“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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The Joint FAO/WHO Expert Meeting on Microbiological Risk Assessment (JEMRA) event, at FAO headquarters in Rome on Sept. 18 to 22, will work on food attribution, analytical methods, and indicators of viruses in foods.

United States-based experts proposed for the meeting are Donald Schaffner, of Rutgers University; Xiang-Jin Meng, at Virginia Tech; Kali Kniel, from the University of Delaware; Lee-Ann Jaykus, at North Carolina State University; and Jacquelina Williams-Woods of the FDA.

In 2022, the Codex Committee on Food Hygiene (CCFH) asked JEMRA to provide scientific advice to inform a review of guidelines established in 2012. This was due to emerging issues associated with foodborne viruses and scientific developments.

Aims of first meeting
The main purpose of the past document was to give direction on how to prevent or minimize the presence of human enteric viruses in foods, especially Hepatitis A virus (HAV) and Norovirus.

It was applicable to all foods, with a focus on ready-to-eat food, from primary production through to consumption.

The guide also contains an annex on the control of Hepatitis A virus and Norovirus in bivalve mollusks and the same two agents in fresh produce.

JEMRA’s work will focus on reviews of the foodborne viruses and relevant food commodities of the highest public health concern; the analytical methods for relevant enteric viruses in foods and of scientific evidence on the potential of viral indicators or other indicators of contamination.

Experts will also look at the scientific evidence on prevention and intervention measures and the efficacy of interventions.

The provisional list of 23 scientists also includes Magnus Simonsson, director of the European Union Reference Laboratory (EURL) for foodborne viruses; Shannon Majowicz, from the University of Waterloo; and Joanne Hewitt, at Environmental Science and Research in New Zealand. 

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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.

More than a dozen scientists, government officials and corporate representatives joined forces yesterday for the “COVID-19 & Food Safety Global Summit,” which was organized by the International Association for Food Protection. The three-session web event attracted hundreds of attendees from around the world. Registered attendees will have access to a playback of the webinar and will be notified by email on how to access it.

During Sessions 1 and 3 presenters touched lightly on the knowledge gap involving the coronavirus and food safety. During Session 2 the presenters and moderator gave their full discussion to what we don’t know and what that means.

“. . . The science is moving very quickly,” said Ben Chapman, panelist and professor and extension specialist at North Carolina State University. “. . .  We’re kind of making decisions a little bit blind.”

Also on the panel was Lawrence Goodridge, Leung Family Professor in Food Safety, Director of the Canadian Research Institute for Food Safety, Director of the Food Safety & Quality Assurance MSc Program, all in the Department of Food Science at the University of Guelph. Donald Schaffner moderated the panel. He also comes from academia, being distinguished professor and extension specialist at Rutgers University.

Goodridge agreed that knowledge gaps are hampering food safety decisions and plans in regard to COVID-19 mitigation. One thing, Goodridge said, that is not unknown are the hygiene practices and food safety procedures that are already in place. Current best practices are a better jumping off point than a food system with no controls at all.

Chapman and Goodridge also agreed that there is very little in the way of published research on the topic of food safety and the virus. Both acknowledged the current thinking is that the current form of the virus is not foodborne, but both pointed to other ways it is impacting food safety.

Without that research, Chapman said, it is “really hard to make best practices decisions.”

Specific knowledge gaps mentioned by Goodridge included information about different virus strains and different foods, buffet and self-serve situations, and various retail scenarios.

In addition to the nuts and bolts of needed research, the panelists discussed the  need for the focus right now in the food industry to be on worker-to-worker infection control.

“One factor we are trying to address here is worker-to-worker transmission and it’s impact on food safety,” Chapman said.

During the question and answer portion of the session one attendee asked about environmental sampling to determine whether the virus is present in food facilities on hard surfaces or other contact points. Chapman did not hesitate with his answer.

“The early detection system of watching for sick employees (is key). We need to focus on person-to-person transmission, not environmental sampling,” Chapman said.

The summit was partially sponsored by the Seattle law firm Marler Clark LLP. Founding partner Bill Marler is publisher of Food Safety News.

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March 2020 was a month unlike any of us have experienced before. Beyond the transition to working remotely and the seemingly endless video meetings and webinars, we’ve collectively learned a lot about coronaviruses, environmental stability, inactivation, transmission routes, how to perform wellness checks of employees,  and have fielded dozens of questions from food industry stakeholders and the media. This tragic pandemic has led to partnerships and collaborations towards many common public health, food safety, and risk goals.

