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食物病原体

食物病原体are microorganisms like bacteria, viruses, and to a lesser extent, fungi, that cause disease when ingested. When someone eats a food contaminated with a pathogen, they become sick. This is known as食源性疾病。According toFoodSafety.gov，导致在美国需要住院的食物中源性导致病原体是：

• Salmonella
• 诺洛伐不沃（诺沃克病毒）
• Campylobacter
• E. coli
• Listeria
• Clostridium perfringens

这些病原体，它们的普通食物来源的总结以及如何最大限度地提出对它们的污染风险如下表列出：

病原	Food Sources	Minimizing Risk
Salmonella	动物来源的任何生物食品（例如，肉，家禽，牛奶和乳制品，鸡蛋，海鲜）和一些水果和蔬菜可能会携带salmonellabacteria. The bacteria can survive to cause illness if meat, poultry, and egg products are not cooked to a safe minimum internal temperature, or if fruits and vegetables are not thoroughly washed.Salmonellacan also contaminate other food that comes in contact with raw meat and poultry.	安全食品处理实践是预防细菌对生物食物引起疾病的必要条件。这包括适当，频繁的洗手;在食品制备过程的所有部分中避免与其他食物的交叉污染;并烹饪食物安全最小的内部温度。
诺洛伐不沃	在煮熟后提供还是处理的任何食物都可以被诺罗病毒污染。其他来源包括污染的食物，如牡蛎，水果或可能已经在生产过程中被污染的蔬菜。	诺瓦克病毒是食源性疾病的主要原因s in the U.S. Most outbreaks occur in food service settings; food handlers are often the source of the outbreaks. Safe food handling practices (e.g., frequent handwashing using proper techniques, wearing clean disposable gloves when handling food, and changing gloves often) can minimize most risk of norovirus transmission. Also, making sure to properly wash fresh fruits and vegetables and cooking other foods to a safe minimum internal temperature can help reduce the incidence of norovirus.
Campylobacter	Meat and poultry can containcampylobacter。The bacteria can be found in almost all raw poultry because it lives in the intestinal track of healthy birds.	Campylobacterbacteria are extremely fragile and are easily destroyed by cooking to a safe minimum internal temperature. Freezing cannot be relied on to destroy the bacteria.
E. coli	Contaminated foods (e.g. undercooked ground beef, unpasteurized milk and juice, soft cheeses made from unpasteurized milk, and raw fruits and vegetables), untreated water, and any foods handled with unclean hands can be sources ofE. coli.	经常洗手,特别是在changing diapers or any contact with animals. Wash hands before preparing or touching food. Cook foods to a safe minimum internal temperature. Avoid eating high-risk foods that are sources of potentialE. coli污染。
Listeria	是潜力来源的食物Listeria污染包括即食熟食肉类和热狗，冷藏肉类蔓延，未经高温消毒（原料）牛奶和乳制品，软奶酪用未经腐烂的牛奶制成（Queso Fresco，Feta，Brie，Cambersmert），冷藏烟熏海鲜或生豆芽。在没有足够的卫生实践的设施中加工的食物也可以港口Listeria。	风险Listeria通过适当的衣服又堆可以减少污染g of fresh produce, storing raw animal-based food products separately from other foods, washing hands and cleaning and sanitizing food preparation surfaces and equipment after handling uncooked foods, eating perishable and ready-to-eat foods as soon as possible, avoiding consuming unpasteurized dairy products, and heating hot dogs and deli meats prior to consumption.
Clostridium perfringens	牛肉，家禽和肉汁和用这些食物制成的任何混合的菜肴 - 是最常见的食物来源产气荚膜梭菌。Additionally, foods prepared in large batches and held or warmed for a long time before serving can causeClostridium perfringensinfections.	Clostridium perfringensis one of the most common causes of food poisoning in the United States. Cooking kills growingClostridium perfringenscells that cause food poisoning, but not necessarily the spores that can grow into new cells. If cooked food is not promptly served or refrigerated, the spores can grow and produce new cells. Thoroughly cooking food and keeping food out of the temperature danger zone minimizes the risk of contamination.

