How to Control Listeria monocytogenes in Food Plants: Why, How, Where, What, and When to Look

How to Control Listeria monocytogenes in Food Plants: Why, How, Where, What, and When to Look Jeffrey L. Kornacki, Ph.D. President and Senior Technica...
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How to Control Listeria monocytogenes in Food Plants: Why, How, Where, What, and When to Look Jeffrey L. Kornacki, Ph.D. President and Senior Technical Director And Adjunct Faculty, Food Science, UGA www.kornackifoodsafety.com, Email: [email protected]; 608-334-2254 Wisconsin Association for Food Protection meeting: Food Safety Industry Issues – Meeting Today’s Challenges Food Safety , June 11, 2014 Holiday Inn & Suties, Madision, WI

Reproduction by permission only

Why Are We Here?

Why Do We Care About Food Safety? 

Illness / death 48 million cases, 128,000 hospitalizations, 3000 deaths per year1,2,3







Recalls-public exposure & lost market share Lawsuits -stricken individuals / class action Lawsuits-shorted customers

1www.cdc.gov/foodborneburden December 2010 2Scallan,

E., R.M. Hoekstra, F.J. Angulo, R.V. Tauxe, M-A. Widdowson, S.L. Roy, et al. 2011. Foodborne illness acquired in the United States—major pathogens. Emerg Infect Dis. 2011 Jan; [Epub ahead of print]

3Scallan,

E., R.M. Hoekstra, F.J. Angulo, R.V. Tauxe, M-A. Widdowson, S.L. Roy, et al. 2011. Foodborne illness acquired in the United States—major pathogens. Emerg Infect Dis. 2011 Jan; [Epub ahead of print]

Microbiological Risks Food Safety (continued) 

Down time until contamination sites determined and eliminated and food safety system overhauled



Costs of repairs / modifications



Costs to remanufacture product



Insurance issues

Where Listeria and Salmonella fit into the big picture of Foodborne Illness 





Illness: 1.) Norovirus (58%), 2.) nontyphoidal Salmonella (11%) Hospitalization: 1.) Non-typhoidal Salmonella (35%), 2.) Norovirus (26%) Death: 1.) Non-typhoidal Salmonella (28%), 2.) T. gondii (24%), 3.) Listeria monocytogenes (19%)

Scallan, E., R.M. Hoekstra, F.J. Angulo, R.V. Tauxe, M-A. Widdowson, S.L. Roy, et al. 2011. Foodborne illness acquired in the United States—major pathogens. Emerg. Infect Dis. 2011 Jan; [Epub ahead of print]

Deaths due to foodborne illness (est.)

Salmonella Listeria

31.0% 28.0% 21.0%

Toxoplasmosis

Other 5.0% E. coli 0157 Campylobacter Norovirus 7.0%

3.0% 5.0%

Source: Mead et al, 1999

6 Adapted from presentation by Art Liang, CDC at IAFP 2006 annual meeting in Calgary, AB

Estimated Annual Foodborne Disease From Selected Pathogens Bacterium

No. Total Illnesses

% Total Illnesses

% Hospitalized

Campylobacter

2M

14.2

17.3

5.5

99

Salmonella (non-typhoidal

1.3 M

9.7

25.6

30.6

553

2493

0.0

3.8

27.6

499

62,458

0.5

3.0

2.9

52

Clostridium perfringens

248,520

1.8

0.1

0.4

7

Staphylococcus

185,060

1.3

2.9

0.1

2

89,648

0.6

2.0

0.8

14

Listeria monocytogenes E. coli O157:H7

Shigella

% Deaths

No. Deaths

Source: Adapted from Mead, et al. 1999. Food-related illness and death in the United States. Emerging Infectious Diseases 5(5): 607-625, September-October

1Commondities

implicated in Foodborne Disease Outbreaks, 1998-2008, n=3641 Commodity

Percentage

Poultry

19

Finfish

19

Beef

12

Leafy

8

Pork

8

Mollusk

6

Fruits-Nuts

6

Dairy

5

Grains-Beans

4

Eggs

4

Other

9

Cheese-73 Outbreaks, 1678 illnesses, 187 hospitalizations, 3 deaths; 54% cheese from pasteurized milk, rest from unpasteurized milk Salmonella and Campylobacter in unpasteurized outbreaks

Adapted from presentation by Gould, L. H. 2012. CDC data on foodborne disease outbreaks associated with cheese, 8 1998-2008. January 18.

