The statistics are sobering. Listeriosis, a serious infection usually caused by eating food contaminated with Listeria monocytogenes (Lm), causes about 1,600 illnesses, 1,500 hospitalizations and 260 deaths in the U.S. annually, according to the USDA’s Food Safety Inspection Service (FSIS). Although it is rare, its fatality rate is about 16 percent, compared to 0.5 percent for Salmonella and E. coli.
Lm is a bacterium that is found in moist environments, soil and decaying vegetation and can persist along the food continuum.
Transfer of the bacteria from the environment (e.g., deli cases, slicers and utensils), employees or raw food products is a particular hazard of concern in ready-to-eat foods, including both meat and poultry products.
“Given the complexity of operations and high-risk products involved, delis require a risk-based audit approach that can identify and prioritize food safety hazards,” says Rade Jankovic, senior account manager of retail and retail services at Alexandria, VA-based NSF International. “NSF International has been conducting risk-based audits of supermarket delis for many years and also has extensive experience in conducting risk assessments and food safety gap analyses of deli operations as well as HACCP plans and SOP development to help retailers build their food safety programs.”
To implement a successful food safety program, supermarket delis must first identify potential food safety hazards in the operation, then develop policies and procedures to address these hazards and establish active managerial controls that call for a proactive approach to the program, according to FSIS.
Implementing proper cleaning and sanitizing procedures and training staff must be accompanied by a myriad of other key procedures, such as the establishment of process flows to prevent cross contamination between raw meats and ready-to-eat foods during preparation and storage, adequate product temperature controls, equipment maintenance as well as daily supervision of staff to ensure adherence to food safety policies and procedures.
While the new menu labeling regulations and their impact on retailers have been publicized widely, food safety and sanitation-specific regulations have not changed in the last year.
However, it should be noted that due to the heightened concerns associated with Listeria monocytogenes in ready-to-eat deli foods, FSIS has been conducting on-going surveillance of retail delis to assess how closely retailers follow its guidance document on controlling Listeria.
Since the study began in 2016, results have shown a continued increase in retailers following recommendations from the guidance document.
According to FSIS, effective food safety sanitation in delis requires a comprehensive approach that includes proper product handling, cleaning procedures, temperature controls, preventive maintenance, cross contamination prevention, employee health and practices as well as appropriate training at the store level.
Furthermore, to control Listeria and other pathogens in the deli environment, it is essential that food equipment, such as slicers, be fully disassembled during cleaning and sanitizing, all surfaces be thoroughly scrubbed during cleaning to prevent biofilm formation and that cross contamination from raw meats, unsanitary items and employee practices be prevented, according to FSIS.
Removing standing water and proper date marking of products that support bacterial growth are also important in controlling Listeria.
While practical, environmental testing, such as ATP testing or rapidly measuring actively growing microorganisms through microbiology techniques, could be considered as a way to augment the sanitation program, it must be based on a well-thought-out sampling plan, according to the FSIS.
Creating the Culture
As the complexity and extent of food preparation in retail delis increasingly resembles that of full-service restaurants, it is essential that deli operators conduct a risk assessment of their processes before expanding their menu offerings to ensure the existing facilities and resources can accommodate the added burden imposed by the addition of new products in a way that ensures their safety, recommends the FSIS.
It is important for leaders to establish a food safety culture as a key prerequisite for a successful training program.
While sales and customer service are essential to the success of any business, these should not be achieved at the expense of food safety, and this message should be shared with the entire team, the FSIS recommends.
The food safety program can be successful only if every team member from the sandwich maker to the executive stays engaged in the food safety effort. When the deli is at its busiest, the food safety program must be at its best.
“Delis present challenges, since the healthier the food, the more susceptible it is to pathogen growth,” says Dr. Hilary S. Thesmar, vice president of food safety at the Food Marketing Institute (FMI), based in Arlington, VA. “That’s why deli and fresh departments are so focused on food safety.”
High protein and moisture contribute to food safety issues, so FMI has focused on minimizing foodborne illnesses through multiple channels and audiences.
“We work with retailers on in-store food safety programs, as it’s important to be aligned on best science and have consistent protocol nationwide to ensure products are safe,” says Thesmar.
Although regulations depend on a store’s jurisdiction, state codes prevail over FDA food codes.
“If products are prepared in a commissary or central kitchen, this is under a federal jurisdiction and must follow the Food Safety Modernization Act (FSMA),” says Thesmar. “These are for facilities not located adjacent to retail establishments.”
FMI offers its Safe Mark, training program for those managing food safety programs as well as food handler training for those working with food.
“These programs train employees on preventing contamination and how to know when things go wrong,” says Thesmar. “These are essential components for store employees.”
State health officials also are willing to help deli operators with food safety.
“Retailers can reach out to food companies directly for assistance and advice, as well,” says Thesmar.
FMI also has a Listeria action plan available to its members and the public on its website and works closely with the FSIS to communicate with the deli industry on Listeria control.
A Game Changer
There has been much innovation in recent years in the area of food safety when it comes to identifying pathogens, tracing their origin and finding patterns of food illness outbreaks.
The U.S. Center for Disease Control’s (CDC) PulseNet system isolated organisms from specimens of those with suspected foodborne illness and entered these into a database to separate the type of pathogen. Because the exact pathogen was able to be identified, patterns of illness outbreaks could be found.
“This was helpful in shortening the speed in which outbreaks were identified,” says Marty Mitchell, technical director at the Marietta, GA-based Refrigerated Foods Association.
Whole Genome Sequencing, or WGS, has accelerated the process of identifying foodborne illness outbreaks. With this process, scientists can look at the whole genome makeup or sequence of bacteria and have a very reliable fingerprint.
“We can reduce the number of people getting sick with each outbreak, since it can be stopped faster with information disseminated quicker,” says Mitchell. “We can track or implicate a deli from a swab at a health agency months later. It’s no different than getting a fingerprint off a gun and implicating someone for a crime years later.”
Every time a case of foodborne illness is diagnosed, the public health agencies are on the hunt to find the source. This is where WGS has been instrumental.
“Twenty years ago, public health labs used pulse field gel electrofreezes,” says Craig Hedberg, professor in the division of environmental health and former epidemiologist at the University of Minnesota. “Chopped up DNA chunks arrayed themselves and formed a pattern characteristic of the isolate.”
By comparing these patterns, scientists could see which ones were related and identify an outbreak pattern.
“This was successful, but a crude technique, since it didn’t tell us what was going on with the chunks of DNA,” says Hedberg. “WGS goes beyond that to reconstitute the genetic sequence of the organism. The cost and speed have gone down so much that we can do this on a routine basis.”
The technique is used to link individual cases together and identify clusters.
“WGS also allows us to go back and compare clinical isolates with environmental or food isolates from food processing plants,” says Hedberg. “It is more accurate and provides us with a lot of information about the isolates.”
WGS has been used for Listeria for awhile now, but just recently is being implemented for Salmonella and E. coli, which are more common.
“This method also may help us identify previously unrecognized food vehicles,” says Hedberg. “What’s important is we recognize outbreaks will happen despite our best efforts, and this gives us better tools so the industry can work to provide new solutions for better prevention methods.”
Re-enforcing food safety policies and procedures through on-going training and daily monitoring of employee practices cannot be overstated, FSIS emphasizes. Food handling in a retail deli poses numerous challenges that, if not managed properly, could lead to serious consequences with public health implications. Given the high employee turn-over rates in the industry, efforts to properly train new employees and re-enforce the food safety knowledge of experienced employees must be viewed as a daily necessity. DB