Buckets of Bath Tub Cheese

Winston Salem, NC

2001

The Story• Winston-Salem, NC, November 2001• 12 individuals admitted to hospital

– 11 females, 1 male with poor immune system• Symptoms: fever, chills, abdominal cramps,

stiff neck, vomiting, and light sensitivity

Investigating Agencies• NC Communicable Disease Control Branch• Forsyth County Health Department• NC Department of Agriculture & Consumer

Services• Environmental and Natural Resources• FDA• CDC

What Happened

Sick with Listeria monocytogenes•10 sick pregnant women•5 stillbirths, 3 premature deliveries, 2 infected newborns•1 woman with meningitis• 1 man with a poor immune system spent 1 month in the hospital

What Went Wrong

• Soft Mexican style (Queso Fresco) cheese made from contaminated raw milk

• Made in 5 gallon buckets fermented in someone's home bathtub

• Cheese sold in small grocery stores, parking lots, and door-to door

Problems• Food not from approved source• Raw (unpasteurized) milk used as an ingredient• Cheese made in non-approved facility• Lack of temperature control for transporting

cheese before saleResult: Contaminated cheese caused 12 illnesses

Big Changes Resulted• NC health authorities stopped sale of raw milk

by dairy farmers to noncommercial processors• Education of store owners – illegal to sell

unregulated dairy products• FDA requires pasteurization of all dairy

products sold across state lines except cheese that has aged a minimum of 60 days

Learning Objectives• Identify growth conditions, control, and

symptoms for Listeria monocytogenes• List groups of susceptible individuals• Define approved suppliers and list requirements• Explain proper procedures for receiving• Describe: Good Agricultural Practices, Good

Manufacturing Practices, and HACCP

Listeria monocytogenes• Likes moist environments• Grows at refrigeration temperatures • Tough to kill, survives months if not sanitized• Not the most common source of food poisoning,

but a leading cause of food related deaths• Naturally present in the environment (soil,

decomposing plant materials)

Listeria

• Unpasteurized milk, soft cheeses, soft serve ice cream, cured meats and cold cuts, fish, fresh fruits and vegetables

• Symptoms include: diarrhea, vomiting, fever• Can cause stillbirths in pregnant mothers• Symptoms start after a few hours or 2-3 days. • At risk populations are susceptible (YOPI)• Fatality rate may be 15 – 30%

How does this case study affect purchasing?

Prevention

• Approved Suppliers• Know your products• Inspect incoming products

• … An ounce of prevention is worth a pound of cure!

FDA Food Code Definition

Approved supplier means acceptable to Regulatory Authority

Follow best principles, practices, and generally recognized standards that protect public health

Approved Suppliers

• Good reputation = Reputable supplier • Get ingredients from approved sources• Inspected by regulators• May have additional food safety

certifications or audits done by other companies

Know your product

• Regulations a producer must meet to be an approved supplier

• Risks

• How to handle that product safely

Good Agricultural Practices(GAP)Best practices to verify that fruits and vegetables are produced, packed, handled, and stored in the safest manner possible to minimize risks of microbial food safety hazards.•Water quality for irrigation, sprays, and washing produce•Proper use of compost and manure for fertilizer•Exclude animals from the field•Employee hygiene•Storage and transportation•Tracking product and notifying customers

Good Manufacturing Practices(GMP)

A lot like FDA Food Code, specific to food processors•Employee health, hygiene, and training•Building condition and pest control•Sanitary procedures for work areas, food contact surfaces, equipment and tools•Proper storage •Processing prevents and controls contamination•Distribution

Special requirements

• Meat and poultry• Dairy products• Seafood• Fruit Juices

Hazard Analysis Critical Control PointsHACCP is required for meat, poultry, seafood & fruit juice. Many processors choose to use this system to minimize risk of contamination. •Identify hazards •Determine critical control points•Set critical limits•Establish monitoring procedures•Set corrective actions•Establish verification procedures•Record keeping and documentation

Soft Cheese

Listeria

Pasteurize milk

145oF for 30 min.

Temp every batch

Heat longer

Check its done

Prove it!

Verifying Supplier Practices

• Do they provide good service at receiving and dealing with quality issues?

• How do they train their employees in food safety?

• Rejecting and returning products?• Do their delivery trucks look/smell clean?

Inspect Before You Accept• Spot check delivery

vehicles for cleanliness • Off odors• Proper temperature

• 41oF or lower• Eggs at 45oF or lower

• Frozen foods signs of temperature abuse

• Expiration dates

Inspect before You AcceptCondition of packages•dirty, discolored, wet•dents, tears, punctures

Signs of pests

Scheduling receiving•Time•Other activities & flow of food

Bill of sale to track products

Procedures for rejecting shipments

What’s your view?

Have you ever had to reject an incoming shipment?

Why?

Case Study

Case Study

Quiz

When receiving food, which of the following is not a reason for rejecting food:a) Frozen food is thawed or partially thawedb) There is visible mold or slimec) Temperature Control for Safety Foods are received at 41oF or belowd) Packaging is damaged or dirty

QuizA shipment of frozen fish arrives at your food establishment. You see that the outside bottoms of shipping cartons have too much ice and the fish fillets held within the carton have brown edges. These are signs of:

a)Thawing and refreezing

b)Safe, high quality seafood

c)Seafood that has been kept in frozen storage too long

d)Seafood that has been blast chilled

Review• Listeria • Susceptible individuals• Use only approved suppliers• Know the requirements for an approved supplier• Communicate about food safety with your

suppliers• Inspect incoming products