Foodborne Illnesses A foodborne illness is a disease

Foodborne Illnesses A foodborne illness is a disease

Foodborne Illnesses A foodborne illness is a disease transmitted to people through food. An illness is considered an outbreak when: 1-2 Two or more people have the same symptoms after eating the same food An investigation is conducted by state and local regulatory authorities The outbreak is confirmed by laboratory analysis Challenges to Food Safety Challenges include:

1-3 Time Language and culture Literacy and education Pathogens Unapproved suppliers

High-risk customers Staff turnover The Costs of Foodborne Illnesses Costs of a foodborne illness to an operation: Loss of customers and sales Negative media exposure 1-4 Loss of reputation Lowered staff morale The Costs of Foodborne Illnesses Costs of a foodborne illness to an operation:

1-5 Lawsuits and legal fees Staff missing work Increased insurance premiums Staff retraining How Foodborne Illnesses Occur Unsafe food is the result of contamination: 1-6 Biological Chemical

Physical Contaminants Biological contaminants: 1-7 Bacteria Viruses Parasites

Fungi Contaminants Chemical contaminants: 1-8 Cleaners Sanitizers Polishes Contaminants Physical hazards:

1-9 Metal shavings Staples Bandages Glass Dirt

Natural objects (e.g., fish bones in a fillet) How Food Becomes Unsafe Five risk factors for foodborne illness: 1. Purchasing food from unsafe sources 2. Failing to cook food correctly 3. Holding food at incorrect temperatures 4. Using contaminated equipment 5. Practicing poor personal hygiene 1-10 How Food Becomes Unsafe 1-11 Time-temperature abuse Cross-contamination Poor personal hygiene

Poor cleaning and sanitizing How Food Becomes Unsafe Time-temperature abuse: 1-12 When food has stayed too long at temperatures good for pathogen growth How Food Becomes Unsafe Food has been time-temperature abused when: 1-13 It has not been held or stored at correct temperatures

It is not cooked or reheated enough to kill pathogens It is not cooled correctly Pg 1.5 SSF 6e Pg 1.5 SSF 6e Pg 1.5 SSF 6e How Food Becomes Unsafe Cross-contamination: When pathogens are transferred from one surface or food to another Pg 1.5 SSF 6e 1-14 How Food Becomes Unsafe

Cross-contamination can cause a foodborne illness when: 1-15 Contaminated ingredients are added to food that receives no further cooking Ready-to-eat food touches contaminated surfaces Contaminated food touches or drips fluids onto cooked or ready-to-eat food A food handler touches contaminated

food and then touches ready-to-eat food Contaminated wiping cloths touch food-contact surfaces Pg 1.5 SSF 6e How Food Becomes Unsafe Poor personal hygiene can cause a foodborne illness when food handlers: 1-16 Fail to wash their hands correctly after using the restroom Cough or sneeze on food

Touch or scratch wounds and then touch food Work while sick Pg 1.5 SSF 6e How Food Becomes Unsafe Poor cleaning and sanitizing: 1-17 Equipment and utensils are not washed, rinsed, and sanitized between uses

Food-contact surfaces are wiped clean instead of being washed, rinsed, and sanitized Wiping cloths are not stored in a sanitizer solution between uses Sanitizer solutions are not at the required levels to sanitize objects Pg 1.5 SSF 6e Food Most Likely to Become Unsafe TCS food: 1-18 Food Most Likely to Become Unsafe TCS food:

1-19 Ready-to-Eat Food Ready-to-eat food is food that can be eaten without further: Preparation Washing Cooking Ready-to-eat food includes: 1-20 Cooked food

Washed fruit and vegetables (whole and cut) Deli meat Bakery items Sugar, spices, and seasonings Populations at High Risk for Foodborne Illnesses These people have a higher risk of getting a foodborne illness: 1-21

Preschool-age children Elderly people People with compromised immune systems Keeping Food Safe Focus on these measures: Purchasing from approved, reputable suppliers Controlling time and temperature

