2. The Problem
Foodborne illnesses are estimated to cause each
year:
76,000,000 illnesses a year
323,000 hospitalizations
5,200 deaths
6.9 billion in economic loss
2
3. What Can We Do to Reduce Foodborne
Illnesses and Outbreaks?
• Improve food safety awareness
• Change bad behavior and
practices
• Follow this Food Handler Guide
3
4. Definition of Foodborne outbreak
is where two or more persons
experiencing a similar illness after
ingesting common food, or where
an epidemiologic analysis
implicates food as the source of an
illness.
4
5. Cause of Foodborne Illness
Drinking or eating foods
contaminated by poisonous
chemicals, pathogens, or other
harmful substances can cause a
foodborne illness.
5
6. A. The Big Five Pathogens That Cause
Foodborne Outbreaks and Illnesses are:
1. Shigella
2. Salmonella Typhi
3. E. Coli
4. Hepatitis-A
5. Norovirus
6
7. 1. Shigella (bacteria)
Shigella infection is caused via ingestion
(fecal–oral) contamination, poor hygiene and is
easily passed from person to person. Sources:
salads, milk and dairy products, and unclean
water. Incubation Period: 1-7 days. Symptoms:
Diarrhea, fever, chills, and dehydration: Must
be reported to manager. Work exclusion
applied.
7
8. 2. Salmonella (bacteria)
can be picked up by eating foods
handled by an infected person or
contaminated water. Symptoms of
fever, constipation, headache and
weakness show within 8 to 14 days.
Shedding continues even after
symptoms are gone. Must be reported
to manager. Work exclusion applied.
8
9. 3. E. Coli (bacteria)
Is associated by eating undercooked
ground beef that has been contaminated
at the processing plant & can be spread
from person to person by not washing
fecal soiled hands. Symptoms of
cramping and bloody diarrhea develop
in 2 to 10 days. Must be reported to
manager. Work exclusion applied.
9
10. 4. Hepatitis -A (Virus)
affects the liver and is spread by fecal-
oral rout or by consuming contaminated
water. Most infectious time is two weeks
before symptoms show- nausea,
vomiting, diarrhea, abdominal pain and
yellowing of the skin. Symptoms may
last several days. Work exclusion
applied. Must be reported to manager.
10
11. 5.Norovirus
After 24 to 48 hours of exposure,
symptoms include vomiting, diarrhea,
abdominal cramps, and low-grade fever.
Norovirus is contagious and is spread by
fecal-oral rout. Infected people can
spread this virus for up to two weeks after
symptoms are gone. Report this illness to
your manager. Work exclusion applied.
11
12. Personal Health
Report any of the following symptoms to your
manager either while at work or outside of work:
12
13. A. What does it mean to exclude a food employee?
If a food employee needs to be excluded, they may
not enter any part of the establishment where food
and equipment is stored, prepared or served.
Exclude: if diagnosed with one of these highly
infectious organisms: Salmonella Typhi, Norovirus,
Shigella, E. coli, or Hepatitis A. If symptoms are
present, the employee must wait until they resolve.
The employee will also need written medical
documentation and approval from the regulatory
authority to return to work.
Exclude: if diagnosed with any other disease which is
transmissible through food such as Salmonellosis,
Giardiasis and Campylobacteriosis. If symptoms are
present, the employee must wait until they resolve.
The employee will also need written medical
documentation and approval from the regulatory
authority to return to work.
13
14. B. What does it mean to exclude a food employee?
If a food employee needs to be excluded, they may
not enter any part of the establishment where food
and equipment is stored, prepared or served.
If employee is/was ill with Salmonella Typhi within the past 3
months, the employee will need written medical documentation
and approval from the regulatory authority to return to work.
If employee was ill with Shigella spp., E. coli or any other
disease that is transmissible through food in past months, the
employee will need written medical documentation and approval
from the regulatory authority to return to work.
If employee has become jaundiced within the past 7 or more
days, the employee must be excluded for at least 7 days from
the onset of jaundice. After 7 days the employee can work if
he/she is free of all symptoms and if he/she has written medical
documentation and approval from the regulatory authority to
return to work.
14
15. A. Restricted from Work
What does it mean to restrict a food employee?
“A restriction means that the food employee may not work with exposed
food, clean utensils and equipment, clean linens and unwrapped single-
service and single-use articles.”
Employee has persistent sneezing,
coughing, runny nose which
causes discharges from the eyes,
nose or mouth (restrict): Employee
can return to normal duties once
the symptoms have stopped.
15
16. B. Restricted from Work
What does it mean to restrict a food employee?
