Lettuce Romaine healthy and safe!

If you are a vegetarian (and a food safety professional) like me, romaine lettuce and other salad items are in your refrigerator all the time. I stayed back from eating my fav lettuce over romaine outbreak in 2017 (November 2017 to January 2018) and earlier this year in 2018 (April to June). One would think in the midst of more than one romaine lettuce E Coli outbreak lawsuit, things would have gotten better?

After more than 200 illnesses and 5 deaths from the outbreak just this Spring and identifying the problem, we are safe now? I mean, at least farmers and harvesters are doing the right thing for food safety and QA, testing their crops, right? Think again!

There is another outbreak of E Coli O157:H7 linked to romaine lettuce. So far, 32 people are sick in 11 states. In addition, 18 people are sick in Canada. Illnesses started October 8, 2018 and ongoing.

I don’t know about you, but I am concerned about what to use in my salads.

What brands of romaine lettuce are contaminated?

The FDA has confirmed that they are conducting a trace-back investigation to determine the source of the romaine lettuce that made the confirmed cases sick.  FDA and many states are conducting lab analysis of romaine lettuce samples. Advisory alert from FDA and CDC ask that consumers do not eat any romaine lettuce because no common grower, supplier, distributor, or brand of romaine lettuce has been identified. Thanks a lot for this scare!

I just brought romaine from my local grocery store, is it safe to eat?

Simple answer – No. And that is all romaine products – whether whole heads, in a package, mixed into a salad mix, or that Caesar salad bought from a restaurant. Stay away from that crispy green leafy stuff for now.

Are you sure romaine is to blame?

CDC and FDA report that epidemiologic evidence from the US and Canadian agencies indicates that romaine lettuce is a likely source of the outbreak.

How can I tell if my romaine lettuce is contaminated?

There is no way for you to know unless you are a scientist in a laboratory. Romaine contaminated with E Coli will look, taste, smell, and look the same as Romaine that is safe. My words for you: Throw it out.

How can this happen?

The last outbreak was linked to irrigation concerns. This one may have the same issue. We just don’t know at this time. Root vegetables and leafy vegetables are the most susceptible to contamination from the application of manure to the soil. The fecal matter (loaded with pathogens) from cattle, pigs, deer, dogs, and goats can be exposed to produce item that is grown in soil.

Lettuce can also be contaminated by bacteria during and after harvest from handling, storing and transporting the produce. Contamination in lettuce is also possible at the grocery store, in the refrigerator, or from counters and cutting boards through cross-contamination with harmful bacteria from raw meat, poultry or seafood.

E coli can cause numerous illnesses because fruit and vegetables are shipped thousands of miles and are rarely cooked to a temperature that would kill E. coli.

Are the outbreaks all related?

CDC has confirmed that “Ill people in this outbreak were infected with E. coli bacteria with the same DNA fingerprint as the E. coli strain isolated from ill people in a 2017 outbreak linked to leafy greens in the US and to romaine lettuce in Canada. The current outbreak is not related to a recent multistate outbreak of E. coli O157:H7 infections linked to romaine lettuce.”

How do I know if I have E coli?

Symptoms show within 2 to 10 days after eating an E coli contaminated product. Signs of the infection: vomiting, nausea, watery (sometimes bloody) diarrhea, abdominal pain, and in some cases, fever. Urgent medical attention is recommended at any sign of the infection, especially if you have eaten romaine recently or are at high risk for foodborne illness.

E.coli strain known as STEC E. coli O157:H7 (referred to as O157:H7), is particularly virulent because of the toxin that is shed by the bacteria. The toxins can result in life-threatening hemolytic-uremic syndrome (known as HUS). This strain is potentially deadly to the elderly, young infants and children, and those with compromised immune systems.

Should I be concerned about HUS?