Preventing cross-contamination Practicing personal hygiene Cleaning and sanitizing 1-22 Biological Contamination Microorganism: Small, living organism that can be seen only with a microscope Pathogen: Harmful microorganism

Makes people sick when eaten or produces toxins that cause illness Toxin: 2-2 Poison Biological Contamination Four types of pathogens can contaminate food and cause foodborne illness: Bacteria 2-3 Viruses Parasites

Fungi How Contamination Happens People can contaminate food when: 2-4 They dont wash their hands after using the restroom They are in contact with a person who is sick They allow ready-to-eat food to touch surfaces that have come in contact with raw meat, seafood, and poultry

They sneeze or vomit onto food or foodcontact surfaces They touch dirty food-contact surfaces and equipment and then touch food They store food incorrectly Symptoms of a Foodborne Illness Common symptoms of foodborne illness: Diarrhea Vomiting

Fever Nausea Abdominal cramps Jaundice (yellowing of skin and eyes) Onset times: 2-5

Depend on the type of foodborne illness Can range from 30 minutes to six weeks The Big Six These pathogens are highly infectious and can cause severe illness: Salmonella Typhi Shigella spp. Nontyphoidal Salmonella (NTS)

Shiga toxin-producing Escherichia coli (STEC), also knows as E.coli Hepatitis A Norovirus The Big Six: 2-6 Are often found in very high numbers in an infected persons feces Can be transferred to food easily

Can make a person sick in small doses General Information about Bacteria Detection: Cannot be seen, smelled, or tasted Growth: Will grow rapidly if conditions are correct Some can change into spores to keep from dying when they dont have enough food Some make toxins in food as they grow and die

Prevention: 2-7 Control time and temperature What Bacteria Need to Grow F T Food Acidity Temperature T O

M Time 2-8 A Oxygen Moisture What Bacteria Need to Grow Food: Most bacteria need nutrients to survive TCS food supports the growth of bacteria better than other types of food o

This includes meat, poultry, dairy products, and eggs F Food 2-9 What Bacteria Need to Grow Acidity: Bacteria grow best in food that contains little or no acid A Acidity 2-10 What Bacteria Need to Grow

Temperature: 2-11 Bacteria grow rapidly between 41F and 135F (5C and 57C) o This range is known as the temperature danger zone o Bacteria grow even more rapidly from 70F to 125F (21C to 52C) Bacteria growth is limited when food is held above or below the temperature danger zone

T Temperature What Bacteria Need to Grow Time: Bacteria need time to grow The more time bacteria spend in the temperature danger zone, the more opportunity they have to grow to unsafe levels T Time 2-12 What Bacteria Need to Grow

Oxygen: Some bacteria need oxygen to grow, while others grow when oxygen isnt there O Oxygen 2-13 What Bacteria Need to Grow Moisture: 2-14 Bacteria grow well in food with high levels of moisture

aw = water activity; the amount of moisture available in food for bacterial growth aw scale ranges from 0.0 to 1.0 Water has a water activity of 1.0 M Moisture What Bacteria Need to Grow The conditions you can control: Temperature o

Time o 2-15 Keep TCS food out of the temperature danger zone Limit how long TCS food spends in the temperature danger zone Major Foodborne Bacteria Bacteria: Bacillus cereus Listeria monocytogenes

Shiga toxin-producing E. coli Campylobacter jejuni Clostridium perfringens Clostridium botulinum Nontyphoidal Salmonella Shigella spp. Staphylococcus aureus Vibrio vulnificus

2-16 Major Foodborne Bacteria Controlling time and temperature can keep these bacteria from causing a foodborne illness: 2-17 Bacillus cereus Listeria monocytogenes Shiga toxin-producing E. coli Campylobacter jejuni

