“I am confident in the safety of the food I eat.” Five years ago, only one-third of U.S. consumers strongly agreed with this statement. While they held the government primarily responsible for food safety, followed by food companies and farmers, when it came to trusting them, farmers were third, federal regulators were eighth, and food companies were eleventh. And we in food safety wonder why consumers don’t always adhere to good food safety practices or follow label instructions. How can food safety experts from government, industry and academia communicate with consumers in a meaningful way? How can we convey that just because something can happen, the likelihood that it will happen varies? And how can we convince consumers to take steps to reduce their risk of foodborne illness?

The 2023 virtual Food Safety Forum, organized by the American Frozen Food Institute (AFFI), will address these questions and more. Taking place Sept.13 and free to attend, the Food Safety Forum is taking a deep dive into the state of risk communications. Science is complicated. Consumers want simple, unambiguous answers, and misinformation is abundant. Effective communication is hard and communicating public health risk — the likelihood that one will get sick, not to be confused with hazards — is an ongoing challenge. 

Like it or not, food safety professionals are risk communicators. Family and friends often ask for my opinion when they see alarming headlines about the safety of our food supply. On a broad scale, scientists are seldom viewed as great communicators and most of us are not trained that way. But facts and data don’t speak for themselves. Most consumers prefer a “tell me what to do” approach rather than delve into the complexities of contamination rates and dose responses. AFFI’s Food Safety Forum is bringing together the right group of experts from diverse backgrounds to address these topics with the goal of communicating in a way that improves public health. 

Perhaps the most notable component of the Food Safety Forum is the breadth of stakeholders from industry, government, academia and consumer groups, that all see the need for better communication of food safety risks. Many of these groups, historically viewed as adversaries, have common goals: we all want safe food and for consumers to view and act on food safety risks appropriately. The collaboration and diversity of partners for this year’s Food Safety Forum are unprecedented.

The event will kick off with the well-known Don Schaffner of Rutgers University discussing the “Current Reality of Risk Communication.” As co-host of the “Risky or Not” podcast, Don is perfectly positioned to talk about risk as distinct from hazards in a food safety context and how to explain these concepts to consumers.

No discussion of food safety communication would be complete without addressing the elephant in the room: lawyers. Whether it’s communicating about a serious outbreak, a recall that warrants immediate action or safe food handling practices, regulators are often criticized for being too slow, too fast and rash, too simplistic or too complicated. Elizabeth Fawell, an attorney with the Hogan Lovells law firm, will moderate a discussion with experts who know first-hand the challenges public health officials face when trying to clear food safety communications internally. Joining to share learnings from their experiences are Brian Ronholm with Consumer Reports, former deputy undersecretary for food safety with the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA FSIS), Roberta Wagner with the International Dairy Foods Association who formerly worked with the U.S. Food and Drug Administration and FSIS, and Frank Yiannas, former deputy commissioner at the FDA. 

Consumers are the ultimate target of food safety communications. When it comes to educating and empowering people to make informed decisions about food safety risks, the rubber meets the road for the scientific community. Who is better to address the consumer view than Mitzi Baum of STOP Foodborne Illness, who represents families of consumers impacted by foodborne illness? Joining Baum are Kristine Butler with FDA’s communications and public engagement team, Ben Chapman with North Carolina State University (and the other half of the “Risky or Not” podcast), and communications representatives from food retail and national food brands. Together, these communicators will speak to their mechanisms to earn trust and gain attention.

Finally, the Food Safety Forum will look to the future. How can risk communicators learn from previous missteps? How can we break through the noise? How can we narrow the gap between mitigating food safety hazards and communicating public health risks? Representatives from the Association of Food and Drug Officials, Consumer Reports, the Centers for Disease Control and Prevention and the food industry will discuss the lessons learned and what it means for the future of communicating food safety to consumers.

