1. Module 2: Food Purchasing and Receiving

2. Case Study

3. Introduce outbreak
Can watch news video if desired

4. What Happened Summer 2016, Hawaii
291 confirmed cases of Hepatitis A virus associated with imported scallops
73 people hospitalized
One woman died
Frozen scallops were imported from Philippines
Possibly harvested from contaminated water
Scallops were served raw at sushi restaurants
Hawaii had an outbreak of Hepatitis A virus linked to scallops served raw
Employees did not test positive for the virus
Virus was linked to scallops originating from Philippines and distributed in the US. Once scallops were identified as the issue they were embargoed (meaning not to be sold, purchased or consumed)
Restaurants had to close for cleaning and sanitation

5. How does this case study affect purchasing?
Discussion
How does this case study affect purchasing?
Discussion: How does this case study affect purchasing?
Suppliers matter…outbreak was probably caused by harvesting in contaminated waters
If sourcing from a foreign supplier it is important to make sure they are in compliance with US regulations
Retaining the bill of sale/invoice is helpful in reporting outbreaks and responding to recall notices

6. Learning Objectives
Understand symptoms, sources and control of Hepatitis A virus and foodborne parasites
Define approved supplier and list requirements
Explain best practices for receiving and describe criteria for accepting/rejecting a shipment

7. Key Terms
Approved supplier - A reputable company in compliance with regulatory authorities.
Flow of food - The path that food follows from delivery to service and consumption.
Shelf-life - The time under proper storage conditions that food will remain microbiologically safe and/or of good quality
Spoilage - Process that occurs that makes food unacceptable to consume; spoilage may be attributed to spoilage microorganisms

8. Hepatitis A Virus Source Infected people
Spread through fecal-oral transmission
Symptoms and onset
Fever, weakness, nausea, abdominal pain, jaundice
Can take up to 50 days for symptoms to appear
Foods associated
Ready-to-eat foods
Shellfish harvested from contaminated waters
Any food contaminated by employee
Hepatitis A virus is one of only two viruses commonly associated with food (norovirus is the other)
Hep A is unique in that it has such a long onset time, so someone can contaminate food for weeks before they show symptoms
Food establishments are required to report to the health department if any employee is diagnosed with hep A. Typically there will be a public announcement so that anyone who ate at the establishment during the time the infected employee worked will be aware of exposure. Exposed individuals are then encouraged to receive a vaccine
Shellfish are filter feeders, meaning they take in water and then strain out microscopic particles that they use for food. (If you’ve ever seen Finding Nemo, it’s like the scene where the baleen whale is swallowing a gulp of water and the krill are furiously trying to swim away.) As filter feeders, shellfish can concentrate bacteria and viruses to large amounts, so if they are eaten raw they cause illness

9. Parasites
Parasites can be associated with contaminated food and water, especially produce irrigated with contaminated water
Sourcing from approved suppliers can decrease risk
Best practices to control parasites include:
Safe water supply and plumbing
Products from approved suppliers
Proper cooking
Parasites are another microorganism of concern with food, and these are often a sourcing or water issue
As a reminder, parasites cannot grow outside of a host, but they often exist in soil or water, waiting for a host
Parasites can be of concern in seafood, as some types of parasites are native to certain regions of the ocean

10. Cryptosporidium Source Found in infected people and animals
Spread by contaminated water and feces
Symptoms and onset
Severe diarrhea, abdominal cramps, mild fever and nausea
Symptom onset around 7 days
Foods associated
Fresh produce
Contaminated water
Cryptosporidium can cause extremely large amounts of diarrhea when it contaminates food, drinks, or “play” water, including swimming pool water or other outdoor water, if it’s swallowed.
The amount of body fluid lost from this illness can be dangerous for anyone, but people who have a weak immune system, such as those with HIV/AIDS or cancer, are at especially high risk.
In YOPI populations, infections can also spread to the liver and lungs.
Otherwise healthy people who get this illness usually get better in 2 days to 2 weeks..

