Day-Care, For Safe Food, Handle with Car

by Food and Drug Administration (FDA)

(Page 4 of 4)

Day-Care Dilemma

Another parasite gaining ground in this country is Giardia lamblia, a protozoan also spread through the fecal-oral route, either directly through person-to-person contact or through contaminated food or water. It infects the small intestine and may cause gas, diarrhea, abdominal cramps, bloating, and, in severe cases, malabsorption and weight loss. Children are infected more frequently than adults, and the parasite is finding a wealth of young hosts in day-care centers. In random surveys, giardiasis has been identified in 10 to 15 percent of diaper-aged children attending day-care centers, compared with 2 percent of same-age children not attending centers, CDC reports. In addition, approximately 20 to 25 percent of day-care staff and family contacts of infected children also become infected. The agency attributes the spread to poor personal hygiene, closer interpersonal contact, and the children's frequent hand-to-mouth and object-to- mouth behavior.

The simplest and most effective way to prevent the spread of giardiasis is hand washing. Experts advise day-care staff to wash their hands when they start work, before preparing or serving food, after diapering a child, and after going to the bathroom. Similarly, children's hands should be washed when they arrive at the center, before they eat or drink, and after they use the toilet or have their diapers changed. Other common-sense measures — such as cleaning and disinfecting diaper-changing areas after each use, keeping food preparation and diaper-changing areas separate, and keeping children with diarrhea at home — should also be followed. Giardiasis is not unique to day-care settings. According to CDC, Giardia is the most common cause of waterborne outbreaks of intestinal disease in the United States, and the number of such outbreaks has increased significantly in recent years. They occur most often in mountain communities and those that get drinking water from streams or rivers without a water filtration system. Hikers and campers who drink from contaminated lakes, rivers and streams are also frequently affected. Swimming pools have also become contaminated.

Giardiasis seldom causes severe disability, but it is one of the leading causes of diarrheal illness in the United States. FDA has approved Furoxone (furazolidone) and Atabrine hydrochloride (quinacrine hydrochloride) for treatment. Flagyl (metronidazole) is also used.

Though parasitic diseases appear to be increasing in the United States, with proper common-sense sanitation practices and careful food preparation, many of these creatures can be kept at bay.

For Safe Food, Handle with Care

Cook it thoroughly. Cook it thoroughly. Cook it thoroughly! That's the most important thing to know about preventing food-borne illness.

FDA advises consumers to cook pork until it reaches an internal temperature of 71 degrees Celsius (160 degrees Fahrenheit). Fish should be cooked to an internal temperature of 60 C (140 F), flake easily, and be firm and opaque, or dull. If it's translucent, or shiny, it's not done. "Proper cooking should kill most parasites," says George Jackson, Ph.D., of FDA's Center for Food Safety and Applied Nutrition, "but you've got to be careful that it's not just the outside that's getting all the heat. Trichinella, for instance, is on the inside of the meat. Anisakids in fish might be on the outside of the fillet, but they could also be in the fillet." This is especially important to remember with microwaving, because the food often does not heat evenly. Rotate the dish once or twice during cooking, observe the standing time called for in the recipe or package directions, and check for doneness with a thermometer after removing it from the microwave oven. Insert the thermometer at several different spots.

Raw fish dishes, such as sushi and ceviche, can be safe for most people to eat if they are made with very fresh fish that is commercially frozen and then thawed.

In 1990, FDA issued an advisory to state and local regulatory agencies recommending that fish served raw, marinated, or partially cooked be blast-frozen to minus 35 C (minus 31 F) or below for 15 hours or frozen by regular means to minus 23 C (minus 10 F) or below for seven days. People with immune disorders should not eat raw fin fish or shellfish because, although freezing kills most parasites, it does not kill bacteria. People with immune disorders need to take extra precautions to thoroughly cook all meat, fish and poultry. Fruits and vegetables should be scrubbed and washed well to loosen any contaminants on the surface of the produce.

Toxo-Tabby

In addition to cooking meats thoroughly, cat owners need to take additional precautions against toxoplasmosis, because cats are a host for Toxoplasma gondii. Cats acquire the parasites from eating rodents, birds, or raw beef.

"Recent studies show that cat ownership is not necessarily a problem," says Randolph Wykoff, M.D., director of FDA's Office of AIDS Coordination, "but people should handle their cat litter boxes appropriately and clean the boxes regularly." Pregnant women and immune-suppressed individuals should have someone else change litter boxes, if possible. If not, they should wear disposable gloves and wash their hands thoroughly afterward. They should also wear gloves when gardening or doing other activities involving contact with possibly contaminated soil. Cat owners should follow these recommended precautions:

Feed cats dry, canned or boiled food — never undercooked meat or poultry — and discourage hunting; that is, keep cats as indoor pets only.

Use disposable plastic liners in cat litter boxes and change the litter daily. (The parasite in the feces is not infectious until two or three days after excretion.) Seal the liner with a twist tie and dispose of it in a plastic garbage bag.

After emptying, disinfect the litter box with scalding water left in the pan for five minutes. (If a plastic liner is used, disinfecting is not necessary.)

Wash hands thoroughly after cleaning the litter box.

Wash hands thoroughly after contact with soil possibly contaminated with cat feces, and especially before eating.

Cover sandboxes when not in use to prevent stray cats from getting into them.

About the Author

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FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.