FACS: Sanitation & Food - Support Services (HST)

Summary

Students will understand the importance of practicing sanitation and proper food handling to promote health and wellness. Through demonstration, students will learn the importance of handwashing in breaking the cycle of infection.

Materials

1. Option I - A white ball or a similar object about the size of a tennis ball, that can be thrown or passed around the room and a sealable plastic bag.
2. Option II - A cutting board, food items, (such as chicken, an apple) a knife, and soap
3- GloGerm powder (www.glogerm.com)
4- A black light
5- An information sheet or a video on food safety
6- A guest speaker relating to food and sanitation such as a county health inspector, a USDA inspector, or a restaurant owner or manager.

Background for Teachers

Foodborne Illness - A Primer

1. Staphylococcus aureus is a bacteria common in meat and meat products, eggs, poultry, cream-filled pastries, and any salads containing eggs. The signs and symptoms of infection include nausea, vomiting, headache, and abdominal cramps. Symptoms usually start one to six hours after eating the contaminated food and last less than 12 hours, though it may take several days to fully recover.
   
2. Bacillus cereus has two different types of bacteria. The first type causes diarrhea has a long incubation period of eight to 16 hours and usually persists for 24 hours. It is found in meats, milk, vegetables, and fish. Signs and symptoms of infection include watery diarrhea and abdominal cramps. Nausea may also be present. The second bacterial type is the emetic (or vomiting) type which appears in one to six hours after eating contaminated food which may include rice, potatoes, pasta, cheese, sauces, puddings, soups and casseroles.
   
3. Clostridium perfringens is a bacteria which produces a toxin that may accumulate in prepared foods - such as meats and gravies - which have been allowed to cool down after cooking. Diarrhea and intense abdominal cramps typically occur 8-10 hours after eating and generally resolve within a day.
   
4. Escherichia coli is a toxigenic bacteria spread through food or water that has been contaminated with waste products. This is the most common cause of Montezuma's Revenge or traveler's diarrhea. The infection causes large amounts of watery diarrhea, abdominal cramps, a small fever, nausea, and fatigue. Symptoms usually occur within 16 to 24 hours after eating the contaminated food. It usually takes a week for all of the symptoms to resolve. up.
   
5. Escherichia coli - invasive This bacteria is spread though food or water contaminated with waste products. It has also been linked to raw hamburger and raw meat. Signs and symptoms of infection include abdominal cramps, fever, vomiting, and bloody diarrhea within six to 48 hours after eating. Antibiotics are used to treat this infection.
   
6. Escherichia coli 0157:H7 is a potentially deadly bacteria. The major food sources of this bacteria are raw meat, raw milk, and juice that has not been pasteurized. Signs and symptoms of infection include bloody diarrhea, abdominal cramps, and NO fever. Eventually, the infection may lead to the destruction of the person's blood. This infection was associated with the undercooked meat at Jack-in-the Box in the early 1990s and the Odwalla Juice Company in the late 1990s.
   
7. Shigella is a bacteria commonly found in salads made with mayonnaise. Signs and symptoms of infection include abdominal cramps, vomiting, fever, and diarrhea within six to 48 hours after eating the contaminated food. Complications may include severe bleeding and destruction of the blood. It is treated with antibiotics.
   
8. Salmonella enteritidis is commonly found in raw and undercooked eggs and chicken. The infection causes diarrhea, nausea, vomiting, abdominal cramps, and fever within six to 48 hours after eating the contaminated food. The infection may take up one week resolve.
   
9. Campylobacter jejuni This bacteria may be found in raw chicken, raw milk, and untreated water. It causes diarrhea, abdominal cramps, fever, and nausea starting within six to 48 hours after eating. It will resolve in about one week
   
10. Vibrio cholerae This bacteria may be found in contaminated water and raw shellfish like clams. It too causes abdominal cramps and watery diarrhea within 16 to 72 hours after eating. It usually resolves within three to five days.
    
11. Vibrio parahaemolyticus is commonly found in raw seafood, especially shellfish. Symptoms include diarrhea, abdominal cramps, nausea, vomiting, fever, headache, and chills that show up anywhere from four hours to four days after eating contaminated food. Symptoms should subside within two to three days.
    
