Section
I: "The
Basics of Bugs"
OBJECTIVES
The participant will …
 Demonstrate
knowledge of the relationship between microorganisms and the safety
of food
Become familiar
with foodborne microorganisms that are of special concern to childcare
providers
Identify conditions
that enhance and inhibit the growth of microorganisms
INTRODUCTION
Chicken salad sickens 15 at Minnesota party From Argus Leader, September
13, 1996
ATLANTA (AP) - Chicken salad served at a Minnesota wedding shower
made 15 people sick because the woman who made it hadn't washed her
hands thoroughly after changing diapers, the government said Thursday.
This was the second outbreak in the United States linked to a parasite
called Cryptosporidium parvum, which is transmitted through human
and animal feces, the Center for Disease Control and Prevention said.
Health officials interviewed 26 of the 50 guests who attended the
party in September 1995. Of the 26, 15 said they had diarrhea and
stomach pain within two weeks of the shower in Mankato in South-western
Minnesota.
The hostess, who ran a day-care center in her home, said she had changed
diapers and then washed her hands before fixing the chicken salad
the day before the party. "She didn't do a good enough job of washing
her hands," said Dennis Juranek of the CDC's National Center of Infectious
Diseases.
Having a basic knowledge of microorganisms enhances the ability of
childcare providers to better understand what their role is in preventing
foodborne illness and related diseases.
Foodborne related illnesses caused by bacteria, and other microorganisms
(microbes) can be prevented through proper personal hygiene and food
safety practices.
Children are considered a high-risk group for developing foodborne
illnesses. Therefore it is critical that childcare providers have
a basic understanding of foodborne illnesses as they relate to the
childcare setting (environment).
The next step is Section II. This contains information related to
the nature of microorganisms. After reading Sections I and II, continue
on to the Action Plan Review to complete the quiz and other assignments.
Then submit for assessment.
"BUGS"
According to the National Institutes of Health (NIH) infectious diseases
can be spread through food causing a foodborne illness (FBI). FBI's
are a common, distressing, and sometimes life-threatening problem
for millions of people in the United States and around the world.
According to the USDA Fight BAC campaign as many as 9,000 deaths and
between 6.5 and 33 million illness are directly linked to foodborne
pathogens. Persons infected with foodborne pathogens may have no symptoms
or can develop symptoms ranging from mild intestinal discomfort to
severe dehydration, bloody diarrhea, and death.
Foodborne illness is also extremely costly. Researchers estimate that
the yearly cost of all foodborne diseases in this country is $5 to
$6 billion in direct medical expenses and lost productivity. Infections
with the bacteria Salmonella and Campylobacter alone account for $1
billion in direct and indirect medical costs.
Micro-organisms: general information
Microorganisms (microbes) are everywhere. However, most microbes are
not harmful to humans. Actually there are slightly more than 40 microbes
that cause foodborne related illnesses. These microbes fall into four
categories: bacteria, viruses, parasites and fungi. Each microbe can
have several to over 1000 different strains and each is very unique.
Growing conditions are a key element in determining the survival and
growth of specific microbes. Some bacteria, such as Listeria monocytogenes
grow at refrigeration temperatures.
When experiencing a foodborne illness, many people do not get sick
immediately. Some foodborne illnesses occur rather quickly and do
not last long, while others can take days or weeks to develop and
can take weeks to fully recover. 
Bacteria
How Bacteria Get in Food?
Bacteria may be present on products when you purchase them. Plastic-wrapped
boneless chicken breasts and ground meat, for example, were once part
of live chickens or cattle. Raw meat, poultry, seafood, and eggs are
not free of bacteria. Neither is fresh produce such as lettuce, tomatoes,
sprouts, and melons - just to name a few.
Foods, including safely cooked, ready-to-eat foods, can become contaminated
with bacteria from other sources such as meat juices, dirty utensils
or food handlers with poor personal hygiene. This is called cross-contamination.
How do bacteria grow?
When bacteria grow, they multiply in a log phase. This means that
the numbers continue to double. Therefore 1 becomes 2, 2 become 4,
4 become 8 and so on. Figure 1, below, depicts how one bacteria can
reach dangerous levels within a very short time. If conditions are
right, growth can be very rapid - a new generation can be formed in
20 minutes. It is important to realize that contaminated food has
a much higher level of contamination. The graphic in figure 1 depicts
one bacteria. However, in most situations the contamination level
is much higher than 1 bacteria per square centimeter, normally there
are 100's of bacteria per square inch. If growing conditions are favorable
- the results can be fatal.
What are some characteristics of bacteria?
Cooking destroys most bacteria. The exception is spore-forming bacteria.
Spore formers - some bacteria form a thick wall that protects them
from conditions that could destroy them, such as cooking. During this
time they do not reproduce, they just survive. When conditions become
favorable again, they start to reproduce.