来源：美国农业部食品安全和检验服务，疾病控制和预防中心，以及Foodsafety.gov。

影响细菌生长的因素

所教训六,有六个因素that affect bacterial growth on food. These include food, acidity, time, temperature, oxygen, and moisture. This is sometimes referred to by the acronym “FAT TOM.” Some foods are more prone to bacterial contamination due to their characteristics. These include foods like meat, poultry, and seafood products; dairy products like milk and cheese; fresh produce like fruits and vegetables; soy products like tofu; and flavored oil immersions. Cooking destroys many of these bacteria, but not all food is cooked prior to serving. When preparing these foods, the food handler should always take proper precautions to avoid transferring the bacteria from these foods to other foods that will be served ready-to-eat or that are already fully cooked.

Preventing Cross-Contamination

During Storage

Cross-contaminationoccurs when pathogens in one food are transferred to another food, either directly or indirectly through contaminated surfaces. This transfer can happen at many different points in the food preparation process. While it is always best to strive to keep contaminated food out of the kitchen to begin with, it’s not always possible to do this. Thus, safe food-handling practices become essential to minimizing the transfer of pathogens from contaminated (or potentially contaminated) foods.

Storage is one place where cross-contamination can occur. Proper storage practices include storing food in designated areas only and not with nonfood items, including chemicals. All food (and nonfood) items should be stored at least 6 inches off the floor and away from walls and ceilings. Food should be stored in wrapped or closed containers to prevent contaminants from getting in. Do not reuse nonfood containers to store leftover food; instead, food should only be stored in equipment designated for food.

If your facility has the space and equipment, it is ideal to store raw or uncooked food separately from ready-to-eat food in the refrigerator. If not, though, the recommended storage practice is as follows:

• Top shelf (ready-to-eat foods): milk, fresh produce, cheese, salads, yogurt
• 2nd shelf (cook to 140 F): reheated foods (precooked), such as ham or breaded chicken
• 3rd shelf (cook to 145 F): fresh beef (not ground beef) or pork, seafood
• 4th shelf (cook to 160 F): ground beef or pork, eggs
• 底架（烹饪到165 f）：生鸡或土耳其（包括地面），剩菜，砂锅

During Preparation

Another opportunity for cross-contamination to occur is during food preparation. Doing things like properly washing hands, washing hands often, and wearing and changing disposable gloves can prevent the transfer of pathogens. Make sure the food prep area, including surfaces and equipment, are thoroughly cleaned and sanitized. Another good practice is to prepare raw or uncooked meat, poultry, and seafood at a different time than ready-to-eat foods, and then clean and sanitize the surfaces and equipment when you are done. Never allow ready-to-eat foods to touch surfaces that have come into contact with raw or uncooked meat, poultry, or seafood.

Not all foods that are at risk for harboring pathogens are meats. Fresh fruits and vegetables can also carry pathogens from growing conditions or handling before they arrive at your facility. Thoroughly wash all fresh produce under warm, running water to remove any dirt or residue. Foods like lettuce and spinach should have each leaf washed separately. Remember to scrub the peels or rinds of fruits and vegetables before cutting them, because if there are pathogens on the outside of the food, cutting them will transfer the pathogens inside as the food is cut. Once fresh produce has been prepped, it needs to be stored, wrapped and labeled in the refrigerator until served. Use the防止食品准备过程中的污染below from the National Food Safety Management Institute and make this resource available to all food service staff at your facility.

• 国家食品安全管理学院Preventing Contamination During Food PreparationFact Sheet

化学品的交叉污染

The chemicals used to clean and sanitize the kitchen can be another source of contamination. Although this type of contamination is not from pathogens, it can still make people sick. Chemicals used in food service should be stored in their own area, away from food and nonfood-related supplies and equipment. Chemicals should be stored in proper containers, which are those labeled with the information about the chemical. Do not reuse old food containers to store chemicals.

