Language and disease control: A partnership made with my partner

Posted on November 22, 2015 by Douglas Powell

We knew it 10 years ago.

Others knew it centuries ago.

Universities and government are now reinventing the wheel.

Since July 2014, the U.S. Centers for Disease Control has sent staff on almost 3,000 deployments to support the Ebola response in West Africa, the United States, and elsewhere around the world. Responders fill a variety of roles, from disease detectives, to laboratorians, to logisticians, to health communication experts. Allison Friedman, a CDC health communication specialist, deployed to Guinea in the summer of 2015 to provide communication support for CDC’s Health Promotion team.

“I wanted to play a role in this historic effort and offer any help my skills could offer,” she says. Allison spent three months in CDC’s Emergency Operations Center (EOC) before being deployed to West Africa. Being a French speaker with a background in behavioral science and health communication made Allison a perfect candidate for working at the community-level in Guinea.

While in Guinea, Allison’s job was to work with response teams going into communities to interact face-to-face with them. Social mobilization teams teach communities about preventing and controlling Ebola through door-to-door campaigns, village meetings, and educational sessions. Anthropologists help response organizations by conducting rapid assessments of communities to better understand the cultural, social, and individual factors that influence community attitudes and behaviors related to Ebola prevention and control. Allison helped bridge the gap between the anthropology and social mobilization teams, offering technical assistance with rapid assessments and ensuring that findings were translated into meaningful communication strategies and tools for social mobilizers. Together, the teams spoke with community members about their needs, concerns, perceptions, and proposed solutions for improving the Ebola response. Communities also got a chance to ask and answer questions about Ebola and ways to protect their families, friends, and neighbors.

One of the biggest challenges that Allison noticed in speaking with communities was the conflict between key infection control practices and prevailing traditions and cultural norms. “There are strategies we know to be effective in stopping the spread of Ebola, but convincing people to set aside their deeply held beliefs and practices, like preparing a loved one’s body for burial in the traditional way, is a very difficult thing to do,” says Allison. “It was especially hard in communities without recent Ebola cases, where villagers didn’t see the need to continue with safe and dignified burials.”

An added challenge was gaining the trust of communities that are accustomed to seeking health care from known local healers and do not trust the government or foreign agencies. Communities were more open to accepting prevention and control measures once they received tailored information, reinforced by trusted community and religious leaders and supported by real-life testimonials from Ebola survivors in their areas.

When she returned to the United States, Allison extended her time in the EOC to support efforts in Guinea from the health promotion team in Atlanta, GA. This gave her the opportunity to leverage CDC resources to create needed messages and tools for use in the field. The health promotion team here supports staff in West Africa with Ebola-related communication research, planning, development, and evaluation.

Although there were challenges working in Guinea, Allison says that she found it very rewarding to work with such kind, committed, and patient people on such an important cause.

“I feel deeply enriched by my experiences working with communities and committed partners in the field. I am humbled and awed by the strength of the Guinean people – particularly the Ebola-affected families who have endured losses beyond what most of us can imagine and who continue to face stigma, discrimination and challenges meeting basic needs.”

Finally, she says “I’d also like to give immense credit to my CDC colleagues who have and currently are deployed to West Africa, working tirelessly, with a focus on getting to zero. With their passion, commitment, and perseverance, we are closer than ever to reaching this goal.”

Ebola (Ebola Virus Disease): Health communication in Guinea and Atlanta

CDC

Allison Friedman, Gary Cobb, Arthur Hudson, and Drenda Morrissette, John Saindon and Brian Bird, Karen Wong, Angela Dunn, Brant Goode

http://www.cdc.gov/vhf/ebola/hcp/stories-health-communications-in-guinea-atlanta.html

Where’s the food safety? Food porn makes bucks for Instagrammers

Posted on November 18, 2015 by Douglas Powell

Like many Instagram users, Natalie Landsberg, Gillian Presto and Emily Morse frequently posted photos of what they were eating.

But as their joint account @New_Fork_City took off, they found themselves with nearly 500,000 followers, and soon, free restaurant meals, gigs “curating” food for a music festival and an offer to create their own cookie-dough flavor.