Moving the needle on consumer behavior is a lofty undertaking and discussion is needed on how to identify effective communication mechanisms and overcome barriers to meaningful communications. The collaborators convened by AFFI come from different perspectives but are united by their commitment to not only improve food safety, but to also improve consumer understanding of complex food safety topics so they can best protect their health. This topic is not going away. Attend this free event on Sept. 13 to learn more about current challenges and approaches for the future. Register now at www.affi.org/food-safety-forum.

About the author: Jennifer McEntire, Ph.D., is the Founder of Food Safety Strategy LLC. With 20 years of food and beverage association experience, she combines her technical background and regulatory insights to help the food industry assess and manage food safety risks in order to protect public health. McEntire earned a B.S. in food science from the University of Delaware and Ph.D. from Rutgers University as a USDA National Needs Fellow in food safety.

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Jennifer Beal, from the U.S. Food and Drug Administration and Laura Gieraltowski, from the U.S. Centers for Disease Control and Prevention gave the U.S. perspective while Anna Manore, of the Public Health Agency of Canada spoke about the practice in Canada.

Social networking websites like Twitter, Facebook, and Reddit focused on foodborne illness reporting such as iwaspoisoned.com. Some forums including iwaspoisoned.com and Yelp, allow people to share details of symptoms, illnesses, or experiences with food products, companies, or brands and retail or dining locations.

However, because these platforms are open, posts vary widely in format and content. These inconsistencies can make it difficult to determine the accuracy of information and to interpret the data. Anonymous posts can also make further investigation with consumers challenging.

Crowdsourced data use in outbreak investigations
Public health professionals and food regulators are evaluating these tools to determine their usefulness in outbreak investigations. 

Setting the scene, Ben Chapman, from North Carolina State University, said crowdsourcing could be used as part of early warning systems and contribute to real-time monitoring of food safety hazards.

Benefits include increased or enhanced data collection, community engagement, a deeper view on certain situations, and a cost-effective approach to data collection.

Chapman said ProMED-mail was likely the first example of crowdsourcing in the field of public health while posts on Twitter and iwaspoisoned.com have played roles in identifying outbreaks.

However, he warned about “armchair epidemiology” and separating out “noise” from useable information. Other negatives include data quality, privacy concerns, participant biases, bots on social media and misinformation skewing data.

Chapman added it was important to look at as many data sources as possible, depending on the question that needs to be answered. Crowdsourced data is a tool to signal things that might not have been caught before and then resources can be allocated to see if it is a real problem.

General Mills cereal example
Beal and Gieraltowski talked through the challenges via four stages including the case definition and identification of a cluster, confirming an outbreak vehicle, implementing control measures and communicating unknowns, using an example of people reporting illness on iwaspoisoned.com after eating Lucky Charms cereal in 2022.

Beal said crowdsourced data turns the normal process upside down as CDC traditionally leads epidemiological investigations but it is the FDA that heads-up the investigation for crowdsourced or non-traditional data types.

One issue is epidemiological data is not standardized as it is provided by complainants, there are also questions around identifying the vehicle, the agent involved and contact with the company.

Beal said FDA was unsure what to tell General Mills, which hampered the firm’s ability to find out what was happening, as there was limited lot code information and variability in symptoms made it hard to know what testing to do.

She added the public scrutiny that often accompanies such incidents adds urgency but people tend to think it was the last thing they ate that made them sick. Also, if they saw others saying Lucky Charms made them sick, they could assume it was the cereal that also made them ill.

Manore presented the use of online surveys in two outbreak investigations.

The first was Salmonella Newport in 2018 and confirmed what Foodbook had told health officials, that the incident was linked to red onions. Foodbook is a survey that was done to describe what foods Canadians eat over a seven-day period to inform outbreak investigation and response.

The second was an outbreak of Salmonella Enteritidis in 2019. Two foods were of interest: frozen fish and mixed fruit cups but they were not asked about in Foodbook. However, it was later found the epidemic was caused by contaminated imported frozen profiteroles.

She said this shows online surveys require careful consideration and their use must be considered alongside other available evidence from epidemiological, food safety and traceback and lab investigations. 

