What’s Making US Food Bank Clients Sick?

Food banks across USA must focus on food safety

| Special In-Depth Coverage by Cookson Beecher, Food Safety News – We get our food from all sorts of places — grocery stores, restaurants, farms, relatives, our own gardens — and sometimes community food banks.

In each and every case, food safety plays an important part in protecting us from getting sick from contaminated food. But nowhere is that more important than at food banks.

Why food banks? The answer can be seen in who turns to community food banks and pantries for help in obtaining enough food to get through the week or month.

US foodborne illness statistics: 

  • 48 million cases per year
  • 128,000 hospitalizations
  • 3,000 deaths | Source: CDC

Unlike the general population, people who receive food from such programs include a large proportion of what health officials refer to as vulnerable or high-risk individuals. Some estimates say they account for up to 60 percent of food bank recipients.

Children and the elderly are vulnerable because their immune systems are either not developed enough to protect them from foodborne pathogens or too fragile to offer much protection.

High-risk groups also include sick people and those with immune systems weakened from medical conditions, such as diabetes, liver disease, kidney disease, organ transplants, HIV/AIDS, or from receiving chemotherapy or radiation treatment.

Add to that group, pregnant women and the malnourished.

In short, these people are more likely to come down with food poisoning if they eat foods containing dangerous bacteria such as E. coli, Listeria, Salmonella or foods containing viruses or parasites such as Cyclospora.

Worse yet, they’re the ones likely to suffer the most severe symptoms when they do get sick from these microscopic foodborne pathogens.

The statistics are grim. The Centers of Disease Control and Prevent estimates that each year 48 million people, which is more people than the entire state of California, get sick from a foodborne illness. The CDC estimates 128,000 are hospitalized and 3,000 die.

However, many cases of foodborne illnesses are not reported, with some people mistakenly referring to their gastric distress as “the stomach flu.”

The most common symptoms of food poisoning are an upset stomach, stomach cramps, nausea, vomiting, diarrhea, and fever. It may take hours or days before these symptoms develop.

According to CDC, while most people don’t take long to recover, some people need to be hospitalized, and some foodborne illnesses result in long-term health problems or even death. Infections transmitted by food can result in chronic arthritis, brain and nerve damage, and hemolytic uremic syndrome (HUS), which causes kidney failure.

“Our food safety guidelines are very important because the last thing a person coming to a food bank needs is to get sick,” said Julie Humphreys, community relations manager for Second Harvest, a Feeding America member food bank. “We want them to be assured that the food they’re getting is safe. Our job is to handle and provide a basic need and feed people today so they can have a better chance of going forward tomorrow.”

With centers in Spokane and the Tri-Cities in Washington state, Second Harvest provides more than 2.5 million pounds of donated food each month throughout the Inland Northwest, which includes Eastern Washington and Northern Idaho. It supplies the food to 250 community food banks/pantries, meal centers, and other programs. The network feeds 55,000 people each week.

Second Harvest enjoys an exemplary reputation for food safety. It has received the highest rating every year for 8 years in a row in its annual audits by AIB International, which focuses on food safety when it comes to food handling and distribution.

Each of Second Harvest’s 250 partner agencies, which include member food banks, pantries, and feeding programs, are also audited for such things as cleanliness, food storage, refrigeration, and distribution.

“Documentation is an important part of this,” said Humphreys. “We have procedures for all of the food that comes in, goes out, and how it’s managed.

Brandon Fullerton, a grant writer at Helping Hands Food Bank in Sedro-Woolley, WA, said food safety is paramount.

“Our job is to feed people,” he said, “and because many of the people who come to food banks are vulnerable, we could actually get them sick if we don’t pay strict attention to food safety.”

Patti Yount, a volunteer at the Helping Hands Food Bank in Sedro-Woolley can attest to how important food safety is to “the vulnerable.” That’s because she was one of them.

Before being diagnosed with cancer in her 70s, she was what she would describe as a “healthy” person.

But when she began chemotherapy, her doctor told her not to eat any fresh vegetables or fruits — not even from her own garden — only those that were frozen or canned.

She was also told not to pet any animals or change any kitty litter, and not to come into contact with any feces whether animal or human. She was even told to wear a mask and gloves when changing grandchildren’s diapers.

That advice highlighted just how vulnerable she was to E. coli and other foodborne infections.

Yet despite all of the care she took to follow her doctor’s advice, she got an E. coli infection anyway and had to go through additional medical care.

