By Jason Masters
     Environmental Health Director

Image of Thinking Health Inspector

 

 


A

Q: : Hi Jason, as summer and hot weather approaches, what do I need to know about protection from mosquitoes, and what role would mosquitoes play in the event of a zombie apocalypse? I want to be prepared…
-Rachael


 

A

Wow Rachael, that’s a really great question… (and I thought I was paranoid…).
The summer months are filled with music, food, fun and skeeters. These little buggers can turn a fun evening into a tormented level of Dante’s inferno.

So here’s what you need to know about mosquitoes, (don’t worry, we’ll get to the zombies later) and how to protect yourself. First, you need to understand where mosquitoes like to hang around, and why. There are approximately 60 species of mosquitoes in NC, and they all like to hang out at pools of water (just like us!) but they want to do more than just take a dip and suck down a cherry coke…they want to lay their eggs in nice, cool, stagnant pools of water. You know where there are some really great pools of nice, cool, stagnant water? How about that lawnmower you’ve been meaning to fix? Does that collect any water? Or how about those 5 gallon buckets you were going to use to brew beer that time, but then you had a kid and now they just stay stashed away under your deck? Do those hold water? What about those holes in that tree in the yard where those branches broke that time in the rain storm, but all you did was get mad because they fell on top of your jeep? I bet those holes fill up with water now. And don’t forget that birdbath that you got as a birthday present from your elderly neighbor, even though nobody really uses birdbaths anymore. Heck, those things are MADE to hold water! That old pair of shoes that your significant other wanted to throw away, but you swore you would use for gardening? Totally full of water now.

My point is, there are hundreds of things that collect water outside your house that you may not recognize, and they are perfect spots for mosquitoes because you have forgotten about them. This is the exact reason for the “tip and toss” campaign. This campaign was designed to increase awareness of items around the home that have the potential to become larval breeding sites for mosquitoes. If you see something collecting water, tip it, and toss it in the trash.
Now, let’s look at what actually draws mosquitoes to you. According to webmd.com, mosquitoes are drawn to heat, movement, and carbon dioxide, and some people are just more genetically inclined to be attractive to mosquitoes due to their bodies abilities to process certain compounds like cholesterol and uric acid. That’s why you always seem to be targeted while you are engaged in that neighborhood volleyball game.
Mosquitoes have the ability to carry lots of awful illnesses, including LaCrosse encephalitis, west nile, Zika, malaria, dengue, chikengunya, eastern and western equine encephalitis, Saint Louis encephalitis, and yellow fever. (Ain’t nobody got time for that…”)

There are several ways to protect yourself from mosquitoes, and probably the most well-known is our old friend, DEET. N,N-diethyl-meta-toluamide was developed by the US government in the 1940s, and was put into use for the general public in 1957. It has been deemed safe by the EPA for direct application to the skin with minimal side effects, and the American Academy of Pediatrics has stated that concentrations of DEET at 10% or less are safe to use on infants over 2 months old. However, there are alternatives. Picaridin (Cutter Advanced) has been shown to be just as effective as DEET, with a lighter feel and smell, and IR3535 (Avons skin-so-soft) is sometimes marketed as a mosquito repellant, although much less effective than DEET. (“Hey look at Billy down there, them skeeters ain’t botherin’ him, and dang! His skin sure is soft…”)

There are some non-chemical alternatives available as well, but they provide considerably less protection than our chemical friends. Citronella, peppermint, and lemon grass (among others) may provide protection for up to about an hour and a half. Oil of lemon eucalyptus (marketed as Repel) can provide protection similar to that of low concentrations of DEET.

Which leads me to zombies…

Have you ever seen a zombie move?!? Except for what we have recently seen on “The Walking Dead”, traditional zombies are extremely slow moving. Historically, zombies wander around malls and suburbs and attack people that get close, but they have never been known to catch fleeing prey. Very little movement here for mosquitoes to detect. Additionally, due to zombies being dead and all, they aren’t going to be breathing as much (or at all) so their carbon dioxide output is minimal at best. That’s strike two against zombies. Finally, they don’t have any bodily processes going on, so whatever they are eating (brains) is just sitting in their rotten tummies. Biologically speaking, the case for zombies is weak. There are no studies showing that mosquitoes would be attracted to zombies, so I’d say the threat of mosquitoes being a vector of whatever turned the zombies into zombies is very low (non-existent).
With that being said, there is no evidence to suggest that DEET provides any amount of protection from the living dead. Stay safe, friends…

 

 

 

By Jason Masters
     Environmental Health Director

Image of Thinking Health Inspector

 

 


A

Q: Hi Jason. I have a question about oysters. I love raw oysters, but I’m worried about eating them in the summer, because my Granny told me to never eat oysters in months with no “R”. Is this true? Why? Am I doomed to only eat oysters in the cold months?
-Jamie

 

A

Well Jamie, this is a very common question, and one that I’m glad you brought up, considering that May is the first month of the year with no “R”. (Convenient how that worked out, huh…) The old adage of not eating oysters in months with no “R” came about for very good reason. In the days of yore, when digging up your own oysters was commonplace, it was a bad idea to eat our little shelled friends in the summer months due to the red tide in warm water areas. The microscopic algae blooms of the red tide produce toxins, and introduce them into areas where shellfish are harvested, and the shellfish then absorb these toxins making them harmful to humans. The scientific community has, in recent years, decided to use the term Harmful Algal Blooms (HAB) rather than “red tide”. Why? Because scientists believe they need to overcomplicate things…Red tides (or HABs) have been documented in every coastal state, and occur almost every summer in Florida.

So, should you eat oysters in the summer months? Of course! (with some caveats…) They are delicious! (so long as you get them from a reputable source…) I like mine raw, with a mignonette (men-ya-NET), and some crackers! (they can also be accompanied by lemon juice, hot sauce, garlic, or any number of stomach churning toppings…)
Today, oysters from most grocery stores and/or restaurants come from commercially harvested areas, are regulated by the FDA, and are usually from cold water climates. In addition, throughout North Carolina, establishments that sell and/or cook shellstock are required to maintain the tags that are attached to bags of shellstock for a minimum of 90 days , record the date of last sale, and maintain them in the establishment in chronological order, just in case anyone does get sick.

