Salmonella and Campylobacter jejuni are major human pathogens and poultry and poultry products are frequent vehicles of these bacteria. Estimates place the annual incidence of human salmonellosis and campylobacteriosis between 1 and 4 million each. Hazards are associated with contamination, survival or growth during production, transportation, processing and preparation. Animals are contaminated from a variety of sources on farms and the contaminants are spread during processing. Scalding, defeathering, evisceration and giblet operations are major points of spread. Further spread can occur during handling in markets and kitchens. Insufficient thermal processing or cooking allows survival. Improper handling of cooked poultry frequently results in cross contamination from previously handled raw carcasses and parts. Improper refrigeration provides conditions for multiplication of salmonellae. Estimates of annual costs of poultry-associated cases of salmonellosis and campylobacteriosis in the United States range from $64 million to $114.5 million and $362 million to $699 million, respectively. The need for a cost-effective solution to these poultry-borne human disease problems is apparent.
Factors that contributed to outbreaks of foodborne diseases reported in the U.S. from 1977–1982 are identified and classified by disease and place where implicated foods were mishandled. Data for these years are tabulated and combined with data from the years 1961–1976. Inadequate cooling - either leaving foods at room or warm outside temperatures or storing them in large containers while being refrigerated - was associated with most of the outbreaks. Ranking of all factors has changed little over four periods of review, but during the last period numerous outbreaks primarily due to ingestion of raw clams and raw oysters caused an increase in the factors: contaminated raw foods and obtaining foods from unsafe sources. This has been primarily due to raw clam-, oyster- and milk-associated outbreaks. The three most frequently identified factors that contributed to salmonellosis were improper cooling, contaminated raw products, and inadequate heating; to staphylococcal food poisoning were colonized persons handling cooked foods, lapse of 12 or more hours between preparing and eating, and improper cooling; to botulism were inadequate heat processing, improper fermentations, improper room temperature holding; to C. perfringens enteritis were improper cooling, lapse of 12 or more hours between preparing and eating, and inadequate reheating (followed closely by improper hot holding); to shigellosis were colonized persons handling implicated foods, improper cooling, and lapse of 12 or more hours between preparing and eating; to V. parahaemolyticus gastroenteritis were contaminated raw ingredients, improper cooling, and cross contamination; to typhoid fever were colonized persons handling implicated foods, lapse of 12 or more hours between preparing and eating, and several time-temperature factors tied for third; to B. cereus gastroenteritis were improper cooling, lapse of 12 or more hours between preparing and eating, and improper hot holding. The principal factors associated with outbreaks stemming from foods prepared in foodservice establishments were improper cooling, lapse of 12 or more hours between preparing and eating, colonized persons handling implicated foods, inadequate reheating and improper hot holding. Important factors that contributed to outbreaks in homes were contaminated raw foods, inadequate cooking, unsafe source, improper cooling, and lapse of 12 or more hours between preparing and eating. Major contributing factors associated with operations in food processing plants were inadequate heat processing, contaminated raw ingredient, improper cooling, colonized persons handling implicated foods, improper cleaning of equipment, and improper fermentation. Those factors cited above for each category are the vital few items to stress in food safety programs. The many other items that are a part of food protection programs are of lesser importance or trivial.
Hazard analyses were conducted at four street-vending stands in the Dominican Republic. Temperatures of foods were measured during cooking, display (holding), and reheating (when done). Samples were taken at each step of the operation and at 5 to 6-h intervals during display. Foods usually attained temperatures that exceeded 90°C at the geometric center during cooking and reheating. At three of the stands, foods (e.g., fish, chickens, pork pieces) were fried and held until sold. Leftovers were held overnight at ambient temperatures in the home of the vendor or in a locked compartment of the stand. They were usually reheated early in the morning and displayed until sold. During the interval of holding, aerobic mesophilic counts progressively increased with time from about 103 after cooking to between 105 to 109/g. The higher counts were usually associated with holding overnight. Escherichia coli (in water, milk and cheese samples), Bacillus cereus (in bean and rice samples), and Clostridium perfringens (in meat, chicken and bean samples) were isolated, but usually in numbers less than 103/g. At the other stand, foods (e.g. beans, rice, meat and chicken) were cooked just before serving as complete meals. There were no leftovers. This operation was less hazardous, although there were many sanitary deficiencies. Recommendations for prevention and control of microbial hazards (mainly reducing holding time, periodic reheating and requesting reheating just before purchasing) are given. The need and suggestions for implementing educational activities to alert and inform those concerned about hazards and preventive measures are presented.
A review of foodborne disease surveillance data from the United States for the years 1977 through 1984 was made to ascertain the relative importance of various foods as vehicles; 1,586 incidents were tabulated. Data are given for all outbreaks and for individual diseases. Foods were classified by category, class and item. Seafoods, meats, poultry and salads were the most frequently implicated categories. The most frequently implicated items were roast beef, ham, turkey, chicken and raw clams. Chinese foods, usually fried rice and Mexican-style foods usually ground or shredded meat or pinto beans were also commonly implicated. Of the salads, potato and chicken salads were identified more frequently than other salads. Mahi-mahi was the most common vehicle of scombrotoxin; amberjack/jack was the most common vehicle of ciguatoxin; roast beef and turkey were the most common vehicles of C. perfringens and salmonellae; ham was the most common vehicle of staphylococcal enterotoxin; potato salad was the most common vehicle of shigellae; peppers were the most common vehicle of botulinum toxin; and fried rice was the most common vehicle of B. cereus toxins. Relative risk for each food is discussed in reference to assessing hazards and setting food safety priorities.
Secular trends in milk-borne diseases in the U.S.A. show numerous outbreaks associated with ingestion of raw milk in the early 1900s until the end of World War II. Diseases common in this period, but no longer milk-borne, were typhoid fever, scarlet fever, septic sore throat, diphtheria, tuberculosis, shigellosis, and milk sickness. Milk-borne and milk-product-borne diseases rarely reported somewhere in the world were botulism, Escherichia coli enteritis, Pseudomonas aeruginosa enteritis, listeriosis, Clostridium perfringens enteritis, Bacillus cereus gastroenteritis, Haverhill fever, Q fever, hepatitis A, poliomyelitis, toxoplasmosis, histamine intoxication and hypertension. After most milk was pasteurized, outbreaks decreased dramatically. Milk-borne diseases of contemporary importance in the U.S.A. are salmonellosis, campylobacteriosis, staphylococcal intoxication, brucellosis, and yersiniosis. These have usually been associated with ingestion of raw milk, certified raw milk, home-made ice cream containing fresh eggs, dried milk, pasteurized milk which was contaminated after heat processing, or either cheese made from raw milk or cheese in which starter activity was inhibited during its manufacture.
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