11. Giardia Source Symptoms and onset Foods associated
Found in infected people and animals
Spread by contaminated water and feces
Symptoms and onset
Fever, diarrhea, cramps, nausea (especially bad smelling gas and diarrhea)
Symptom onset around 7 days
Foods associated
Fresh produce
RTE foods handled by infected person
Giardia (pronounced “jee-AR-dee-ah”) is a parasite that can make people sick when they eat or drink contaminated food or water.
In some cases, there are no symptoms, but, often, people who have giardiasis (the illness caused by Giardia) have diarrhea that smells especially bad, gas, nausea, cramps, vomiting, and weight loss.
Giardiasis can be spread through direct contact, Children in day-care centers often get giardiasis in this way.
Giardia can also survive chlorine in swimming pools, and can also be found in water sources in the wild

12. Toxoplasma gondii Source Symptoms and onset Foods associated
Found in contaminated water and soil
Cat feces
Symptoms and onset
Over 60 million people may be infected
Few have symptoms; immune system prevents illness
Severe infection can cause damage to eyes, brain and other organs
Pregnant and immunocompromised could have serious illness
Foods associated
Fresh produce
Pork products, wild game
Toxoplasma in pork products is the pathogen-food combination with the second highest disease burden in the United States, second to Campylobacter and poultry
Many of the symptoms present as organ failure, neurological issues or mental illness
Toxoplasma gondii is killed off easily with proper cooking to 145°F

13. Trichina spiralis Source Symptoms and onset Foods associated
Found in the environment
Problem when pigs are fed garbage/ allowed to roam free
Symptoms and onset
Nausea, abdominal pain, vomiting, diarrhea
Muscle pain, fever, breathing difficulty
Average symptom onset, 2-28 days
Foods associated
Pork products
Wild game
Trichina has been reduced significantly due to modern pork production that does not allow pigs to forage or eat garbage
This was a pathogen of great concern several decades ago, and one reason why many people were taught to severely overcook pork
Can be of concern in wild game, especially boar and bear, so proper cooking and handling is important

14. Alternatively, don’t serve products raw.
Anisakis simplex
Source and Foods
Ocean water
Fish and shellfish
Symptoms:
Tingling in throat, coughing up worms
Stomach pain, vomiting, diarrhea
Can infect the stomach and intestines; must be surgically removed
Onset 4-6 hours, sometimes up to 14 days
Purchase sushi grade fish (previously frozen). Proper freezing will kill this parasite.
Alternatively, don’t serve products raw.
These worms are common in fish and squid, cuttlefish, and octopus
Proper cooking (described below) inactivates them.
If you eat them alive in raw or undercooked fish, they can infect your stomach or intestine. Sometimes, the only symptom is tickling caused by a worm crawling up the throat. If a worm burrows into the wall of the stomach or intestine, it can cause stomach or abdominal pain, nausea, vomiting, and diarrhea, from mild to severe.
Sometimes these worms cause an allergic reaction.

15. Best Practices for Sourcing Food and Supplies

16. What do you think this means? Who is the regulatory authority?
Approved Suppliers
FDA Model Food Code Definition
Approved supplier is acceptable to the regulatory authority based on conformity to best principles and practices that protect public health.
What do you think this means?
Who is the regulatory authority?
WHAT DOES THIS MEAN??
Read the definition according to the FDA Food Code
Discuss what participants think that translates to practically

17. Approved Suppliers Characteristics: Have a good reputation
Get ingredients from approved sources
Are inspected by regulators
May have additional food safety certifications or audits done by other companies
What makes a good reputation? Timely deliveries, quality, foods delivered in acceptable condition, etc
Suppliers must also use approved suppliers. Think of the case study. Maybe the scallop suppliers didn’t vet their fishery suppliers
Different foods are subjected to regulations by different agencies
Some companies use third party certifications as an extra measure to ensure food safety

18. Regulatory Approval
Know regulations a producer must meet to be an approved supplier
Fresh fruit and vegetable production is regulated under the FDA’s Food Safety Modernization Act (FSMA) Produce Safety Rule
USDA Food Safety Inspection Service regulates food safety of meat, poultry and some egg products
FDA’s FSMA sets the regulations for processed foods that are not meat and poultry
Food Safety Modernization Act was signed in 2011 and final rules are in the beginning stages of being enforced.
Produce Safety Rule includes regulations for growing conditions, irrigation water, harvester hygiene, packing, transportation, etc
USDA FSIS regulates meat, poultry and some egg products. This is where you’ll see “USDA certified” or “USDA Grade A”