Now, with all that being said, a bigger worry about eating oysters (at least raw oysters) is Vibrio parahaemolyticus (para-HEEMA-lit-a-cuss) and Vibrio vulnificus (vul-NIF-a-cuss). These two species of bacteria live and thrive in warm, salt water environments, and are associated with eating raw or undercooked seafood, particularly shellfish. A V. parahaemolyticus infection causes all the standard flu-like symptoms, (fever, chills, vomiting, diarrhea, abdominal pain, etc.) but most people make it through, without medication, in about 3 days or so. V. vulnificus, however, is a much meaner little fellow, and is particularly harmful to those who are immunocompromised. V. vulnificus can enter the body through ingestion, or through open wounds or cuts. Symptoms usually show up between 1 and 7 days after exposure, and can include similar issues to parahaemolyticus, but can include skin lesions, and shock. About 50% of patients die from a V. vulnicus infection, even with aggressive treatment. The good news is, only about 30 cases are reported in the United States per year. For you math nerds, that means about 0.6 cases per state, per year. Not enough for me to worry about, but if you are, you should know that heat kills all species of Vibrio. Heat is the ONLY thing that kills vibrio. Hot sauce will NOT kill vibrio. Lemon juice will NOT kill vibrio. Prayer will NOT kill vibrio.

So, while you may think a groovy vacation is digging oysters for your next shucking, while listening to “Pulling Mussels From a Shell” and “Rock Lobster”, it would be advisable to get all your shellstock from a reputable source, just so you live to see next year’s vacation…

Mignonette recipe
-2 tablespoons finely chopped shallot (or onion)
-About ½ cup red wine vinegar
-Salt and pepper to taste
-Combine all ingredients and chill (and I mean put into refrigeration, not just hang out on the couch listening to jazz…) until ready to serve.

 

 

 

By Jason Masters
     Environmental Health Director

Image of Thinking Health Inspector

 

 


A

QHi Jason. Why is sushi so gross? I would NEVER eat anything that was raw, especially fish! How in the world did people decide that eating raw fish would be a good idea? And what do all those other words mean? Sashimi. What’s that?!? Nigiri? How do I even pronounce that?!? Don’t people get really sick from that stuff?
-April

 

A

Glad you asked April. Let’s talk about sushi. One of American cuisines biggest challenges, and a mystery to almost everyone. A Japanese staple since the ninth century, sushi is a term that really doesn’t mean what most people think of when sushi is mentioned. Sushi is actually the preparation and combination of ingredients with rice and vinegar. Sashimi (Sa-SHE-me) is usually confused with the term “sushi” and means thinly sliced, raw fish sometimes served with daikon radish or other ingredients. Nigiri (Ni-GEAR-ee) is raw fish served on a small bed of rice. What most people think of when they hear sushi is the maki (MA-key) roll. Rice with seaweed (nori) rolled up with avocado, fruit, crab, fish etc. topped with thin slices of fish and/or roe. It is important to note that there are a million varieties of this, and every restaurant may have a different term for what they call something.

The important thing to know about the safety of sushi is how the fish and rice are handled. In NC, most sushi grade fish is supplied to restaurants from suppliers that have frozen the fish to a temperature of -4 degrees F, and held for 168 hours (7 days). This will effectively kill any parasites that may be present in the fish. Additionally, each food establishment that serves sushi is required to maintain a “parasite destruction form” on site, from the supplier of the fish. Yellowfin, bigeye, northern and southern Bluefin tunas are exempt from the parasite destruction requirement. Rice is handled in a variety of ways. If sushi rice is too hot, it can’t be rolled or formed correctly. If it is too cold, same problem. From a food safety standpoint, we have issues with food (in this case, the rice) being held at room temperature. Therefore, establishments can either choose to create a plan called a HACCP (Hazard Analysis Critical Control Point) plan, that will allow them to add enough vinegar to reach a certain pH so they can leave the rice out for an extended period of time, or they can choose to use time as a public health control (TPHC) which will allow the establishment to keep the rice out of temperature for a period of not more than 4 hours, and is then discarded. Either way is an accepted method, and these are items that are reviewed at each inspection. So, theoretically, sushi, if prepared and handled correctly, is safe.

So let’s talk a little about what makes people sick from sushi. Just a warning before we start…it’s not pretty…

The most common illness associated with eating sushi and other raw or undercooked seafood is anisakis (annie-SOCK-us) simplex. Basically, anisakis is a nematode, or in regular people terms…a worm. It is present on certain types of fish, and through mishandling of fish products after harvesting, it can make its way from the flesh of the fish to the muscle. It is a parasite that is destroyed by freezing at a certain temperature for a certain period of time (there won’t be a test on this, but we covered it above…). So let’s say you eat your favorite maki roll, and it just so happens it is infected with a herring worm…what happens next?
Well, first, the worm you ate is going to attach itself to your intestinal walls, where it will make a home for itself, and begin enjoying its new surroundings. You may notice symptoms in as little as one hour, up to two weeks. Symptoms may include the normal feelings of queasy-ness, up to feelings associated with appendicitis, or you may experience a tingling or tickling sensation in your throat… (In the literary world, this is known as foreshadowing)… So when you get back from vacation, make sure to remember the name of that cute, little out-of-the-way sushi place that the locals recommended… The worm can detach and reattach as often as it likes. After you vomit up, or manually extract (think about that for a second) the matured worm, you can take it to the doctor just to verify that you actually did get it from the raw fish you ingested… (I can only imagine what my doctor would say if I brought that to him in a jar)… In some cases, the doctor may have to use a camera device to look around inside your stomach and intestines to verify the presence of the nematode. An infection can be very painful and if the worm is not removed manually or involuntarily, then surgery may be the only course of action….

I know…awful, right?

