Food Safety and Foodborne Illnesses

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Food Safety and
Foodborne Illnesses
1. What are foodborne illnesses?
They are diseases contracted by ingesting contaminated food. About two- The practices commonly
thirds of all outbreaks involve bacteria. The rest are caused by viruses, linked to such illnesses are
parasites, fungi and chemicals. The illnesses can be caused either by the mishandling, poor
microorganisms themselves or by toxins they release.
refrigeration, improper

The Centers for Disease Control and Prevention (CDC) has identified more cooking, cross-contamination
than 400 food-related illnesses. Some are rare while others occur frequently. The of cooked with raw foods,
foodborne pathogens that scientists consider most hazardous are the bacteria unclean utensils or serving
Campylobacter jejuni, Clostridium botulin, Clostridium perfringens, E. coli plates, poor hygiene and time
O157:H7, Listeria monocytogenes, Salmonella, Staphylococcus and Vibrio vul- or temperature abuse.
nificus; the Hepatitis A and Norwalk-like viruses; and the parasites Crypto-
and Cyclospora. These microor-
ganisms and the diseases they cause are dis-
Temperatures at Which Foodborne
cussed later in this paper.
Pathogens Live, Multiply and Die
2. What are the sources of food-
borne illnesses?
The organisms responsible for foodborne
illnesses are found throughout nature — in
plants, animals, people and even in soil. The
Kill temperature
practices commonly linked to such illnesses
are mishandling of food, poor refrigeration,
Growth zone for
improper cooking, cross-contamination of
pathogens in most
cooked with raw items, unclean utensils or
serving plates, poor hygiene and time or
temperature abuse. The most common food-

handling error is keeping foods for more
than four hours between 40oF and 140oF
(4oC and 60oC) — the growth or so-called
pathogen growth
danger zone for most bacteria. Some mi-
crobes can grow in temperatures as low as
38oF (3oC), while it takes an internal tem-
perature of 160oF (71oC) for 15 seconds to

kill E. coli O157:H7 in ground meat.
Contamination can occur at any
point in the food chain: in processing
plants, at supermarkets and restaurants
For more information, visit FMI’s online Food
or in the consumer’s kitchen — in short,
Safety Center (
from the farm to fork.
Food Marketing Institute (FMI) conducts programs in research, education, industry relations and public affairs on behalf of its
1,500 member companies — food retailers and wholesalers — in the United States and around the world. FMI’s U.S. members
operate approximately 26,000 retail food stores with a combined annual sales volume of $340 billion — three-quarters of all
food retail store sales in the United States. FMI’s retail membership is composed of large multi-store chains, regional firms and
independent supermarkets. Its international membership includes 200 companies from 50 countries.

655 15th Street, N.W., Washington, DC 20005
202.452.8444 fax: 202.429.4519

[email protected]

Food Safety and Foodborne Illnesses

3. What are the symptoms of foodborne illnesses?
Diarrhea is the most common symptom. Others include vomiting, headaches, The symptoms may not
cramps, abdominal pain and lethargy. The most common foodborne illnesses appear for days or weeks
and pathogens are covered at the end of this paper and include descriptions of after ingesting a
their associated symptoms.
4. How serious are foodborne illnesses?
People are continually exposed to various pathogens, yet illnesses usually de-
velop only when large quantities are ingested — except for virulent microbes
such as Listeria and E. coli O157:H7. Even then, food poisoning, although un-
pleasant, does not pose a serious health hazard for most people. The distressful
vomiting, abdominal cramps and diarrhea are short-lived.

Foodborne illnesses, however, can be quite serious and even fatal for some
older people, infants, children and people suffering from illnesses that weaken
the immune system, such as cancer, liver disease and AIDS. In a small percent-
age of victims, infections can lead to chronic ailments, such as kidney damage,
arthritis or heart problems.