19. Know Your Products Know risks involved with your products
Receiving temperatures
Package and product conditions
Allergens
Know how to handle your products safely
Monitor alerts from suppliers about recalls and ingredient changes
Knowing your products involves knowing risks, such as temperatures for TCS foods, ingredients, allergens, etc
Know how products must be handled, such as which items are in fragile packaging or which items can be easily damaged
Monitoring alerts from suppliers is important, as ingredients may have changed (making something an allergen) or safety recalls may have been issued

20. Know Your Products: Fish & Shellfish
Purchase from approved suppliers
Parasite destruction for sushi-grade fish
Harvesting from approved waters
Retain shellfish tag for 90 days
In case of an outbreak, shellfish can be traced back to harvesting waters
As mentioned before, fish and shellfish can be a sourcing concern
Fish and shellfish products are often consumed raw or lightly cooked, which would not destroy pathogens most
Sushi grade fish is frozen for set times/temperatures in order to destroy parasites.
Note that freezing will not kill bacteria or inactivate viruses!
For shellfish, it is important to retain the tag for tracing purposes. Circle that in your notes, fair game for the exam

21. Verifying Supplier Practices
Do suppliers provide good customer service during ordering, receiving and dealing with quality issues?
How do suppliers train their employees in food safety?
Do suppliers’ delivery trucks look and smell clean?
What is the protocol for rejecting and returning products?
When choosing a new supplier, it is important to ask questions
You should also note how the supplier treats you as a customer and handles your product. It’s your money, so your products and services should be worth what you pay

22. Scheduling Deliveries
Schedule receiving
At a convenient time
When people will be available for receiving
So it won’t interfere with other activities and flow of food
Retain bill of sale to track products
Have procedures for rejecting shipments
You don't want deliveries to get in the way of the flow of food during high volume times
You also don’t want food to be left out because of high volume
Foods should not be delivered before opening unless they are scheduled to arrive right before someone arrives. Food can be subjected to temperature abuse (think of a milk delivery on a summer morning), pest infestation, theft or deliberate contamination. If your delivery people have access to your establishment it is best practice to make sure that they are stocking your items properly.

23. Accepting or Rejecting

24. Inspect Before You Accept
Check delivery vehicles for:
Cleanliness
Off odors
Proper temperature
41°F or lower
Eggs at 45°F or lower
Frozen foods - signs of temperature abuse
Use-by dates
Make sure you’re getting what you pay for, and no surprises
Extensive criteria are on page 18
Signs of temperature abuse include: wet boxes, items all stuck together, chunks of ice, discoloration, etc
Sometimes drivers will turn up the temperature in the refrigerated truck so that they can get more miles to the gallon

25. Inspect Before You Accept
Condition of packages
Dirty, discolored, wet
Dents, tears, punctures
Pests or their evidence
Ask about receiving surprise deliveries.

26. Have you ever had to reject an incoming shipment?
Discussion
Have you ever had to reject an incoming shipment?
Why?

27. Case Study What Happened What They Found
Nearly 300 people got sick from contaminated scallops
73 were hospitalized
One died
Scallops were contaminated with Hepatitis A virus

28. Case Study What Went Wrong Prevention
Scallops were most likely harvested from contaminated water
Scallops were served raw
Purchase products from approved suppliers

29. Quiz
When receiving food, which of the following is not a reason for rejecting food:
Frozen food is thawed or partially thawed
Visible mold or slime
Eggs received at 41°F or below
Packaging is damaged or dirty
Answer c).
Maker sure they read the question closely, notice the word “not”

30. Quiz
When receiving food, which of the following is not a reason for rejecting food:
Frozen food is thawed or partially thawed
Visible mold or slime
Eggs received at 41°F or below
Packaging is damaged or dirty
Answer c).
Maker sure they read the question closely, notice the word “not”

31. Quiz
A 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:
Thawing and refreezing
Safe, high quality seafood
Seafood that has been kept in frozen storage too long
Seafood that has been blast chilled
Answer: a)

32. Quiz
A 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:
Thawing and refreezing
Safe, high quality seafood
Seafood that has been kept in frozen storage too long
Seafood that has been blast chilled
Answer: a)

33. Review Approved suppliers
Requirements for inspecting and accepting shipments
Hepatitis A virus and parasites
Recap what was learned
Ask if there are questions