The good news is that only about 10 cases are diagnosed each year in the U.S. (that’s 0.2 per state, for all you math nerds) however, there is some suspicion that not all cases are reported. So, the takeaway here is that, though very rare, it is possible to become sick from raw fish. Anisakis is most commonly associated with cod, haddock, fluke, pacific salmon, herring, flounder, and monkfish. Remember those species I mentioned above that are exempt from the parasite destruction form? Well, I’m not going to tell you what to eat, but I know the rolls I’m going to pick. By the way, I know this cute, little out-of-the-way place that has great sushi…you should totally check it out…

 

 

 

By Jason Masters
     Environmental Health Director

Image of Thinking Health Inspector

 

 


A

QHello Jason. Well, I have a question… Every year at this time, I remember taking my kids
out for Halloween trick or treating. They would come home with bags and bags of candy, and
being the good parent I was, I had to go through all of it and pull out the “moldy” pieces. I’m
sure I saved my kids from all kinds of sickness, but I’d like to understand the differences
between mold on food and mold in a dirty ice machine. I’ve read a lot of health inspections,
and I noticed that “Ice machine is in need of cleaning to remove visible accumulation of mold
and mildew” is marked quite a bit. In the spirit of Halloween, I was hoping you could lend
some insight as to why this mold and slime is such a big deal.
-Keith M.

 

A

Happy Halloween Keith! Great question. You know, I remember when I was a kid growing up in the 80s, after my mom bought my brothers and me a costume, you know, one of those old 80s costumes with the one piece outfit and plastic mask? When you were at the store shopping for them, you could look right in the box and see that plastic mask through the cellophane window? Things like Smurfs, Transformers, He-Man, Magnum PI… those kind of things? Anyway, Halloween would finally arrive and we would all get our costumes on and my dad would drive us around the community and stop at all the houses. We would have to drive because we didn’t live close enough to any neighbors to walk. It was a big deal to get three kids out of the car, make sure all of our costumes were right, and finally get to the door. Of course, after all that, there was certainly no surprise when we knocked on the doors of the neighbors. Heck, we’d been there for twenty minutes before ever walking up to the house! But still, that didn’t stop my dad from loading us all back up after we got our usual Mary Janes, sugar daddies, maybe a Twix, and those inevitable (and awful) peanut butter things wrapped in orange or black paper, and heading out for the 4 minute drive to the next house. Yep, Halloween was a special time for my family and me in the 80s, and we still love it. But now, on to your question…

Slime. Mold. Mildew. All of these words evoke thoughts of an oozing mass of green, pink, black, or red ectoplasm, especially when used in conjunction with something like an ice machine, where it is usually seen. Makes sense though, ice machines are full of water and humidity, which is the perfect environment for the growth of moldy-ness. Now, is all mold harmful? Heck no! Penicillin comes from mold! Bleu Cheese comes from a molding process! And fermentation is kind of like controlling a molding process, and we all know what that leads to…Of course! Kimchi! And beer and wine, and that stuff too, if that’s what you’re into.

 

So if mold leads us to good things like fermented beverages, fizzy vegetables and tangy cheeses, why is it such a big deal in an ice machine?

 

Well here’s why… Picture, in your mind’s eye, a big green Jell-O mold in the shape of Slimer from Ghostbusters, with some tasty raisins inside. Here is the catch though, you can only get to those delicious raisins by wiping the side of the Jell-O with a rag. It’s going to take a lot of rubbing to get to those raisins. Well, in an ice machine, things like Listeria, E. coli, and Salmonella can get stuck in that mold and mildew layer. That layer is called a biofilm, and is going to provide a certain amount of protection to those pathogens, and allow them to grow and multiply, just like our friend Slimer is protecting those raisins. Wiping out mold and mildew when I point it out during a routine inspection does not solve the problem. Only a thorough cleaning, with the use of some kind of sanitizer will effectively clean the mold and mildew in an ice machine. How do those pathogens get in the ice machine in the first place? Well, if you are a regular reader of my articles, you already know that people don’t always wash their hands when they should. Food Employees in restaurants frequently handle raw proteins, and inevitably, some amount of pathogenic contamination is going to occur. Why do I care? I care because the 2017 FDA Food Code defines ice as a food. Now because we all live in a time where we don’t really have to worry about how safe our drinking water is, it really should come as no surprise that we just believe something as ubiquitous as ice is also safe and clean. Think about the applications of ice in a restaurant. Of course, the obvious, ice in drinks, but ice is used to cool foods quickly, by either placing hot pots or pans of food into ice baths, or by simply adding ice to a food product. Sometimes bottles or cans are placed in ice to keep them cold. That’s a lot of back and forth trips to the ice machine
with scoops and hands plunging deep into mounds of shiny, cold ice. Take a look at any meat market and you’ll see raw proteins sitting on top of ice all over the place. Easy to see how pathogens could make the jump there. Now that we’ve talked about some of biological hazards associated with ice machines, let’s talk for a second about physical hazards. In much the same way that pathogens can jump from bare hands into an ice machine, think about chunks of food that might be stuck on a food employees hands. If you work with food, you know that there is always a moment when something sticks to your hands. Could be a small piece of diced onion, might be a sticky piece of raw chicken fat, heck, it could even be something that gets stuck in your jewelry. Sometimes pieces of mold fall into the ice, sometimes screws fall into the ice, sometimes people put their leftover sardine sandwich in the ice machine to keep it cold. My point is, always be sure to keep an eye open for things in food that isn’t supposed to be there. You might be able to spot a nut or bolt in your cherry coke, but you aren’t going to see Salmonella or E. coli. That is
one of the reasons you have to be SUPER detailed if you call in to our office and claim you got sick. We are going to need to know EVERYTHING you ate, including what beverages.

Stay safe, friends, and have a great Halloween!

 

 

 

By Jason Masters
     Environmental Health Director

Image of Thinking Health Inspector

 

 


A

Q: Jason. I’ve got a question. I read ALL your articles, and I’m not sure how I feel about you using my name all the time as an example. I mean, just because I’ve got a big burly beard and I work at a restaurant doesn’t mean I’m so gross. I’m just a person, same as you. By the way, what’s the problem with beards? What is the length of beard that is OK to have? I think you’ve got something against people with hair just because you’re bald… And why did you take points off of our inspection for having our cell phones and cigarettes laying on the prep table? We don’t have much time to smoke, and we need to keep our materials close by. I’ve seen you in my restaurant before, and I’ll be waiting for YOU in the parking lot…
-Bubba

Image of bearded man grabbing pull up bar/  (Photo by cottonbro from Pexels)

A: Wow…well Bubba, those are good questions, and I’m hoping we can settle this without coming to blows. A beard and/or hair restraint is something that the 2017 NC food code requires all food employees engaged in food preparation to wear. Does that mean that everyone is going to wear one? Nope. Not gonna happen. But before we answer your questions, we need to look a little deeper as to why hair restraints are required in the first place, and why it’s not OK to leave your smokes and cell phones all over the prep tables.