Yes. HUS is a potentially life-threatening complication affecting the kidneys because of a STEC E coli infection.  About 5 to 10% of those diagnosed with STEC E coli end up developing HUS.  People with HUS should be hospitalized; otherwise, they could experience kidney failure and other serious health problems.  In some cases, long-term damage to the kidneys and other organs can result in persistent or recurrent health concerns that can have a drastic effect on a patient for the remainder of their life.

As with E coli infections, one should seek immediate medical attention at the first sign of any of these symptoms. Early medical intervention can help reduce the risk of more severe illness and long-term complications.

So, if you were planning to serve healthy salads for your Thanksgiving gathering, you will need to make a run to your grocery store and fight for that last head of lettuce or the ready mixed bags – just make sure to not pick any romaine and please be civil and no fights…after all, we are in giving thanks mode.



FBI Risk Factors and Intervention Strategies – FDA Study

The U.S. Food and Drug Administration (FDA) released findings today from the initial phase of a 10-year study that is evaluating trends in food preparation practices and employee behaviors that contribute to foodborne illness outbreaks in the retail setting.

You can read the 84-page document (link provided below) or read a quick summary here.


Foodborne illness remains a major public health concern in the United States. Foodborne diseases cause ~48 million illnesses and ~3000 deaths each year. Economic burden due to foodborne illness is estimated at $77 billion dollars (Scharff, 2012).

Restaurant industry is a major driver of food service and consumer demand for food away from home has led to increased spending in both fast food and full-service restaurants, with more than one million restaurant locations employing 14 million people. Per CDC studies, more than half of foodborne illness outbreaks that occur each year are associated with food from restaurants. Activities related to food handling and preparation practices were the most commonly reported contributing factors within restaurant-associated outbreaks by CDC.

Most regulatory food inspection programs monitor the following risk factors while conducting routine food safety inspections, and each factor necessitates specific food safety behaviors and practices.

  • Poor personal hygiene
  • Improper food holding/time and temperature
  • Contaminated equipment/protection from contamination
  • Inadequate cooking
  • Food obtained from unsafe sources

FDA specialists collected inspection data in 2013-2014 for research – to be used as baseline for better intervention strategies, food safety practices – moving forward. This data collection period combined with current 2017-2018 and future (2021-2022) will be useful for identifying relationship between Food Safety Management System (FSMS) and Certified Food Protection Manager (CFPM), and how these risk factors and food safety behaviors are associated with foodborne illness in restaurants.

FSMS refers to a specific set of actions (procedures, training, and monitoring) to help achieve Active Managerial Control (AMC). Non-existent or inadequate FSMS are thought to contribute to the worldwide burden of foodborne disease.

CFPM is an individual who has shown proficiency in food safety and possess an accredited certificate, as required by most regulatory agencies. Research has shown that the presence of a CFPM is associated with improved inspection scores (Hedberg et al., 2007; Brown et al., 2014)

Food Code emphasizes the need for risk-based preventive controls and daily AMC of the risk factors contributing to foodborne illness. AMC is “the purposeful incorporation of specific actions or procedures by industry management into the operation of their business to attain control over foodborne illness risk factors” (FDA, 2013). AMC involves the continuous identification and proactive prevention of food safety hazards. Two strategies supporting AMC efforts in food establishments that have received growing attention are presence of a CFPM and an effective FSMS.

Research and results:

Data items that were included in FDA’s studies included:

  • proper handwashing practice
  • no bare hand contact of ready-to-eat foods
  • protection from cross contamination (during storage, preparation, and display)
  • food contact surfaces properly cleaned and sanitized
  • TCS foods are held at proper temperature
  • displayed or stored hot foods are held at proper temperature
  • foods are cooled properly
  • TCS RTE foods are properly date marked/discarded within 7 days
  • raw animal foods are cooked to required temperatures
  • foods are reheated to required temperatures

From food safety behaviors/practices that were investigated in this FDA study, we see that restaurants had better control over no bare hand contact with ready-to-eat foods and making sure that raw animal foods are cooked to their required internal temperatures. But, there remains a huge need to gain better control over food employee’s handwashing habits and controlling temperatures of TCS foods.