They never figured out where she was exposed to the bacteria.

“My immune system was so weak that I couldn’t fend anything off,” she said.

Not surprisingly, she’s passionate about the need for food banks to follow good food-safety practices.

“We have to be twice as careful,” she said.

“You can do what you want at home but if you’re serving the general public and vulnerable people, it’s a different kind of responsibility,” said Mitzi Baum, managing director of Food Safety at Feeding America. “You can’t be too careful.”

Steve Davis, chief operating officer for Harvesters Community Network, which serves a 26-county area of northwestern Missouri and northeastern Kansas, agrees.

“What people do at home is their business,” he said.“But it might not be OK when you’re serving vulnerable people, and therein lies the difference.”

The big microscopic 3

Microscopic pathogens can be lurking in all sorts of foods: meat, poultry, fish, eggs, and surprising to many, fresh fruits and vegetables, including leafy greens. Here’s a quick rundown of three of them:

E. coli

E. coli, which is commonly found in the lower intestine of warm-blooded organisms, is associated with undercooked ground beef, typically used for hamburgers; vegetables grown in cow manure or washed in contaminated water or cross-contaminated with already contaminated produce; and milk and fruit juice that hasn’t been pasteurized to kill germs such as E. coli.

Salmonella

Salmonella bacteria typically live in animal and human intestines and are shed through feces (poop). Humans become infected most frequently through contaminated water or food. While it is commonly associated with eggs and poultry, it has also contaminated cucumbers, pistachios, raw tuna, sprouts, fruits, pork, sprouts, vegetables, and even processed foods, such as nut butters, frozen pot pies, chicken nuggets, and stuffed chicken entrees and many other foods.

Listeria

Listeria bacteria can live in soil, water, dust, animal poop, and other substances. .According to the CDC, Outbreaks of Listeria infections in the 1990s were primarily linked to deli meats and hot dogs. Now, Listeria outbreaks are often linked to dairy products and produce. Investigators have traced recent outbreaks to soft cheeses, celery, sprouts, cantaloupe, and ice cream.

Pregnant women are 10 times more likely than other people to get a Listeria infection. Many times, this leads to a miscarriage.

Bottom line, there are many foods that can cause food poisoning and no one is immune.

That’s why it’s so important for food bank managers and volunteers to be diligent about keeping an eye on the food that’s being given out and about keeping foods at proper temperatures.

For example, leafy greens, which includes spinach and lettuces that have been cut, need to be kept at 41 degrees F or colder.

The reason for that is that once a leaf has been cut, allowing in bacteria that might be on the uncut greens. If the holding temperature is not cold enough, the bacteria begin to multiply rapidly.

This, in turn, leads to the dangerous situation in which the bacteria hangs on tight and can’t be dislodged. No matter how many times you wash it, you can’t remove all of the bacteria.

Who are the volunteers?

Volunteers — often called the “lifeblood” of food banks— make up a diverse group. Some are old, some are high school and college students. Some have their Ph.Ds; others never finished high school. Some are business people, community leaders, veterans and even politicians. Many are retired people happy to be helping their community.

Many volunteers come to the job with only a smattering of information about food safety, although they’re usually required to get a food handlers license, which gives them basic information relevant to restaurants.

Go here https://furtherwithfood.org/resources/servsafe-food-handling-guide-for-food-banking/ for information about getting a copy of ServSafe Food Handler Guide for Food Banking. This easy-to-implement program has been tailored to meet the unique needs, quality and spirit of Feeding America’s network of food banks and agencies.

While some volunteers show up on a regular basis, some might show up only once and others only now and then, sometimes with a large gap of time between.

“Volunteers come and go,” said Joe Corby, immediate past executive director of the Association of Food and Drug Officials. “That why there’s such a need for continued food-safety education.”

Harvesters’ COO Davis said his organization makes sure the local food banks and pantries and other feeding programs understand the food safety requirements.

“We give them tools they can use with their volunteers,” he said. “If there are problems, we’ll take the chance to retrain volunteers and help them be successful. We do a lot of point-in-time training.”

He said he believes that food safety has to be part of your DNA and culture.

“Anything you want to be good at, you need to do all the time,” he said.

For older volunteers, it’s hard to throw out produce just because it has come nicks or cuts or mold on it. “Waste not, want not,” was a maxim they grew up with. Sometimes the phrase, “Beggars can’t be choosers” also comes into play.