The hair restraint requirement is, despite its name, not as much about keeping hair out of foods, as it is discouraging food employees from touching their face, head and body. Think about all the things on your head and face for a second… hairspray, gel, conditioner, did you work out before coming to work? Got some tasty sweat up there? Did you take a shower today? Sometimes people don’t… Remember that parking lot you were walking through earlier, where that guy was blowing leaves and stirring up dust? Remember how you cursed at him for blowing dirt in your face while he was laughing? (*Smug jerk with his safety glasses and orange vest*) Think any of that dirt and dust got trapped in your hair (and/or beard)? What about those crumbs from that chicken sandwich you got at the mall while you shopping for some new kicks? Remember how they stayed in your beard after you dunked that last fry in the ketchup? Mmmm. Well, all those hair products, sweat, dust, dirt, crumbs, and whatever else you can think of cause your head and face to itch. And what happens when you itch? You scratch! And what happens when you scratch? You contaminate your hands! And what happens when you contaminate your hands? Unless you wash immediately, you’re going to contaminate food, or cleaned utensils, or single service items, or whatever. And of course, while we realize that wearing a hair and/or beard restraint won’t stop you from itching, it may at least prevent you from contaminating your hands or gloves. The food code does not specify a particular length of beard that is acceptable. It simply states that exposed hair must be restrained by clothing, hats, nets, chefs hats, sombreros, etc. (OK I added the chefs hats and sombreros, but I’d be cool with that). Some establishments have a policy that allows them to have a particular length of exposed hair or beard, however, the policy of any establishment does not trump the NC food code. Now I’m not trying to be a Grumpy Gus here, but if we see you without a restraint, we are going to mark it. Go ahead and get some big, burly beard restraints. Now with all that being said, while finding a hair in your food is sometimes appetite-killing, it’s probably not going to make you sick. (I mean sick from foodborne illness, not grossed out…) BUT, finding a hair in your food is one thing… realizing you have one in your mouth, and feeling it unwind around your teeth, through whatever glob of food you are chewing, and across your tongue is a sensory experience that one must live through to truly appreciate.

Now before we get into the other part of your question Bubba, let’s talk about something else related to hand washing. If you’ve been an avid reader of my past articles, you are already familiar with the importance of handwashing. And unless you’ve been in Lake Diefenbaker for the past 25 years, you are undoubtedly familiar with that sign in all the restaurant restrooms that specifically mentions how all employees are required to wash their hands using soap and warm water before leaving the restroom. That’s not just a suggestion, that’s part of the NC food code. Now, what I want to talk about for a second is the other part of that requirement. The hand drying part. Seems like everyone forgets about that part (or just doesn’t care). The hand drying rule states that an approved method for drying hands must be in place at every hand wash sink. That means you have to have paper towels, or an air dryer, or napkins to dry your hands. One study (shown here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538484/#:~:text=care%E2%80%93associated%20infections.-,The%20proper%20drying%20of%20hands%20after%20washing%20should%20be%20an,contamination%20of%20the%20washroom%20environment ) indicates that drying your hands with paper towels is the most effective method. In fact, a 95% reduction of Staph Aureus was measured just after rinsing with water and drying with a paper towel! This indicates that just the simple friction of hands on paper towels produces significant results (in your favor!) when it comes to reducing the number of active bacteria on your hands. That’s a lot.
Your REO Speedwagon shirt (although awesome) is not an approved hand drying device. Your Levi 501 jeans are not an approved hand drying device. It is already well known throughout the scientific community that wet hands are more likely to spread bacteria and viruses. Think of it this way…you know when you’re at the beach, and you come splashing out of the ocean from a hardcore session of body surfing, and just as you fall on that vintage Thundercats (HOOOOO!) beach towel you reach up to wipe the salty ocean water out of your eyes, but you realize that your hands are covered with sand? Well, that’s the same thing that happens when you don’t properly dry your hands after washing. All that sand? Might as well be bacteria and viruses. Keep that in mind the next time you go down to Myrtle Beach…

Alright, now let’s get to the other part of your question… Why can’t you leave your personal items on or above prep areas? What’s the big deal? This is actually pretty self-explanatory, and, I get it… It’s easy and convenient to leave your stuff where you can grab it when you need it. Makes perfect sense. The problem isn’t so much where it IS, as where it’s BEEN. Let’s think about this for a second. Where do you normally keep your cell phone and cigarettes? Probably in your pocket or purse. What else is in there? Keys, cash, Chapstick, credit cards, dirt, hair, glass eye…could be anything. All those things have the potential to contaminate each other, and consequently, you. And let’s be honest, OK? We all take our cell phones places that we probably shouldn’t. I’m talking about the gym… or…other places… (you know what I’m talking about). In fact, a pretty recent article in TIME magazine (http://time.com/4908654/cell-phone-bacteria/) has indicated that a study performed at the University of Arizona found ten times more bacteria on cell phones than the average toilet seat. That’s pretty gross. Now with all that being said, that doesn’t mean that you’re going to get sick by talking to your granny when she calls to tell you “happy birthday”, but just as all those contaminants move from your environment to your personal stuff, so can those contaminants move from a cell phone to a cutting board or prep area. The best course of action is to leave all your stuff somewhere away from your workspace so you don’t get distracted and inadvertently contaminate everything you come in contact with. And keep this in mind, Bubba… When you have your cell phone on that prep table, listening to Stevie Ray Vaughn, and slicing prime rib, what happens when you get a text from your buddy with that gif of the cat knocking things off the table? I know what I would do…I would look at my phone! So would you! Great, you just contaminated your hands again. Are you going to wash? That sink is all the way across the kitchen…. Nobody is looking, so you say forget it, and keep on cutting while the image of that cat pushing the remote off the shelf lingers in your head, and you just stand there… chuckling, slicing, and contaminating every bite of that moist meat… Yum.
Stay safe, friends!