Some results are very alarming: For full service restaurants, more than 2/3 of visited facilities did not date-mark their TCS foods properly; more than 2/3 did not cool their hot foods properly before storing it; almost 2/3 had dirty food contact surfaces; and 1/3 failed to reheat foods to proper temps. For fast food restaurants, 1/2 of visited facilities failed to cool foods properly; 40% had dirty food contact surfaces; 1/3 did not date-mark their TCS foods properly; and more than 1/3 failed to prevent cross-contamination of foods.


  • Fast food restaurants that are multi-unit operation showed 2.65 out-of-compliance items compared with the ones that are not a chain operation, who showed 4.51 out-of-compliance items. CHAIN RESTAURANTS PEFORMED BETTER.
  • The difference in mean number of out-of-compliance items for graded inspection was extremely minor. The difference was also minor for jurisdictions that required public disclosure of inspection report. The difference where food handler training is mandatory or not was equally minimal. This was true for fast food and full-service restaurants. GRADING OR PUBLIC DISCLOSURE DOES NOT IMPACT COMPLIANCE.
  • Fast food restaurants with a CFPM present and in charge had a significantly lower number of data items out-of-compliance than those with no CFPM. 2.88 vs 3.46 – HAVING A CFPM MEANS BETTER COMPLIANCE.
  • Full-service restaurants that are multi-unit operation showed 4.66 out-of-compliance items compared with the ones that are not a chain operation, who showed 5.30 out-of-compliance items. CHAIN RESTAURANTS PEFORMED BETTER.
  • Full-service restaurants with a CFPM present and in charge had a significantly lower number of data items out-of-compliance than those with no CFPM. 4.73 vs 5.69 – HAVING A CFPM MEANS BETTER COMPLIANCE.
  • FSMS were the strongest predictor of items being out-of-compliance in both fast food and full-service restaurants: those with well-developed FSMS had significantly less food safety behaviors/practices out-of-compliance than those with less developed systems. HAVE AN EFFICIENT AND PROPERLY IMPLEMENTED FSMS.
  • Restaurants with a CFPM present at the time of data collection were associated with fewer out-of-compliance food safety behaviors/practices.
  • Simply having a CFPM employed without that individual being present does not materially improve the restaurant’s compliance. The correlations between CFPM and out-of-compliance become non-significant, indicating that FSMS (not the presence of a CFPM) predicts better compliance with food safety behaviors/practices.

What do we learn from this?

It is extremely important to have your own FSMS. Documents can sit in a binder and collect dust but unless you have provided adequate and proper training, all tools and ways to resolve discrepancies, it is absolutely of no use. Train all team members, requiring mandatory accredited certification and provide all necessary tools for them.

It is not complicated y’all!


Read all 84 pages (including checklist used) from FDA publication here.

Some reference material used in FDA’s publication:

Cates, S.C., Muth, M.K., Karns, S.A., Penne, M.A., Stone, C.N., Harrison, J.E., and Radke, V.J. (2008). Certified Kitchen Managers: Do They Improve Restaurant Inspection Outcomes? Journal of Food Protection, (72)2, 384-391.
Hedberg, C.W., Smith, S.J., Kirkland, E., Radke, V., Jones, T.F., Selman, C.A., and EHS-Net Working Group (2006). Systematic Environmental Evaluations to Identify Food Safety Differences between Outbreak and Nonoutbreak Restaurants. Journal of Food Protection, (69)11, 2697-2702.
Leinwand, S.E., Glanz, K., Keenan, B.T., and Branas, C. C. (2017). Inspection Frequency, Sociodemographic Factors, and Food Safety Violations in Chain and Nonchain Restaurants, Philadelphia, Pennsylvania, 2013-2014. Public Health Reports, 10,1-8.
Luning, P.A., Marcelis, W.J., Rovira, J., Van der Spiegal, M., Uyttendaela, M., and Jacxsens, L. (2009). Systematic Assessment of Core Assurance Activities in a Company-specific Food Safety Management System. Trends in Food Science & Technology, 20(6), 300-312.