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The researchers from the University of Mississippi discovered that a component of tara flour, which is made from the seeds of a plant grown in Peru, was likely behind the illnesses that spanned 39 states in 2022. That component, baikiain is a nonprotein amino acid and is present in high levels in tara. 

The researchers published the study in “Chemical Research in Toxicology,” which is an American Chemical Society Journal. The authors are part of the National Center for Natural Products Research, which is partly funded by the Food and Drug Administration.

The researchers stated that their objective was to undertake a multipronged pharmacognosy approach to assess the quality and safety of the tara flour ingredient within the Daily Harvest’s Crumbles product. 

They concluded that “adverse events” reported by people who had consumed the Daily Harvest crumbles originated from the tara flour ingredient.

Tara flour was not used in any other Daily Harvest products, but tara protein was used in Revive Superfoods Mango and Pineapple smoothies. A number of consumers who drank those smoothies reported illnesses consistent with those reported by the patients who ate the Daily Harvest frozen crumbles. 

Outbreak investigators were stumped by the illnesses traced to the Daily Harvest crumbles, which included at least 393 people, many of whom required hospitalization. About 30 had to have their gallbladders removed. 

The outbreak began in April of 2022 and continued to at least September that year, according to federal officials. People started reporting illnesses shortly after the Daily Harvest Lentil & Leek frozen crumbles were introduced to the public.

During the outbreak the owners of Daily Harvest and investigators from the Food and Drug Administration tested the frozen crumbles product. None of the tests revealed any common food toxicantsmicrobial pathogens, mycotoxins, major allergens, heavy metals, pesticides, hepatitis A or norovirus. 

In February this year FDA scientists hypothesized that the illnesses were linked to the tara flour, but they stopped short of saying that the tara component was the culprit in the outbreak.

Professor Ben Chapman, Department Head and Food Safety Specialist for the Department of Agricultural and Human Sciences at North Carolina State University, said the new study out of Mississippi University is based on sound science and appears to resolve the mystery behind the Daily Harvest illnesses.

“This outbreak has stumped many of us in the food safety world over the past year. Without a common pathogen or toxin, there certainly appeared to be something going on that led to hundreds of serious illnesses,” Chapman told Food Safety News.

“The authors present a very compelling case for amino acid, baikiain, being a possibility as the causative agent for these illnesses. What I liked about this study is the they went in-depth on what is in this relatively newly used — in high-protein foods — and novel tara flour, and found that there was a detectible amino acid that has no published toxicological or safety assessment studies about it in the literature.”

Don Schaffner, an Extension Specialist in Food Science and Distinguished Professor at Rutgers University, had comments similar to those of Chapman. Schaffner said an important aspect of the study is the effort the authors to establish that what they were testing was actually botanically the correct species.

“In terms of the central findings of the article, the authors have done a good job of showing that the nonprotein amino acid baikiain is present in the tara flour and that it causes effects in male mice that are consistent with liver damage and the effects seen in humans,” Schaffner told Food Safety News.

“The authors have convinced me that they have figured out the correct cause of the illnesses in humans epidemiologically linked to tara flour.”

Chapman was also convinced that the authors of the story had found significant evidence linking tara flour in the Daily Harvest crumbles to the hundreds of illnesses recorded in 2022.

“I’m not sure this is a smoking gun or anything that definitive but it definitely provides data for others to investigate the toxicity of the protein source further,” Chapman said.  

“I think things like this demonstrate how complex food processing is — like adding a high protein flour in a high dose to a really popular product can have unintended consequences like these illnesses and outbreak — highlighting to me the importance of making sure that new/seldom used ingredients are assessed by manufacturers, in conjunction with regulators, before putting it out there.”

Chapman also noted the significance of the researchers work in the laborartory, noting that they fed baikiain to mice, at a dose similar to what might have been provided in the Daily Harvest product and found that the mice exhibited liver and kidney impacts similar to overdoses of acetaminophen as the baikiain breakdown in the body created a metabolite that’s similar to the common OTC drug.