“A restriction means that the food employee may not work with
exposed food, clean utensils and equipment, clean linens and
unwrapped single-service and single-use articles.”
Experiencing diarrhea, vomiting, fever, sore
throat with fever, open sore. The employee can
work once symptoms have stopped. If
employee is suspected being the source of a
foodborne outbreak, written medical
documentation and regulatory authority
approval will be needed before resuming
normal duties. If an open sore can be covered
with a water tight covering, the employee can
work as normal.
16
17. What is “written medical
documentation? Exclusion or Restriction Lifted
Employees must have written proof that they’re
free of diseases, which could be transmitted to
others through food. This may be satisfied by
providing copies of lab tests showing negative
stool cultures; however, some times it will require a
written note from a licensed doctor, nurse
practitioner or physician’s assistant. This must be
provided to the local Board of Health. They can tell
you what documentation will be needed in order to
have an exclusion or restriction lifted.
17
18. A. What Can Cause a Foodborne Outbreak?
1. Improper hand washing
2. Chemical or bacterial toxin
3. Improper cooling
4. Inadequate hot holding
5. Improper reheating of leftovers
6. Inadequate cooking time or
temperature
18
19. B. What Can Cause a Foodborne Outbreak?
Ingestion of raw contaminated foods
Ill employees working with food
Improper cleaning and sanitizing
Improper thawing of frozen foods
Multistage food preparation with long time
lapses between stages
Poor personal hygiene
Cross contamination
Foods from unsafe source
19
20. A. Hand Washing
is the number one thing you can do to prevent the spread
of a foodborne illness?
Only wash hands and arms at hand
sink
Use warm water
Use hand cleanser
Scrub all surfaces for 10 to 15
seconds
20
21. B. Only Wash Hands at the Hand Sink!
Wash back of hands
Wash arms
Wash between fingers
Wash wrists
Wash tips of fingers
Wash under fingernails
Dry hands with a clean towel or dryer
o Always provide soap and towels at each hand sink,
and do not block the hand sink. Do not store items
in the sink basin. Do not use the sink for anything
other than hand washing
21
22. A. When to Wash Your Hands
Before/after preparing food
Before and after eating food
Before starting work
During food prep
When moving from one preparation to
another
Before putting on or changing gloves
22
23. B. When to wash your hands
After handling soiled dishes, After using toilet
money, or trash
After eating, chewing gum, or
After hands become tobacco
contaminated
After handling raw meats
After tending to the sick or
After clean up activity
treating wounds
After changing diapers
After blowing your nose,
coughing, or sneezing After using the toilet
After handling animals or their After touching hair, body and face
waste
After handling garbage, face
and hair
23
24. Good Hygienic
Practices
• Don’t eat or smoke in the kitchen
• Use gloves, utensils, or deli tissue
• Cover mouth when sneezing (wash hands)
• Bandage cuts and sores
• Keep hands away from face & body
• Trim nails
• Remove jewelry and nail polish (plain wedding
band allowed)
• Restrain hair
• Bathe and shower daily
• Keep aprons and clothing clean
• No animals in the kitchen area
24
25. Drinking in The Kitchen Area
You can drink in the kitchen area, but:
Cups must be spill proof and have a straw.
Cups must be stored in a way that does
not contaminate food or food items.
No bottles with screw top lids: no
containers that require hands to open and
close spout in-between sips.
Hands and fingers must not become
contaminated while drinking.
25
26. Service Dogs!
Providing that service dogs
are not a nuisance and do not
contaminate food, food
contact surfaces, or food
items, they are allowed in the
dinning area and lobby of food
serving establishments.
(not the kitchen area)
26
27. Bare Hand Contact
With Ready to Eat Foods
• Customer base: • Active management
establishment serves non oversight and corrective
susceptible population action: procedure for
• Employee training: managers corrective action
employee verifies in writing • Involved foods and handling
receipt of hand sanitation activities: list all ready to eat
training (filed on-site) foods and food handling
• Additional safeguard activities that involve bare
measures: at least two hand contact
additional safeguard control
measures written into
published hand sanitation
procedure
27
28. A. You may not use bare hand Contact
with ready to eat foods if serving a
susceptible population
Ready to eat foods means food that is in a form
that is edible without washing, cooking, or
additional preparation: unpackaged and cooked
potentially hazardous food; raw, washed, cut fruits
and vegetables that are for consumption such as
at the buffet and other foods from which rinds
peels husks or shells are removed. Ready to eat
foods that receives no further processing such as
cooking to destroy microorganisms presents the
highest risk of causing illness if it becomes
contaminated. 28
29. B. How do I Know if I Serve a Highly Susceptible
Population? You May Not Use Bare Hand Contact
With Ready to Eat Foods.