Possible contributing factors listed 

Inadequate pasteurization



Poor sanitation



Insufficient separation between raw milk processing and packaging of finished product

Adapted from presentation by

9Gould, L. H. 2012. CDC data on foodborne disease outbreaks associated with cheese, 1998-2008. January 18.

Predicted US Listeriosis Cases on a Per Serving Basis (log scale)

Adapted from USDA_FSIS/ FDA-CFSAN/ CDC. 2003. Quantitative Assessment of Relative Risk to Public Health from Foodborne Listeria monocytogenes Among Selected Categories of Ready-to-Eat Foods. September.

10

DM = Deli meats; FNR = Frankfurters (not reheated); P= Pâté and Meat Spreads; UM= Unpasteurized Fluid Milk; SS= Smoked Seafood; CR = Cooked Ready-To-Eat Crustaceans; HFD = High Fat and Other Dairy Products; SUC = Soft Unripened Cheese; PM = Pasteurized Fluid Milk; FSC = Fresh Soft Cheese; FR = Frankfurters (reheated); PF = Preserved Fish; RS = Raw Seafood; F = Fruits; DFS= Dry/Semi-dry Fermented Sausages; SSC = Semi-soft Cheese; SRC = Soft Ripened Cheese; V = Vegetables; DS = Deli-type Salads; IC= Ice Cream and Frozen Dairy Products; PC = Processed Cheese; CD = Cultured Milk Products; HC = Hard Cheese.

Predicted US Listeriosis Cases/yr by Food Category (log scale)

DM = Deli meats; FNR = Frankfurters (not reheated); P= Pâté and Meat Spreads; UM= Unpasteurized Fluid Milk; SS= Smoked Seafood; CR = Cooked Ready-To-Eat Crustaceans; HFD = High Fat and Other Dairy Products; SUC = Soft Unripened Cheese; PM = Pasteurized Fluid Milk; FSC = Fresh Soft Cheese; FR = Frankfurters (reheated); PF = Preserved Fish; RS = Raw Seafood; F = Fruits; DFS= Dry/Semi-dry Fermented Sausages; SSC = Semi-soft Cheese; SRC = Soft Ripened Cheese; V = Vegetables; DS = Deli-type Salads; IC= Ice Cream and Frozen Dairy Products; PC = Processed Cheese; CD = Cultured Milk Products; HC = Hard Cheese.

Adapted from USDA_FSIS/ FDA-CFSAN/ CDC. 2003. Quantitative Assessment of Relative Risk to Public Health from Foodborne Listeria monocytogenes Among Selected Categories of Ready-to-Eat Foods. September. 11

Joint FDA/CDC/USDA Listeriosis risk assessment-some highlights and “draft guidance” from FDA, 20081 Highest risk foods: Support growth of L. monocytogenes. Lowest risk foods: Intrinsic or extrinsic factors that prevent growth of L. monocytogenes, Or Processed to alter the normal characteristics of the food. Examples: L. monocytogenes does not grow when: pH of the food < 4.4 Aw of the food < 0.92; or The food is frozen or formulated to prevent growth of Listeria Proposes a standard in these instances of 150 national or multistate & >1,000 state & local investigations



Since 2006, 13 newly recognized food vehicles that can transmit pathogens

Preliminary data

Source: Foodborne Disease Outbreak Surveillance System

Listeriosis (and selected illness to other foodborne disease hazards) compared to 1996-1998 (FoodNet Data)

What is enough? Testing?

GMP Audits? (Systems) – Personal experiences across 25 years

What About HACCP Verification Audits? (Tomato example)

So What is Missing?

