Food Safety is for Everyone Module Two Written and developed by: Lorraine Harley, Assistant Professor University of Maryland Extension Calvert/Charles/St Mary’s Counties Equal Access Programs Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension

Module 2 Personal Hygiene Module 2- Personal Hygiene Most recently poor personal hygiene has been the cause of the spread of many foodborne diseases. Source: www.cdc.gov Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension

Personal Hygiene: Handwashing is the single most important means of avoiding sickness and preventing the spread of disease Also teach your children how to wash their hands properly Personal Hygiene. Clean hands prevent infections and prevent illnesses at home, school and in work settings. Hand hygiene practices are a major deterrence against the spread of infection and illness in daycare facilities, healthcare settings, schools and public institutions. Proper handwashing at home can prevent the spread of infection from one person to another and sometimes throughout the community. Source: www.cdc.gov/print.do?url=http%3A//www.cdc.gov/cleanhands www.cdc.gov/Features/HandWashing/ Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension

Critical handwashing steps Wet your hands thoroughly with warm water and add soap Thoroughly scrub your hands, wrists, fingernails, and in between fingers – for at least: 20 SECONDS Rinse, then dry hands with a clean cloth towel or use a paper towel Critical handwashing steps. Now I know you are probably saying to yourself, why is this instructor trying to tell me how to wash my hands. This instructor is trying to tell you how to wash your hands because—too many people do not know how to wash their hands properly. Because too many of us do not know how. Adults can sing happy birthday to themselves twice. Children can recite their ABCs twice. If soap is not on hand, use an alcohol-based gel, that is at least 50% alcohol to clean your hands. When using alcohol-based sanitizers: Apply the product to the palm of one hand. Rub your hands together. Rub the product over the entire surface of your hands (do not forget your cuticles) until your hands are dry. Source: www.cdc.gov/Features/HandWashing www.fda.gov Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension

When should we wash our hands in the home? Before eating After changing diapers After coughing or sneezing When should we wash our hands in the home? The basic rules for handwashing in the home: Wash hands before preparing food and after handling uncooked meat and poultry; Before eating; After changing diapers; After coughing or sneezing (cough or sneeze into your upper arm, not into your hand); Source: www.cdc.gov/print.do?url=http%3A//www.cdc.gov/cleanhands Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension

When should we wash our hands in the home ??? Continued… After blowing your nose After using the bathroom Source: www.cdc,gov When should we wash our hand in the home? The basic rules for handwashing in the home: After blowing your nose into a tissue and; After using the bathroom. Source: www.cdc.gov/print.do?url=http%3A//www.cdc.gov/cleanhands Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension

Pet alert!!! Pets, such as dogs, cats, turtles, snakes, birds and lizards Soil Pet Alert. In July of 2005, the Food and Drug Administration, Center for Veterinary Medicine put out an alert regarding turtles: Small turtles are a source of infection of the intestines caused by bacteria called Salmonella. Symptoms of headache, fever, diarrhea, stomach pain, nausea and/or vomiting, can begin in 6 to 72 hours (usually 12 to 36 hours) after exposure to the bacteria. “Anyone can get the infection, but the risk is higher in infants and young children as well as the elderly and people with lowered resistance to disease due to pregnancy, cancer, chemotherapy, organ transplants, diabetes, liver problems, or other diseases. Salmonella occurs naturally in turtles. Turtles with the bacteria do not appear sick at all. Turtles do not shed salmonella at all times. If a turtle tests negative for salmonella it does not mean it does not have the bacteria. It just may not be shedding salmonella at the time of the test. Source: www.fda.gov Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension

Pet alert!!! Continued… Continued… Due to the turtle associated salmonella, the sale of turtles with a shell of four inches or less have been banned in the United States since 1975. In spite of the ban, turtles have recently increased in sales. The Food and Drug Administration alerts parents and individuals with responsibility for the care of children that: The sale of small turtles as pets is illegal. Be alert for turtles in petting zoos, parks, child day care facilities, or other locations where children may be. Make sure everyone washes their hands before leaving petting zoos. If you come in contact or handle turtles or their housing, be sure to wash your hands thoroughly with soap and water. Remember also to always wash your hands after handling all animals and after handling soil. Source: www.fda.gov Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension

Cuts and abrasions Clean the wound Wash your hands Cover with a clean dry bandage Use gloves if necessary Cuts and abrasions. As stated earlier, 30% of all people have staph bacteria on their hands and in their nose. Hands that have cuts and other wounds can emit infection. ALWAYS Clean the wound Wash your hands Cover with a clean dry bandage and Use gloves if necessary Source: www.fda.gov Adobe Connect: “Antimicrobial Resistance, the Food Supply, and Our Health” 1 hour Guest speaker: Dr. Jianghong Meng. 2009. Webna:“Cold and Flu Season”, sponsored by The Soap and Detergent Association. 1 hour Speaker: Mary Anne Linder. 2009. Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension

Common foodborne diseases spread by poor hygiene: Hepatitis A E. coli 0157:H7 Salmonella typhi Shigella Staphylococcus Aureus MRSA Norwalk virus Common foodborne diseases spread by poor hygiene. Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension

Hepatitis A (HAV) What is it ? How is it spread? Prevention Hepatitis means inflammation of the liver. Hepatitis A is a serious contagious liver disease caused by the hepatitis A virus (HAV). The disease can last anywhere from three weeks to several months. It is transmitted from person-to-person by putting something in the mouth that has been contaminated with the stool of an infected person. The virus is easily spread (transmitted) in places with poor sanitation or where people do not wash their hands. The virus lives in the environment for a long time so it can be transmitted by: Swallowing contaminated water or ice. Eating raw or undercooked shellfish harvested from sewage water. Eating raw fruits, vegetables, or other foods that were contaminated during growing, harvesting, processing or handling or; By eating cooked foods that were contaminated after cooking. Prevention: 1. Hepatitis A vaccination is recommended for: All children (check with your doctor concerning the age); Travelers to certain countries and; High risk populations as discussed earlier in the course.” Good personal hygiene as well as proper sanitation practices are necessary to prevent person-to-person spread. Source: www.cdc.gov/hepatitis/index.htm www.dphpe.org/infect/hepa.html Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension

Ecoli 0157:H7 What is it? How is it spread? E coli are bacteria that naturally live in the intestines of humans and animals. There are many different strains of E. coli but most of them are harmless. One particularly nasty strain of E.coli, is E coli 0157 H:7. This strain can cause very serious illness in people. Symptoms: Bloody diarrhea Painful stomach cramps Fever Symptoms can appear from 1 – 10 days after exposure, usually 2-4 days E coli 0157 H:7 can cause hemolytic uremic syndrome, or HUS, which can seriously damage the kidneys, especially in high risk groups. How it is spread: E coli 0157 H:7 lives in the intestines of cattle and can spread to humans who eat raw or undercooked meat or other foods that have come in contact with raw beef products or water contaminated by sewage or animal manure. Drinking unpasteurized milk Contaminated water Contact with animals in petting zoos or farms if proper hand washing is not observed. E coli 0157 H:7 can spread easily from one person to another, when a person who has not washed their hands well after a bowel movement contaminates food, water, or surfaces that other people touch. Source: www.cdc.gov Center for Agrosecurity, University of Maryland Photographs: www.cdc.gov/nczved/blog/2009/09/cookie-dough-gooey-sweet-seasoned-with-bacte... Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension

Ecoli 0157:H7 continued… Diagnosis Treatment How is it diagnosed: E coli 0157 H:7 is diagnosed by testing a stool sample using a specific test that is not available in all labs. Treatment: Presently there is no cure for E coli 0157 H:7. Antibiotics can make the disease worse. Most people get better in a few days with rest and plenty of fluids to prevent dehydration or fluid loss. Anti-diarrheal medicines are also not recommended. Source: www.cdc.gov Center for Agrosecurity, University of Maryland Photographs: www.cdc.gov/nczved/blog/2009/09/cookie-dough-gooey-sweet-seasoned-with-bacte... Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension

Salmonella What is it? How is it spread? Salmonella is the name of a group of bacteria that is common in the intestines of birds, reptiles, and mammals. It can also live in the intestine of humans. Salmonella accounts for forty-two percent of all foodborne illness in the United States making this disease the most reported cause of foodborne illness. Source: (The Surveillance Report from the Food Diseases Active Surveillance (foodNet) for 2004 identified Salmonella as the most common bacterial infection; reported at 42%.) How it is spread Salmonella is usually spread to humans by eating foods contaminated with animal feces. Salmonella exist on raw meat and poultry and can survive if the food is not cooked to a safe internal temperature measured with a thermometer. It is also spread through food handlers who do not wash their hands. Other foods include: Milk and dairy products Eggs Seafood and Some fruits and vegetables Source: www.fsis.usda.gov/Fact_Sheets/Salmonella_Questions_&_Answers/index.asp Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension

Salmonella Symptoms Long term consequences Salmonella. Symptoms include: fever, diarrhea, abdominal cramps and nausea. The illness can last several days. In high risk populations it can cause life threatening infections. Some high risk populations can experience long term consequences: Can take a while for bowel habits to become normal. Pains in the joints Irritation of the eyes Painful urination that can last for months or years and can lead to chronic arthritis that is difficult to treat. Source: www.fsis.usda.gov/Fact_Sheets/Salmonella_Questions_&_Answers/index.asp Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension

Shigella What is it? Symptoms How is it spread? Shigella is a disease caused by a family of bacteria called shigella. Symptoms: Diarrhea (often bloody) Fever Stomach cramps The symptoms occur within a day or two of exposure and last for 5 to 7 days. A rare and severe form of shigella can occur including high fever and seizures in children less than 2 years of age. Still, others may have no symptoms at all but can still pass the bacteria to others. How is it spread: The shigella bacteria passes from one infected person to another. Most infections occur when the bacteria passes from: Stools or soiled fingers of one person to the mouth of another person. Poor personal hygiene and handwashing habits. Toddlers who are not fully toilet trained. Certain types of sexual activity. Source: www.cdc.gov/nczved/dfbmd/disease_listing/shigellosis_gi.html Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension

Staphylococcus aureus What is staphylococcus aureus? How is it spread? Staphylococcus. Staphylococcus aureus is often called “staph”. It is a bacteria commonly found on the skin and in the nose of healthy people. It can be found in the nostrils of at least 30% of the population. How it is spread-poor personal hygiene It is usually spread from person-to-person from contact with secretions from infected skin lesions, nasal discharge, or spread by infected hands. Occasionally staph can get into the body and cause infections. The infection can be minor such as boils, pimples and other skin conditions. However, it can produce serious infections such as blood infections or pneumonia. Source: www.cdc.gov?ncidod/aip/research/mrsa.html Adobe Connect:“Antimicrobial Resistance, the Food Supply, and Our Health” 1 hour Guest speaker: Dr. Jianghong Meng   Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension

Noroviruses Or Norwalk like virus The Norwalk viruses are a group of viruses that cause “gastroenteritis” more commonly referred to as the ”stomach flu.” This “stomach flu” is not related to the flu (or influenza). It is an extremely common and contagious virus and spreads easily from one person to the next. Noroviruses are rarely diagnosed due to the often unavailability of the laboratory test. It got its name from Norwalk, Ohio, where the first outbreak occurred. Noroviruses are found in the vomit or feces of an infected person. In recent years, some ocean liners have been infected with the Norwalk virus and were forced to dock early due to passenger illness. Symptoms: nausea, vomiting, diarrhea, and some stomach cramping. These symptoms are sometimes accompanied with headache, fever, chills, tiredness and muscle aches. There is no vaccine. Cause: food or drink infected with the virus surfaces; utensils and other objects infected with the virus and placed in the mouth; direct contact with another infected person. Prevention: frequent hand washing; wash fruits and vegetables for at least 30 seconds with potable water, carefully clean and disinfect surfaces, flush, clean and get rid of feces and vomit and clean well around the toilet area. Be careful in child care facilities and nursing homes when caring for infected persons; wash your hands frequently. Source: http://www.cdc.gov/ncidod/dvrd/revb/gastro/norovirus-qa.htm PHIL #10708 photo credit : Charles D. Humphrey, Centers for Disease Control and Prevention (purple). Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension

The 4 most commonly recognized foodborne diseases today… Campylobacter Salmonella E-coli 0157:H7 Norwalk virus *Just 20 years ago these pathogens were not recognized as foodborne pathogens The pathogens of greatest concern today and the most commonly recognized foodborne infections are—camphylobacter, salmonella, E-coli 0157:H7, and a virus group called calicivirus which is also known as Norwalk and Norwalk like viruses. What is camphylobactor? Campyhlobactor is a family of bacteria and are the second most commonly reported cause of foodborne illness in the United States. Camphylobactor can be found almost everywhere, such as the gut of some humans, rodents, cats, dogs, poultry, swine and untreated water. Campyhlobactor bacteria flow through the body and into the environment. If food and water come in contact with the stool of infected animals or humans, it becomes contaminated. This is why a comprehensive approach must be used to counter this bacteria from farm-to-fork. Cause: Drinking untreated water, unpasteurized milk, raw or undercooked poultry and meat. Symptoms: Abdominal cramps, fever, often bloody diarrhea. This illness can last about a week. Complications can include urinary tract infections, reactive arthritis (most always rare and short lived) and even more rare Guillain-Barre syndrome an uncommon kind of paralysis. Source: www.cdc.gov/ncidod/dbmd/diseaseinfo/foodborneinfections_g.htm http://ohioline.osu.edu/hyg-fact/5000/5565.html Photograph: http://www.nbafoodadvocate.com/the-four-foodborne-pathogens-responsible-for-most-foodborne-illnesses-2445 Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension

When should I consult a doctor? High fever (over 101.5 F) Blood in stools Prolonged vomiting Diarrhea lasting more than 3 days Dehydration Decrease in urination Dry mouth and throat Dizzy upon standing When should you consult a doctor? As stated earlier, the symptoms of foodborne illness often mimic those of so many other illnesses, especially the flu. The CDC suggests you consult a doctor when the following symptoms occur: High fever (over 101.5 F) Blood in the stools Prolonged vomiting Diarrhea lasting more than 3 days Dehydration Decrease in urination Dry mouth and throat Dizzy upon standing Source: www.cdc.gov/ncidod/dbmd/diseaseinfo/foodborneinfections_g.htm Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension Copyright 2010 by Lorraine Harley, Assistant Professor, University of Maryland Extension