It is important to note that the symptoms of a foodborne illness may not ap-
pear for days or weeks after ingesting a pathogen. The time lapse makes it diffi-
cult for scientists to identify the cause, especially the particular food that was
5. How many illnesses occur in the United States each year?
It is difficult to calculate the actual number. Many local and state health agencies It is difficult to calculate
are just beginning to gather detailed foodborne illness data and report that in- the actual number.
formation to CDC. Even that information is unreliable because only 1 percent to Many local and state
5 percent of foodborne illness cases are reported, according to CDC. In the vast health agencies are just
majority of instances, people do not seek medical help because the symptoms beginning to gather
are mild and disappear after a short period. Even when people do seek medical detailed foodborne
help, their doctors may not collect cultures and request a laboratory analysis, or illness data and report
they may not report the results of such analyses to health agencies.
that information to
The federal government is trying to develop more accurate estimates CDC.
through the Foodborne Diseases Active Surveillance Network (FoodNet). Since
1996, CDC, the Food and Drug Administration (FDA) and Food Safety and In-
spection Service (FSIS) of the U.S. Department of Agriculture (USDA), along
with local and state health departments, have been monitoring food contamina-
tion in targeted locations. In 2003, FoodNet collected data on confirmed cases of
foodborne illnesses associated with seven bacteria and two parasites in Colo-
rado, Connecticut, Minnesota and Oregon and selected counties in California,
Georgia, Maryland and New York and Tennessee — covering a total population
of 41.5 million or 14 percent of the U.S. population (see the table on the next

1 FoodNet data are available at

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Food Safety and Foodborne Illnesses


(Cases per 100,000 people)
26.9 14.6 15.7 7.0 7.4 18.7 11.8 16.4 7.9
14.9 10.0 11.6 23.3 14.6 11.5 10.0 10.7 13.0
8.6 9.5 2.0
13.2 8.5 2.1 6.0 3.0 6.9
E. coli
O157:H7 0.9 1.5 1.1 0.3 0.3 2.7 1.2 2.4 0.6
(Cases per 1 million people)
5.9 2.0 4.6 5.7 2.0 2.4 3.8 1.4 5.0
5.3 2.4 6.4 3.7 5.1 1.2 2.8 1.4 1.9
6.2 0.4 2.9 3.4 4.0 0.8 1.8 1.7 1.9

5.7 4.8 5.8
14.1 3.1 30.7 12.1 9.7 7.2
NR* NR 1.2 0.9 0.4 NR 0.3 NR NR
*NR=None reported.
Note: These are preliminary results. The final 2003 data are scheduled to be released in late 2004.
Source: FoodNet

Comparing FoodNet results from 1996 to 2003, CDC found significant de-
creases in illnesses linked to the following pathogens:
Cryptosporidium — down 51 percent.
Yersinia — 49 percent.
E. coli O157:H7 — 42 percent, mostly due to a 36 percent drop from
2002 to 2003.
Campylobacter — 28 percent.
Salmonella — 17 percent.
Over that same period, FoodNet data show no substantial changes in infections
caused by Listeria and Shigella. Illnesses associated with Vibrio increased 116
percent; this relatively rare bacterium is found in seafood from saltwater.

In 2003, food recalls associated with the three common bacteria Salmo-
nella, E. coli O157:H7 and Listeria declined by more than half to 28, from 65 in In 2003, food recalls
2002, according to USDA. Dr. Elsa Murano, the agency’s undersecretary for associated with the three
food safety, attributed the declines in recalls and illnesses to policies and direc- common bacteria
tives implemented over the past 18 months by FSIS:2
Salmonella, E. coli
O157:H7 and Listeria

Mandating that all slaughter and ground beef establishments reassess declined by more than half
their Hazard Analysis and Critical Control Point (HACCP) plans to 28, from 65 in 2002.
(See Question 8 for a description of HACCP plans).
The first comprehensive audits of HACCP plans for scientific valid-

2 April 29, 2004, statement by Dr. Murano “Regarding CDC Foodborne Ill-
ness Data.”

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Food Safety and Foodborne Illnesses

ity, carried out by an expanded, scientifically trained force of FSIS
HACCP experts and epidemiologists.
Elimination of the E. coli O157:H7 testing exemption at slaughter
plants that did their own carcass testing. All beef plants are now sub-
ject to FSIS ground-beef sampling.
A new education program, Food Safety Regulatory Essentials, to im-
prove training of inspectors in science-based regulations.
Accelerating in-depth reviews of plants that have exceeded their
Salmonella performance standards so that potential sanitation prob-
lems can be identified and corrected promptly.
Publishing the final rule to control Listeria monocytogenes, based on
a quantitative risk assessment, to reduce the risk of contamination at
plants that process ready-to-eat meat and poultry products.