The Environment is Critical “… cross contamination ...was mentioned as the most important factor relating to the presence of pathogens in prepared foods”1 Environmental contamination is the principle source of contamination of processed foods It is from the post-processing (post-CCPm) environment2 1Riej,

et al. 2005. Recontamination as a source of pathogens in processed foods-A literature review. ILSI. Quoting, Rocourt, J., et al. 2003. Present state of foodborne disease in OECD countries. WHO, Food Safety Department, Geneva.

2Kornacki,

J. L. 2009. The missing element in microbiological food safety inspection approaches, Part I. Food Safety Magazine. February / March.

Examples of Outbreaks Attributed to Environmental Contamination Product

Pathogen

Comment

Reference

Ice Cream

S. Enteritidis

Pasteurized ice cream mix in tanker truck previously used for transporting raw liquid eggs

Hennessy et al. (1996)

Infant formulae

S. Eealing

Contamination from the processing environment, insulation material of the drying tower

Rowe et al. (1987)

Soft cheese

S. Berta

Cheese ripening in buckets previously used for chicken carcasses

Ellis et al. (1998)

Cooked sliced ham

S.Typhimurium

Cooked ham placed into containers previously used for curing raw pork

Llewellyn et al. (1998)

Chocolate

S. Napoli

Possibly contaminated water used in double-walled pipes, tanks,

Gill et al. (1983)

Chocolate

S. Eastbourne

Contamination from the processing environment

Craven et al. (1975)

Butter

S. Eastbourne

Contamination from the processing environment

Lyytikainen et al. (2000)

Hot dogs

L. monocytogenes

Contamination from the processing environment

Anonymous (1999)

Canned salmon

C. botulinum

Contamination from the processing environment, cooling water

Anonymous (1984);Stersky et al. (1980)

Lasagna

S. aureus

Growth of S. aureus in the processing equipment, improper cleaning

Woolaway et al. (1986);Aureli et al. (1987)

Examples of Outbreaks Attributed to Environmental Contamination continued Product

Pathogen

Comment

Reference

Different foods

E. coli O157:H7

Contaminated meat grinder and equipment at retail level

Banatvala et al. (1996)

Chocolate milk

Y. enterocolitica

Probably during manual mixing of pasteurization milk and chocolate or contaminated chocolate syrup

Black et al. (1978)

Canned meat

S. Typhi

Use of non-potable water for can cooling

Ash et al. (1964); Stersky et al. (1980)

Crabmeat

S. aureus

Contamination during manual picking of cooked meat

Bryan (1980)

Canned mushrooms

S. aureus

Possible growth of S. aureus in the brine bath before canning

Hardt-English et al. (1990)

Flavored Yogurt

E. Coli O157:H7

Pump previously used for raw milk

Morgan et al. (1993)

Pastry

S. Enteritidis PT4

Equipment previously used for raw eggs or insufficiently cleaned piping and nozzles used for cream

Evans et al. (1996)

Yeasts

S. Műnchen

Contamination from the processing environment

Joseph et al. (1991

Pasteurized milk

S. Typhimurium

Possibly cross-connection between raw and pasteurized milk

Lecos (1986)

Pasteurized milk

E. coli O157:H7

Contamination from pipes and rubber seals of the bottling

Upton & Coia (1994)

Mexican type cheese

L. monocytogenes

Contamination from the processing environment

Linnan et al. (1988)

Microbial Growth Requirements Food (soil)

Water

Time

How To Look 

   

Many tools Sponges Swabs Tongue depressors 1 - Ply tissues

Kornacki, J. L. 2010. How do I sample the environment and equipment, Chapter 7. In, J. L. Kornacki (Ed.), Principles of Microbiological Troubleshooting in the Industrial Food Processing Environment. Springer, New York. Pp. 125-136.

Sampling Supplies: What to bring Pre-sterilized  Bags  Sponges  Swabs  Scoops  Tongue depressors  Neutralizing buffer  Gloves  Extension rod  Cutting devices (scissors, knives, box cutters etc.)