People who are most likely to
experience foodborne disease are
immunocompromised due to old age,
very young age, or a medical condition.
People which reside in a hospital or
nursing home, or in a facility which
provides custodial care to preschool
age children such as a day care center.
29
30. C. Bare Hand Contact with Ready to eat
Foods Acknowledgement of hand sanitation training.
Employee must sign a form acknowledging
they have received hand sanitizing training in:
Customer increase risk
Proper hand washing
When to wash hands
Proper fingernails
Prohibit of jewelry (plain wedding band ok)
Good hygienic practices
Employee health policy (exclusion/restriction)
30
31. D. Hand Washing With Supplemental Control:
Manager Picks Two of the Following
Double hand washing
Nail Brush
Hand Sanitizer
Paid sick leave or
Other approved documented similar
incentive policy to encourage employees
not to work when sick.
31
32. E. Managers will monitor the activities of
their employees and issue corrective action.
Corrective action Record Keeping
If your manager finds you not For each infraction,
following guidelines for bare
management will document
hand contact with ready to eat
foods, he/she will ask you to the corrective action
sign an acknowledgement of Who committed the infraction
hand sanitation training. What the infraction was
Will ask you to use employee The date of infraction
hand washing procedures
Where the infraction was
Discard ready to eat foods you
touched What corrective action taken
Retrain you
Reassign, discipline or
terminate chronically non
compliant employees
32
33. F. Bare Hand Contact With Ready to Eat Foods
How to wash hands: All employees must observe the
employee Hand Wash Procedure when washing their
hands.
Where to wash hands: All employees must restrict
hand washing to designated hand sinks.
Extraordinary Precautions: Employees required to
touch ready to eat food with bare hands must
complete and sign the acknowledgement of hand
sanitation training form prior to duty
Monitoring: manager must monitor the activities of
their employees and issue corrective action.
33
34. G. What are the Risks Involved With Bare
Hand Contact With Ready to Eat Foods?
Possible contamination of exposed, ready
to eat food, by bacteria, viruses and
parasitic pathogens, can be transferred to
ready to eat foods by infected employee’s
hands. Ready to eat foods must be
protected at all times.
34
35. A. Potentially Hazardous Foods (PHF)
natural or synthetic food that needs to be held at 41 F or
colder or 135 F or hotter, because it is in a form capable of
supporting:
Rapid and progressive
growth of infectious or
toxigenic bacteria
Growth and toxin
production of Clostridium
botulinum
The growth of Salmonella Doing okay?
Enteritidis in/on raw shelled
eggs.
35
36. B1. PHF Do Not Include:
“…air-cooled hard-boiled egg with shell intact, or a
shell egg that is not hard-boiled, but has been
treated to destroy all viable Salmonella, such as
pasteurized in the shell eggs”
“A food with a water activity value of 0.85 or less,
such as jams or jellies”;
“A food with a pH level of 4.6 or below when
measured at 75 F, such as properly prepared
sushi rice or pickles.”
36
37. B2. PHF Foods does not include:
“A food, in an unopened hermetically sealed container,
that is commercially processed to achieve and maintain
commercial sterility under conditions of non refrigerated
storage and distribution.”
“A food for which laboratory evidence demonstrates
that the rapid and progressive growth of pathogens
cannot occur.”
“ A food that does not support the growth of pathogenic
microorganisms even though the food may contain an
infectious or toxigenic microorganism or chemical or
physical contaminant at a level sufficient to cause
illness.” 37
38. C. Potentially Hazardous Foods
Meat
Eggs (not treated for salmonella)
Milk
Heat treated plant foods, rice, beans, vegetables
(not including sushi rice)
Tofu and soy protein
Untreated garlic and oil mix
Mushrooms
Raw sprouts
38
39. Danger Zone
The temperature range in which
foodborne bacteria can grow rapidly is
known as the danger zone . According
to the 2005 FDA Food Code, the
danger zone is defined as 41 F - 135 F
(5 C - 57 C). Potentially hazardous
food should not be stored at
temperatures in this range in order to
prevent foodborne illness, and food that
remains in this zone for more than four
hours, must be discarded.
39
40. Thawing:
Keep Food from lingering in the danger zone by
proper thawing.
Keep foods inside refrigerator.
Thaw foods under cold running
water.
Thaw foods using the microwave
if cooking follows immediately.