The three 19-year-olds, who started the account in high school, are now in college, and their modest Instagram earnings aren’t footing their tuition bills yet. But their parents spent almost $15,000 to trademark the New_Fork_City name and create a limited liability company, “so down the road, if there is an opportunity to figure out a financial business model, the company is established,” said Ms. Presto’s father, Michael Presto.

Meet the professional food Instagrammers, courted by restaurants for their six-figure followings and stylish, sometimes over-the-top photography. Some have turned their accounts into full- or part-time professions, earning up to $350 for posting a flattering image, while others have parlayed their social-media savvy into free meals or public-relations jobs.

“There are people who decide on where they want to go out to eat by their Instagram feed, and that’s a fact that we in the hospitality industry just cannot ignore,” said Helen Zhang, director of media strategy at LFB Media Group, a public-relations agency that works with such restaurants as the Stanton Social and Casa Nonna.

Olivia Young, brand and communications director for the Altamarea Group, which operates restaurants such as Vaucluse and Osteria Morini, said the company has begun inviting some Instagram users for meals and plans to pay some to post photos.

Good managers help keep food safe

Posted on November 12, 2015 by Ben Chapman

A good food safety culture (a term as ubiquitous as Drake’s Hotline Bling) is really about having all the staff in an organization know what hazards are associated with the food they make/handle from the owner, to management, to the front line staff. And when someone is sick, or gets fired, whoever steps into the role as a replacement. Managers have to know what’s needed to keep food safe – and ensure their staff are actually doing it.

KTNV has a great video of a poor inspection that tells the story of a poor food safety culture.

Inspectors found visibly dirty food contact surfaces, old food debris on the can opener and meat slicer and a dirty ice machine. There was also heavy debris on the floor under kitchen equipment, a badly stained cutting board, and no hair restraints for food handlers.

“A lot of things I didn’t know,” said temporary manager Angela Liu. She says she’s not used to overseeing the kitchen staff and admits she didn’t check everything the night before their unannounced inspection.

Inspectors also found a full handsink leaking dirty water. And food in the prep table not protected from contamination. Angela takes us back to show us what is now a much cleaner kitchen.

She says the owner made it clear that he never wants to see another “C” grade.

And then this excellent dialogue happens.

Angela: If C again, they all lose their job.

Darcy: That’s it. Everyone’s job’s on the line.

She shows us how everything is now labeled and double-covered to keep inspectors happy and customers healthy.

Darcy: It’s about food safety.

Angela: Yeah, food safety. Right. It’s very serious. Oh, my god. (she pauses to swat away a fly buzzing around her face.)

Darcy: You don’t want a fly in here, do you?

Safer food saves lives

Posted on November 7, 2015 by Douglas Powell

That’s the view from the U.S. Centers for Disease Control and Prevention, and I agree.

Contaminated food sent to several states can make people sick with the same germ. These multistate outbreaks cause serious illness, and more of these outbreaks are being found. Multistate outbreaks caused 56% of deaths in all reported foodborne outbreaks, although they accounted for just 3% of all such outbreaks from 2010 to 2014. Foods that cause multistate outbreaks are contaminated before they reach a restaurant or home kitchen. Investigating these outbreaks often reveals problems on the farm, in processing or in distribution that resulted in contaminated food. Lessons learned from these outbreaks are helping make food safer. To protect the public’s health, government at all levels and food industries need to work together to stop outbreaks and keep them from happening in the first place.

Food industries can:

Keep records to trace foods from source to destination.

Use store loyalty card and distribution records to help investigators identify what made people sick.

Recall products linked to an outbreak and notify customers.

Choose only suppliers that use food safety best practices.

Share proven food safety solutions with others in industry.

Make food safety a core part of company culture.

Meet or exceed new food safety laws and regulations.

Problem

Multistate foodborne outbreaks are serious and hard to solve.

Multistate outbreaks can be hard to detect.

Contaminated food grown or produced in a single place can wind up in kitchens across America.