The current challenges to ensuring the health and safety of employees and customers have never been more difficult. There are likely unintended positive food safety impacts that are being seen across the food system. We guess that employee handwashing practices are likely at an all-time high with all the added focus. Extra attention to proper chemical use to clean, sanitize and disinfect both food and non-food contact surfaces, especially high-touch surfaces, is almost certainly happening. 

Although much of what we know about COVID-19 is emerging, many media outlets are sharing consistent (and evidence-based) messages that food safety professionals have been teaching and preaching for years. On a more personal level, hearing our kids belt out new handwashing songs, watching Tik-Toks on social distancing, and now all know a little something about epidemiology – flattening the curve — is heartening. There is even a slick new website, Wash Your Lyrics, that you can use to generate your own song and handwashing poster with everything from Styx to Post Malone to the Grateful Dead. It’s been truly amazing to see how in the face of adversity some amazing advancements in enabling and supporting behavior change can happen. Of course, we would have preferred there be no pandemic, but this is now the new normal. 

Since food manufacturing, food service, food retail, agriculture, and transportation are all classified as essential critical infrastructure, the collective food industry has a responsibility to respond. It is with great thanks and admiration to these organizations and the numerous individuals that run them who are helping the rest of us get through daily life by ensuring we have safe food which is essential for our survival. We are also trying to find any positives that may result such as better reporting, and creative approaches to food manufacturing and sales.

After conversations over the last few weeks at GFSI in Seattle, then AFFI-Con in Las Vegas we thought it might be time to take a minute to share some of the ideas and recommendations  because it’s never too late to start planning for what comes next and being ready for the next challenge including the potential for seasonal reemergence (and don’t forget a pandemic flu is likely in our future as well). How can food safety professionals learn from our current situation to establish sustainable practices? Here is what we have so far. The list is not all-inclusive but includes  ideas we feel merit further consideration, action and diligence: 

Management Team:

• Implement an employee health and wellness program that supports pro-active restriction and or exclusion.  
• Have a pandemic response plan incorporated into your organization’s Business Continuity Plans which should include key aspects of service limitations, increased cleaning/sanitizing and disinfection, etc.
• Designate roles within your organization that will connect to global, national, regional and local regulatory authorities to monitor the situation and to deploy adequate control measures to continue operations. 
• Identify backups for each job position and if possible alternate production sites to offset production delays.
• Promote remote work for non-production or essential roles. Digital food safety management systems (FSMS) are a great tool to facilitate and maintain adequate processes and controls are being met even from a remote location.  
• Consider providing transportation for employees that use public transportation.

Perishable Food:

• Reduce food waste by lowering par inventory levels.
• Identify if/what products in your inventory that can be frozen without quality compromises, and used at a future date. Think about consolidating inventory in preparation for staff reductions 
• When closing a facility, divert safe food to local food banks or shelters – donate as much product to them as possible as long as it has not passed its expiration date.
• To assist locations in returning to normal operations (post-pandemic) discard perishable products near the end of useful life. 

Refrigeration Recommendations:

• Reorganize inventory and condense products into fewer refrigeration units. 
• Empty refrigerators should be turned off, as empty refrigeration space places more stress on the cooling system that could lead to unnecessary wear and tear. This also conserves energy and allows for deep cleaning to take place as well as preventative maintenance to ensure optimal functionality once placed back into service.

Technology:

• Adopt Digital Food Safety Management systems (DFSMS) based on HACCP guidelines that enable real-time refrigeration temperature monitoring and alert based operational compliance reporting. These systems have the ability to consolidate multiple important critical food safety reporting activities by providing visibility and awareness across an entire organization 
• Implement the use of infrared handheld thermometers as a pre-screening tool  to measure temperatures of individual employees at the start/end of their shift. Screening methods and results should be based on CDC guidance and confirmed by a medical professional.   
• Investigate the use of advanced thermal imaging instruments to assess elevated body temperatures and in consultation with local health professionals and legal advisors, make decisions to protect employee health.

Communication Practices:

• Leverage technology to maintain internal communication (teleconference, video conference, and webinar). 
• Keep handwashing and hand sanitizing and employee health top of mind for employees and family members via job aids and training 
• Encourage  customers to use order ahead options and delivery services.
• Promote the use of cashless payment at operating locations. 

