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Farm-to-fork food safety: Would you like hepatitis A with that?

05.dec.03, Douglas Powell (with files from Ben Chapman and Brae Surgeoner), Commentary from the Food Safety Network

I've never been a fan of the raw green onion; they taste like cellophane. But as a master of food that is predominantly brown and gray, who am I to offer culinary advice?
Yet for the over 600 consumers -- of which three have died -- who ate at a Pittsburgh-area Chi-Chi's Mexican-style restaurant and contracted hepatitis A, fresh green onions are probably not high on the condiment wish-list.
How could this happen? Is it new? Is fresh produce safe to eat?
Straightforward questions with complex answers -- answers most likely not in the realm of international conspiracy or corporate greed but in that most basic and seemingly boring arena: sanitation.
Hepatitis A has popped up many times before. It is a sturdy virus shed by infected humans for a couple of weeks before symptoms actually appear. So the usual scenario is a food service worker who becomes infected, goes about preparing food until symptoms develop, and unless stringent handwashing and sanitation is followed, will spread that virus, via food, to customers.
In a 2002 outbreak in British Columbia, an infected food handler at a Capers Community Market infected eight individuals. Over 6,000 other
customers were also treated with protective injections. Recently, a class-action lawsuit against Capers was certified and is set to go
forward. Two Ontario grocery stores also dealt with ill food handlers last year, though no reports of hepatitis A in customers followed.
This latest outbreak comes at a time when restaurants are under fresh scrutiny for food safety as the investigative reporting television program
Dateline ranked America's top 10 fast food chains on their cleanliness. Its researchers tallied the number of "critical violations" reported by public
health inspectors in the past 18 months from 100 of each of the chain's restaurants in 38 states. Most food regulations mandate the critical
violations be corrected immediately and include things like handling food with bare hands or unwashed hands, undercooked meat, improper food holding temperatures, sick employees preparing food.
Except that the term critical violation is one of contention, because some of the violations may not be so critical. Further, while the very nature of the fast food industry makes it susceptible to these "critical violations," the sheer volume of meals served creates a huge liability and brand vulnerability -- one that companies are extremely eager to protect, making many fast food restaurants some of the safest places to purchase meals. After all, making one's customers sick is bad for business.
The Dateline investigation, though skewed for entertainment purposes, does add to the public discussion of food safety, and shows that, for the most part, the system works. It even provides an opportunity to the food service industry to show all they do, behind the scenes, for food safety. McDonalds in the U.K. has done just that, opening its kitchen doors to the public in a display of transparency to demonstrate they are a clean and trustworthy organization.
The Pennsylvania hepatitis A outbreak goes beyond the restaurant. In a typical outbreak, a food handler is diagnosed with hep A, and subsequently patrons of the establishment come down with the disease. However, with Chi-Chi's, the food handlers got sick at the same time as the customers.
So investigators focused their attention on a suspect food -- green onions from Mexico -- and found that the same strain of the virus had been linked to outbreaks earlier this fall in other U.S. states.
Investigators from the U.S. Food and Drug Administration and the Centers for Disease Control are currently visiting suspect farms in Mexico to examine production practices.
The problem with fresh produce, and why over 300 known outbreaks have been traced to fruits and veggies since 1990 is that the very characteristic that affords dietary benefit -- fresh -- also creates microbiological risk.
Because they are not cooked, anything that comes into contact with fresh fruits and vegetables is a possible source of contamination. Is the water used for irrigation or rinsing clean or is it loaded with pathogens? Do the workers who collect the produce follow strict hygienic practices such as thorough handwashing? Are the vehicles used to transport fresh produce also used to transport live animals that could be sources of microbial contamination? The possibilities are almost endless. By employing the principles of the Hazard Analysis Critical Control Point system, such risks can be identified, and control steps enacted.
To capture the nutritional benefit of fresh produce -- and we should be eating more -- while minimizing the risk, programs have been, or need to be, created to reduce risk on the farm, right through to the kitchen.
But program is the wrong word: it implies manuals, checklists and bureaucratic oversight. What's needed is the data and people to provide on-going interaction with farmers, retailers and food service, to compel each individual in the farm-to-fork food safety system to do whatever is possible to further enhance the safety of fresh produce.
Whether your preference is green onions -- or in my case tomatoes -- constant vigilance is the best defense.

Douglas Powell is an associate professor and scientific director of the Food Safety Network at the University of Guelph.