 

 

 

By Jason Masters
     Environmental Health Director

Image of Thinking Health Inspector

 

 


A

Q: Dear Jason, my boyfriend insists upon grabbing raw hamburger and chicken with his bare hands before throwing it on the grill, and then wiping his hands on his pants or shirt before moving on to prepare salads. I have begged him to wash his hands in between. He says it’s no big deal, I say he’s crazy. Please help us settle this argument.
-Cindy

A: Wow. I hope your boyfriend doesn’t work at a restaurant, Cindy. (If he does, you can let me know where in a separate email…*wink*)This reminds me of “The Curious Case of Sam and Ella’s Chicken Shack”* (see what I did there?). After receiving several complaints of bare hand contact with ready-to-eat food (which incidentally is the #1 thing that grosses me out, and is the subject of an entire forthcoming article) at this establishment, we made a few site visits and determined that several employees were, in fact, handling food with bare hands. After speaking to Chef Nora Firus*, it was discovered that employees had never been informed about the dangers of handling food with bare hands.  To really understand why this is so important, we have to know a little about the microbiology of the organisms we mainly deal with when handling foods:

Norovirus-Commonly called stomach flu, or viral gastroenteritis, norovirus is the leading cause of vomiting and diarrhea in the United States. It is commonly spread by infected food service workers who touch ready-to-eat foods, or cleaned utensils. You can become infected with norovirus by getting feces or vomit from an infected person in your mouth…think about that for a second. We are talking about the leading cause of gastroenteritis in the U.S., and one of the major transmission routes is fecal-oral… Watch what foods go into your mouth, and WASH. YOUR. HANDS, KIDS. And if you happen to work at a food service establishment, if you think you have norovirus, go to the doctor, and DON’T GO TO WORK!

Salmonella-One of the most prolific bacteria strains in existence. Salmonella is currently the leading cause of food borne illness in the United States. Salmonella is found mainly on chicken, but can also be found on other raw meats. It can be killed by proper cooking, and salmonellosis can be prevented by washing hands before and after handling raw foods, and keeping utensils clean and separated.

Escherichia Coli O157:H7-Commonly known as E. Coli, this bacteria produces a toxin called Shiga toxin. A common complication with E. Coli is Hemolytic Uremic Syndrome (try saying that three times fast). The toxin can destroy red blood cells, and cause injury to the kidneys. E. Coli exists naturally in the gut of warm blooded animals (including you!) and can be spread from the feces of infected people and animals (that whole handwashing thing should be starting to make sense now, huh?) An E. Coli infection can be prevented by properly washing hands, and by avoiding the consumption of undercooked GROUND beef (sorry Pierre, no tartare today) but it is important to note that bacteria cannot live in whole muscle, so that delicious medium-rare ribeye is perfectly safe.
This is only a small list of bacteria and viruses that cause food borne illnesses. A simple google search will turn up many, many results, so make sure to get your information from a reputable source. (FDA, USDA, CDC, etc).
Back to our bare-handing friends at Sam and Ella’s… Per the NC food code manual, it is required that food employees do not touch ready-to-eat foods with bare hands. Hand washing alone does not remove enough of the bacteria and viruses from your hands to allow bare hand contact with ready to eat food products. Gloves are acceptable (as long as they are used correctly), and utensils can be used so long as they do not contribute to possible contamination, (this means you can’t grab cooked chicken off the grill with the same pair of tongs you used to pull it out of the marinade of Italian dressing…yes, that’s all it is…). Employees are further required to wash their hands before donning gloves, and when switching tasks. This means you can’t go from making sandwiches to taking out the trash, to grabbing the fryer baskets, to sweeping up the spilled chips from some snotty-nosed kid, and back to making sandwiches with the same gloves. It is required of a food establishment to inform employees of their responsibility to relate information about their health and activities, as they relate to diseases that are transmissible through food, to a person in charge (PIC). It is then the duty of the PIC to reduce the likelihood of foodborne illness transmission through asking for more information, watching for symptoms of illness (vomiting, diarrhea, jaundice, etc), or more commonly, restricting or excluding the employee from work.  So, what should you do if you are at a restaurant and see a food service worker handling food with bare hands?

1. Don’t eat the food! It is ultimately your decision as to what you put in your own body. Hopefully you can make an informed decision about where you eat using the sanitation rating that should be hanging in your favorite restaurant. (We will talk more about sanitation ratings in another issue…) If you don’t see a sanitation rating hanging in plain view, you might want to ask yourself, “why?” This should be a good indication of the practices of this food establishment.

2. Ask to speak to a manager or person in charge. Explain to them what you have seen and why you are deciding not to eat the food they are serving. It is a manager’s job to make sure that the food that is being served at their restaurant is not only delicious, but also safe.

3. Submit a complaint to the food and lodging division of the environmental health department. It can be anonymous. It is our job to speak to people about food safety. We do it every day.

So, to answer your question, Cindy, you are correct…your boyfriend is crazy. Hand washing is the single most effective way to prevent the spread of infections.

And remember, most of these illness won’t kill you… but they might make you wish you were dead…

*Names have been changed to protect the innocent*

 

 

 

By Jason Masters
     Environmental Health Director

Image of Thinking Health Inspector

 

 


A

Q: Dear Jason,
Hey Jason, I have a question about snow. I know you are not a meteorologist or anything, but can you tell me if it is safe to eat snow? I have a 4-year-old grandson, and he won’t stop shoveling snow in his mouth! Should I be worried?
-Carol

Well, Carol, that’s a great question, and one I’m glad you brought up at such a special time of the year. You know, when I was growing up, I remember standing with my brothers at the front window of our house, all of us jumping up and down, pointing at the snow, and yelling for my mom to open the door so we could go out there in it. She would help us get on our snow suits, and send us out, watching us run around, trying to catch falling snow on our tongues. Sometimes we would bring in big bowlfuls of snow and she would help us make snow cream. It was a family tradition for all of us kids (and usually the grown-ups, too!) to run outside on New Year’s Day, grab big handfuls of snow, and eat till we couldn’t eat anymore. The layer of clean, pure white snow would blanket our whole house and yard, and I remember how the barely visible red bows on the fence posts would cast a slight reddish-pink contrast on the crisp shell of the snow. After our hands were freezing and wet, we would go warm up by the fire that my dad built before he left for work, and have mugs of hot chocolate, and my mom would explain to us that the snow signified a blank canvas for the coming year…one we could fill with experiences and memories and whatever else we wanted, and by eating it on New Year’s Day, we were opening ourselves up to whatever possibility may present itself in the coming year. It was a wonderful tradition, and one my family carries on today.