12. Clostridium botulinum refers to a bacterial toxin which is found in improperly processed foods, including home-canned foods as well as meat products. The signs and symptoms of infection include nausea, vomiting, diarrhea, and botulism's characteristic muscle paralysis. The diaphragm (the breathing muscle) can also be paralyzed leading to respiratory failure and death. Other symptoms include muscle weakness, dizziness, double vision, difficulty speaking, and difficulty swallowing. Treatment includes supportive care for the symptoms as well as the administration of antitoxin.
    
13. Hepatitis A is caused by a virus called HAV or the hepatitis A virus. It is an oral-fecal infection which means people are infected with this virus after eating contaminated food. The food is usually contaminated when food handlers who have not washed their hands after using the restroom or before preparing your food. Vegetables that grow directly in the soil like green onions, carrots, or alfalfa sprouts can be growing in contaminated soil OR picked by workers who have not washed their hands. There may be no symptoms associated with hepatitis A. If symptoms are present, they may include general body aches, nausea, diarrhea, headache, fever, loss of appetite, dark-colored urine, light colored feces (stool), rash, fatigue, and jaundice (yellow coloring to the skin or the whites of the eyes (sclera). There is no cure for hepatitis A. Treatment is aimed at relieving the symptoms. The liver may be permanently damaged by the infection. A person cannot donate blood after being infected with HAV. There is a series of two vaccines that can be given with a 99% success rate for preventing hepatitis A. The vaccine series is recommended for any one who eats out.
    

Preventing Food Poisoning:
The following are tips that are provided to help prevent food poisoning.

1. Don't buy any damaged packages or cans.
2. Keep cold foods cold and hot food hot.
3. Never buy or drink raw milk or unpasteurized juices.
4. Use eggs that are clean and do not have cracks.
5. Don't use fish or meat that has a strong or unpleasant odor.
6. Don't eat raw eggs. This includes not licking the spoons after making cookie dough or eating eggs "sunny side up."
7. Cook all meat thoroughly before eating. There should be no pink in the middle of the meat.
8. Keep raw meat separate from cooked foods. Use separate cutting boards for meat and vegetables.
9. Wash all fruits and vegetables thoroughly. Read the packages of lettuce and other vegetables to determine if they have been pre-washed. Not all bagged vegetables have been washed.
10. Wash your hands before handling food.
11. Wash hands after using the bathroom.
12. Eat cooked food promptly and use leftovers quickly.
13. Clean the can opener.
14. Wash dish cloths, dish towels, and sponges frequently.

Cycle of Infection

1. For an infection to spread, a disease-causing agent must be present. These pathogens include bacteria, viruses, protozoa, worm, fungi, or rickettsiae.
2. The pathogen must find a place to live. This is called the reservoir or reservoir host. Common reservoirs include people, animals, money, doorknobs, etc.
3. The pathogen must be able to leave the reservoir host called the portal of exit. This can be through blood, draining wounds, saliva, and other body fluids.
4. When the pathogen leaves, it has to find another place to live. This is done by transmission such as direct contact (person to person), indirect contact (touching contaminated objects), and animal bites (such as mosquitoes).
5. The new host must be susceptible to the new pathogen -- such as a person who is not eating or sleeping well or a person has another illness may make them more susceptible to getting sick than others.

Handwashing is the best way to break the cycle of infection.


Proper Handwashing Technique -- When Should You Wash Hands?

• Before eating or handling food
• When you come home from school
• Any time you cough, sneeze, or use a tissue
• After using the bathroom
• After changing a baby's diaper
• Before putting your contacts in your eyes or before you take them out
• After handling money

The Procedure For Handwashing

1. Make sure you have towels, water, soap, and a waste container available. I suggest getting the paper towel ready so you do not have to touch the paper towel dispenser after you wash your hands.
2. Turn on the faucet. Use tepid water. (Do not use hot water since it will dry out your hands quickly).
3. Keep your fingertips pointing downward to prevent water from running down your arms.
4. Use soap to lather your hands.
5. Rub the palms of your hands together.
6. Use the palm of one hand to rub the back of the other hand. Repeat the procedure with the other hand.
7. Interlace the fingers on both hands and rub them back and forth.
8. You should wash your hands for a good 15-30 seconds. In order to time yourself, sing the ABC (alphabet)song while washing.
9. Rinse your hands while keeping your fingertips down.
10. Use the clean, dry paper towel to dry your hands.
11. Use a paper towel to turn off the faucet.
12. Use a paper towel to open the door while exiting the bathroom.

Intended Learning Outcomes

1. Identify potential hazards that exist in health care and demonstrate prevention of injury or illness through safe work practices.
2. Practice the proper handwashing technique and explain its importance in preventing the spread of disease.
3. Explain safe food-handling procedures and government agencies responsible for making sure restaurants and other food handling companies comply with those practices.