40
41. A. Cooking Temperatures
Foods rich in protein, like meat, poultry, or seafood, are
more likely involved in foodborne illness outbreaks than
non-protein-rich foods for two reasons:
“package of ground meat Protein-rich
foods tend to be of animal origin, and
the bacteria from the animals can be
found in these foods.”
“Animal foods are rich in proteins,
which are an important nutrient
source for some bacteria.”
41
42. B1. Cooking Temperatures (Ground Meat)
Meat may have harmful bacteria on the surface from the
slaughter process, equipment from the processing plant, or
from germs on hands, utensils, or kitchen surfaces. When
meat is "ground up" at the supermarket and then handled at
home, the surface bacteria may end up inside the meat. This
is what makes ground beef at risk for E. coli O157:H7
contamination.
Proper cooking will kill harmful bacteria on the surface of a
solid cut of meat, such as steak, because the surface gets
direct heat, but harmful bacteria on the inside of the meat are
less likely to be killed by cooking if proper internal
temperatures are not reached.
42
43. B2. Cooking Temperatures (Ground Meat)
That's why it's important to be careful that the
internal temperature of ground meat reaches
a high enough temperature to kill bacteria
that may be present in ground meat
All consumers should cook ground meat to at
least 155 F for 15 seconds. Make sure the
thermometer goes straight into the meat and
does not come out the other side and touch
the pan.
43
44. C. Cooking Temperatures (Pork)
People may contract trichinosis (a disease
from the parasite Trichinella spiralis) from
eating undercooked pork. Pork must be
cooked to a safe internal temperature to
eliminate disease-causing parasites and
bacteria that can be present.
Pork must reach an internal temperature of
145 F, for 15 seconds.
44
45. D. Cooking Temperatures (Poultry)
Bacteria can be found on raw or undercooked chicken.
Cook poultry to a minimum internal
temperature of 165 F (74 C) (for 15
seconds). Consumers can cook poultry to a
higher temperature if you want.
If whole poultry that's pre-stuffed but not
cooked is left out at room temperature, the
warm environment, along with the raw meat
juices mixing with the stuffing, present an
ideal environment for bacterial growth.
45
46. E. Cooking Temperatures
Minimum Internal Temperature
Stuffing, stuffed products: 165F for 15
seconds
Poultry: 165F for 15 seconds
Ground or injected meats: 155F for 15
seconds
Pork, seafood, eggs, beef cuts: 145F
for 15 seconds
46
47. F. Internal Temperatures
Frequently check temperatures, and
report to manager when they are out
of range.
Use food thermometers; do not guess.
Sanitize thermometer probes.
Calibrate thermometers regularly.
47
48. Calibrate a Thermometer (cold)
Fill a container with crushed ice and
water.
Container must have enough crushed
ice to provide an environment of
32 F. You may need to pack more ice
into the cup during the process.
When the mixture of the water has
stabilized, insert the thermometer to
be calibrated.
If your thermometer is not accurate
within +/- 1 F of 32 F., adjust the hex
nut on the thermometer accordingly.
48
49. Calibrate a Thermometer (Hot)
Place water in a container and heat it up.
When water in the container has reached a
rolling boil, insert food thermometer into the
container.
Be sure there is at least a two-inch clearance
between the stem and the bottom and sides of
the container.
If your thermometer is not accurate within +/-
1 F of 212 F., adjust hex nut on thermometer
accordingly. 49
50. Reheating Foods
Rapidly reheat foods to 165 F or higher to
kill any germs that may have multiplied when
food passed through the danger zone. Hold
hot foods at 135 F .
Do not reheat food using steam tables, slow
cookers, or similar hot holding equipment.
50
51. Cooling Foods Down Safely
Cool foods from 135 F
to 70 F within two
hours and then to
41 F within four
hours; this gives you
Six hours total.
Cut foods into smaller
portions and re-pan
foods to 2 inch depths
pans.
Use Ice baths
51
52. Temperature For Food Safety Summary
Germs grow rapidly when perishable food is held at
unsafe temperatures. Avoid illness by:
Keep foods from remaining in the danger zone
Cooking foods to safe temperatures
Keeping hot food above 135 F
Deep cold food below 41 F
Cooling foods to 70 F in 2 hours and to 41 F
within four hours. (total of six hours)
Using a chefs food thermometer to check
temperatures
52
53. A. Cross Contamination
Germs can be spread from one food to
another through improper storage and
mishandling: indirect bacterial
contamination of food by contact with an
infected raw food or non food source
such as clothes, cutting boards or
knives.