But, to answer your question, we need to know a little bit about why eating snow might be dangerous to our health. *SPOILER ALERT*-it’s not the snow you need to be worried about…If you are familiar with my articles, you already know about hot and cold holding, why it’s important, and keeping food for appropriate times, and discarding food after a certain length of time, but if this is your first time, here it is in a nutshell…to be safe, foods must be maintained at 135 degrees F or above, or if they are maintained at 41 degrees F or below, they may be held for 7 days. After this time, however, they should be discarded. Now, with all that being said, why should we discard these foods after this amount of time, and what in the world does this have to do with eating snow?!?

Well first, let’s take a look at the most obvious reasons that eating snow off the ground might be dangerous. Got any dogs in your neighborhood? Dogs don’t usually use a public restroom, and rarely (if ever) stop to let you know that nature is calling. Let’s think of some other things that might be on the ground…dirt, rocks, lead paint chips… What if the snow is on top of a failing septic system? What if the snow is on the road that DOT just sprayed with salt solution and sand? What if Uncle Adam was just out smoking a cigarette, and dropped his cigarette butt and ashes right there? (Have you ever accidentally picked up a drink that someone used as an ashtray? I have…its gross…especially when that cigarette butt plinks off your teeth…ugh) Would you eat a cheeseburger that fell on the ground? (and don’t give me any of that “5 second rule” stuff…) If the answer is “no”, then why in the world would you think it would be OK to eat snow off that same ground?!? Ok…I think you get the point here.

Let’s talk for a minute about psychrophilic bacteria. Psychrophilic bacteria are cold-loving organisms that thrive in temperatures ranging from around 32 to 77 degrees F. Remember when I told you to throw food away after 7 days at 41 degrees F or below? Well this is why. Meet Listeria monocytogenes. This guy loves to hang around in your fridge and make you sick, especially if your foods are not maintained at safe temperatures. And guess what? Listeria loves the same foods you do! Deli meats! Hot Dogs! Soft cheeses! Sprouts! Cantaloupe! Seriously, who doesn’t love these foods?!? Now, Listeria is not the only psychrophile, but based on information about the growth phases of Listeria, the NC food code recommends discarding foods after 7 days. After that amount of time has passed, the amount of harmful bacteria on food can be enough to make someone sick. Listeria is especially happy to find a fridge that hasn’t been cleaned in a while…. You know that black stuff in the corners in the back?…Yeah, that’s gonna be a great spot for listeria to set up shop. This brings me back to the snow…temperatures have to be pretty low outside for snow to hang around. Listeria is widely found in the environment…It can live in soil, water, decaying vegetation (remember those leaves you told your significant other you were going to rake last fall, but then you got busy, ’cause, you know…life…and now they are just hanging out under all that beautiful snow, decaying and providing food for the grass that will be so lush in the spring…?) Sounds to me like conditions are just right for Listeria to start multiplying.

Now, don’t get me wrong, I’m not saying you shouldn’t build a snowman, or a snow angel, or an igloo, or make your neighbors take a snowball to the face. I’m just letting you know that if your kid (or grandkid) is dying to eat some snow, then do the little guy a favor, and get it from somewhere ABOVE THE GROUND! And maybe it’s time to let that winter-warmer recipe for your (in)famous sprout/cantaloupe salad with bologna chunks and a warm queso topping to go back in the drawer (or in the trash…)

Stay warm and enjoy winter, friends!

SNOW CREAM

1) Gather a big bowl of fresh, CLEAN snow. You will need a big bowl, and it will need to be nice and full.
2) Stir in one 14 oz. can of sweetened condensed milk. You may have to adjust amount according to how much snow you have.
3) Add a few teaspoons of vanilla extract. (Or go crazy and add some other flavor like orange!)
4. Mix up and add some toppings like sprinkles or chocolate syrup and enjoy!

 

 

 

By Jason Masters
     Environmental Health Director

Image of Thinking Health Inspector

 


A

Q: Dear Jason,
I just have a question…Is it possible for a large group of people to get sick from one meal? I was recently at a holiday party with some “friends”, and a few days later, several of them got sick! We are not sure of the cause, but we suspect one individual as the source….

-G. Rinch

Hello! Well that’s a great question that frequently comes up around the holiday season. The chances of a large group of people getting sick from one meal is pretty high, especially around the holiday season, due to people not paying attention to proper cooking times, food storage issues, and generally being distracted by the events around them. In fact, this reminds me of a poem I once heard…I’ll try to recreate it here the best I can. Any similarity to other stories or poems is purely coincidental…

To be read in the voice and style of a large, hairy, green being that initially dislikes his neighbors and their penchant for the holiday season, but through a series of misadventures and a journey of self-discovery, comes to the realization that his lifelong loathing may have been slightly misplaced…

“Merry Christmas to all, and to all a good night!”
Was the thing I was thinking as I took my last bite.
I had no idea I was in for such trouble,
When I heard Mindy Sue Whoo’s small tummy grumble.

“It’s a Christmas feast!” I thought to myself,
“Fit for a King!” (Or at least a large elf)
The biggest spread! Hours it lasted!
Complete with orange flavored effervescent antacid.

When I took the Whoo’s pudding, and I took their roast beast,
I couldn’t have imagined it would be such a feast!
I didn’t hot hold it or keep anything cold.
“Why would I?” I thought, “It’s just hours old!”

I rolled it all up on the living room rug,
And then stuffed it all up with the rodents and bugs.
No reason to think I did anything wrong,
when I put all their food on a sleigh with a dog.

You know the story, I brought it all back,
and I carved it and served it right out of the sack.
Each Whoo got a serving (including the dog)
Topped off with a cup of Great Gram’s raw egg nog

Two days later, a few Whoo’s got sick,
complaining and saying they couldn’t sing worth a lick.
They took some painkillers! They drank soda water!
They used cool rags, but their fevers got hotter!

It came without warning! Not any red flags!
But it DID come with retching, and bloating, and gags!

Yes, all The Whoos down in Whooville were walking among us,
With cases of E. Coli and salmonellosis.
Diarrhea! And fever! And abdominal cramping!
No sleep in the night, just occasional catnapping!

About 10 percent of the Whoo’s were sent home, diagnosed with hemolytic uremic syndrome.
Red blood cells were damaged! Failure of the kidney!
Which is especially dangerous to young Whoo’s and the elderly…

About a week later, the Whoo’s felt much better,
Following textbook symptoms right down to the letter.