People in many states may get sick from a contaminated food, making it difficult to spot the outbreak.

Detecting that an outbreak is happening requires specialized testing of germs in laboratories across the country.

Multistate outbreaks can be hard to investigate.

Investigators depend on sick people to remember what they ate several weeks earlier.

If the problem is a contaminated ingredient, people may unknowingly eat it in many different foods.

Unexpected foods have been linked to recent multistate outbreaks, such as caramel apples and chia powder.

Contaminated food can be hard to trace to the source.

Companies may not have complete records of the source or destination of foods.

Imported food can be even harder to trace to its source, and imports to the US are increasing.

Many different farms may produce the beef in a single burger or the fresh vegetables sold in a single crate.

Innovative methods are helping detect and solve more multistate outbreaks.

New DNA sequencing technology is improving public health’s ability to link germs found in sick people and in contaminated foods.

Information technology is helping investigators in many places work together.

Efforts by food industries are helping trace contaminated foods to their source.

What Can Be Done

The Federal government is

Implementing improved food safety laws and regulations.

Working with state and local health departments to use better methods, including DNA sequencing, to find, investigate and quickly stop multistate foodborne outbreaks.

Helping state and local health departments improve food safety inspections and guidelines.

State and local public health agencies can

Encourage clinical laboratories to quickly submit germs from sick people to the public health laboratory for advanced testing.

Test the germs from sick people quickly to find if others got sick from the same germ.

Interview sick people promptly about what they ate, using standard questions.

Test suspect foods, if available.

Participate in national networks to share improved methods for investigating multistate outbreaks.

Encourage industry actions that focus on preventing foodborne disease.

Health care providers can

Submit germs from sick people quickly to public health laboratories for advanced testing.

Report suspected outbreaks rapidly to the local or state health department.

Inform patients or caretakers of those in high-risk groups that they have an increased risk for food poisoning. These include pregnant women, adults over 65 years, children under 5, and people with weakened immune systems. Steps to prevent food poisoning can be found on: www.foodsafety.gov

Food industries can

Keep records to trace foods from source to destination.

Use store loyalty card and distribution records to help investigators identify what made people sick.

Recall products linked to an outbreak and notify customers.

Choose only suppliers that use food safety best practices.

Share proven food safety solutions with others in industry.

Make food safety a core part of company culture.

Meet or exceed new food safety laws and regulations.

Everyone can

Check for food recalls and information about how to handle and prepare food safely on: www.foodsafety.gov

Take action if you think you have a foodborne sickness:

Talk to your health care provider.

Write down what you ate in the week before you started to get sick.

Report your sickness to the health department if you think you are part of an outbreak.

Assist public health investigators by answering questions about your sickness.

Consider getting a loyalty card where you shop. If there is a recall, the store can use the card to notify you.

Food fraud nothing new: But we will survive

Posted on November 7, 2015 by Douglas Powell

Historian Madeleine Ferrieres, until recently Professor of Modern History at the University of Avignon and the author of my favorite food book, 2002’s Mad Cow, Sacred Cow, said in a recent interview, “we still live with the illusion of modernity, with the false idea that what happens to us is new and unbearable. These are not risks that have arisen, but our consumer behavior has changed.”

What’s new is better tools to detect fraud, which also presents an opportunity: those who use the real deal should be able to prove it through DNA testing and brag about it.

The days of faith-based food safety are coming to a protracted close.

As Ferrieres wrote in her book,

“All human beings before us questioned the contents of their plates. … And we are often too blinded by this amnesia to view our presents food situation clearly. This amnesia is very convenient. It allows us to reinvent the past and construct a complaisant, retrospective mythology.”

I’ve quoted those words before, but increasingly find myself reinventing the past.

That’s OK, just sorta boring, so I coach and play hockey.

CBC’s (that’s the Canadian Broadcasting Corporation, and it’s in Canada) Marketplace, which has always had a flair for the dramatic, broadcast an episode tonight about labeling, mis-labeling, and food fraud.