Instructional Procedures

PROPER HAND WASHING and CROSS CONTAMINATION

Option I -- Obtain a white ball or an object about the size of a tennis ball and place it in a sealable plastic bag containing some GloGerm powder. Shake the ball to coat it with the powder. The students will probably notice the powder. The teacher may or may not decide to comment on the powder. The students could be told that there is a powder on the ball but it is harmless and will help in a later part of the lesson.

Continue to ask questions. But this time, toss the ball to the person who will be answering, or have the students pass the ball around so everyone gets a chance to touch it. Some questions might have many answers, so several students could respond differently to the same question.

Pass the ball around some more to make sure all students have had a chance to get some GloGerm on their hands. Ask for student responses to the following questions:
** What are some things you know you are supposed to do (or not do) to keep food safe to eat?
(Accept all answers and guide students to respond with ideas like keeping cold foods cold, using food before expiration dates, not thawing meat at room temperature, wiping down counters, washing hands before preparing foods, promptly taking care of leftovers, etc.)

If the students do not volunteer the answer, washing hands before preparing food, be sure to mention it as a lead in to the next part of the lesson. Continue the lesson by telling the students that the powder on the ball represents cross contamination -- which means that whenever they touch a surface contaminated with germs, bacteria, or whatever, their hands become contaminated also. Tell them that the powder on their hands will show up under a black light. Demonstrate this by going around the room with the black light.

Have several students wash their hands like they normally would. Use the black light to see if they did a good job. Ask the class if anyone has ever taught them the correct way to wash their hands. Demonstrate the correct method of hand washing, then have the students wash their hands. If desired, go around the room again with the black light to see the results.

Ask questions like:
** What do you suppose a food inspector is?
** Between the time produce (fresh fruits and vegetables) is ready for harvest in the field and eaten by you at home, name as many people as you can who might touch or handle it in some way.
** If food is eaten in a restaurant, what additional people may have touched or handled it?
** What kinds of diseases can people get from eating spoiled or contaminated food?

Option II -- A teacher or student demo: Rub some GloGerm powder on your hands. The teacher may or may not decide to comment on the powder. You can explain that the GloGerm enables you to see germs under the black light which will be used later in the demo. Wash your hands under running water (without soap or rubbing much). Pick up and handle a food item (i.e. raw chicken), placing it on a cutting board and cutting it up. Wash your hands again under water and then the cutting board and knife (without soap or rubbing much). Cut another raw food item (i.e. an apple) on the cutting board. Turn on the black light and show how the GloGerm powder has spread from the hands to the chicken, cutting board, knife, and then the apple. Talk about what would happen if the apple is then eaten. This is called cross contamination and is how germs can easily be spread. Proper hand washing and washing of food equipment/utensils with soap and hot water for 20 seconds and the proper washing of kitchen equipment/utensils using hot water, soap, and scrubbing is critical in preventing cross contamination. Place hands, food and equipment items under the black light to see the difference. (The same discussion can occur during the demonstration as in Option I) Students can each put GloGerm on their hands, wash their hands, and check under the black light to see how effectively they washed their hands.

Help students understand that all food sold commercially in the United States must pass inspection by one of two government agencies - United States Department of Agriculture (USDA) and the Food and Drug Administration (FDA). These agencies employ thousands of people who inspect food, train food workers, and concern themselves with the safety of the food supply in the United States. Once the food is purchased for home consumption, however, no federal inspector comes into the home to make sure you continue safe food-handling procedures.

It may be wise to reassure the students that their bodies have defenses against disease and not to become paranoid about touching things like doorknobs, desktops, each other, etc. The best advice is to be cautious and wash hands frequently -- especially:
• Around sick people
• Whenever preparing or eating food
• After using the bathroom
• After changing diapers
• After handling money
• After sneezing, coughing, or blowing one's nose
• After playing with or petting animals

FOOD-BORNE ILLNESSES

After using the "Disease Detective" have the students discuss how to keep foods safe.

Follow up the activity with the Operation Risk Student Activity Guide Sheet.

Extensions

Have students discuss communicable diseases as it relates to their health and well-being. Stress the importance of maintaining good health and wellness by utilizing appropriate precautions.

Students can explore various therapeutic, diagnostic, biotechnology research and development, and support services health care careers that directly work with communicable diseases.