53
54. B. Cross Contamination
Separate raw meats such Never place cooked
as poultry and seafood foods on a surface that
from other foods. previously held raw
Recognize ready to eat meats.
foods from raw Clean and sanitize
unprepared foods. equipment and utensils
Use separate surfaces when changing food
and equipment for raw products.
meats and fruits and Store foods in a container
vegetables. or wrap them
54
55. A. Cleaning versus Sanitizing
• Sanitizing kills germs.
• Cleaning removes solids and oils
on surfaces by use of
surfactants.
55
56. B. Washing at the 3 compartment sink
Wash, rinse, sanitize, and air
dry.
Scrape off leftovers from
dishes.
Fill first compartment sink up
with hot soapy water to wash
dishes.
Fill second compartment sink
with clean warm water; Rinse
dishes.
Fill third compartment sink;
sanitize with warm sanitizing
solution.
Air dry.
56
57. Washing Dishes at the Dishwasher
Presoak items on which food has dried and hardened.
Rinse off food residue before racking.
Inspect cleaned articles for food deposits.
Check dishwasher sanitizer and temperatures at every
shift; If you use heat as your sanitizer, the final rinse
cycle must reach 180 F. If you use chemicals, use
your test trip to make sure your sanitizer is calibrated
correctly.
Clean dishwasher frequently
Air dry dishes
57
58. C. Washing equipment with cloths
Equipment too large to put into the 3
compartment sink: wash, rinse, sanitize and
air dry all removable parts.
With your three buckets of warm soapy
water, fresh warm water, and warm sanitizer
solution, use a cloth to wash, rinse and
sanitize the equipment in place.
Let parts and equipment air dry.
58
59. D. Use Separate Cloths For
Ready to eat food surfaces
Raw food surfaces
Non food surfaces
Store cloth in sanitizer solution
Rinse cloths clean before returning it
to sanitizer solution.
59
60. E. Sanitizers
Quaternary Ammonia: 150 to 200ppm
Chlorine: 50 to 100ppm
Iodine: 12.0 to 25ppm
Use test strips to test the concentration.
Measure out concentration
Use water mark in 3 compartment sink or bucket
Use warm water (70 F 90 F)
Never add soap or other chemicals to sanitizer
60
61. Illness From Chemicals
Improper use and storage of chemicals can cause injury and
illness (example)
• Chlorine Bleach
• Quaternary Ammonia
• Home-style chemicals
• Pest Control Chemicals
• Degreasers
61
62. Properly Stored Cleaning Supplies
Keep all chemicals stored in a way that does not contaminate
food or food contact items such as utensils, pans, plates
napkins, countertop.
All chemicals must be in their original containers that are
properly labeled, or transferred to a designated container that
is properly labeled.
Do not use home-style chemicals; only use chemicals that are
approved for the commercial kitchen.
High concentrations of chemicals such as degreasers and
bleach can cause an illness or injury.
62
63. A. Rotating Food and Supplies
• Never mix new foods with old foods
• Using first in first out rotation
• Do not exceed 7 days
• Using date labels for tracking
63
64. B. Rotating Food and Supplies
Using date labels for tracking
Mark labels with date received
Mark labels with date prepared/
opened
Mark labels with use by date
Especially for highly perishable foods
Do not exceed 7 days
64
65. Do not exceed 7 days
When you open or prepare a product, you
have 7 days to use it up or discard.
If you freeze the product, time stops.
After 5 days in the refrigerator, if you then
freeze it for 10 days, and then you thaw it out,
you still have 2 days to use the product or
discard it. (5+2=7)
Use date labels to track the use by date.
65
66. Now you’re ready to take your
exam. It’s a very simple
References exam, so jump on in.
• Texas Food Establishment
Rules
http://www.dshs.state.tx.us/foodestablishments/pdf/TFERFIMSept
ember282006.pdf
• FDA:
http://www.fda.gov/Food/FoodSafety/RetailFoodProtection/FoodC
ode/FoodCode2009/
• CDC:
http://www.cdc.gov/foodsafety/
• Texas Department of State
Health Services
http://www.dshs.state.tx.us/
66
67. After graduating from Texas
Woman's University, with a
Bachelor of Science, in Health
Studies, Mrs. Baxter went to work
for the U.S. Food and Drug
Administration (FDA); as a
Federal Agent, she conducted
audits, inspections, and
investigations. For the past few
years, she has been a Health
Inspector for the Tarrant County
Public Health Department. The 8
cities in her charge keep her on
the go. Her family invented the
Fletcher’s Corny Dog . With no
children, she has been married to
David Baxter for 13 years. She
has a family dog named Gromit.