Needle or Blade tenderized?

Have you observed new labels on some steak (beef) packages at your local grocery stores and wholesale clubs?

Beginning May 17, 2016 – USDA (U.S. Department of Agriculture)’s branch, FSIS (Food Safety and Inspection Service) started requiring meat processors to disclose mechanical tenderization and provide safe cooking instructions on meat product labels for customers to know how to handle these products.

Keep in mind that since 2000, the CDC (Centers for Disease Control and Prevention) received reports of six (yes, you heard it correct!) outbreaks from MTB (mechanically tenderized beef) products prepared in restaurants and your homes. 

What is MTB? To increase tenderness, some cuts of beef are tenderized mechanically by piercing them with needles or small blades in order to break up tissue. Typically, this process takes place before the beef is packaged and sold in grocery stores. It can also occur at the grocery store’s butcher counter, at a restaurant, or in the home.

What is the reason for enhanced label? MTB products look no different from other intact products, so without disclosure on the label, consumers may not know about this “higher food safety” risk, as the blades or needles can introduce pathogens from the surface of the beef to the interior. Undercooking MTB products was a significant contributing factor in the previous outbreak cases. Some cases resulted in hospitalization and HUS (hemolytic uremic syndrome).

What is changed? Beginning May 2016, home cooks, restaurants, and other food service facilities will have enhanced information about the MTB products along with cooking instructions so they know how to safely prepare them.

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What is safe temperature? According to USDA and science, cook these MTB products to a minimum internal temperature of 145°F. Don’t forget to measure with a food thermometer before removing meat from the heat source.  Important: For safety, you must allow meat to rest for at least three minutes after it has been removed from the heat source before carving or consuming.  During this post-cooking (rest) time, the internal temperature destroys harmful pathogens. This cooking temperature and three minutes allow the same effectiveness as cooking to 165°F.

You can read more about it on USDA’s Food Safety results page. You can call the USDA Meat & Poultry Hotline at 1-888-674-6854 for questions and concerns.

Safe grilling y’all!

Continue reading “Needle or Blade tenderized?”

Local-grown or not?


The “tractor-to-table” (or farm-to-fork or whatever else you call it) movement attracts restaurants and grocery stores to adapt to guests wanting locally grown foods that may be looked as more “natural.”  Food establishment operators may forget that several factors make food commodities from small local suppliers a possible source of brand protection risk, especially for quick-serve and fast-casual operations.

Factors for the operators when “tractor-to-table” movement is added:

All food establishment operators know about these risks and this is nothing new.  The operators and decision-makers must focus on how the “tractor-to-table” approach makes business sense so long as these risks are identified and remedied in a systematic way, and not just being part of a standard operating procedure (SOP) document. Unless operators manage risks with a layered approach and building food safety into daily culture, there are more chances of failure.

  • Employee knowledge and food-safety awareness.

Operators attract transient workers like students, workers that are searching for any job, workers that are retired and someone who is simply new to workforce.  They lack a background in food safety. Their leader (supervisor) may also be new to their responsibilities. The risk elimination and management is a must.

  • Brand protection and regulatory compliance.

In a social media dominant world with Facebook, Twitter, Instagram, Snapchat and Yelp – bad customer experience or an alleged foodborne illness linked to a particular location/brand or food supplier can go viral—pun intended—in minutes.  Public health department and consumers will know about the problems instantly. With the federal, state and local regulatory workforce being at more aware-level, operators and risk management officials need to know how to assess and remedy each situation very quickly. These so called challenges go beyond the regulatory compliance level. The media and guests will demand to be informed.  Enhanced and efficient crisis communications strategy can be very useful in preventing severe damage to brand identity and overall reputation if rumors and wrong information is shared and re-tweeted by the consumers.

