This morning when Sorenne and I got up, we turned on the Disney channel to watch Special Agent Oso. The episode, “A Zoo to a Thrill” showed Oso helping June Kim feed a llama at the petting zoo. Special Agent Oso always has to accomplish “three special steps” in each of his missions. This time it was:

• step one: get the llama food
• step two: wait your turn in line
• step three: feed the llama.

Not included in the steps, but clearly shown in the episode were washing hands before getting the llama food and after feeding the llama. Our veterinary friend Kate Stenske told us that washing your hands before handling the animals is a question of not transmitting whatever you have to the animals and washing them afterwards is about not transmitting what the animal has to you.

I was especially pleased in this episode to see that June Kim’s father stayed outside of the petting zoo area while he fed his baby a bottle. Bottles and pacifiers are at high risk for cross-contamination in such areas because some of the pathogens can be aerosolized.

If Sorenne wants to meet a llama, I may take her to a petting zoo someday, or to our friend and contractor Russell’s house. We’ll try to make sure she washes her hands so her first visit to a zoo does not give her a bad thrill.

If I hadn’t been informed by my food safety guru husband, I could have very easily consumed ready-to-eat deli meat on our car trip north, potentially putting my baby at risk. Sorenne turned out healthy, huge and wonderful. And we are thankful every day.

Several of my former students, friends, and family members are pregnant right now, and somehow I’ve become the expert on food safety during pregnancy. These women have expressed frustration and confusion about the conflicting information they read and receive from their doctors regarding what they can and cannot eat during pregnancy. While I generally think moderation and eliminating stress are priorities, there are a few food safety concerns that are definitely worth considering. I’ve already written on “What you can and cannot eat during pregnancy,” but in light of major outbreaks (and this is barfblog, of the 4 Rs), the information bears repeating.

Pregnant women should avoid:

-       ready to eat refrigerated foods such as deli meats, smoked fish, hot dogs, sausages, pâté, and the like. If the food is shelf-stable (canned), it should be ok. Unfortunately, it was impossible to find canned pâté in Manhattan, KS during my pregnancy – but now it’s available at Hyvee.

-       soft-serve ice-cream which has been suspected as a listeria risk

-       soft cheeses (brie, camembert – pasteurized or not) and we are uncertain about blue-veined cheeses (I toasted or melted my cheese to alleviate my fears. Now this seems laughable since I’m not eating any dairy while I breastfeed.)

-       and sprouts because they have been identified as a source of listeria and other pathogens.

Listeria is one of the main food safety concerns during pregnancy because it causes a high rate of miscarriage and stillbirths.

For further reading, consult the Bad bug book, http://www.foodsafety.gov/~mow/chap6.html and the CDC’s excellent site http://www.cdc.gov/ncbddd/pregnancy_gateway/infection_list.htm#protect

First, host Reno Collier made a cooking demonstration. No handwashing stations are present anywhere in sight (see right). After Collier explained how he likes to talk to his meat as he formed a raw patty, he threw it on the grill and wiped his hands on a towel. The condiment station was well stocked, but there were no meat thermometers and no safety instructions. The DiSalvatore dad said he’d never cooked anything in his life. Silvio quickly asked for tips from his wife Amy who said, “Just don’t overcook it.”

Silvio: “How do I know when it’s cooked?”

Amy: “A little bit of pink inside. Good luck.”

The father of the Rico family made the decision to cook his entire 5 lbs of meat and he commented, “I really misjudged how long it would take to cook those things.” Ricardo’s giant burgers were far from being done when it was time to serve. Host Collier yelled out, “Feel free to check these things out before you go sticking them in your mouth.” [Katie, that was for you.] One of the kids commented, “I was more nervous about barfing than about winning the challenge.”

It’s mindboggling how much cross-contamination took place in this highly edited clip (see approximately minutes 11 to 20). I think I threw up a little bit in my mouth while watching. In the end, the Ricos went home, but surprisingly they did not receive the lowest score for their burger.

