National Food Safety Education Month® 2008

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Food safety is important for everyone — but it's especially important for you. That's why the U.S. Department of Agriculture's Food Safety and Inspection Service has prepared this booklet. It's designed to provide practical guidance on how to reduce your risk of foodborne illness. In addition to this practical guidance, we encourage you to check with your physician or health care provider to identify foods and other products that you should avoid. You have a special need for this important information . . . so read on!

Food Safety:
It's Especially Important for You

As a cancer patient, your healthcare provider may have recommended that you take chemotherapy, radiation, and/or other medications to help fight your disease. A side effect of these therapies is that they may weaken your immune system. Cancer also may weaken your immune system over time due to its chronic disease process.

• A properly functioning immune system works to clear infection and other foreign agents from the body. However, cancer and its treatments can weaken your immune system –– making you more susceptible to many types of infections. These infections include those that can be brought on by disease-causing bacteria and other pathogens that cause foodborne illness.
• Because you have cancer and are receiving cancer treatment, you are more likely to have a lengthier illness, undergo hospitalization, or even die should you contract a foodborne illness.
• To avoid contracting a foodborne illness, you must be especially vigilant when handling, cooking, and consuming foods.

Make safe food handling a lifelong commitment to minimize your risk of foodborne illness.

Eating at Home:
Making Wise Food Choices

Some foods are more risky for you than others. In general, the foods that are most likely to contain pathogens fall into two categories:

• Uncooked fresh fruits and vegetables
• Animal products, such as unpasteurized milk, soft cheeses, raw eggs, raw meat, raw poultry, raw fish, raw seafood and their juices

Interestingly, the risk these foods may actually pose depends on its origin or source and how it is processed, stored, and prepared. Follow these guidelines (see chart on page 8) for safe selection and preparation of your favorite foods.

If You Have Questions ...

... about Wise Food Choices:

Be sure to consult with your doctor or health care provider. He or she can answer any specific questions or help you in your choices.

... about Particular Foods:

If you aren't sure about the safety of a food in your refrigerator, don't take the risk. When in doubt, throw it out!

Wise choices in your food selections are important.

All consumers need to follow the Four Basic Steps to Food Safety: Clean, Separate, Cook, and Chill.

Taking Care:
Handling and Preparing Food Safely

Foodborne pathogens are sneaky. You can't tell by looking, smelling, or even tasting a food whether it contains pathogens. But these pathogens — like disease-causing bacteria, viruses, or parasites — can make you sick.

As a person with cancer, it is especially important for you — or those preparing your food — to be careful with food handling and preparation. The easiest way to do this is to follow the Four Basic Steps to Food Safety — clean, separate, cook and chill — from the Fight BAC!^® Campaign, the national campaign developed and promoted by the Partnership for Food Safety Education.

Four Basic Steps to Food Safety

1. Clean: Wash hands and surfaces often

   Bacteria can spread throughout the kitchen and get onto cutting boards, utensils, counter tops, and food.

   To ensure that your hands and surfaces are clean, be sure to:

   • Wash hands in warm soapy water for at least 20 seconds before and after handling food and after using the bathroom, changing diapers, or handling pets.
   • Wash cutting boards, dishes, utensils, and counter tops with hot soapy water after preparing each food item and before going on to the next food.
   • Consider using paper towels to clean up kitchen surfaces. If using cloth towels, you should wash them often in the hot cycle of the washing machine.
   • Wash produce. Rinse fruits and vegetables, and rub firm-skin fruits and vegetables under running tap water, including those with skins and rinds that are not eaten.
   • With canned goods: remember to clean lids before opening.
2. Separate: Don't cross-contaminate

   Cross-contamination occurs when bacteria are spread from one food product to another. This is especially common when handling raw meat, poultry, seafood, and eggs. The key is to keep these foods — and their juices — away from ready-to-eat foods.