In fact, many who turn to food banks are people you might know. It could be a neighbor or relative who lost a job because of an accident or a cancer diagnosis. Others may be too old to work and yet only get a small Social Security check each month. Others might be homeless, struggling to get back on their feet. Some, in their younger years, were pillars of the community.

And some are employed. In fact, 36 percent of client households served by the Feeding America network have one or more adults working.

Respect

“It’s important to serve recipients with respect,” said Harvesters’ Davis. “This is one of the things we talk about a lot with agencies in our network. You wouldn’t want to give food out that you wouldn’t want to eat yourself or serve your family.”

Feeding America’s Baum agreed. “Dignity is always an important issue,” she said.

“Making our clients feel respected and at ease,” is how Helping Hands staff member Fullerton put it on his food bank’s website.

Let them know why

Feeding America’s Baum said that telling someone to do something can go in one ear and out the other.

“It works best when people understand why the food safety requirements are so necessary,” she said.

For example, telling someone to throw out a cantaloupe because it’s got nicks or dents or mold on it is one thing. But explaining that because cantaloupes grow on the ground and have a netted exterior, they’re more likely to have bacteria on them. To cut through the exterior can take some of the bacteria or mold into the sweet flesh, where the bacteria will multiply. When that happens, people can get sick, or worse.

In 2011, more than 30 people died from eating cantaloupe contaminated with Listeria.

Berries with mold on them is another example. According to the USDA, in the case of soft foods such as berries, it’s very easy for the roots or tentacles of the mold to penetrate deeper into the food. By the time mold has moved in, other harmful kinds of bacteria associated with food spoiling may have also infiltrated the food.

Then there’s the question of green potatoes. While some people say, they won’t hurt you, others caution that the green, which is a sign that solanine, a toxin, has developed in the potatoes, can be harmful to children and other vulnerable people. Peeling off the green skin won’t remove the solanine in the potato.

“When in doubt, throw it out.” That’s was food-safety experts say when it comes to questionable fruits and vegetables. No need taking the chance of getting someone sick.

So much has changed

AFDO’s Corby remembers that back when he was the director of the Division of Food Safety and Inspection in New York City, food banks were just starting up.

“We had field people go out to the food banks,” he said. “But since then, things have changed. Now everyone relies on the regional food banks to do the food-safety training. New people are coming in all of the time so there’s always a need for continued training.”

He’s also seen some changes in what the food banks are giving out. Whereas in the past, a lot of it was canned foods, now there are a lot more perishables, including fresh produce.

Second Harvest’s Humphreys can confirm that, saying that 70 percent of the food given out is perishable, including meat, cheese, and milk. And almost one half of it is fresh produce.

“It’s a huge portion of what we distribute,” she said.

At Second Harvest, volunteers do about 14 food sorts a week in three-hour shifts. Before each shift, the volunteers watch a food-safety video and also one about who comes to the food banks.

“When you have a vision of the people you’re sorting the food for, you get a good understanding of why food safety is so important,” said Humphreys.

Humphreys also said that volunteers need to know what to look for when sorting produce.

“We manage this with both a video clip and a personal demonstration,” she said. “For example, if a group comes in and we are sorting apples that day, they will watch a video on sorting apples and what to look for in removing the ‘bad’ apple. Then our volunteer supervisors will hold up examples of a good and bad apple. They give a ‘live look’ at an apple that may have a small soft spot, but is perfectly good and also show an apple that is too bruised or moldy to pass on.”

Humphreys said that the overriding marker volunteers are asked to consider is

“Is this piece of fruit or this vegetable one that you would like on your table?”

The unsalvageable produce goes in a bin that is then donated to area hog farms so nothing is wasted.

“We get a significant amount of produce, and we have to work with volunteers to understand what’s good and what’s bad, said Harvesters COO Davis. “It takes a lot of work and training and identifying to look for problems. We do a lot of point-in-time training.”

Poster photos worth a thousand words

Davis believes posters showing which produce is good and which should be tossed can be very helpful.

“The value of a poster is that anything visual is easier for people to learn and remember,” he said. “You get a higher level of adoption, especially when there’s a lot of volunteer turnover. Posters make volunteers more comfortable so they’re not as nervous to dispose of bad produce. The posters give them approval to do that.”

Corby agrees.

“We’re talking about making posters and getting them to food banks and government agencies,” he said. “ What would be ideal is to get the produce industry in on this.”