They interviewed me about 2 am my time today, probably as a follow-up; I tried to shift to a broader discussion, they were more interested in gotcha-style; bottom line, all food purchases are faith-based, no matter how well you think you know a farmer, and food fraud has been going on as long as people have sold food.

Supermarket workers are speaking out to CBC’s Marketplace about how stores tamper with best-before dates and how it can make food unsafe.

For five years, Mohammad Saffari has worked as a bakery clerk at a Loblaws store in Montreal. He says he was told to change best-before dates on fresh or frozen bakery items such as cheesecakes, muffins and pastries that were weeks or months past the best-before date.

Saffari says he was told to take cheesecakes that had passed their best-before dates and add toppings, so they would appear fresh.

He says cakes were then given a new best-before date and put back on the shelves for sale.

“I decorate it and I’m selling expired stuff for $13.99,” he says. “I won’t eat this cheesecake myself. But I sell it to you.”

‘You think other stores don’t do it?’

Saffari approached Marketplace after he became frustrated with being asked to change dates. “I couldn’t take it anymore,” he says. “I was on sick leave for three to four months because of the pressure; because what you’re doing you’re not proud of and you’re forced to do it.”

After speaking up about this on a number of occasions, Saffari decided to secretly record a conversation with his supervisor where he asks about the practice. He shared the recording with Marketplace.

“Every store does the same f—ing thing. You think other stores don’t do it?” the supervisor says on tape.

“Everyone f—s with the dates, Mo. Because at the end of the year, the managers, their bonus, you understand?”

In an email, Johanne Héroux, a senior director at Loblaws, told Marketplace:

“As a company, we are fully committed to upholding the highest standards in terms of product quality and safety. We have strict protocols in place to ensure their application across all our stores and departments.

“As for the store-specific allegations brought to our attention and in accordance with our zero tolerance policy regarding actions that jeopardize the safety and quality of our products, an investigation was undertaken immediately. Necessary actions will be taken upon completion of the ongoing investigation.”

Problems industry-wide

But Saffari is only one of a number of former and current supermarket employees who spoke out about how supermarkets change best-before dates.

Marketplace heard from people who have worked in the bakery, meat and produce departments of a number of different grocery stores, both chains and independent. They described a number of tricks that supermarkets employ to make food appear fresh.

These tactics include grinding old meat with fresher meat, marinating old meat in sauces that mask the smell, cutting mould off fruit and vegetables for party trays, and cutting cakes in half to facilitate a faster sale after the best-before has passed.

One insider also says his store took meat that had gone brown from sitting out, and dipped it in blood to make it look redder. Others said they would take mouldy fruit off custard tarts, replace it and glaze it to make it look fresh.

In each of these cases, food was put out with new best-before dates that significantly extended the shelf life.

Food treated this way can harbour microbes that can make you sick, says Keith Warriner, a microbiologist at the University of Guelph.

Best-before dates aren’t a guarantee that food is safe to eat. Other factors, such as the way food is stored, can make a big difference.

For dry food, such as cookies, crackers and pasta, best-before dates are a guarantee of freshness and flavour, and don’t mean that food past that date is unsafe to eat.

So how do you know that the food you’re buying is fresh? Employees recommend buying meat from the back of the shelf, and avoiding pre-marinated or cut foods. They also suggest buying whole cakes, pies and tarts.

Restaurant owner blames homeless restroom users for outbreak

Posted on November 7, 2015 by Ben Chapman

There’s a lot of amateur epidemiology going on this week. The latest comes from the owner of San Jose’s Mariscos San Juan #3, which reopened yesterday after being linked to 182 illnesses including 12 hospitalizations.

According to ABC 7, owner Segio Cruz says that homeless individuals using his restroom may have introduced the pathogen. Public health folks believe it was a food handler. 1052002_630x354

“This is first time this happened in my store, I opened my store in 2000,” said Segio Cruz, the restaurant owner.

Cruz owns three restaurants. He says since the shigella outbreak, business has dropped off 70 percent. He says even more damaging is the negative reputation generated by the incident, which he feels his restaurant does not deserve. “You can get sick in your house, your office, anywhere,” insists Cruz.