   To prevent cross-contamination, remember to:

   • Separate raw meat, poultry, seafood, and eggs from other foods in your grocery shopping cart, grocery bags, and in your refrigerator.
   • Use one cutting board for fresh produce and a separate one for raw meat, poultry, and seafood.
   • Never place cooked food on a plate that previously held raw meat, poultry, seafood, or eggs without first washing the plate with hot soapy water.
   • Don't reuse marinades used on raw foods unless you bring them to a boil first.
3. Cook: Cook to proper temperatures

   Foods are safely cooked when they are heated to the USDA-recommended safe minimum internal temperatures, as shown on the "Is It Done Yet?" chart (see below).

   To ensure that your foods are cooked safely, always:

   • Use a food thermometer to measure the internal temperature of cooked foods. Check the internal temperature in several places to make sure that the meat, poultry, seafood, or egg product is cooked all the way through.
   • Cook ground beef to at least 160 °F and ground poultry to a safe minimum internal temperature of 165 °F. Color of food is not a reliable indicator of safety or doneness.
   • Reheat fully cooked hams packaged at a USDA-inspected plant to 140 °F. For fully cooked ham that has been repackaged in any other location or for leftover fully cooked ham, heat to 165 °F.
   • Cook seafood to 145 °F. Cook shrimp, lobster, and crab until they turn red and the flesh is pearly opaque. Cook clams, mussels, and oysters until the shells open.
   • Cook eggs until the yolks and whites are firm. Use only recipes in which the eggs are cooked or heated to 160 °F.
   • Bring sauces, soups, and gravy to a boil when reheating. Heat other leftovers to 165 °F.
   • Reheat hot dogs, luncheon meats, bologna, and other deli meats until steaming hot or 165 °F.
   • When cooking in a microwave oven, cover food, stir, and rotate for even cooking. If there is no turntable, rotate the dish by hand once or twice during cooking. Always allow standing time, which completes the cooking, before checking the internal temperature with a food thermometer. Food is done when it reaches the USDA recommended safe minimum internal temperature.
4. Chill: Refrigerate promptly

   Cold temperatures slow the growth of harmful bacteria. Keeping a constant refrigerator temperature of 40 °F or below is one of the most effective ways to reduce risk of foodborne illness. Use an appliance thermometer to be sure the refrigerator temperature is consistently 40 °F or below and the freezer temperature is 0 °F or below.

   To chill foods properly:

   • Refrigerate or freeze meat, poultry, eggs, seafood, and other perishables within 2 hours of cooking or purchasing. Refrigerate within 1 hour if the temperature outside is above 90 °F.
   • Never thaw food at room temperature, such as on the counter top. It is safe to thaw food in the refrigerator, in cold water, or in the microwave. If you thaw food in cold water or in the microwave, you should cook it immediately.
   • Divide large amounts of leftovers into shallow containers for quicker cooling in the refrigerator.
   • Follow the recommendations in the abridged USDA Cold Storage Chart (see page 13). The USDA Cold Storage Chart in its entirety may be found at http://www.foodsafety.gov/~fsg/f01chart.html.

Is It Done Yet?

You can't tell by looking. Use a food thermometer to be sure.

In the Know:
Becoming a Better Shopper

Follow these safe food-handling practices while you shop.

• Carefully read food labels while in the store to make sure food is not past its "sell by" date. (See Food Product Dating on page 15.)
• Put raw packaged meat, poultry, or seafood into a plastic bag before placing it in the shopping cart, so that its juices will not drip on — and contaminate — other foods.
• Buy only pasteurized milk, cheese, and other dairy products from the refrigerated section. When buying fruit juice from the refrigerated section of the store, be sure that the juice label says it is pasteurized.
• Purchase eggs in the shell from the refrigerated section of the store. (Note: store the eggs in their original carton in the main part of your refrigerator once you are home.) For recipes that call for eggs that are raw or undercooked when the dish is served — Caesar salad dressing and homemade ice cream are two examples — use either shell eggs that have been treated to destroy Salmonella by pasteurization, or pasteurized egg products. When consuming raw eggs, using pasteurized eggs is the safer choice.
• Never buy food that is displayed in unsafe or unclean conditions.
• When purchasing canned goods, make sure that they are free of dents, cracks or bulging lids. (Once you are home, remember to clean each lid before opening the can.)

When shopping for food, reading the label carefully is key.

