureusRemember:•Personal hygiene•Cross contamination •Temperature Danger Zone
QuizYou see that the food handler you assigned to prepare the salad has a small cut on their hand. You should:
a)Have them start preparing the salad anyway
b)Move them to the meat slicing area
c)Send them to see the doctor, then home for the day
d)Have them put on a watertight bandage over the cut and wear gloves
Quiz
When an individual is made sick by a toxin present in the food, it is called
a)Toxin mediated infection
b)Foodborne infection
c)Foodborne intoxication
d)None of these
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