Gastroenterology Book

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Prevention of Foodborne Illness

Aka: Prevention of Foodborne Illness, Foodborne Illness Prevention, WHO Food Handling Recommendations
  1. See Also
    1. Foodborne Illness
    2. Waterborne Illness
    3. Water Disinfection
    4. Traveler's Diarrhea
    5. Traveler's Diarrhea Prophylaxis
  2. Prevention: Choose foods processed for safety
    1. Processed milk
    2. Precooked meats
    3. Well dried foods
    4. Acidified foods
    5. Pressure cooked foods
  3. Prevention: Prepare food carefully
    1. Cook food thoroughly
      1. Eliminate pink coloration to meat
      2. Minimum cooking Temperature: 165-175 degrees
      3. Reheat cooked foods to 165-175 degrees and stir well
    2. Avoid letting raw foods contact cooked foods
    3. Use water of drinking quality to prepare food
    4. Protect food from Insects and animals
    5. Dry foods (e.g. breads, chips) are typically safe
  4. Prevention: Foods prepared by others (avoid if possible)
    1. Rule 1: "Boil it, Cook it, Peel it or Forget it"
    2. Avoid raw, unpealed vegetables, lettuce, tomatoes (e.g. salads)
    3. Avoid pre-peeled fruit
    4. Avoid poorly-cooked or raw meat or seafood
    5. Avoid unpasteurized dairy products (cream, milk, cheese)
    6. Avoid cold sauces and salsas
    7. Avoid tap water or ice (Alcohol does not sterilize)
    8. Avoid foods that are not steaming hot
      1. Food should be heated above 65 degrees Celsius
      2. Food should be too hot to touch
  5. Pearls: Keep food contact surfaces clean (3 wash cycle)
    1. Rinse off excess food
    2. Wash surface with detergent
    3. Rinse with sterilized water
      1. Tamed Chlorine to sterilize wash water
  6. Prevention: Eat cooked food as soon as possible
    1. Avoid leftovers if possible
    2. Store foods carefully in clean containers
  7. Prevention: Maintain clean hands
    1. Wash hands repeatedly
      1. Use Double hand washing technique
      2. Use Germicidal soap (e.g. Hibiclens)
      3. Use at least 500 cc of water for rinsing
    2. Prepackaged wipes (Chlorhexidine Gluconate)
      1. Use if water and germicidal soap not available
      2. Active hand washing is preferred for debridement
    3. Do not cook if hands have open wounds
      1. Risk of Staphylococcal Food Poisoning
  8. Prevention: Seafood Preparation
    1. Use separate cutting boards and knives for seafood
    2. Consider wearing gloves when working with raw seafood
    3. Refrigerate leftover seafood promptly
    4. Exercise caution with raw oysters and seafood
      1. Highest risk in mid-summer months
      2. Avoid if immunocompromised
      3. Avoid in Chronic Liver Disease
    5. Cook shellfish thoroughly
      1. Boil: Until shells open, then for 5 minutes more
      2. Steam: Until shells open, then for 9 minutes more
    6. Cook shucked oysters thoroughly
      1. Boil: For 3 minutes minimum
      2. Fry: 10 minutes at 375 F minimum
  9. Resources
    1. CDC Food Safety
      1. http://www.cdc.gov/foodsafety/facts.html
    2. U.S. Food Safety
      1. http://www.foodsafety.gov
  10. References
    1. Wayman (2017) Crit Dec Emerg Med 31(6): 3-10

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