Being Smart
When Eating Out

Eating out can be lots of fun — so make it an enjoyable experience by following some simple guidelines to avoid foodborne illness. Remember to observe your food when it is served, and don't ever hesitate to ask questions before you order. Waiters and waitresses can be quite helpful if you ask how a food is prepared. Also, let them know you don't want any food item containing raw meat, poultry, fish, or eggs.

Basic Rules for Ordering

• Ask whether the food contains uncooked ingredients such as eggs, meat, poultry, or fish. If so, choose something else.
• Ask how these foods have been cooked. If the server does not know the answer, ask to speak to the chef to be sure your food has been cooked to a safe minimum internal temperature.
• Avoid buffets, which may contain undercooked foods or foods that have been at room temperature too long. Order from a menu to minimize your risk.
• If you plan to get a "doggy bag" or save leftovers to eat at a later time, refrigerate perishable foods as soon as possible — and always within 2 hours after purchase or delivery. If the leftover is in air temperatures above 90 °F, refrigerate it within 1 hour.

If in doubt, make another selection!

Ask questions about how your food is cooked.

Tips for Transporting Food

• Keep cold food cold, at 40 °F or below. To be safest, place cold food in cooler with ice or frozen gel packs. Use plenty of ice or frozen gel packs. Cold food should be at 40 °F or below the entire time you are transporting it.
• Hot food should be kept hot at 140 °F or above. Wrap the food well and place in an insulated container.

Stay "Food Safe" When Traveling Internationally

Discuss your travel plans with your physician before traveling to other countries. Your physician may have specific recommendations for the places you are visiting, and may suggest extra precautions or medications to take on your travels.

For more information about safe food and water while traveling abroad, access the Centers for Disease Control and Prevention Web site at www.cdc.gov/travel.

Select your foods with care when traveling to other countries.

Foodborne Illness:
Know the Symptoms

Despite your best efforts, you may find yourself in a situation where you suspect you have a foodborne illness. Foodborne illness often presents itself with flu-like symptoms.

These symptoms include:

• Nausea
• Vomiting
• Diarrhea
• Fever

If you suspect that you could have a foodborne illness, there are four key steps that you should take. Follow the guidelines in the Foodborne Illness Action Plan on page 19, which begins with contacting your physician or health care provider right away.

When in doubt — contact your physician or health care provider!

For More Information on Food Safety

You may contact the USDA Food Safety and Inspection Service to obtain additional food safety information in both English and Spanish.

Online:

Information can also be accessed on the FSIS Web site at www.fsis.usda.gov.

• Food Safety Questions? "Ask Karen" —The FSIS Virtual Representative — an automated response system available 24/7 at www.fsis.usda.gov.
• Send e-mail inquiries to mphotline.fsis@usda.gov.

By Phone:

Call the USDA Meat and Poultry Hotline at 1-888-MPHotline (1-888-674-6854) or TTY: 1-800-256-7072.

• The year-round, toll-free Hotline is available Monday through Friday from 10 a.m. to 4 p.m. Eastern Time.
• An extensive selection of timely food safety messages is also available at the same number, 24 hours a day.

_______________________________________________________________________

Local Resources:

State Department of Agriculture: __________________________________________

Health Department: _____________________________________________________

Other: _________________________________________________________________

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Additional Food Safety Resources:

• Food and Drug Administration
  www.cfsan.fda.gov
• Centers for Disease Control and Prevention
  1-888-232-3228 (24-hour recorded information)
  www.cdc.gov/foodsafety
  • National Center for Infectious Diseases/Traveler's Health
    www.cdc.gov/travel/index.htm
  • National Center for Infectious Diseases /Water-Related Diseases
    www.cdc.gov/ncidod/diseases/water/index.htm
• U.S. Environmental Protection Agency Office of Water
  www.epa.gov/OW
• Gateway to Government Food Safety Information
  www.foodsafety.gov
• Partnership for Food Safety Education (Fight BAC!^®)
  www.fightbac.org

Thank you to Lydia Medeiros, Ph.D., R.D., Patricia A. Kendall, Ph.D., R.D., and Val Hillers, Ph.D., R.D., for their assistance and groundbreaking research to the at-risk community.

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual's income is derived from any public assistance program. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA's TARGET Center at (202) 720-2600 (voice and TDD). To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.