What about liability?

Under the Bill Emerson Good Samaritan Food Donation Act, a federal act that blankets all of the states, donors and recipients are protected against lawsuits as long as they’re acting in good faith. Each state also has its own Good Sam act.

Feeding America’s Baum said that the foundation of the Good Samaritan Act is that the donor is protected as long as there is no evidence of malicious intent or gross negligence.

“It would be up to a court of law to determine whether inadequate adherence to basic food safety principles is consistent with gross negligence and therefore not protected under the Good Samaritan Law,” she said.

She said that in her 22 years of working at the organization, it has never had a complaint regarding a case of foodborne illness associated with products that were distributed by Feeding America or its partner agencies that she’s aware of.

What about the recipients?

The people getting food from the food banks are often the forgotten part of the food chain. Yet even if everything is done right at the food bank, if someone puts a box of food containing meat, eggs, and produce in the car’s trunk and then goes to watch a kids’ soccer game, leaving the car parked in the hot sun, all of the efforts of the food bank can go for naught.

Feeding America’s Baum said she thinks it’s a good idea to hand out information to recipients, pointing out that there are plenty of resources available such as one (www.fightbac.org), highlighting the four core food-safety basics: clean, separate, cook and chill, put out by the Partnership for Food Safety Education. However, she pointed out that this sort of information is only useful if it’s in the appropriate language of the people it’s being given to.

Setting the tone

Feeding America’s Baum said that the most important advice she would give to a community food pantry manager is that she or he needs to be educated in food safety.

“Lead by example,” she said. “If you understand the basic concepts of food safety and discuss them, you will influence the staff and volunteers. Teach them that feeding the public is different than feeding people in their homes; the risks are greater and we must be more diligent that foods are safely handled. Ensure that food safety practices are followed by observing and empowering staff and volunteers with knowledge and information. And don’t just train someone, educate them and train them. If people understand the ‘why’ they will execute the appropriate practices.

“You can’t be in your office all day. You have to be out there because you’re managing people as well as doing administrative work. You need to be providing constructive advice. It’s important for leadership to know they’re setting the tone when it comes to food safety.”

Appreciation

One common theme among food bank recipients is appreciation. It’s what the volunteers and food bank staff members hear on a regular basis. It’s what makes their work so satisfying.

A video shown to volunteers at Second Harvest in Spokane and the Tri-Cities about who gets food from the food banks features Edwin and Debbie, the head of a multi-generational family that pulled together under one roof to help make ends meet after Edwin, a concrete finisher, had to leave his job because of a disability.

“With me on disability and Debbie working full time and our daughter working, we get so close to getting over the hump, but we just don’t quite get there,” Edwin says in the video. There’d be times that Debbie and I would have to skip meals in order to make sure the grandkids eat every day. Without the food bank and Second Harvest, we’d struggle. We’d have to spend a lot more of what little money we do have on food. The food bank and Second Harvest just supplements us tremendously.”

“It helps us by feeding us food we might not have,” said one of Edwin and Debbie’s grandsons during a food-bank cooking class.

The big food-bank umbrella

In the “food-bank world,” a “food bank” is the term used to describe a large- scale, logistically complex distribution center. On the local level, what most people call a food bank is referred to in the food-bank world as a “partner agency” — a smaller community partner that distributes food directly to the end consumer.

Feeding America is the nation’s largest domestic hunger-relief agency and its third largest charity. It oversees a network of more than 200 food banks that feeds more than 46 million people through community food banks, food pantries, soup kitchens, shelters, and other community-based agencies. Among the recipients are 12 million children and 7 million seniors.

Thirty-six percent of client households served by the Feeding America network have one or more adults working.

Food banks and partner agencies in the Feeding America network receive funding through many different channels. These include, but are not limited to: foundation and community grants; Feeding America; and donations from individuals, businesses and organizations. The food is donated by grocery stores, food clubs such as Costco and Sam’s Club, food manufacturers, retailers such as Starbucks and Quik Trip, online retailers such as Amazon, retail deliveries such as Instacart and Peapod, restaurants, farmers, the USDA, and individuals.

Community food drives are also an important source of food for food banks. While they might not necessarily bring in a huge volume of food compared to other food sources, they give everyone in the community an opportunity to help their hungry neighbors by donating even one can of food.

Republished with permission of Food Safety News. To sign up for a free subscription to Food Safety News, click here.