KEY 1: KEEP CLEAN - (prevent the growth and spread of dangerous microorganisms)

• Wash your hands with soap and water (or other means such as wood ashes, aloe extract or dilute bleach) after toilet visits, before and after handling raw food and before eating
• Avoid preparing food directly in surroundings flooded with water
• Wash/sanitize all surfaces and equipment - including hands - used for food preparation
• Protect kitchen areas and food from insects, pests and other animals
• Keep persons with diarrhoea - or other symptoms of disease - away from food preparation areas
• Keep faecal material away from food-preparation areas (separate kitchen and toilet areas)
• Avoid eating food raw if it may have been flooded, e.g. vegetables and fruits - see also Key 5.

Why?
Dangerous microorganisms are widely found in the gut of animals and people and therefore also in water and soil in areas with poor sanitation as well as in areas with flooding. These microorganisms can be transferred to food and can, even in low numbers, cause foodborne disease.

KEY 2: SEPARATE RAW AND COOKED FOOD (prevent the transfer of microorganisms)

• Separate raw meat, poultry and seafood from ready-to-eat foods
• Separate animal slaughtering and food preparation areas
• Treat utensils and equipment used for raw foods as contaminated - wash and sanitize before other use
• Separately store raw (uncooked) and prepared foods
• Avoid contamination with unsafe water: ensure water used in food preparation is potable or boiled
• Peel fresh fruits before eating

Why?
Raw food, especially meat, poultry and seafood and their fluids may contain dangerous microorganisms that can be transferred onto other foods during food preparation and storage. Prevent the transfer of microorganisms by keeping raw and prepared food separate. Remember that cooked food can become contaminated through the slightest contact with raw food, unsafe water or even with surfaces where raw food has been kept.

KEY 3: COOK THOROUGHLY (kill dangerous microorganisms)

• Cook food thoroughly, especially meat, poultry, eggs and seafood until it is steaming hot throughout
• For cooked meat and poultry to be safe their juices must run clear and no parts of the meat should be red or pink
• Bring foods like soups and stews to boiling and continue to boil for at least 15 minutes to make sure all parts of the food has reached at least 70°C.
• While cooked food should generally be eaten immediately, if necessary thoroughly reheat cooked food until it is steaming hot throughout.

Why?
Proper cooking kills dangerous microorganisms. The most important microorganisms are killed very quickly above 70°C, but some can survive up to 100°C for minutes. Therefore all cooked food should generally reach boiling temperatures and be cooked at such temperatures for extended periods. Remember that big pieces of meat will only heat up slowly. It is also important to remember that in emergency situations with the potential for significant contamination levels in food, the food should be cooked for longer periods.

KEY 4: KEEP FOOD AT SAFE TEMPERATURES (prevent growth of microorganisms)

• Eat cooked food immediately and do not leave cooked food at room temperature longer than 2 hours
• Keep cooked food steaming hot (more than 60°C) prior to serving
• Cooked and perishable food that cannot be kept refrigerated (below 5°C) should be discarded

Why?
Microorganisms multiply quickly if food is stored at ambient temperature - the multiplication is quicker the higher the temperature - and quickest at around 30-40°C. The higher the number of microorganisms in the food the higher the risk for foodborne disease. In general discard food that cannot be eaten within 2 hours - if necessary, food should be kept really hot or really cold. Most microorganisms cannot multiply in food which is too hot or too cold (higher than 60°C or lower than 5°C)

KEY 5: USE SAFE WATER AND RAW MATERIALS (prevent contamination)

• Use safe water or treat it to make it safe - e.g. through boiling or treatment with chlorine tablets
• Wash or preferably cook vegetables and peel fruits that are eaten raw
• Use clean containers to collect and store water and clean utensils to dispense stored water
• Select fresh and wholesome foods - discard damaged, spoiled or mouldy food
• Breastfeed infants and young children at least up to the age of 6 months

Why?
Raw materials, including water, may be contaminated with microorganisms and dangerous chemicals, especially in areas hit by flooding. Likewise the risk of vegetables and fruits being contaminated with water containing sewage is high under a flooding disaster Toxic chemicals may be formed in spoiled and mouldy foods. Safe water may be seriously contaminated with dangerous microorganisms through direct contact with hands or unclean surfaces. Breastfeeding protects infants against diarrhoea through its anti-infective properties, and minimizes their exposure to dangerous foodborne microorganisms.

Ensuring food safety in the aftermath of natural disasters: 1,2,3,4,5,6,7