Raw burger is not safe to eat. Hamburger is done when it reaches an internal temperature of 160F as measured by a tip sensitive meat thermometer. (See Doug’s videos on youtube.) Color is an unsafe indicator of doneness. Wash your hands after touching raw meat and before touching ready to eat products like buns. I personally find it challenging to grill and avoid cross-contamination … so why does everyone keep saying how simple it is to make a burger?

If you want to risk your own stomach or life, that’s your business; but please do not try to kill your neighbors or your children with undercooked meat or cross-contaminated condiments. 

According to the New York Times article, “Five-star tour cuisine for guys who eat and ride” the men on the tour require 5000 to 8000 calories a day.

Eating that much demands enticement and Team Garmin-Slipstream (the team of my fantasy cyclists Farrar, Wiggins and Zabriskie) has its own chef, American Sean Fowler. Fowler works with the team’s physiologist to keep the guys feeling good and their bowels running smoothly. Juliet Macur writes:

Every day at the Tour, Fowler cooks exclusively for Garmin’s nine riders, to the chagrin of team management. (…)

On a typical morning, they will gather their cooking gear and take it to the motor home in which they follow the race. They make sure to arrive early at the team’s next hotel, to inspect the kitchen.

If it is not up to Sean Fowler’s standards for cleanliness, which has happened a few times at this Tour, he will cook in the motor home. He takes precautions to keep the riders safe from food poisoning or other gastrointestinal problems, which could be devastating to their performance. In his motor home, he wields utensils and pots and pans like a careful samurai because the space is cramped.

Although Leipheimer’s out, as of this morning my fantasy team still has four of the top ten riders. Let’s hope none of the others are injured or downed with foodborne illness.

On the 7/14/09 edition of the Today Show, Martha Stewart cooked “Zesty Chicken Burgers” for Meredith Viera and a somewhat reluctant Matt Lauer. While Martha was going on about how special chicken burgers are, Matt quietly asked a food safety question.

Matt: “Obviously people are going to say you have to be careful how to cook a chicken burger. You have to get it to a certain temperature. Is that about right?”

Martha: “Um. Yeah. Well, you’ll see. It’s… It’ll won’t be pink inside. It’ll get …

Meredith: “It will have to be white inside.”

Martha: “Yeah, all the way.”

And then on to how beautiful they are. Martha went on from touching raw chicken to touching the bun she served Matt’s finished burger on. He turned away from the camera both times he “took a bite” and claimed they were very good. Who knows if he really ate the potentially killer chicken burger. I wouldn’t have.

If you cook chicken burger, use a tip-sensitive digital thermometer to make sure they reach an internal temperature of 165F. Wash your hands between touching raw meat and anything that is going to be served, especially if the person you are feeding is famous.

Many thanks to the barfblog fan who signaled Katie about yesterday’s Today Show.

Doug reminded me, as I got ready for the extremely complicated process of slicing the dough to put on a cookie sheet, that I needed to treat the product as though it were contaminated. I said, “But this isn’t the recalled dough.” To which Doug responded, “Just because it wasn’t recalled doesn’t mean that it isn’t contaminated.” True that. So we were careful not to cross-contaminate. We put the tube on a cutting board. I used a pair of scissors to open it up and immediately put them in the dishwasher. I sliced up the dough, put it on the cookie sheet, washed my hands thoroughly, and Doug took care of the actual baking.

The cookies were not nearly as delicious as the ones Katie and I used to make during her 5 month stay in Manhattan, and I’m sure they contained some dairy, but we ate all of the cookies anyway.

This week Tom sent us a book advertisement from Amazon.com, “Cooking with Pooh: Yummy Yummy Cookie Cutter Treats.” If you’re potentially cooking with poo, be careful not to cross-contaminate and do not eat uncooked dough.