Clostridium perfringens Clostridium botulinum Bacillus cereus Bacteria: Bacillus cereus (Diarrhea Illness) Illness: Commonly Linked Food Most Common Symptoms Cooked vegetables Watery diarrhea Meat products

No vomiting Milk 2-18 Bacillus cereus gastroenteritis Bacillus cereus Bacteria: Bacillus cereus (Vomiting Illness) Illness: Commonly Linked Food Cooked rice dishes including: 2-19 Fried rice

Rice pudding Bacillus cereus gastroenteritis Most Common Symptoms Nausea Vomiting Bacillus cereus Most important prevention measure: Control time and temperature Other prevention measures: 2-20 Cook food to minimum internal temperatures

Hold food at the correct temperatures Cool food correctly Listeria monocytogenes Bacteria: Listeria monocytogenes Illness: Listeriosis Commonly Linked Food Raw meat Ready-to-eat food such as: Deli-meat Hot dogs Soft cheese

Unpasteurized dairy products 2-21 Most Common Symptoms Pregnant women: Miscarriage Newborns: Sepsis Pneumonia Meningitis Listeria monocytogenes Most important prevention measure: Control time and temperature Other prevention measures: 2-22

Throw out any product that has passed its use-by or expiration date Cook raw meat to minimum internal temperatures Prevent cross-contamination between raw or undercooked food and readyto-eat food Avoid using unpasteurized dairy products Shiga toxin-producing E. coli Bacteria: Shiga toxin-producing Escherichia coli, also known as E. coli, including: O157:H7, O26:H11, O111:H8, and O158:NM Illness: Hemorrhagic colitis Commonly Linked Food

Most Common Symptoms Ground beef (raw and undercooked) Diarrhea (becomes bloody) Contaminated produce Abdominal cramps Kidney failure (in severe cases) 2-23 Shiga toxin-producing E. coli Most important prevention measure: Control time and temperature Other prevention measures:

2-24 Cook food, especially ground beef, to minimum internal temperatures Purchase produce from approved, reputable suppliers Prevent cross-contamination between raw meat and ready-to-eat food Keep staff with diarrhea who have been diagnosed with hemorrhagic colitis out of the operation Campylobacter jejuni Bacteria: Campylobacter jejuni Illness: Campylobacteriosis Commonly Linked Food Most Common Symptoms Poultry Diarrhea (May be watery or bloody)

Water contaminated with the bacteria Abdominal cramps Meat Fever Stews/gravies 2-25 Vomiting Headaches Campylobacter jejuni Most important prevention measure: Control time and temperature Other prevention measures:

2-26 Cook food, particularly poultry, to required minimum internal temperatures Prevent cross-contamination between raw poultry and ready-to-eat food Clostridium perfringens Bacteria: Clostridium perfringens Illness: Clostridium perfringens gastroenteritis Commonly Linked Food Most Common Symptoms Meat Diarrhea

Poultry Severe abdominal pain Dishes made with meat and poultry, such as stews and gravies 2-27 Clostridium perfringens Most important prevention measure: Control time and temperature Other prevention measures: 2-28 Cool and reheat food correctly

Hold food at the correct temperatures Clostridium botulinum Bacteria: Illness: Botulism Commonly Linked Food Most Common Symptoms Incorrectly canned food Initially: Nausea and vomiting Reduced-oxygen packaged (ROP) food Temperature-abused vegetables,

such as baked potatoes Untreated garlic-and-oil mixtures 2-29 Clostridium botulinum Later: Weakness Double vision Difficulty speaking and swallowing Clostridium botulinum Most important prevention measure: Control time and temperature Other prevention measures: 2-30

Hold, cool, and reheat food correctly Inspect canned food for damage Major Foodborne Bacteria Preventing cross-contamination can keep these bacteria from causing a foodborne illness: 2-31 Nontyphoidal Salmonella Salmonella Typhi Nontyphoidal Salmonella Bacteria:

Nontyphoidal Salmonella Illness: Commonly Linked Food Most Common Symptoms Poultry and eggs Diarrhea Dairy products Abdominal cramps Produce Vomiting Fever 2-32

Salmonellosis Nontyphoidal Salmonella Most important prevention measure: Prevent cross-contamination Other prevention measures: 2-33 Cook poultry and eggs to minimum internal temperatures Prevent cross-contamination between poultry and ready-to-eat food

Keep food handlers who are vomiting or have diarrhea and have been diagnosed with salmonellosis out of the operation Salmonella Typhi Bacteria: Salmonella Typhi Illness: Typhoid Fever Commonly Linked Food Most Common Symptoms Ready-to-eat food High fever Beverages Weakness Abdominal pain Headache Loss of appetite Rash

2-34 Salmonella Typhi Most important prevention measure: Prevent cross-contamination Other prevention measures: 2-35 Exclude food handlers who have been diagnosed with an illness caused by Salmonella Typhi from the operation Wash hands

Cook food to minimum internal temperatures Major Foodborne Bacteria Practicing personal hygiene can keep these bacteria from causing a foodborne illness: 2-36 Shigella spp. Staphylococcus aureus Shigella spp. Bacteria: Illness: Commonly Linked Food Shigella spp.

Shigellosis Most Common Symptoms Food easily contaminated by hands, including: Salads containing TCS food (potato, tuna, shrimp, macaroni, chicken) Bloody diarrhea Food in contact with contaminated water, such as produce Abdominal pain and cramps Fever (occasionally) 2-37 Shigella spp. Most important prevention measure:

Practice personal hygiene Other prevention measures: 2-38 Exclude food handlers who have diarrhea and have been diagnosed with an illness caused by Shigella spp. from the operation Wash hands Control flies inside and outside the operation Staphylococcus aureus Bacteria: Staphylococcus aureus Illness: Staphylococcal gastroenteritis

Commonly Linked Food Food requiring handling during prepping, including: Salads containing TCS food (egg, tuna, chicken, macaroni) Deli meat Most Common Symptoms Nausea Vomiting and retching Abdominal cramps 2-39 Staphylococcus aureus Most important prevention measure: Practice personal hygiene

Other prevention measures: 2-40 Wash hands, particularly after touching the hair, face, or body Cover wounds on hands and arms Hold, cool, and reheat food correctly Major Foodborne Bacteria Purchasing food from approved, reputable suppliers can keep these bacteria from causing a foodborne illness: 2-41

Vibrio vulnificus Vibrio parahaemolyticus Vibrio vulnificus & Vibrio parahaemolyticus Bacteria: Vibrio vulnificus Illness: Vibrio gastroenteritis Vibrio vulnificus primary septicimia Commonly Linked Food Most Common Symptoms Oysters from contaminated water Diarrhea Abdominal cramps and nausea Vomiting Low-grade fever and chills

2-42 Vibrio vulnificus & Vibrio parahaemolyticus Most important prevention measure: Purchase from approved, reputable suppliers Other prevention measures: 2-43 Cook oysters to minimum internal temperatures General Information About Viruses Location: Carried by human beings and animals o Require a living host to grow

o Do not grow in food o Can be transferred through food and remain infectious in food Sources: 2-44 Food, water, or any contaminated surface Typically occur through fecal-oral routes General Information About Viruses

Transfer: 2-45 Viruses can be transferred from o Person to person o People to food o People to food-contact surfaces People o

Carry viruses in their feces o Can transfer them to their hands after using the restroom General Information About Viruses Prevention: 2-46 Not destroyed by normal cooking temperatures Good personal hygiene must be practiced when handling food and food-contact surfaces

Quick removal and cleanup of vomit is important Major Foodborne Viruses Practicing personal hygiene can keep these viruses from causing a foodborne illness: 2-47 Hepatitis A Norovirus Hepatitis A Virus: Hepatitis A Illness: Hepatitis A