Editor’s note: Ben Chapman, associate professor and food safety extension specialist at North Carolina State University, has posted this tip sheet for dining outside the home during the coronavirus (COVID-19) outbreak. We thank him for his diligence and service.

Although they’re the last living creatures on any invitation list, when pathogens make surprise appearances it’s important to know how to handle cleanup, especially if norovirus is the culprit. The highly contagious virus usually has sudden onset of vomiting as a primary symptom, which helps the bug reach travel farther and faster than other pathogens.

Research that’s been underway for a couple of years at North Carolina State University is generating data that some may find less than appetizing, but it provides further evidence for the need for specific cleanup procedures in homes, schools, restaurants, etc.

Grace Tung-Thompson’s Vomit Machine demonstrates the aerosolization of the virus that occurs when an infected person vomits. Others can ingest the virus by breathing air that has been contaminated by the process. The aerosolized virus can also land on hard surfaces, where it can live for long periods of time.

“I’ve talked to lots of environmental health specialists, retailers and foodservice food safety folks about what Grace and fellow graduate student Dominic Libera put together and many respond with a weird level of enthusiasm for the barf project,” Ben Chapman, an associate professor and food safety extension specialist at North Carolina State University, wrote recently in barfblog.com.

Chapman added that the main question those folks struggle with is how far the virus particles travel in a vomiting event, writing “knowing this, and then cleaning and sanitizing helps limit the scope of a potential outbreak.”

So what’s the app for that?
Professor Lee-Ann Jaykus, who heads norovirus research with NoroCORE at NC State is known as The Norovirus Woman. She has said “there is no known technology that will eliminate norovirus if it’s in the air.” Jaykus believes such technology is “really, really important” but wonders “how the heck we’re going to develop it? I’m at a loss for words.”

“And norovirus can hang around for weeks, so anyone that touches (contaminated surfaces) and then puts their hand to their mouth could be at risk for infection,” Jaykus wrote in a 2015 report. Since then, cleanup recommendations have changed as the scientists’ understanding of vomiting has broadened.

So, how large of a diameter from the barf spot should be deep cleaned? In 2016 the thought was a 25-foot diameter was enough, but Lee-Ann Jaykus has been quoted this year saying 100 feet is needed.

“The best you can do is get yourself far away from a vomiting incident,” Jaykus says. “If you were in the middle of a meal at a restaurant and someone at the next table threw up, you’d probably be wise to stop eating, and to wash yourself and your clothes when you are able.”

With this, Jaykus stresses the importance of doing a “really, really good job of the cleanup.”

Commercial vomit and fecal matter cleanup kits are being used by more and more foodservice operators and schools. These kits provide the material required to clean up the mess, as well as personal protection equipment including disposable coveralls and respirator masks for the person doing the cleaning.

The Centers for Disease Control and Prevention recommends using a chlorine bleach solution with a concentration of 5 to 25 tablespoons of household bleach per gallon of water to clean surfaces.

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The two-year study is at the half-way point and only one retailer has agreed to share with the researchers how cantaloupe is handled in stores, according to an update this week on the work led by produce safety Extension Specialist Laura Strawn of Virginia Polytechnic Institute and State University.

Discovering how to help all links in the supply chain minimize Listeria and Salmonella transfer to and from cantaloupe as it travels the farm-to-fork continuum is the goal of Strawn, who is working with Extension Specialist Ben Chapman of North Carolina State University and microbiologist and food safety Associate Professor Michelle Danyluk from the University of Florida.

A Listeria outbreak traced to fresh cantaloupe in 2011 sickened at least 147, hospitalizing 143 of the victims, killing at a least 35 and contributing to 10 other deaths, according to the Centers for Disease Control and Prevention. Since then there have been studies about how pathogens find their way on to the fruit in the field and packing house, but no one has looked at the entire supply chain before.

The team is specifically looking at contact surfaces, which range from single-use cardboard packing table tops used in the field during harvest to the counters at retail stores where deli staff cuts fresh fruit. The Center for Produce Safety is funding the $217,000 research project.