In September 1999, CDC released a study on overall foodborne disease While more definitive than
rates that is regarded as the most authoritative to date: “Food-Related Illness and previous research, the
Death in the United States,” published in the September-October 1999 edition of 1999 CDC study of overall
its journal Emerging Infectious Diseases. The study estimates that foodborne foodborne illnesses still
pathogens cause 76 million illnesses, 325,000 hospitalizations and 5,000 deaths relies mostly on
per year.
extrapolation because

While more definitive than previous research, the CDC study still relies numerous cases are not
mostly on extrapolation, because numerous cases are not reported or the patho- reported or the pathogen
gen could not be identified. Of the 5,000 estimated deaths, only 1,800 were as- could not be identified.
sociated with reported and documented foodborne diseases. Unknown agents
accounted for the remaining 3,200. Likewise, 14 million of the 76 million esti-
mated illnesses were caused by known and reported agents, and 60,000 of the
325,000 hospitalizations.

Until reporting systems significantly improve, nationwide data on food-
borne illnesses must be regarded as rough estimates. “The new estimates should
not be compared to previous estimates since the estimates are the result of better
information and new analyses rather than changes in disease frequency over
time,” said CDC in a September 16, 1999, news release. “The new estimates
provide a snapshot of the problem and do not indicate that the problem is getting
better or worse.” For more information, visit the CDC Web site
6. What is the economic cost?
Foodborne illnesses cost the U.S. economy at least $6.9 billion a year, according
to the USDA Economic Research Service (ERS). The actual figure is higher,
since this estimate reflects illnesses caused only by the major pathogens (E. coli
O157:H7, Campylobacter, Listeria monocytogenes and Salmonella). The costs
include medical expenses, productivity losses from missed work and the esti-
mated value of premature deaths. They do not include the cost to industry for
product embargoes, voluntary destruction of products and recalls, or the exten-
sive measures undertaken to reduce the spread of foodborne pathogens.

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Food Safety and Foodborne Illnesses

7. What is the food industry doing to reduce the incidence of
foodborne illnesses?
The industry is working with federal, state and local government agencies to re-
The food industry is
duce foodborne illnesses and control the pathogens that cause them. These in-
working with federal,
state and local
Implementation of Pathogen Reduction/Hazard Analysis and Critical government agencies to
Control Point (HACCP) systems, a government regulatory program reduce foodborne
to inspect meat and poultry slaughtering, processing plants and more illnesses and control
aggressive monitoring of fruit and vegetable juices and seafood. (See the pathogens that
Question 8 for more details.)
cause them.
Greater regulation, including inspection of products and handling
practices, product recalls and legal actions against companies that do
not comply with health codes and food safety standards.
Surveillance of the food supply from the farm to the retail store to
identify pathogens and practices that contaminate food, along with
increased monitoring of foodborne diseases.
Egg quality-assurance programs for Salmonella enteritidis.
Increased attention to fresh produce safety through better agricultural
New intervention technologies to reduce food contamination, such as
Increased regulation and inspection of imported food.
Extensive safety education targeting all people who come into con-
tact with food, from industry food handlers to consumers. Question
13 covers these programs and their effectiveness in more detail.
additional steps to improve food safety, which are
detailed in Questions 11 and 12.
8. What is the Hazard Analysis and Critical Control Point
(HACCP) system?
HACCP is different from traditional quality control procedures. Rather than re- Rather than relying only
lying only on product inspection to identify contaminants, it provides a compre- on product inspection to
hensive system to prevent or minimize contamination. The system was identify contaminants, the
developed in the early 1960s to safeguard food for U.S. astronauts. Since then, HACCP program provides
the industry has been incorporating its principles into food manufacturing, dis- a comprehensive system to
tribution and handling practices. In recent years, government agencies started in-
corporating HACCP principles into health codes and food safety regulations. prevent or minimize
HACCP programs are based on seven basic principles:
1. Identify the hazards.
2. Determine the critical control points (CCPs).
3. Set criteria or limits to determine if the hazard is under control.
4. Monitor the CCPs.
5. Take corrective action if needed.

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6. Verify that the system is working.
7. Keep records of CCP monitoring.