  • Farms – Supply chain issues.

The recent Food Safety Modernization Act (FSMA) requires monitoring and inspection for farm operations. Smaller food suppliers, which are not covered by FSMA, are less scrutinized. This doesn’t mean local suppliers don’t follow proper food safety and sanitation procedures. They are less regulated, which could increase the potential risk of tainted foods entering the supply chain.

How do we address these factors?

  • Being Proactive

Revise and modify training to ensure essential practices are included and related rationale is clearly explained and continuously refreshed.  This training is for everyone, not just new hires.  Review every step in food handling to document potential gaps. Where are the more transient food handlers? Where the most significant turnover? Every vendor in supply chain is visited to check their food safety and sanitation practices.  If FSMA rules exempt the vendor, the review and visit become even more important.  A crisis response plan is included in training so that food handlers know their roles before any critical event happens.

  • Timely Identification

Establishment operators must have proper system(s) in place to identify issues quickly. Example: Storage facilities are continuously monitored for safe holding temperature and sanitation. Invest in technology so that temperature monitors provide 24/7 coverage and alert you when critical issues occur.

Let the guests and customers alert you to major concerns that they experienced during their visit. Monitor these hotlines and email ID to resolve as they are reported. Most social media will display a “trending” item/topic. Have dedicated staff member monitor web-based activities.

  • Quick Remedy

Take immediate corrective actions in conjunction with senior management personnel.  Launch the crisis response plan as soon as possible.  Consult legal authority, crisis communications team or outside agencies and others who need to weigh in and manage the crisis. Identify the root cause for the problem and how it can be prevented in future.  Learning from a successfully managed crisis, update food safety and sanitation processes.

Reach out to the guest as soon as possible and inform them that the crisis has been resolved. Let them know that they should feel confident in a positive future dining experience.

I am hopeful that this will help you decide whether you want to go “local” or not!

Planning a Picnic? Wanna serve Safe Food?


Are you planning a 4th July picnic? a company picnic? or a weekend get-together? A few well-planned steps may mean the difference between a food safety nightmare and sure success.

Although you may see ants, insects and other crawling creatures outdoors, it is not possible to see, taste or smell harmful microorganisms that may cause illness if food served is mishandled. Make sure that you pack food safety in your carryout box or picnic basket before leaving.

Warm temperatures are ideal for bacteria and other harmful pathogens to multiply and cause foodborne illness. Pathogens grow best between 41°F and 135°F. Potentially hazardous foods transported without proper temperature control will not stay safe for long. Please make a note of the following to avoid your family, customers, friends, relatives and guests making a comment to you that they have the “Summer Bug”!



  • PLAN AHEAD. Plan the right amount of food. That way, you will not have to worry about the storage of leftovers.
  • Foods cooked ahead need to be cooked in adequate time to thoroughly chill in the refrigerator. Store and transport the food with sufficient ice or refrigeration to MAINTAIN FOODS at 41°F or lower.
  • Carryout foods such as fried chicken and barbecue, should be consumed by the guest within two hours or pack ahead of time to store them REFRIGERATED.
  • Divide large quantities of bulk foods into SHALLOW CONTAINERS for quick cooling and quick reheating outdoors.
  • Keep all meat and poultry, seafood, dairy items refrigerated to minimize bacterial growth. Use insulated coolers, ice packs, refrigerated containers on trucks to ensure safe temperature. When handling raw meats, remove from the cooler only the amount that will fit the cooking needs.
  • Pack salads, deli meats and other cold items by nesting dishes in containers of ice.
  • When outdoors, keep the coolers and other food storage equipment in the shade. Keep the lid closed and AVOID FREQUENT OPENING. Do not forget to replenish ice in the cooler as it melts.
  • If entertaining, set out only SMALL AMOUNTS of food at time and replace with fresh food rather than adding fresh food to a dish that already has food in it.
  • Use SEPARATE COOLERS for drinks so the food containers won’t be constantly opened and closed.
  • KEEP HOT FOOD HOT until served. Use a chafing dish, warming tray, steam table, slow cooking pot or on the side of the cooking grill.
  • To destroy all harmful microorganisms, COOK ALL MEATS properly. Keep a product thermometer available to check the internal temperature. Cook poultry to at least 165F and burgers to 150F.