There are three types of foodborne illnesses:
1. Foodborne infections - some bacteria make people sick from eating
the live bacteria. It can be days before developing a foodborne illness
after eating food contaminated with live bacteria. Salmonella is an
example of bacteria that causes an infection.
2. Foodborne intoxications - some bacteria produce a toxin (poison)
when reproducing. People usually get sick very quickly from this form
of foodborne illness. Staphylococcus aureus and Clostridium botulinum
cause intoxication.
3. Foodborne toxin-mediated infections - illness from eating food
containing pathogens (disease causing micro-organisms). These pathogens
produce a toxin when they grow in the intestine. This very serious,
E. coli 0157:H7 is an example of this type of foodborne illness.
Foodborne Illness can develop immediately after eating a food contaminated
with a toxin or bacteria or it may take several days to weeks before
the symptoms develop.
The following factors affect the growth of bacteria:
 Water Activity
(moisture) - high moisture foods (refer to Table 1)
Temperature -
bacteria grow well when in the TDZ (temperature danger zone) is 41
F to 140 F Nutrients - bacteria like protein and carbohydrate foods
Atmosphere -
some like oxygen (aerobic), some only grow without oxygen (anaerobic),
and many bacteria grow well with or without oxygen (facultative)
Acidity - foods
high in acid do not support the growth of most bacteria
Time - reproduce
every 20 minutes when conditions are favorable · Presence of inhibiting
substances - preservatives and additives (i.e. salt or corn syrup)
|
Water
Activity of Selected Foods
Most bacteria grow well at a minimum water activity level of
0.91
|
| Food |
Water
Activity
|
| Fresh
fruits |
.91-1.00
|
| Pudding |
.91-.99
|
| Bread |
.96-.97
|
| Cheese |
.95-1.00
|
| Fresh
meat |
.95-1.00
|
| Cakes |
.90-.94
|
| Cured
Meats |
.87-.95
|
| Jam |
.75-.80
|
| Honey |
.54-.75
|
| Dried
fruit |
.55-.80
|
| Chocolate
Candy |
.55-.80
|
| Caramels |
.60-.65
|
| Dried
milk |
.20
|
| Dried
vegetables |
.20
|
| Crackers |
.10
|
From The HACCP Food Safety
Manual by Joan K. Loken, CFE. 1995
Viruses
What are the characteristics of viruses?
Transmitted by
poor personal hygiene
Food, water and
air can become the vehicles by which viruses are spread
Cannot grow on
food (however they can survive) - need a living host to reproduce
Some survive
cooking and freezing
Smallest of microbial
food contaminants
Parasites
What are the characteristics of parasites?
Lives in or on
a host organism to survive.
Can live inside
many animals that humans use for food.
Proper cooking
and freezing will destroy parasites.
Can be transmitted
through water, feces and food.
Several parasites
are a concern for childcare providers because of diaper changing.
OBJECTIVES
Participants will…
Identify the personal
hygiene and sanitation practices that are critical to spreading foodborne
illness in the childcare setting.
Determine if the
sanitation practices in their childcare facility are effective in controlling
the spread of disease causing microorganisms.
PERSONAL HYGIENE AND SANITATION
Handwashing 
Good handwashing is the single most effective practice that prevents
foodborne illness in the child care setting.
Wash
hands often
Before and after
handling food
After changing
diapers or assisting a child in using the toilet
After playing with pets
After wiping runny
noses
After using the
bathroom
After cleaning
up a child, the room, toys, etc.
After removing
plastic/rubber gloves
Upon arrival at
work and before going home
Washing and drying
hands
Follow this procedure for handwashing:
1. Wet hands with warm running water.
2. Apply a small amount
of liquid soap to hands. Rub hands together vigorously until a soapy
lather appears. Rub hands together 20 seconds. Scrub between fingers,
under fingernails, and around tops and palms of hands.
3. Rinse hands under warm running water. Leave the water running while
drying hands.
4. Dry hands with a clean, disposable towel.
5. Turn the faucet off using the towel as a barrier between your hands
and the faucet handles.
6. Discard the used
towel in a trashcan lined with a plastic bag.
Soaps, hand sanitizers and towelettes
Waterless hand
cleaners are not a substitute for soap and water.
Premoistened towelettes
should only be used to remove residue.
Antibacterial soaps
are not required.
Gloves
If the provider
has a cut, sore, boil or pimple on his/her hands, he or she must wear
disposable gloves when handling food.
Always wash and
dry hands before wearing gloves and immediately after removing them.
Diaper Changing
Improper techniques
in changing diapers is one of the most critical factors in spreading
disease or contributing to a foodborne illness outbreak in child care
settings. Many bacterial and viral diseases are spread by the fecal-oral
route.
Have a diaper changing
table that is used exclusively for that purpose.
Sanitize the table
after each diaper change - 1 tablespoon 5.25% chlorine bleach per quart
of water (70º to 120º F). Check your health agency for local requirements.
It may be kept
in a spray bottle so it's easy to use.
Make new solution
every day; discard remainder at the end of each day.