HACCP requires each meat and poultry plant to develop and implement a
written sanitation plan, as well as a plan to systematically address all significant
hazards associated with its products. In addition, slaughter plants must regularly
test for generic E. coli to verify their procedures for preventing and reducing fe-
cal contamination. Raw products from slaughter plants and plants that grind
meat and poultry are subject to Salmonella testing by FSIS.

Food retailers and wholesalers have developed food safety programs for the
departments and foods most susceptible to contamination: delis, restaurants,
soup and salad bars, seafood including sushi, ground meats and pre-cut produce.
9. How does the government monitor and regulate the indus-
try to control foodborne pathogens?
FSIS regulates meat, poultry and egg products in nearly 6,500 processing plants.
These products include raw beef, pork, lamb, chicken and turkey, as well as USDA’s Food Safety and
processed meat and poultry products, including hams, sausage, soups, stews, Inspection Service regulates
pizzas and frozen dinners. Processed egg products include dried egg yolks, meat, poultry and egg
scrambled egg mix, dried egg powder and liquid eggs.
products in nearly 6,500

More than 7,600 FSIS inspectors verify that these plants meet food safety processing plants. More
regulations. In slaughter plants, inspection involves examining birds and animals than 7,600 FSIS inspectors
before and after slaughter. In egg-processing plants, inspectors examine eggs be- verify that these plants meet
fore and after breaking. FSIS also:
regulations regarding food
Sets requirements for meat and poultry labels and for certain slaugh- safety and other consumer
ter and processing activities such as plant sanitation.
protection concerns.
Enforces regulations governing unsafe, unwholesome or inaccurately
labeled products.
Tests for microbiological, chemical and other types of contamination
and conducts epidemiological investigations with CDC.
Ensures the safety of imports products through a system of inspec-
tions and scientific controls.
Ensures that the inspection systems in all foreign countries that ex-
port meat and poultry to the U.S. are equivalent to those in this coun-
FSIS tests for
try, and it reinspects all imported meat and poultry products.
microbiological, chemical

and other types of
Ensures that state inspection programs for meat and poultry are meet
federal standards.
contamination and
conducts epidemiological

State and local government health officials are the primary regulators of investigations with CDC.
sanitation in retail food stores. The health codes and regulations are similar from
state to state — most based on the FDA Food Code — although inspection and
enforcement methods vary. In some areas, inspectors have the authority to close
a store immediately if significant violations are found; in others, they must first
issue a warning letter.

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10. What about criticisms that the current inspection system
is outdated?
For decades, inspectors relied largely on their senses — look, touch and smell For decades, inspectors
(organoleptic methods) — to detect contamination. It is widely recognized now relied largely on their
that such methods are ineffective in detecting microbes such as Salmonella and senses — look, touch and
E. coli O157:H7. The government has responded with a series of initiatives:
smell (organoleptic
In 1993, FDA issued its first edition of a model Food Code, a guide methods) — to detect
that encourages food companies to implement HACCP-based sys- contamination. It is widely
tems, along with other food-handling and sanitation requirements. In recognized now that such
1995, FSIS launched a program now known as FoodNet (the Food- methods are ineffective in
borne Diseases Active Surveillance Network), an initiative by CDC, detecting microbes such as
USDA, FDA and state health departments to improve the surveil- Salmonella and E. coli
lance of foodborne illnesses.
In 1998, FDA’s Center for Food Safety and Applied Nutrition and
USDA issued for industry the Guide to Minimize Microbial Food
Safety Hazards for Fresh Fruits and Vegetables
. This guide presents
microbial food safety hazards and best agricultural and management
practices for growing, harvesting, washing, sorting, packing and
transporting fruits and vegetables.
In 1999, FDA initiated an import produce survey targeting 21 coun-
tries. The goals are to collect and analyze samples of imported fresh
produce for microbial contamination; to protect U.S. consumers and
to gather data for research, risk assessment, industry training and
food safety policy.
Since 1999, FDA training and outreach have focused on fresh produce
safety. Workshops have attracted educators, scientists, farmers, pro-
ducers, processors, retailers, quality assurance and food safety manag-
ers, harvesters and others from at least two dozen countries.
In 2000, FSIS completed HACCP implementation. Question 9 ad-
dresses HACCP in greater detail.
In an FSIS pilot project, new inspection models are used in plants
that slaughter young, generally healthy and uniform animals. Inspec-
The best food safety
tors focus on public health concerns rather than on sorting carcasses, strategies do not always
which is left to the plant. The results indicate fewer defects in meat require additional
regulation. Inconsistent,
FSIS is developing federal standards for the safe handling of food incompatible and
during transportation, distribution and storage.
impractical standards are
FSIS is relying more on risk assessments as a means of guiding food counterproductive; layering
safety policy. The agency has conducted risk assessments for Salmo-
federal and state authorities
nella enteritidis in eggs and egg products, E. coli O157:H7 in ground and overlapping
beef and, working with the FDA, for Listeria monocytogenes in a va-
enforcement policies are
riety of foods.
inefficient and confusing.