Cruz said homeless people often use the bathroom inside his restaurant and that perhaps could be another contributing factor. But again, there is still no definitive answers as to what caused this massive, and now mysterious, outbreak.

If his theory is correct, how did the Shigella get from the restroom to the food?

Food truck operators need tools to reduce risks – like a handwashing sink

Posted on November 7, 2015 by Ben Chapman

I like a good food truck meal. The experience is less about eating food from a small sweaty kitchen and sitting on the ground and more about ordering something from a small menu that the chef specializes in. A couple of weeks ago I had a fantastic sautéed cauliflower and roasted potato pita from a food truck at a community event. foodtruck

Before eating there I checked out whether they had an inspection grade (because there are some trucks that like to operate incognito, outside the law) and asked how they washed their hands. The chef told me that they have a handwashing sink with running water and a collection tank. I still have to trust that he actually uses it but at least he had the tools.

That’s a bit different from a food truck on the Carnegie Mellon campus. According to the Pittsburgh Post-Gazette, Tartan Express was forced to close following an inspection where they were cited lots of risky things including not having a sink.

The Allegheny County Health Department has cleared the Tartan Express food truck on the Carnegie Mellon University campus to reopen after it was closed earlier this week for multiple food safety violations, including lack of running water.

The truck, which serves Asian food, operates at 5000 Forbes Ave. “No one in the vehicle is able to wash hands when beginning new tasks, after handling money or touching the face or hair,” an inspector wrote this week.

Other violations included holding food at unsafe temperatures and inadequate sanitization.

Scientists Evaluate Food Safety Practices to Help Support Nonprofit Food Pantries

Posted on November 2, 2015 by Ben Chapman

From an NC State press release,

Researchers from North Carolina State University and the University of North Carolina at Chapel Hill have done an in-depth analysis of food safety at nonprofit food pantries that distribute food directly to people in need. While the work has identified shortcomings at many such pantries, the goal was to identify how food safety experts can help these pantries best meet the needs of their clients.

“We knew that food pantries, in North Carolina and many other states, aren’t regulated the same way that restaurants are, and that pantries are crucial distributors of food to those in need, but we did not have a good understanding of how food safety is practiced at food pantries,” says Ben Chapman, an associate professor of youth, family, and consumer sciences at NC State and senior author of a new paper on the work.

“This is a particularly important issue because research tells us that the people most likely to rely on help from food pantries are also those who have less access to health care to address foodborne illness in the event that they do get sick,” says Ashley Chaifetz, lead author of the paper. Chaifetz completed the research while a doctoral student at UNC-Chapel Hill.

For this study, the researchers examined operating procedures and interviewed managers at 105 food pantries in 12 counties across North Carolina. The researchers found that pantry food safety procedures were often informal.

In many ways, the results were promising.

For example, researchers found that virtually all pantries did a good job of limiting opportunities for cross-contamination and providing adequate handwashing facilities – both of which are incredibly important in reducing food safety risk.

However, the pantry managers lacked full information on storage and handling or did not have available resources to properly store all perishable items. Given the focus on health and poverty, many pantries have increased the amount of fresh produce and perishables they distribute, which require proper handling and refrigeration. But more than 75 percent of pantries didn’t provide volunteers with formal training on how to handle that food safely. Thirty-six percent of pantry managers didn’t have a system in place to obtain information on food safety recalls. Additionally, only 32 of the 105 pantries had a protocol in place on how to determine whether sick volunteers should be allowed to handle food.

“This is not about bashing food pantries, which provide an essential service to their communities on a shoestring budget,” Chapman says. “But we needed to identify areas of concern so that we could find ways to help them protect the communities they serve.

“Pantries are doing a lot of things right. Our goal was to develop tools to help them do even better, and to help protect underserved groups. We need to know where the gaps are to better support this incredibly important and passionate nonprofit sector.”

The research has already been used to develop a suite of free, online resources for food pantries, which has been used by nonprofits across North Carolina – both those that participated in the research and those that did not.