Towels used for cleaning and sanitizing should be kept in their respective pails when not in use. Towels used to clean food spills should not be used for any other purpose; doing so can cause cross-contamination. Make sure that all cleaning agents and sanitizing solutions are used in the proper concentrations and that residues are rinsed or wiped clean.

Food Allergens

Food Allergies vs. Food Intolerances—What’s the Difference?

Many people get food allergies confused with food intolerances. While both conditions can cause adverse symptoms as a result from exposure to a trigger food,food intolerancesonly involve the digestive system and do not involve an immunological response from the body. Common food intolerances include gluten, milk and dairy, and monosodium glutamate. Although food intolerances do not cause life-threatening symptoms, they can still be very uncomfortable for the food-intolerant child, and considerations should be made when menu planning.

Food allergies,另一方面，当某些食物被摄取时发生，触发身体的免疫应答。当具有食物过敏的人暴露于触发物食物时，它们的身体开始产生称为免疫球蛋白E的特异性抗体，其与负责过敏的食物中的蛋白质结合。反过来，这导致过敏症状，如荨麻疹，皮疹和限制呼吸。

Children may not be good at articulating their symptoms, especially young children. A child experiencing symptoms from an allergic response to a food might say things like:

• 我的喉咙是痒/刮擦/浮肿/感觉紧
• My tongue is hot/itchy/tingly
• There’s something stuck in my throat
• 我的嘴巴感觉很有趣
• 这种食物辛辣（特别是在不吃辛辣食物时）

过敏反应的症状可以轻度或严重。轻度症状可包括荨麻疹或皮疹，恶心或呕吐，胃痛，鼻塞或流鼻涕。严重的过敏反应包括症状，如肿胀或喘气的嘴唇，舌头或喉咙;气促;胸部紧绷;头晕;心跳加速;血压下降;或者过敏症。Severe allergic symptoms need to be addressed right away, as death can occur if not treated promptly. If a child exhibits symptoms of anaphylaxis, he or she will require immediate medical treatment, including an epinephrine injection and a trip to the emergency room. Check your center’s policy for storage, administration, and training related to epinephrine medications. An allergic child should have a designated person to administer emergency medication in her or his food allergy action plan on file at the center.

While the supervision of children during mealtimes is primarily the responsibility of direct care staff, it is important for all program staff to be aware of the signs of an allergic reaction and the necessary steps for addressing the situation. Check with your program’s specific protocols for handling food allergies.

8种主要食物过敏原

特定类型食物的蛋白质负责食物过敏。虽然有超过160种类型的食物，可导致敏感性的过敏反应，但这八种食物占90％的食物过敏反应：

1. Milk
2. 蛋
3. Fish
4. Crustacean shellfish (e.g. crab, lobster, shrimp)
5. Tree nuts (e.g., almonds, walnuts, pecans)
6. Peanuts
7. Wheat
8. Soybeans

These foods—and any food containing them—by law must be identified on the food product’s label. The allergen can be identified in the ingredients list, or at the end of the ingredients list, with a statement such as “Contains wheat, soy, and milk ingredients.” Some companies may also opt to use precautionary labeling, in which they voluntarily disclose when a food product that does not contain any of the eight major food allergens is produced in a facility where these allergens are also processed. An example of a statement might read, “Processed in a facility that also processes peanuts and tree nuts.” Precautionary labeling is not required by law and can vary widely in its use. Make sure to check the labels of all food products for the presence of allergens during the receiving process. When you serve the food, a recommended practice is to keep the labels of all foods prepared for 24 hours in the event a child suffers an allergic reaction. You might even consider keeping a “label library,” where you retain all actual food labels (or scan them and save them electronically).