The industry is working with government to refine and adapt these regula-
tory initiatives to workplace conditions. FMI believes that a partnership among
federal and state governments and the industry can achieve significant im-

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Food Safety and Foodborne Illnesses

provements. The best food safety strategies do not always require regulation. In-
consistent, incompatible and impractical standards are counterproductive. Layer-
ing federal and state authorities and overlapping enforcement policies are
inefficient and confusing. Retail stores are already highly regulated and subject
to unannounced inspections by state and local health authorities, along with
FDA regulation.
11. How are food retailers and wholesalers taking action to
improve food safety?
Since the early 1990s, FMI has worked with its retail members to develop The FMI Total Food
HACCP-based programs for the foods and departments most vulnerable to con- Safety Management
tamination, including seafood, soup and salad bars, delis, poultry and ground Program applies scientific
meat and poultry. In 2003, FMI launched the Total Food Safety Management controls to the real-world
, initially targeting ground beef and fresh-cut produce. Under this pro- food retail environment.
gram, supermarkets are creating science-based models to prevent contamination
of these products at their points of vulnerability and to control identified hazards.
The program applies scientific controls to the real-world food retail environ-
ment. Future models are planned for salads, deli meats and poultry.

In 2003, FMI assumed ownership of the global Safe Quality Food (SQF)
certification program from the Department of Agriculture of Western Australia.
The SQF program offers a complete approach to managing the safety and qual-
ity of foods before they reach the retail market. It includes safety standards,
training, auditing and certification that enable a supplier to verify that food has
been produced, processed, prepared and handled in accordance with the most
rigorous international standards.

SQF certification is a way suppliers can let retailers and wholesalers know The FMI Safe Quality
that they manage food safety and quality following the highest standards. This Food system complements
includes their ability to conform to HACCP principles, along with country- government programs,
specific regulations. The SQF system complements government programs and strengthens global food
industry initiatives, strengthens global food safety and trade, and offers consum- safety and trade, and
ers an extra measure of protection. Currently, 4,000 businesses in 17 countries offers consumers an extra
have been certified as complying with SQF codes. In 2004, the SQF program measure of protection.
was endorsed by the Global Food Safety Initiative, which benchmarks stan-
dards, among other activities, on behalf of its members, accounting for 65 per-
cent of food retail sales worldwide.

Food irradiation is another means the industry is using to improve food
safety. Irradiation uses short wavelengths of radiant energy to rid food of harm-
ful microorganisms, insects, fungi and other pests, and to retard spoilage. The
technology has been approved for use in the U.S. for several decades and by at
least 39 countries in all. It has been endorsed by organizations including the
American Medical Association, World Health Organization, FDA and many
other scientific and government bodies.

In 1999, FDA added refrigerated or frozen red meat, including ground beef,
to the list of foods approved for irradiation. Since then, hundreds of food retail-
ers have introduced irradiated ground beef and poultry. An increasing number of
consumers looking for an extra measure of food safety are buying these prod-
ucts. For more information, see the FMI Food Irradiation Backgrounder.

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Food Safety and Foodborne Illnesses

12. How are retail food handlers being trained to control con-
For decades, FMI has offered training programs focusing on safe food-handling In 2003, FMI launched
methods. In 2003, FMI launched SuperSafeMarkTM, the most comprehensive SuperSafeMarkTM, the
food safety and sanitation instruction program ever offered to food retail em- most comprehensive food
ployees at all levels. This multimedia program helps provide people the knowl- safety and sanitation
edge and skills to become certified food handlers, as well as certified trainers instruction program ever
who can instruct others. SuperSafeMarkTM includes the following materials:
offered to food retail
Retail Best Practices and Guide to Food Safety and Sanitation.
Retail Best Practices and Supervisor’s Guide to Food Safety and
Retail Best Practices and Quick Reference to Food Safety and Sani-
Retail Best Practices and Trainer’s Kit to Food Safety and Sanita-
tion, including five videos, a PowerPoint program, posters and other
materials to help instructors illustrate food safety controls.
The program includes methods for combating foodborne illnesses with time-
and-temperature controls, measures to prevent cross contamination, personal
hygiene and pest control. In 2004, FMI introduced a Web-based version of the
training program.