As recounted by Prevuze:

Lucas opens his mouth (something he's very experienced at) and prepares to snack on the delectable poison egg. Kate walks into the kitchen and sees him about to commit eggicide. As predicted by thousands of viewers, Kate dives across the room and slaps the egg away from him. The egg goes one way, the tray goes another and the people in the room dive for cover to avoid the shower of garbage. Lucas has a total conniption, but Kate doesn't back off. She stomps on the offending egg and grinds it under her shoe. Daniel and Chloe walk in, all properly zipped up.

Lucas explodes, "WHAT DID YOU DO THAT FOR, HUH? WHAT? WAS IT POISONED OR SOMETHING?"

Finally Kate comes up with an excuse:

"I poisoned the eggs. I did it without thinking. I put mayonnaise in them and they sat under the hot TV lights."
Lucas echoes what all of us are thinking, "This is lame, Mom."

Lame for sure. As Doug has explained, the danger of leaving deviled eggs out in the heat is not from the mayonnaise which, if bought from the supermarket, should have pasteurized ingredients. If you’re making mayonnaise from scratch, however, it does contain raw egg. Whether it’s temperature abused or not, raw egg can contain Salmonella. Somehow I doubt that Kate or Aunt Maggie make their own homemade mayo.
 

“That's the ultimate check-out horror story. I usually put meat items in plastic bags to be on the safe side. I bag fresh produce for the same reason. I also leave the meat items till last to minimize contact with my other groceries (which doesn't help the person behind me, but I can't cover for everyone). On the downside, I'm not doing the environment any good with all those plastic bags.”

Putting my story out there and realizing how ashamed I was to not be more aggressive with the checkers to protect my food has caused me to become far more proactive. Now two months later, we once again headed to Dillons on Saturday morning. This time I carefully organized items on the conveyor belt with produce first and meat last. I still do not know what was on the belt before I got there, but at least it was not visibly wet. When the bagger asked, “Plastic OK?” I said, “No, we have our own bags, but I want all of the meat put in plastic.” I did not notice until we got home, however, that the bagger did not classify salmon as meat. She did put the chicken and beef in their own plastic bags and kept them separate from the cloth bags. After unloading everything onto the belt, I asked the checker if I could have one of her sanitary wipes for my hands. She said sure but looked at me a little weird. She didn’t use one, but I have seen checkers religiously use them in the same store.

I am still adapting to reusable cloth bags and will likely continue to adjust my habits (That's me, left, not exactly as shown). I still do not put produce in separate plastic bags, but I keep a supply inside one of the cloth bags to cut down on waste. I either dispose of or recycle the ones that have been used for meat and fish so they do not get reused later on produce. More importantly, I’m learning to politely but quickly direct the checker and bagger about how I want my food handled. It’s not fail-safe, but in a short order of time I have learned that it is my responsibility to protect my family, and especially my baby, from pathogens whenever possible.
 

I eventually decided that cutting dairy for a couple of days would not kill me, and Sorenne did seem to get a little better. But Doug and I were really not sure if it was the dairy or any number of other variables in our daily life that could be affecting her. I had changed detergents and soaps and made sure she wore only 100% cotton material in the meantime.

The first two weeks of avoiding dairy were very difficult. Giving up cheesecake was almost painful, but I eventually found substitutes and cheated a little here and there when necessary. Sorenne had flare ups that I attributed to a dairy allergy, but we really have no way of knowing for sure. Sorenne doesn’t complain – neither does Doug – and I brought this challenge entirely on myself. After I discovered tofutti cream cheese and (yes it’s gross) veggie cheddar, quitting milk no longer seemed like such a big deal. I noticed I’m generally less gassy (pleasant for everyone around me) and Sorenne vomits significantly less.