Dispose of diapers
in a plastic lined trash receptacle. Put soiled reusable diaper WITHOUT
RINSING in a plastic bag to give to parents.
Wash your hands
after changing diapers.
Wash the infant/toddler's
hands under running water.
Wash your hands
after disinfecting the changing table.
Disinfecting
Kill germs after cleaning with soap and rinsing with clear water by
disinfecting agents. 
Chlorine bleach
is the least expensive disinfecting agent (kills most germs, but cryptosporidia
is only killed by ammonia or hydrogen peroxide.)
Never mix bleach
with other chemicals!
For bathrooms
and diapering areas use 1 tablespoon bleach/1 quart cool water.
For use on toys,
eating utensils etc., use 1 tablespoon bleach/gallon cool water. Check
with your health agency for local requirements.
Sanitizing dishes
The best way
to wash, rinse, and disinfect dishes and eating utensils is to use
a dishwasher.
For hand washing,
use a three-compartment sink. First compartment for hot tap water
and a dishwashing detergent
Second compartment for hot tap water to rinse. Third compartment for
sanitizing solution.
Food preparation
and dishwashing sinks should never be used for handwashing or diaper
changing.
If you're ill
Don't prepare
or serve food if you have diarrhea, unusually loose stools, or any
other gastrointestinal symptoms of an illness.
Handling food
Supervise meal
and snack times to make sure children do not share plates, utensils,
or food that is not individually wrapped.
Eating utensils
that are dropped on the floor should be washed, rinsed and sanitized.
Discard food
that is dropped on the floor.
Remove leftovers
from the eating area after each snack or meal. Discard or refrigerate
immediately.
Clean and sanitize
table tops before and after each use.
Pets
Turtles and other
reptiles often carry salmonella bacteria which can spread to children
and adults. It would be wise not to have these animals as pets for
children.
Children and
the providers must wash hands after any contact with any pet or pet
cages and equipment.
Quiz:
Participants will read related materials and complete quiz with 90%
accuracy to demonstrate knowledge.
Digging Deeper - Do two of the six activities listed below - they are
all optional - choose the ones you feel would work best for your situation.
Activity 1
Locate information about a foodborne illness outbreak(s) that has occurred
in the past year in your local area or state. The information can be
obtained through several different mediums, such as newspapers, magazines,
television, Internet, Public Health Service, Extension Office and possibly
others. From your investigation attempt to determine the following:
1. What was the foodborne illness?
2. What was the cause - microorganism, food involved, how was the food
mishandled?
3. What happened to the establishment involved in the foodborne illness
outbreak?
4. What was learned by you?
Activity 2
Go to the following website: "The ABC's of Safe and Healthy Childcare"
http://www.cdc.gov/ncidod/hip/abc/abc.htm
1. Clique on fact sheets.
2. Clique on foodborne illnesses that are of specific concern to childcare
providers.
3. From the list choose one of the following diseases to learn more
about food borne microbial diseases that are of specific concern to
child care settings: Campylobacter, Cryptosporidium, Diarrheal Diseases,
E. coli, Giardiasis, Hand-Food-and-Mouth Disease, Hepatitis A, Rotavirus
Diarrhea, Salmonella, and Shigellosis.
4. Review at least one of the diseases from the above list to determine
the disease, foods often associated with this disease, symptoms, incubation
period, duration of illness, foods often involved with this disease,
preventive measures.
Go to the Centers for Disease Control website at www.cdc.gov/ncidod/hip/abc/abc1.pdf
to read The ABCs of Safe and Healthy Child Care. In particular, read
pages 44-53 and pages 87-88.
Activity 3
Practice proper handwashing techniques as described on page 45 of The
ABCs of Safe and Healthy Child Care at the above website. Then demonstrate
the technique with your day care children. Have each of them practice
proper handwashing. Suggest they sing the ABC song while washing hands
to estimate the 20 seconds of scrubbing. (Singing it once will take
about 20 seconds.) Monitor them each time they wash hands and reinforce
your training with them.
Activity 4
Ask your public health department or childcare licensing person if they
have the "Glo-Germ" kit. Borrow it if you can. This will help you determine
how well you wash your hands. You may also want to use it with older
children in your care.
Activity 5
Test your sanitizing (bleach) solution throughout the day to determine
if it maintains its concentration. Test strips are available for chlorine
bleach and other sanitizers. What must you do if you find the strength
diminishes before the end of the day? Refer to pages 47-48 in The ABCs
of Safe and Healthy Child Care.
Activity 6
Develop a list of "best practices" that should be implemented in a childcare
setting to prevent the spread and incidence of foodborne illness. This
list will be posted on the wall of the childcare setting and submitted
for approval.
Food Safety and sanitation are emerging as important issues for providers.
Children under the age of five are especially susceptible to foodborne
illnesses. Serious side effects or even death can result from a foodborne
illness.
Click here to take Foodborne
Illness Quiz and follow directions for requesting a hard copy
certificate mailed to you.
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