Without the open-arm reception the cantaloupe industry gave the project, Strawn said her team wouldn’t have been able to gain the real-world knowledge needed to make the results useful. Scientists spent a week this past summer observing cantaloupe harvest crews in Arizona and California and collecting microbial samples from various surfaces the fruit contacted during field packing.

Members of harvest crews, for example, may wear gloves made of different materials ranging from rubber or nitrile to cotton-blend. They also may employ pack tables covered in materials, such as stainless steel or single-use cardboard. In addition, crews may use stainless steel knives, cotton rags to wipe melons or brushes to remove dirt — all of which were sampled.

“For them to show us and let us see what it was like in real life and ride along with harvest crews, it was just amazing,” Strawn said in a news release from the Center for Produce Safety. “I was really grateful to them to be able to trust us. We had a lot of doors opened because we were working with a group like CPS.”

At the same time, Chapman is working with retail cooperators to identify surfaces that the cantaloupes may contact. So far, he has identified 17 surfaces, from the distribution center to the retail display. His work includes both whole and cut cantaloupe.

“One of the things that we’re investigating is whether there are certain contact surfaces that are more likely to harbor those pathogens,” he said.

“If there are, we can recommend specific management practices to address those cantaloupe contact surfaces.”

Although only one retailer has stepped forward so far to assist the researchers, Chapman said a few others are interested in participating, which would make the results much more meaningful.

“It’s always better to have more than less,” he said. “If you only have one, they may be special — they may use a different surface or have different operating procedures so we’re not really measuring any variability.”

Once Strawn, Chapman and other members of the research team know more about how pathogens transfer to and from contact surfaces to cantaloupe, Danyluk can put her expertise in sanitizing and cleaning to work. She has done extensive food safety research work on tomatoes and cantaloupe.

Danyluk was also on hand when inspectors checked Florida growers’ cantaloupe operations in the years following the 2011 outbreak, giving her additional insight. The Florida scientist will validate sanitation procedures in the laboratory to ensure any suggestions to industry will be effective.

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As a Canadian in the U.S., I’ve fully embraced the holiday season that runs from Thanksgiving through December. I enjoy spending a day planning and shopping for an event-style meal and then another day actually preparing and cooking it.

I throw on some tunes (this year it will probably be Drake, for my Canadian roots, and the Avett Brothers, as a nod to North Carolina) and, with the help of the rest of the family, I’ll roast a turkey, make mashed potatoes, green beans, squash, beets and a couple of other harvest vegetables.

And we’ll make a lot of stuffing.

Depending on your preference and food persuasion, there are lots of different stuffing or dressing options.

A common question that pops up is whether it’s better to cook stuffing in the bird to preserve moisture (and get flavored by the turkey juices) or prepare it as a separate dish. The concern is that if someone puts the stuffing in the turkey cavity, it may become contaminated by the turkey juices and Salmonella and Campylobacter will migrate through the stuffing.

It’s easier to recommend not messing with the cross-contamination instead of managing the risk. But what does the science say?

I’m a food safety nerd and take a science-based approached to my meals. Armed with a digital, tip-sensitive thermometer, I’m happy to jam stuffing up inside of my poultry and use the probe to check the temperature. And I use 165 degrees F as a target for my bread-based stuffing.

There’s some history to that number. In 1958, Raymond Rogers and Millard Gunderson of the Campbell Soup Co. published some work evaluating the safety of roasting frozen, stuffed turkeys (a new product at the time).

Using a known amount of Salmonella pullorum, nine turkeys and some then-fancy ceramic thermocouples, they found that they could get an 8-log (or 99.999999 percent) reduction when the deepest part of the stuffing hit 160 degrees F. They recommended 165 degrees to be conservative — and because some thermometers aren’t always very accurate.

From the manuscript, comments that still apply today: “The initial temperature and the size of the turkey influence considerably the time required to reach a lethal temperature in the stuffing. The lower the initial temperature of the turkey, the longer the roasting period required. Present recommended roasting procedures designating hours cooking time or which stipulate a thigh or breast temperature to be attained alone does not appear to be adequate bacteriologically.”