Power outage? Worried about your food?

No lights? No A/C? No power to your refrigerator?

The techniques for handling food during power outages, when applied, will reduce the possibility of bacterial growth in food and help food remain safe for human consumption.

Raw Foods:

As a general rule, discard fresh meats, fish, poultry, or dairy products if the color or odor is poor or questionable. The rule is “When in doubt, throw it out.” Saving or eating a possibly contaminated food product is never worth the risk of food borne illness.

Perishable (or potentially hazardous) Foods:

Perishable food, including meat, poultry, fish, dairy products and leftovers that have been held at temperatures greater than 41ºF for more than four hours should be discarded.

Thawed food in the freezer, including raw meats and vegetables and fruits without sauces, that contain ice crystals or have been held at 41ºF or below can be refrozen and cooked. However, do not refreeze thawed cooked foods or packaged dinners that have thawed out. Pre-cooked thawed items are highly susceptible to bacterial growth.

Maintaining Foods Safe in the Freezer:

After a power outage, keep the freezer door shut for as long as possible. A full freezer will keep food at freezing temperatures for about two days. A half-full freezer will keep food frozen for about one day. If the power is off for several days consider using dry ice. Check the yellow pages of your telephone directory for “ice”. Many grocery stores have dry ice. Call ahead to make sure that the grocer has an adequate supply. Allow 2 ½-3 pounds of dry ice per cubic foot of freezer space in a chest freezer. In an upright freezer more dry ice is required so that ice can be placed on each shelf. Because dry ice can burn exposed skin, do not touch it with bare hands. Follow instructions on dry ice usage carefully. Make sure it is wrapped in several layers of newspaper before placing it in the freezer.


Cook or heat food to a minimum of 145º. If food is to be reheated, it must be rapidly reheated to a minimum of 165º. Use a probe-type metal thermometer to test the final cooking temperature.

Store perishable or potentially hazardous food cold food at a minimum of 41º F or below.

Water and Cleanliness

Safe potable water must be available and used for cooking, dishwashing, drinking and maintaining personal hygiene. If the Municipal water supply is not safe, use bottled, boiled or treated water. Make sure dishes and utensils are clean by washing, rinsing and sanitizing them in safe potable water. Sanitization is very important at this time. Effective sanitization can be obtained by adding one ounce of regular household chlorine bleach (unscented type) to each gallon of safe potable cool water. Wash with soap and water first, rinse with clean water second, and sanitize with bleach water, using the proper proportion of bleach to water. Allow bleach-water solution to air-dry on the utensils. Store the clean utensils in a clean place to protect them from recontamination.

The use of single service items is encouraged to reduce the possibility of food borne illness. Paper plates and cups, plastic knives and forks that are used only once and discarded are highly recommended.

Insects and Rodent Activity

Since air conditioning usually does not work during power outages, door and windows are usually kept open. Insects and rodents may gain entrance into the building. Make sure that doors and windows are adequately screened, using screening material of not less than 16 mesh to the inch.

By discarding spoiled food, controlling food temperatures, keeping utensils clean and sanitary and by keeping pests out, the fear of food borne illness can be eliminated from your post-disaster recovery concerns.

If you have specific concerns, please let me know or call your local Health Department.

Hope you get your power and utilities back up and running soon! Stay safe!