Prevention

The current system for ensuring food safety is complex, with authority divided between federal, state, and local governments. Currently in the United States, the FDA inspects food-processing plants and, along with the US Department of Agriculture, regulates the interstate commerce of these foods. Final delivery destinations, such as restaurants, supermarkets, and cafeterias, are regulated by local health departments. The movement of food from the farm or water sources follows a predictable process-specific pathway. Contamination can occur at one or more points in the process. Hazard Analysis and Critical Control Points (HACCP) is an applied methodology that identifies and controls the key steps in the process that are vulnerable to contamination. It requires cooperation between government regulatory agencies and the food industry and replaces the simple inspection of a final product. Industry-wide solutions can be implemented once contamination points are identified. 1,71,11

Emergency physicians should advise infected patients of the potential risks they pose to family members or others, particularly if they are food handlers or health care workers.19 A small number of factors in food handling are responsible for a large percentage of foodborne disease. 21 The most important steps that can be taken in the home to prevent foodborne disease is thorough cooking and eating cooked food promptly. Educate patients that food from animal sources such as meat, dairy, and eggs should be either pasteurized or completely cooked and not eaten undercooked or raw. Cross contamination from the juices or drippings from raw meat, poultry eggs, or shellfish with other foods must be avoided by washing hands or common preparation surfaces with soap and water. Prepared food should not be left for extended periods of time at temperatures that will promote bacteria growth.421 The World Health Organization has established rules for the preparation of safe food in the home that can be accessed via the Internet at http://wwW.,W.hO:j.D.t/fS^f/gld.Dr].s..htm.

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