So, inside the bird, outside the bird, meat or no meat: Use a thermometer.

Note: Chapman has also made an entire video devoted to minimizing risk from foodborne illness when cooking turkey. More food safety tips from him are available here.

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• “Ten pantry managers assumed the food bank would remove any recalled items before distribution or that the food bank would contact them in the event of a recall, even though it had never done so.”
• “Twenty-nine managers had never pulled nor searched the pantry for a recalled product, but 13 pantry managers explicitly remembered that they had to search for or pull peanut butter during its most recent recall.”
• “[S]ix pantry managers currently post information for clients, seven additional pantries would tell the clients if they learned of a recall (but had never done so), and 15 pantry managers responded that they would not tell the clients, either because they were unable to do so or because they made the assumption that recalled food would not reach the client.”

Chaifetz and Chapman emphasized in their report that there are limitations in stating that their findings are representative of other states, but they offered some recommendations for things any food pantry could do to improve food safety. These include emphasizing regular hand-washing, obtaining more regular information on recalls, creating strict rules for what foods they will and will not distribute, and having set procedures on repackaging items, from glove use to packaging and labeling. Producing a written set of Standard Operating Procedures would also help pantry staff and volunteers understand the reasons for, and importance of, food safety tasks. There is a lot more research still to be done regarding emergency food operations, but this study has already been used by officials with North Carolina Cooperative Extension to develop a set of free educational resources for food pantries. (To sign up for a free subscription to Food Safety News, click here.)

“The Internet is there to provide data for what you already believe.” That’s what Doug emailed me in a conversation we were having about the endless coverage of the supposed maim and chaos that reusable shopping bags have on public health.. The reusable-shopping-bags-are-killing-us discourse took a turn into the mainstream when the NY Post and San Francisco Chronicle covered a publishing-by-press-release paper by Jonathan Klick and Joshua Wright.

They also put their paper on the Internet, on the Social Science Research Network, carrying the tag line of U of Penn Inst for Law & Econ Research Paper. But not in a peer reviewed journal that deals with food safety, microbiology or public health.

Klick and Wright claim that something stinky has been going on since San Francisco banned plastic shopping bags, and the replacements, reusable polypropylene and or canvas bags, are killing people.

From the paper,

We examine the pattern of emergency room admissions related to bacterial intestinal infections, especially those related to E. coli around the implementation of the San Francisco County ban in October 2007. We find that ER admissions increase by at least one fourth relative to other California counties. Subsequent bans in other California municipalities resulted in similar increases. An examination of deaths related to intestinal infections shows a comparable

Krick and White choose to report hospital room illnesses and deaths from pathogenic E. coli – and omit statistics on other pathogens – and it’s not clear why. In the Chronicle, San Francisco health officer Tomás Aragón calls the research sloppy. I’m with him.
Cited in the research note is a paper from Williams and colleagues (2011) who have published the only peer-reviewed study on the microbial safety of reusable bags. They sampled 58 bags taken from shoppers in Arizona and California, finding coliform in just over half.  And E. coli matters more than coliform (which is commonly found on plant material and is not a good indicator of pathogen presence on food). At least E. coli demonstrates that a pathogen might be there. The Williams study showed generic E. coli can float around in bags – they recovered it in 12% of what they sampled (n=58).

An unanswered question is, can E. coli or other bugs be (or is it likely) transferred to any ready-to-eat foods, or somehow to food contact surfaces in the home? Seems like that matters. Just because the bacteria might be there, doesn’t mean it can contaminate a ready-to-eat food. No one has presented data to support that. We’ve done some cross-contamination work in bags recently and although I’ll wait for the peer review, the data shows that transfer is pretty unlikely.

I don’t know what happened in Frisco (I hear the folks from there hate that) but my guess is it ain’t the bags. I also visited in San Francisco in 2007, which correlates (but doesn’t prove causation) with the onset of the start of the illnesses. Maybe it was something I left behind.