The paper, “Evaluating North Carolina Food Pantry Food Safety–Related Operating Procedures,” was published online Nov. 1 in the Journal of Food Protection. The work was supported by Agriculture and Food Research Initiative grant 2012-68003-30155 from the U.S. Department of Agriculture’s National Institute of Food and Agriculture.

For more information contact Ben Chapman (919 515 8099/benjamin_chapman@ncsu.edu).

Emergency food should be safe food

Posted on November 2, 2015 by Ben Chapman

A few years ago an outbreak linked to a Denver homeless shelter made it into the barfblog new and notable category. Forty folks who depended on the emergency food were affected by violent foodborne illness symptoms after eating donated turkey. Fourteen ambulances showed up and took those most affected to area hospitals.

Volunteering as a food handler at a mission, shelter or soup kitchen and having a good heart and intentions doesn’t automatically lead to safe meals. An understanding of risks and having systems how to reduce them may.

Exposing individuals coping with food security and hunger to risky practices isn’t a good humanitarian approach. Last week KOMO News (Seattle) covered the possible closure of a free meal program for food safety reasons:

Every Thursday, Celeste Wilson whips up some of her best recipes. “They say it tastes very good because it’s Chinese food,” she said with a laugh. “It’s not just soup or salad or sandwich. Something different.”

Wilson is one of dozens of volunteers who makes food at home and then serves it at the Issaquah Community Hall.

As many as 80 people attend the free Thursday lunch as well as volunteer provided dinners, which are served seven days a week to countless people.

The diners come for something they wouldn’t have otherwise – a healthy, home cooked meal. But “home cooked” just got the attention of the Public Health of Seattle-King County, which says meals like these must be prepared in a commercial kitchen by someone with food safety certification.

“We don’t like to think of food in that way of having that potential of being the source that could make us sick. But just because we don’t know that someone has gotten sick, doesn’t mean that someone hasn’t. With food it’s very possible,” said Becky Elias, Manager of Food Protection and Water Recreation Programs at Public Health.

Around the same time as the Denver outbreak, colleague, friend and STEC CAP collaborator Christine Bruhn created a set of food safety materials for folks volunteering with food in their communities. Ashley Chaifetz, a former graduate student in the department of public policy at UNC-Chapel Hill took Christine’s content foundation and went out to the food pantry community to assess infrastructure and current food safety practices to tailor materials to the audience.

The assessment work was published in the November issue of the Journal of Food Protection:

Evaluating North Carolina Food Pantry Food Safety–Related Operating Procedures

Ashley Chaifetz, University of North Carolina at Chapel Hill; Benjamin Chapman, North Carolina State University

Journal of Food Protection

Vol. 78, No. 11, 2015, Pages 2033–2042

DOI: 10.4315/0362-028X.JFP-15-084

Abstract: Almost one in seven American households were food insecure in 2012, experiencing difficulty in providing enough food for all their members due to a lack of resources. Food pantries assist a food-insecure population through emergency food provision, but there is a paucity of information on the food safety–related operating procedures that pantries use. Food pantries operate in a variable regulatory landscape; in some jurisdictions, they are treated equivalent to restaurants, while in others, they operate outside of inspection regimes. By using a mixed methods approach to catalog the standard operating procedures related to food in 105 food pantries from 12 North Carolina counties, we evaluated their potential impact on food safety. Data collected through interviews with pantry managers were supplemented with observed food safety practices scored against a modified version of the North Carolina Food Establishment Inspection Report. Pantries partnered with organized food bank networks were compared with those that operated independently. In this exploratory research, additional comparisons were examined for pantries in metropolitan areas versus nonmetropolitan areas and pantries with managers who had received food safety training versus managers who had not. The results provide a snapshot of how North Carolina food pantries operate and document risk mitigation strategies for foodborne illness for the vulnerable populations they serve. Data analysis reveals gaps in food safety knowledge and practice, indicating that pantries would benefit from more effective food safety training, especially focusing on formalizing risk management strategies. In addition, new tools, procedures, or policy interventions might improve information actualization by food pantry personnel.

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Category Archives: Food Safety Culture

More cases linked to Chipotle; some patrons aren’t concerned