For the past week Sorenne’s skin has been almost entirely clear. Today, while contemplating the dairy-free brownies I was about to make, I realized that living dairy free is a challenge I enjoy. I still salivate thinking about Roquefort, but I lived without most of my favorite cheese throughout my pregnancy due to the risk of listeria. (At least now I can eat pâté without much worry.) Finding substitutes has been somewhat enjoyable with some pleasant side effects. For those who cannot enjoy dairy due to serious allergies or lactose intolerance, the diet may feel more like a burden. Worse yet, it’s scary to not know if an allergen has contaminated your food when you’ve been careful to protect yourself or your child. I’m fortunate to have a choice and a knowledgeable partner tolerant of my neurotic parenting.
 

I have virtually no athletic capabilities, but during my elementary school days I was quite the track star. OK, maybe not a star, but I was good enough to make the track and field team.  I remember winning a few races, but usually a day at the track resulted in an embarrassing sunburn. Students at Arden Elementary school in British Columbia weren’t so lucky, with more than one hundred students sent home from the track meet with Norwalk-like virus, reports Comox Valley Echo.

Dr. Jordan Tinney, superintendent of the school said the health department was contacted and the symptoms are consistent with Norwalk. The virus affected no other schools at the track meet.

Dr. Charmine Enns, Comox Valley medical health officer, said,

 "Norwalk or Norovirus is ubiquitous. It's in all of our communities. It's easily transmitted because people have very little warning that they're going to get sick."

Enns stressed that gastro-intestinal illnesses of any type could be thwarted with good hygiene, especially hand washing.

While lab diagnosis had not been sought out, Enns said she was confident the students had been struck with Norwalk.

She explained,

"Typically if it walks like a duck and quacks like a duck then it probably is a duck. And it's quacking and walking like Norovirus."

Arden Elementary has been thoroughly sanitized and nearly all students have returned to classes.



 

Checkout on Saturdays is always busy, and with a baby, a shopper’s plus card, a payment method, eco-friendly shopping bags, and chatter with the cashiers and baggers, there are plenty of distractions. On this particular day, the new store manager was bagging our items and complementing Doug on his culinary ability: “I can see you must be a good cook because those items require skill.” I chimed in with full-hearted agreement. Doug’s an awesome cook.

In the meantime, as the hamburger was being passed over the scale and scanner, juice poured out all over the place. I watched the cashier and was about to say something, but she pulled out a sanitary wipe and cleaned her hands. She then proceeded to pass every one of our produce items over the scale and through the hamburger juice. I felt like I should say something but wanted Doug to be the bad ass. And as I stood there stunned, not wanting the store manager to fire the woman, she completed our transaction and was on to the next person.

As soon as we exited the store, I declared we would have to wash every piece of produce in the bags. It didn’t even occur to me until later that the following person’s items were also going to pass over that potentially E.coli-laden scale. And maybe the same thing had already happened five times before we arrived. Maybe we were already at risk before our hamburger leaked all over.

It’s important to wash fresh fruits and vegetables to remove external contamination, because you never know where it’s been. Once your produce is exposed, it can contaminate other items in your bag or at home. Even if you are a careful consumer, it’s difficult to know just where that tomato has been.

(P.S. Doug cooked the burgers to a perfect 160F and they were delicious.)

 

Eat fresh. Use soap.

Botulinum is a deadly toxin that comes from bacteria in soil and grows in warm, moist environments with no oxygen and low acidity. For example, it can grow on a baked potato wrapped in foil and left out on the counter. There have also been cases of poisoning in carrot juice, home-canned green beans, and enchiladas in France.

Botulism can cause serious complications such as paralysis and death.

Common symptoms include difficulty swallowing or speaking, facial weakness, double vision, trouble breathing, nausea, vomiting, abdominal pain and paralysis.

In infants, symptoms include constipation followed by "poor feeding, lethargy, weakness, pooled oral secretions, and wail or altered cry. Loss of head control is striking."

If having botulism is better than being married to Chloe, then Lucas better hope Victor, Kate, Sammy or even Daniel will ruin that wedding (you can vote online at nbc.com).

And p.s., Victor Kiriakis is played by John Aniston, the father of Jennifer Aniston IRL.