Commonly Linked Food Most Common Symptoms Ready-to-eat food Fever (mild) Shellfish from contaminated General Weakness water Nausea Abdominal pain Jaundice (appears later) 2-48 Hepatitis A Most important prevention measure: Practicing personal hygiene Other prevention measures:

2-49 Exclude staff who have been diagnosed with hepatitis A from the operation Exclude staff who have jaundice from the operation Wash hands Avoid bare-hand contact with ready-to-eat food Purchase shellfish from approved, reputable suppliers

Norovirus Virus: Norovirus Illness: Norovirus gastroenteritis Commonly Linked Food Most Common Symptoms Ready-to-eat food Vomiting Shellfish from contaminated Diarrhea water Nausea Abdominal cramps 2-50 Norovirus Most important prevention measure:

Practicing personal hygiene Other prevention measures: 2-51 Exclude staff who are vomiting or have diarrhea and have been diagnosed with Norovirus from the operation Wash hands Avoid bare-hand contact with ready-to-eat food

Purchase shellfish from approved, reputable suppliers Characteristics of Parasites Location: Require a host to live and reproduce Source: 2-52 Seafood, wild game, and food processed with contaminated water, such as produce Characteristics of Parasites Prevention: 2-53

Purchase food from approved, reputable suppliers Cook food to required minimum internal temperatures Fish that will be served raw or undercooked must be frozen correctly by the manufacturer Major Foodborne Parasites Purchasing from approved, reputable suppliers can keep these parasites from causing a foodborne illness: 2-54

Anisakis simplex Cryptosporidium parvum Giardia duodenalis Cyclospora cayetanensis Anisakis simplex Parasite: Anisakis simplex Illness: Anisakiasis Commonly Linked Food Most Common Symptoms Raw and undercooked fish,

including: Herring Cod 2-55 Pacific salmon Halibut Mackerel Tingling in throat Coughing up worms Anisakis simplex Most important prevention measure:

Purchase from approved, reputable suppliers Other prevention measures: 2-56 Cook fish to minimum internal temperatures If serving raw or undercooked fish, purchase sushi-grade fish that has been frozen to the correct time-temperature requirements Cryptosporidium parvum Parasite: Cryptosporidium parvum Illness: Cryptosporidiosis

Commonly Linked Food Most Common Symptoms Contaminated water Watery diarrhea Produce Abdominal cramps Nausea Weight loss 2-57 Cryptosporidium parvum Most important prevention measure: Purchase from approved, reputable suppliers

Other prevention measures: 2-58 Use correctly treated water Keep food handlers with diarrhea out of the operation Wash hands Giardia duodenalis Parasite: Giardia duodenalis lamblia or G. Intestinalis) Illness: Giardiasis Commonly Linked Food Most Common Symptoms

Incorrectly treated water Initially Produce Fever Later Diarrhea Abdominal cramps Nausea 2-59 (G. Giardia duodenalis Most important prevention measure: Purchase from approved, reputable suppliers

Other prevention measures: 2-60 Use correctly treated water Keep food handlers with diarrhea out of the operation Wash hands Cyclospora cayetanensis Parasite: Cyclospora cayetanensis Illness: Cyclosporiasis Commonly Linked Food Most Common Symptoms

Incorrectly treated water Nausea Produce such as berries, lettuce, or basil Abdominal cramps Mild fever Diarrhea alternating with constipation Loss of weight Loss of appetite 2-61 Cyclospora cayetanensis Most important prevention measure: Purchase from approved, reputable suppliers

Other prevention measures: 2-62 Purchase produce from approved, reputable suppliers Keep food handlers with diarrhea out of the operation Wash hands Fungi Fungi: Commonly cause food spoilage and sometimes illness Fungi

Molds 2-63 Yeasts Mold Basic characteristics of mold: Spoil food and sometimes cause illness Some produce toxins Grow well in almost any condition, especially in acidic food with low water activity