The moral of this story is just this my friends: keep your food safe from beginning to end.
Maintain hot temperatures if you plan to hot hold it,
One thirty five (135) is the number it must hit.
Forty one (41) or below for cold holding for later,
Use an ice bath or your Whoo-frigerator

Fully cook all your food, (roast beast included)
So you don’t get sick, like Mindy Sue Whoo did
Final cook temps are the things you must know
To reduce the microbial/bacterial load

Don’t put your roast beast under raw chicken juice
You may need a physician, (or one Dr. Seuss)
Storing food properly is the thing you must do
To avoid contamination, and adulteration too!

Fully wash your hands, small, large, or green.
Use soap and warm water, and scrub until clean.
In order to be safe this holiday season,
simply follow these rules, you all know the reason.

And one last thing before biding adieu,
Remember the story of G. Rinch and the Whoos…
Be kind to your family and neighbors alike,
Children are watching, even the tiniest tyke.

Happy Holidays, Everyone!

 

 

 

By Jason Masters
     Environmental Health Director

Image of Thinking Health Inspector

 

Thanksgiving!


A

Q: Hey Jason, my family is coming in for thanksgiving this year and I want it to be extra special (it’s my first one with my new in-laws!) What are some ways to make sure that my feast is safe? How far ahead can I prepare my broccoli/cheese casserole? I have a small kitchen and I want to prepare as much as possible before the big day.

-Sarah

Happy Thanksgiving Sarah! Great questions for this time of year.  You know, at my house on Thanksgiving, we always have broccoli cheese casserole too! It’s a staple at any of our holiday meals, but Thanksgiving is celebrated in a variety of ways across this great country of ours, and with a variety of delicious dishes. For example, if you live in Nevada or Idaho, you may be enjoying some frog eye salad. Or, if you live in Ohio, dirt pudding may be on your plate right next to the mashed potatoes. Either way, with all the tongue tickling dishes being prepared around this holiday, food safety is especially important to keep in mind. Let’s go ahead and dig in… (pun intended…)

 

Let’s start at the beginning and talk about thawing. I’m assuming that you are having turkey for dinner. Turkey is usually the “guest of honor” at Thanksgiving, but any meat will do…after all, Thanksgiving is not about the food, it’s about the people you spend it with. The food is secondary. How big is this bird? How long did you let this turkey thaw? Did you just remember this morning to take it out of the freezer?  It’s going to take more than a few hours to thaw out that 16-pound bird, and you can’t just throw it in the fridge and expect it to happen before noon. Generally speaking, you should allow about 24 hours for every 4 pounds of bird. That 16-pound bird you’ve got there? That’s going to take about 4 days to completely thaw. Don’t make the mistake of watching The Charlie Brown Thanksgiving special and forgetting to put the bird in the fridge.

 

Now, if you are familiar at all with my Ask A Health Inspector articles, you will remember how I have gone on and on about knowing, and reaching, final cook temperatures for safety. No exception here. Turkey must get to an internal temperature of 165 degrees F to be safe. I don’t care if you roast it, bake it, broil it, boil it, fry it (my personal favorite), smoke it, grill it, whatever…It must reach 165 degrees F inside the thickest part. Oh! and if you are one of those people who like to cook the stuffing inside the cavity of your turkey, well, that must reach 165 too. Just sayin’.  If you only take one thing away from this article today, let it be this: TURKEY MUST REACH 165 DEGREES F INTERNALLY TO BE SAFE.

 

Alright, moving right along through this thanksgiving feast, let’s talk about make-ahead preparation. Let’s say you want to make that broccoli cheese casserole about a week before the big day and check that off your list. That’s fine. Just remember to properly cool your casserole before putting it in the fridge. The requirement for restaurants in North Carolina, (and in my kitchen) is moving from a temperature of 135 degrees F to 70 degrees F within 2 hours, and from 70 degrees to 45 degrees in the next 4 hours. That should be easily achievable in your home kitchen unless you are making 47 pounds of casserole. (I always ask my wife to make extra because I COULD eat 47 pounds of broccoli cheese casserole…Ok, ok, probably not more than 45 pounds, but who’s counting?) Just be sure not to put your piping hot casserole into the fridge to cool. It won’t cool safely, and if your guests are going to get sick, you want it to be from over-indulgence, (they can’t blame YOU for that one), not improperly cooked and cooled food. And remember, you can hold a cooked and cooled food in your refrigerator for 7 days if it is maintained at 41 degrees or below.

 

Alright, let’s move right into reheating that delicious casserole. According to the 2017 NC Food Code, foods must be reheated from 41 degrees F to 165 degrees F within 2 hours. Doesn’t matter if you use the stove or the microwave, it must get to 165. This should be easy to remember because your TURKEY MUST REACH 165 DEGREES F INTERNALLY TO BE SAFE. (I might have said that before in this article.) Its only one temperature to remember, people! 165 degrees F. Know it. Live it. Love it.

 

OK, OK. I get it. The real question you want to know is how long can I nap while the food is still on the counter? Great question. In restaurants, if a food is going to be held outside of temperature control (that is, 135 or above for hot holding, and 41 or below for cold holding) it is safe for 4 hours, but they must have written procedures in place, and a way to monitor that food. Now at home, of course, you don’t need written procedures, but you do need to remember that you put that sliced turkey on the platter at 1:00, and you have 4 hours to safely leave it there. (6 hours if you can manage to keep the house temperature below 70 degrees F, but good luck with that if you have the stove and oven going, football on TV, kids screaming, coffee brewing, Uncle Adam leaving the front door open, neighbors popping in and out, and the other neighbor’s dog barking…A better move is it shoot for no more than 4 hours.) Now, the kicker is that at the end of that 4-hour period, that turkey must be discarded.  A far better move is to properly cool and refrigerate or freeze any leftovers as soon as possible so you get to have my favorite breakfast sandwich the next day…that is bread+mayo+broccoli cheese casserole+cranberry+gravy+turkey+mashed potatoes+dressing+cheesecake+more gravy+chocolate chip pecan pie+mayo+bread. Now THAT’S a breakfast sandwich.