 

Ratatouille is a relatively safe dish from a food safety perspective. It’s a combination of vegetables like eggplant, zucchini, green bell peppers, tomatoes, garlic, onions and the like, simmered or roasted together until the flavors meld into a gorgeous Mediterranean flavor. Any unsavory microorganisms should be amply cooked out by the time it is ready to serve.
 

Breastfeeding has been tricky on numerous levels. Fortunately, storing breast milk is one of the few areas where I’ve found really conflicting advice. The most helpful book I purchased, The Nursing Mother’s Companion by Kathleen Huggins, only briefly covers milk storage stating in a chart that the limit is 72 hours in the refrigerator (p. 189). She contradicts herself elsewhere saying, “You can keep your milk for 24 to 48 hours in the refrigerator or for up to three months in the freezer” (p. 104).

Huggins explains that fresh refrigerated milk is somewhat better than frozen because it retains more antibodies, but if you do freeze milk, it should be labeled with the date. Furthermore, “Milk cannot be refrozen or refrigerated after it has been thawed or warmed; whatever is left over after the feeding must be thrown out” (p. 104).

Huggins and multiple other sources discourage reheating milk in the microwave. While Huggins doesn’t explain, the U.S. Food and Drug Administration states that microwaves heat unevenly and may create dangerous hot spots that may burn the baby. In addition, Laura Jana and Jennifer Shu in Heading Home with Your Newborn say that the microwave destroys the protective antibodies found in breastmilk (p. 50).

In a section entitled “Focusing on Food Safety” Jana and Shu also encourage thorough handwashing and drying before preparing formula.

“Do not use prepared formula if it has been left unrefrigerated for more than 2 hours. Once you have fed your baby from a bottle, do not refrigerate the bottle in hopes of using it again later; bacteria from your baby’s mouth can multiply, even in the refrigerator. Be sure to discard any formula remaining in the bottle after 1 hour from the start of your baby’s feeding.” (p. 45)

I am unsure what the authors advise for breastmilk.

On the Lansinoh brand Breastmilk Storage Bags there is a chart indicating “How Long To Store Breastmilk”:

Where                                                                    Temperature                  Time

At Room Temperature                                            66-72 F (19-22 C)         10 hours
In a Refrigerator                                                     32-39 F (0-4 C)              8 days
In a Freezer Compartment inside a Refrigerator   Temperature varies        2 weeks
In a Freezer Compartment with a Separate Door  Temperature varies        3-4 Months
In a Separate Deep Freeze                                    0 F (-19 C)                     6 Months or longer

FDA’s advice comes from “Breastfeeding Made Easier at Home and Work” at womenshealth.gov and is almost identical. womenshealth.gov, however, gives a detailed breakdown of milk storage times at room temperature:

    * At 60 degrees F for 24 hours
    * At 66-72 degrees F for 10 hours
    * At 79 degrees F for 4-6 hours
    * At 86-100 degrees F for 4 hours

FDA also advises to make sure hands are clean and dry before handling milk, to store milk away from the door in the freezer “to avoid changes in temperature that may compromise the milk” and when you need to take the milk with you, “pack it in a cooler filled with ice. Do not leave the milk in a cooler for more than 24 hours.”

Here’s to many more healthy milestones for Sorenne.

 

When we were meeting with the lactation consultant in the hospital (Melanie – you are fabulous, by the way), we asked her if foodborne illness could be passed on to the baby. She said no. She said not to worry about viruses such as flu or colds and that the baby cannot get Listeria or Salmonella from anything I eat.

Once home from the hospital, I immediately went for the pâté, brie, goat cheese (thank you Graduate Students!), and smoked salmon. Who knew that motherhood could be so delicious?
 