Are only slowed not destroyed by cooler or freezer temperatures Prevention: 2-64 Throw out all moldy food unless the mold is a natural part of the food Yeast Basic characteristics of yeast: Can spoil food quickly May produce a smell or taste of alcohol as it spoils food

May look like a white or pink discoloration or slime and may bubble Grow well in acidic food with little moisture Prevention: 2-65 Food containing yeast should be thrown out Biological Toxins Origin: Naturally occur in certain plants, mushrooms,

and seafood Seafood toxins: 2-66 Produced by pathogens found on certain fish Occur in certain fish that eat smaller fish that have consumed the toxin Major Fish Toxins Purchasing from approved, reputable suppliers can keep these fish toxins from causing a foodborne illness: 2-67

Histamine Ciguatoxin Histamine Toxin: Histamine Illness: Scombroid poisoning Commonly Linked Food Most Common Symptoms Tuna Initially

Bonito Reddening of the face and neck Mackerel Mahimahi Sweating Headache Burning or tingling sensation in the mouth or throat Possibly later Diarrhea 2-68 Vomiting Histamine Most important prevention measure: Purchase from approved, reputable suppliers

Other prevention measures: 2-69 Prevent time-temperature abuse during storage and preparation Ciguatoxin Toxin: Ciguatoxin Illness: Ciguatera fish poisoning Commonly Linked Food Most Common Symptoms Predatory tropical reef fish from Pacific Ocean, Western Indian

Ocean, and Caribbean Sea: Reversal of hot and cold sensations Barracuda Grouper Nausea Jacks Snapper

Vomiting Tingling in fingers, lips, or toes Joint and muscle pain 2-70 Ciguatoxin Most important prevention measure: 2-71 Purchase predatory tropical reef fish from approved, reputable suppliers Major Shellfish Toxins Purchasing from approved, reputable suppliers can keep these shellfish toxins from causing a foodborne illness: 2-72

Saxitoxin Brevetoxin Domoic acid Saxitoxin Toxin: Saxitoxin Illness: Paralytic shellfish poisoning (PSP) Commonly Linked Food Most Common Symptoms Shellfish found in colder waters

such as those of the Pacific and New England coasts: Numbness Clams Mussels Tingling in mouth, face, arms, and legs Oysters Scallops

Dizziness Nausea Vomiting Diarrhea 2-73 Saxitoxin Most important prevention measure: 2-74 Purchase shellfish from approved, reputable suppliers Brevetoxin Toxin: Brevetoxin Illness:

Neurotoxic shellfish poisoning (NSP) Commonly Linked Food Most Common Symptoms Shellfish in warmer waters of west coast of Florida, Gulf of Mexico, and Caribbean Sea: Tingling and numbness of the lips, tongue, and throat Clams Dizziness Mussels Reversal of hot and cold

sensations Oysters Vomiting Diarrhea 2-75 Brevetoxin Most important prevention measure: 2-76 Purchase shellfish from approved, reputable suppliers Domoic acid Toxin: Domoic acid

Illness: Amnesic shellfish poisoning (ASP) 2-77 Commonly Linked Food Most Common Symptoms Shellfish found in coastal waters of Pacific Northwest and east coast of Canada: Initially Vomiting Diarrhea Abdominal pain Clams

Mussels Oysters Scallops Possibly later Confusion Memory loss Disorientation Seizure Coma Domoic acid Most important prevention measure:

2-78 Purchase shellfish from approved, reputable suppliers Mushroom Toxins Foodborne illnesses linked with mushrooms: 2-79 Are caused by eating toxic wild mushrooms Occur when toxic mushrooms are mistaken for edible ones