Operations Planning:

• Incorporate the use of a daily set of health assessment questions as part of temperature monitoring  (are you sick, have you been around anyone sick, do you live with anyone that  is sick) based on the CDC guidance for employee wellness.
• Decide when to close dining rooms, restrooms, and seating areas and reassessment plans for reopening. 
• Protect cashiers by providing physical barriers between them and customers
• Clean and disinfect credit card pin pads and touch screens between each customer at indoor self-checkout locations.
• Clean and disinfect outdoor touch screens/credit card pin pads at routine intervals.
• Eliminate self-serve items, buffets, and areas that encourage high touch surfaces and when possible package foods that are sold individually. 
• Designate continuous cleaning and disinfection of high touch surfaces in the entire facility (door knobs/handles, handrails, phones, light switches, hand sinks, paper towel dispensers, restrooms, credit card pin pads and touch screens, etc.) to one or more employees
• Have liquid hand sanitizer stations as well as sanitizer wipe stations in operating locations so employees can sanitize hands when hand washing is not feasible 
• Designate employees to monitor customers’ entrances to ensure that all consumers are prompted to use sanitizer prior to entering.
• Set up que line placements (e.g., X every 6 feet) and signage  to ensure customers are able to stand 6 feet apart IF a line is likely for pick-up service. 
• Place signage encouraging anyone who feels ill to not enter and provide alternatives as to how to help them with food essentials (delivery, curbside pickup).
• Consider transition from traditional paper and laminated menus to a digital format, when re-opening. Further, consider systems that allow the customer to use their own device to access menus.

Production Planning:

• Review your operation’s production and operating hours, should they be shorter or different from normal operating hours. 
• Reduce or rethink your menu to take advantage of alternate labor models or product availability. 
• Consider simplifying your menu items to less complex products, this would support a more sustainable labor pool that may have less formal culinary training as well as reducing the amount inventory which should help control food waste during such an unpredictable event.     
• Divide employees into small function-based teams and stagger production times or production areas to promote adequate social distancing.

We have all had people ask us where to get information and stay up to speed with the newest and emerging information about COVID-19. Here are links to the most accurate resources that we are using daily to answer our food safety questions.

http://Whitehouse/CDC/HHS COVID-19

FEMA COVID-19 Rumor Control

National Governors Association

CDC COVID-19

FDA Food Safety and COVID-19

USDA COVID-19

World Health Organization – COVID-19

NC State’s COVID-19 Food Safety Materials

Apple/CDC COVID-19 Screening Tool

https://coronavirus.jhu.edu/map.html

http://91-divoc.com/pages/covid-visualization/

About the authors

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Presentations and an abundance of creative posters were shared, each primarily based on unique experiences. Many sessions covered the importance of kitchens and food safety protocols in the healing of patients and residents in hospitals and long-term care facilities.

The most common theme was the wide range of challenges in achieving acceptable hand washing compliance rates. Hand washing was clearly the dominant intervention of choice to lower infection rates. Reports from Ho Chi Minh City University, the University of Lagos Nigeria and the University of Chicago all called for process improvements. In the underdeveloped countries having clean water available at points of care was the top concern.

A presentation by Emily Landon of the University of Chicago’s Center for Healthcare Delivery, Science and Innovation, was a true rendering of today’s best practices in action. Her multi-year experience with electronically assisted hand washing monitoring provided insights for starting such programs as well as covering the hurdles in sustaining the process improvements. Her message stressed the importance of departmental collaboration and verified compliance data to change behaviors from the C-Suite level down to bedside patient care.

Landon monitors over 100,000 hand washes each day. A 10 percent increase in compliance at University of Chicago could save $1.2 million per year in MRSA costs alone.

Another Chicago area hospital reported using data to double their hand washing compliance within six months. Many competing technologies were studied in depth. Only 3 percent of hospitals currently are using one of the automated technologies, but if attendees at APIC 2017 are representative of the trend, the other 97 percent are busy considering data as the driver to get to the next level of risk-reduction and patient safety.

A recent publication by Rutgers University’s Donald Shaffner debunked the hot-water hand washing theory, which was welcomed by the nursing profession where frequent hand washing is a must and irritant hand dermatitis is a risk. Washing with “cooler but comfortable” water protects the skin’s natural protective barrier.

Discussions on disposable glove changing, echoed the typical foodservice issues. Are the gloves protecting the caregiver or the care-receiver? The unchanged glove is every bit as bad as the unwashed hand or possibly worse.

Now that handwashing can be verified, does this change glove usage? Deb Burdsall, a doctoral candidate at the University of Iowa, is an internationally renowned expert on this complex subject. She used a comedic approach to demonstrate the plight of a conscientious caregiver attempting to follow the standard gloving policy in a nursing home toileting situation. It dramatized the challenge of needed glove changing in times of patient distress and opened a discussion as in foodservice on the merits of double-gloving.

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