Many states require that food handlers be certified by passing an accredited
food protection certification exam. They can be certified by passing the Food
Safety ManagerTM exam provided by the National Registry of Food Safety Pro-
fessionals through a partnership with FMI. This is the only exam available in the
U.S. tailored specifically to the sanitation requirements in a food retail environ-

As a quick and convenient reference tool, FMI offers a series of laminated
cards titled Quick Tips for Food Handlers, along with two posters that deliver
critical food safety messages. Quick Tips summarizes the FDA Food Code, ba-
sic hygiene measures, product receiving, pest control, and cleaning and sanitiz-
ing food-contact items. One poster reminds employees to scrub their hands for
20 seconds and the other to avoid cross-contamination.
Product Recalls — Situation Management manual helps food retail-
ers and wholesalers manage recalls. It emphasizes proper planning, coordination
with employees, suppliers and government officials, and communication with
the news media.

FMI represents the industry on numerous committees and councils world- FMI represents the
wide that establish food safety standards, and training protocols, examinations industry on numerous
and regulations. These include the Conference for Food Protection; Food Safety committees and councils
Training and Education Alliance for Retail, Food Service, Vending, Institutions worldwide that establish
and Regulators; USDA Meat and Poultry Advisory Committee; and Association training standards and
of Food and Drug Officials Education Teleconference Committee.
examination protocols.

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Food Safety and Foodborne Illnesses

14. How aware are consumers of the hazards associated with
foodborne pathogens?
There is some evidence that consumer awareness is growing, according to FDA From 1993 to 2001, FDA
Food Safety Survey data collected from random samples of several thousand surveys found that the
American consumers in 1988, 1993, 1998 and 2001. After years of little pro- percentage of consumers
gress, the study showed significant improvements in the single most important who did not wash their
measure consumers can take to prevent foodborne illness — repeated and vig- hands after touching raw
orous hand washing. From 1993 to 2001:
meat declined from 29
The number of consumers who do not wash their hands after touch- percent to 15 percent.
ing raw meat declined from 29 percent to 15 percent.
The number after cracking eggs went from 66 percent to 55 percent.
And after cutting raw fish, from 11 percent to 4 percent.

FMI focus group research and surveys show that consumers know that food
safety is important and that they personally should observe sound food-handling
practices. It is clear, however, that they do not fully comprehend some of the
most important messages, or they fail to take measures they do understand.

These findings were reaffirmed by a 2004 survey of 4,900 consumers by
the Partnership for Food Safety Education, a public-private coalition that FMI
helped found. For example, 85 percent of consumers understand the importance
of washing hands vigorously when handling food, but only 65 percent “always”
do so. And while 94 percent have heard that surfaces used to prepare fresh meat
and produce should be thoroughly sanitized, 76 percent “always” take this pre-

FMI and government agencies have developed numerous resources to edu-
cate consumers (see Sources of Additional Information on page 12). In 1997,
FMI spearheaded the launch of Fight BAC!TM, a major
public education program intended to compel consumers to
“Keep Food Safe From Bacteria.” The program empha-
sizes four basic sanitation measures: wash hands and sur-
faces often, don’t cross-contaminate, cook to proper
temperatures and refrigerate food promptly. In 2002, FMI
adapted Fight BAC! TM to provide year-round food safety
training for store-level employees. And in 2004, the Part-
nership for Food Safety Education launched an animated
and interactive Web site — — to teach
children proper hand-washing methods.
FMI members have launched special hamburger-
safety education programs for customers. These efforts
were prompted by scientific research showing that color is
not a reliable indicator that ground beef has been cooked
well enough to kill all harmful bacteria. The only way to be
certain that cooked ground beef has reached the safe inter-
nal temperature of 160oF is to use a thermometer. Retailers
and wholesalers communicate this message with stickers
on ground beef packages.

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