Sampling Supplies: What to Bring Duct tape Alcohol (wipes, etc.) Tools Sanitizer test strips pH strips Thermometer Laser pointer FLASHLIGHT! Kornacki, J. L. How do I sample the environment and equipment? Chapter 7. In, J. L. Kornacki (Ed.), Principles of Microbiological Investigation in the Industrial Food Processing Environment. Springer, New York. Pp. 125-136.

Additional helpers 

Technical person – key role observe, coordinate activities



Assistant (swabber; set of eyes)



Scribe



Maintenance/repair personnel

Kornacki, J. L. Where do I begin the investigation? Chapter 6. In, J. L. Kornacki (Ed.), Principles of Microbiological Investigation in the Industrial Food Processing Environment. Springer, New York. Pp. 117-123.

High, Medium and Indirect Risks







High risk - as an area or practice which may directly contaminate the product, either continually or intermittently (in a direct measureable manner) Medium risk - similar to “high risk”, but mitigating factors (such as further heat processing) may reduce risk by and undetermined amount Indirect risk - any situation or condition (such as standing water) which potentially may contaminate product under certain conditions

When to Look Pre-operationally-Zone 1 and 2 Usually indicators (APC, Yeast, EB/coliforms, 1Esculin Hydrolysing Organisms (MOX1,3, HQA3), HTEB1,2,3, Establish a sanitation break point. Operationally/Post Operationally – Zone 3 & 4. Listeria spp. principally wet processing environments Salmonella principally in dry processing environments 1Kornacki,

J. L. 2011. Indicator organism assays: Chaos, confusion and criteria. Food Safety Magazine. February/March. J. L. 2010. IAFP Symposium S22. Food and Food Environment Test Considerations in View of Changing Regulations. (Organizer and Co-convener). Presentation entitled, “An Indicator Approach to Enteric Contamination of at Risk Foods.” August 1-4. Anaheim, CA. 3Kornacki, J. L. 2014. Kornacki, J. L. 2014. An environmental sampling approach to product risk assessment. Food Safety Magazine. February/March issue. 2Kornacki,

An Example of Site Specific Risk Assessment Frame Work (Salad Dressing)

Suggested Risk

Priority

Site

Comments/Observations/ Data

Recommendations

A chance to drill into the specifics

Parking Tickets Vs. Parking Permits Direct vs indirect approaches

HQA Enrichment and plating Experience in a complex environment (meat, poultry, seafood, vegetables, etc.)

Currently licensed laboratories: ABC Research, Gainesville, FL Food Microbiological Laboratories, Cypress, CA

Listeria monocytogenes PCR and culturally confirmed positives on 19 Samples Compared to HQA Enrichment with and without FAC and Streaking Onto Baird-Parker and Modified Oxford Medium (NH = No halo)

Listeria PCR negative results compared to HQA enrichment and streaking onto Baird-Parker and Modified Oxford medium

Inoculated Sponge Study

Relationship of Selected Microbiological Tests/Organisms APC HQA

Enterobacteriaceae

MOX

Listeria spp. LM

Coliforms HTEB

Salmonella B. cereus

Bacillus spp.

Development of a Risk Assessment Approach

Correlation of % Listeria spp. Isolated from Packaging Lines and Floors to RTE Meat

Lead to in-plant risk assessment concept

Tompkin, R.B., L.N. Christiansen, A.B. Shaparis, R.L. Baker, and J.M. Schroeder. 1992. Control of Listeria monocytogenes in processed meats. Food Australia 44:370-376 Kornacki, J. L. and J. B. Gurtler. 2007. Incidence and control of Listeria in food processing facilities, Chapter 17. In, E. T. Ryser and E. H. Marth (eds.), Listeria, listeriosis and food safety, 3rd ed. CRC Press, Taylor & Francis Group, Boca Raton, FL. Pp. 681-766.(see page 729).

Correlations of % Environmental to % Finished Product Contamination Smoked fish plant: Correlation of environmental L. monocytogenes to finished product (p