 

And while we’re at it, let’s go ahead and address some thoughts on “The Charlie Brown Thanksgiving special”:

  1. Why does Charlie Brown keep trying to kick that football?
  2. As a health inspector, I find it appalling that a dog and a bird are placed in charge of the kitchen. The risk of salmonella alone would be astronomical!
  3. Why is Charlie Brown completely bald? (Don’t get me wrong, it’s a great look, but he’s a kid!) And Linus has a serious hair thinning problem…is there something in the water?
  4. It’s no wonder Charlie Brown’s eyes look like that…look how close he sits to the TV! Does he need glasses? This should be addressed!
  5. Why did everyone get invited to Charlie Brown’s grandmothers house except Snoopy, when Snoopy is the one who did all the work in the first place?
  6. Isn’t it weird that Woodstock would eat turkey?
  7. Where the heck are all the adults? The kids were going to have toast, popcorn, and jellybeans for thanksgiving, for Pete’s sake!

 

Happy Thanksgiving, Everyone!

 

 

 

 

By Jason Masters
     Environmental Health Director

Image of Thinking Health Inspector

 

Fairs and Festivals


A

Q: Hello Jason, I’ve had a great summer and I love all the festivals in our area and throughout North Carolina! I’ve had a chance to try all kinds of foods that I wouldn’t normally  have an opportunity to eat, (like liver mush! Yum!) and they have been delicious! As the Mountain State Fair approaches, is there anything I should be worried about as far as food goes? And what about food trucks in places like the wonderful festivals I’ve attended this year?

Vendors at festivals and other events are required to obtain a temporary food establishment (TFE) permit from the environmental health department before serving food. Our department makes a visit to the vendor, usually on the day of the festival or event, and after a review of menu items and preparation processes, as well as a checklist of items relating to general food safety, we issue a permit.  It is important to note that no food is allowed to be prepared before the beginning of a festival. We won’t let Bubba use the same meat at this event that he patted out at last month’s  burger festival.  Now, here’s what you need to know…

There are no regulations relating to the people working at these TFEs. No one is required to be a certified food protection manager (like at restaurants) and  (usually) no one from our office does an inspection after a permit is issued (except in the case of a multi-day event, like the mountain state fair, where there is potential for things to go awry).

When we issue a permit to a TFE, we only make sure that sanitation tools are in place. We can’t guarantee that anybody uses them on a regular basis. Yes, we make sure they have gloves. Yes, we make sure they have a means to wash their hands. Yes, we make sure the food they are preparing to sell appears to be maintained properly and safely. But that doesn’t mean that Bubba over at the burger tent is wearing his beard restraint and washing those enormous mitts of his after grabbing the meat for a big ol’ double bubba.

Now Jason, does that mean that nothing is safe at festivals and fairs?

Of course not!

Keep in mind that most of the people that own these business make their living selling food. It is certainly not in their best interest to simply ignore basic hygiene and food safety. To help ease your mind, here are some things to look for before ordering that deep fried double bubba:

-All temporary food establishments are required to have a canopy or tent over the entire operation. If you see someone selling shrimp cocktail off the back of a tailgate, they are probably not permitted.

-All TFEs are required to have some sort of ground cover. Concrete, asphalt and even grass is OK. Don’t let Bubba wade through the mud to take your 15 dollars 

-All water must be from an approved source, and there must be a way to heat water on site.  Lake Lure and Lake James are not approved sources.

-A means to wash, rinse and sanitize utensils must be on site, as well as sanitizer, and sanitizer test strips. If you see Bubba throw down some raw meat on top of an Igloo cooler, you might want to consider going back for that grilled cheese sandwich at the Queso-Loco food truck.

-A handwashing station must be available with hot water under pressure. We will even allow a cooler with hot water inside, but the water must be able to flow freely. Also, the water has to be caught in a bucket or container of some kind. We don’t want Bubba to get his boots all muddy before he steps on the onions.

-Food must be stored where it can be secured against tampering, and off the ground. Don’t let Bubba “go around back” to grab some more “real special” meat for your order.

-Cold holding equipment and food thermometers must be available and in working order. Of course, that doesn’t mean they will use them, but they at least have to be there.

The best advice I can give you is to pay attention to the surroundings, pay attention to the people working, and make good choices relating to what you eat at fairs and festivals. As always, if you have issues, go to the doctor so they can verify that you have a foodborne illness, and be sure to report it to the Environmental Health Department. If the fair or festival is still in town, we may be able to address the situation immediately. If you wait too long, though, those vendors may disappear faster than a funnel cake in front of a four year old.

Well, what about food trucks?

Here is the quick and skinny on food trucks, or Mobile Food Units (MFUs) as we call them. (We will save the really good details of MFUs for another issue…) Basically, an MFU is inspected the same way a restaurant is. They are required to have a certified food protection manager on site (or lose two points), they are required to have employee health policies on site, and follow all the other rules and regulations that a restaurant is required to follow. In addition, they are required to have a commissary that they “partner” with to store supplies, cleaning equipment and other food items they may not have room for on their truck. A commissary can be a restaurant, or an establishment that meets all the necessary requirements for a commercial grade kitchen, and must be a permitted establishment, and inspected on a regular basis. An MFU is required to return to their sponsoring commissary at the end of each day of operation for cleaning, dumping, refilling, etc.

Ok then, what about pushcarts? Is it safe to eat a hot dog in this town?

Pushcarts operate in much the same way as a mobile food unit. They are required to work in conjunction with a permitted commissary, they must return to the commissary at the end of each day of operation, and they are required to provide a list of events or locations at which they will be setting up. The pushcart itself must be inspected to ensure that all components are smooth and easily cleanable, and NSF (or commercial grade) approved. They are only allowed to use single service items, like wax paper, and plastic utensils, and…here is the big thing…they can only prepare hot dogs on the cart. They can’t grill you a burger. They can’t mix you up a milkshake. They can’t toss you a fresh salad. They can sell/serve things that have been previously pre-portioned, pre-wrapped and prepared (how’s that for an alliteration?) in their commissary, but that’s it. If you see somebody selling freshly prepared ceviche at a pushcart, it would probably be best to keep on moving.

So, to sum it up, Patsy, there are lots of things to be worried about, but with a little observation and some good decisions, you should be able to rest assured that the only reason you are throwing up is the double order of chili cheese fries with extra jalapenos, and the poor timing of riding the Cyclops right after.

Enjoy the fair, friends!