Can be prevented by purchasing from approved, reputable suppliers Plant Toxins Foodborne illnesses linked with plant toxins: 2-80 Usually happen when plants are purchased from unapproved suppliers Can happen when certain plants arent cooked correctly (i.e., undercooked kidney beans) Can be prevented by purchasing plants

from approved, reputable suppliers Physical Contaminants Sources: 3-2 Common objects that get into food o Metal shavings from cans o Wood o Fingernails

o Staples o Bandages o Glass o Jewelry o Dirt Naturally occurring objects such as fruit pits and bones

Physical Contaminants Symptoms: Mild to fatal injuries are possible Cuts, dental damage, and choking Bleeding and pain Prevention: 3-3 Purchase food from approved, reputable suppliers

Closely inspect food received Take steps to prevent physical contamination, including practicing good personal hygiene Chemical Contaminants Sources: 3-4 Cleaners, sanitizers, polishes, machine lubricants, and pesticides Certain types of kitchenware and equipment (items made from pewter, copper, zinc, and some types of painted pottery)

Deodorizers, first-aid products, and health and beauty products (hand lotions, hairsprays, etc.) Chemical Contaminants Symptoms: Vary depending on chemical consumed Most illnesses occur within minutes Vomiting and diarrhea are typical If an illness is suspected:

3-5 Call the emergency number in your area Call the Poison Control number Consult the chemicals MSDS Chemical Contaminants Prevention: Only use chemicals approved for use in foodservice operations

Purchase chemicals from approved, reputable suppliers Store chemicals away from prep areas, food-storage areas, and service areas o 3-6 Chemicals must be separated from food and food-contact surfaces by spacing and partitioning Chemicals must NEVER be stored above food or food-contact surfaces Use chemicals for their intended use and follow manufacturers directions

Chemical Contaminants Prevention: 3-7 Only handle food with equipment and utensils approved for foodservice use Make sure the manufacturers labels on original chemical containers are readable Keep MSDS current, and make sure they are accessible to staff at all times

Follow the manufacturers directions and local regulatory requirements when throwing out chemicals The Deliberate Contamination of Food Groups who may attempt to contaminate food: Terrorists or activists Disgruntled current or former staff Vendors Competitors FDA defense tool:

3-8 A.L.E.R.T. The Deliberate Contamination of Food Assure Look Employees Reports Threat 3-9 Make sure products received are from safe sources Monitor the security of products in the facility Know who is in your facility Keep information related to food defense accessible Develop a plan for responding to suspicious activity or a threat to the operation

Food Allergens Food allergen: 3-10 A protein in a food or ingredient some people are sensitive to These proteins occur naturally When an enough of an allergen is eaten, an allergic reaction can occur Allergy Symptoms Allergy symptoms:

Nausea Wheezing or shortness of breath Hives or itchy rashes Swelling of various parts of the body, including the face, eyes, hands, or feet Vomiting and/or diarrhea Abdominal pain

Allergic reactions: 3-11 Symptoms can become serious quickly A severe reaction, called anaphylaxis, can lead to death Food Allergens The Big Eight food allergens: 3-12 Milk

Eggs Fish Crustacean shellfish, including lobster, shrimp, and crab Wheat Soy Peanuts

Tree nuts, such as almonds, walnuts, and pecans Food Allergens Know How to Read Food Labels 3-13 Check food labels for allergens Preventing Allergic Reactions Service staff: 3-14 Describe menu items to guests and identify any allergens in the item

Suggest menu items without the allergens Clearly mark the guests order for kitchen and service staff Deliver food separately to prevent cross-contact Preventing Allergic Reactions Kitchen staff: 3-15 Avoid cross-contact o

Do NOT cook different types of food in the same fryer oil o Do NOT put food on surfaces that have touched allergens Preventing Allergic Reactions Kitchen staff: 3-16 Avoid cross-contact o Check recipes and ingredient labels o Wash, rinse, and sanitize cookware, utensils, and equipment before preparing an allergen special

order o Make sure the allergen doesnt touch anything for customers with food allergies (food, beverages, utensils, etc.) o Wash your hands and change gloves before prepping food o Label food packaged on-site for retail use

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