But what’s the protocol for handling other people’s puke? When I told Doug what happened he reminded me that if the student was sick with a virus like Noro, the germs could be aerosolized and make the rest of us ill. This particular student believed it was a problem with medicine, but to be safe … Washoe County Nevada Health Department suggests:

•    Staff should wear disposable gloves and aprons when cleaning up after ill guests, especially when handling vomit, diarrhea, or other bodily wastes. It is recommended that persons who clean areas substantially contaminated by feces and/or vomitus wear masks because spattering or aerosols of infectious material might result in disease transmission. Use of cleaning cloths and other items used to clean toilets should only be used for that purpose and should not be used from room to room. Do not use these items to clean other surfaces. Effective virucides should be used in bathrooms and high hand-contact areas in guest rooms such as taps, faucets, door and drawer handles, door latches, toilet or bath rails, telephones, rails on balconies, light and lamp switches, thermostats, remote controls, curtain pulls and wands, covers on guest information books, alarm clock buttons, hair dryers, irons, and pens.
•    Staff should promptly bag and clean soiled linens or dispose of them as infectious waste. Linens soiled with vomit or feces should be washed in a hot wash and dried at high temperature (drier temperature >170º F).
•    When responding to a Public Vomiting Incident (PVI), the area within at least a 25-foot radius should be cleaned and disinfected using the above procedures.
•    Staff should wash hands thoroughly using soap and water and then dry them thoroughly after completing the clean-up procedure and again after completing the disposal procedure.

A teacher named “Koko” blogged that when this happened in her classroom in China, she used dirt to cover the vomit, made sure it was dry, then swept, threw out the waste, and mopped afterwards. She made her students participate in the cleaning.

 

In addition to pet food which may contain pathogens, I pay close attention to the handling of dog treats which have been found problematic in the past. Our dogs have been getting their fill of bones lately because we haven’t had the usual time and energy to devote to their exercise. I try to avoid touching the dog bones when I take them out of the package and I wash the scissors I use to cut the packages open. I always wash my hands afterwards.

It really isn’t easy to think about washing hands every time you feed and pet the dogs, but the following are things I am trying to do to keep me and my future baby safe:

• regularly wash the dog dishes
• wash my hands every time I fill the dog water and food bowls (the dogs eat and drink, spreading any microbes from one bowl to the next)
• wash my hands after opening treats and/or giving them to the dogs
• wash the scissors after opening treat bags
• wash my hands after playing with the pets
• avoid letting the dogs lick my face of hands
• wipe down the counter where pet treats have touched

These steps are all much more difficult for me than they sound. I’m usually very playful and affectionate with my pets, even though I no longer allow the dogs on the bed or couch. It’s also very difficult to think about handwashing when you are out on a walk with the dogs and give them treats as part of a training process. In those cases I just remind myself not to touch my face or use a wet wipe when I have one handy.

I am still learning after years of taking it for granted that my dogs’ food was safe. Food safety, even for pets, is not simple.

For human symptoms of salmonella poisoning, check out http://barfblog.foodsafety.ksu.edu/2008/06/articles/salmonella/salmonella-symptoms/

According to an article in the North Country Gazette (April 3, 2007) related to a past pet food recall:

Pets with salmonella infections may be lethargic and have diarrhea or bloody diarrhea, fever, and vomiting. Some pets will have only decreased appetite, fever and abdominal pain. Apparently well animals can be a carrier and infect other animals or humans. If your pet has consumed the recalled product and has these symptoms, please contact your veterinarian.
 

• Symptoms occur on average between 6 and 36 hours (and not more than 15 days) after consumption of the contaminated food
• Botulism can cause serious complications such as paralysis and death
• Common symptoms include difficulty swallowing or speaking, facial weakness, double vision, trouble breathing, nausea, vomiting, abdominal pain and paralysis 
• Botulism commonly grows at room temperature in an anaerobic environment – that means when food is deprived of air. Risky foods include potatoes left in aluminum foil at room temperature
• In 2006, 7 people were stricken due to botulism in bottled carrot juice
• Botulism cannot be transmitted between humans

Check out the FDA’s Bad Bug Book for more detailed botulism information.