避免交叉联系

幼儿中心负责促进保护儿童的安全物理环境。国家和当地卫生法规概述了有关可以保护的表面和其他实践的清洁和消毒的要求cross-contact在食品准备期间。交叉触点是指无意转移过敏原从含有过敏原于不含过敏原的食物的食物转移。重要的是要了解这一点cooking does not reduce or eliminate一个人对食物过敏的机会对食物进行反应。

Some practices to reduce the incidence of cross-contact include:

• Clean and sanitize—with soap and water or all-purpose cleaning agents and sanitizers that meet state and local food-safety regulations—all surfaces that come into contact with food in kitchens, classrooms, and other locations where food is prepared or eaten.
• Clean and sanitize food preparation equipment, such as food slicers, and utensils before and after use to prevent cross-contact.
• 每次使用后清洁和消毒托盘和烤盘。（油可以通过蜡纸或其他衬里渗透并导致交叉接触。）
• 使用适当的洗手程序，强调使用肥皂和水。手动消毒剂在去除食物过敏原方面无效，这些过敏原是基于蛋白质的物质。

食品服务人员可以使用的其他最佳实践来减少准备食物时交叉接触的发生率：

• Prepare and store allergen-free foods separate from other foods.
• Label foods with stickers, color coding, or other methods to indicate whether a food is allergen-free.
• Store allergen-containing foods away from other foods to prevent cross-contact.
• Prepare allergen-free menu items first. These foods may need to be prepared on a separate, clean pan to avoid cross-contact.
• Wear a new pair of disposable gloves when preparing and handling allergen-free foods.
• Thoroughly wash any work surface with detergent solution using a clean towel. Rinse with clean water. Sanitize surface and allow to air dry
• Change your water and obtain a different cleaning towel before cleaning any other area of the kitchen, serving, or dining area.
• 在使用之前，请确保所有器具，刀具，切割板或其他设备在下一个产品使用前清洁和消毒。根据需要更换围裙以防止交叉接触。
• Familiarize yourself with the children who have food allergies.
• 培训员工和其他人员识别症状，并监测过敏患者周围的地区。
• Designate an allergy-free area and or table (note that children cannot be required to use these designated allergen-free zones because of privacy laws).
• 用肥皂和水彻底清洁所有桌子和椅子，并通过批准的消毒剂消毒。使用专用铲斗进行清洁和消毒不含花生区域。

Accommodating Children with Food Allergies in Child Care Centers

The National Food Safety Management Institute identifies four strategies or steps to accommodate children with food allergies.

步骤1:了解您儿童保育中心的食物过敏;当您了解菜单规划，阅读标签以及以下安全食品处理原则时，请考虑各种过敏。

第2步：Know the requirements for serving food to students with special dietary needs. This information is in the USDA guidance, and if your child care center has a food allergy policy, the information would be there, as well.

第3步:Develop a partnership with open communication and education for all those involved with the child’s care. Parents of students with food allergies have a lot of experience and expertise in the topic, so they can be an asset to the child care center’s team.

Step 4:实施许可医师，医师助理或护士从业者的指令。如果孩子有一个表格与中央的记录表明学生有与食物有关的disabilityas defined by the Americans with Disabilities Act Amendment Act of 2008, food services is required to make the accommodation. If there is no disability, the accommodation is not required, but can be made as a gesture of support and customer service.

Because food allergies can be severe—and potentially life-threatening—child care providers must be aware of all allergies in the children in their classroom or care group. Proper and accurate documentation and regular communication between parents, child care center directors, classroom staff, and food service personnel can help to keep everyone in the loop about food allergies. For instance, the child care center’s director should discuss allergies with the child’s family when the child is being enrolled. Any information about the child’s allergies, including treatment plans, should be documented in the child’s file. As food service personnel, your responsibility is to know which allergies, restrictions, and preferences are present at your center so that the menu planning process can account for these situations.

食物过敏行动计划

疾病控制和预防中心发表了2013年的资源在学校和早期护理和教育方案中管理食物过敏的自愿准则。This is a comprehensive resource for food service personnel when it comes to procedures for addressing food allergies. One outcome of the CDC’s work was the recommendation for each facility to develop a food allergy management plan with these five priority areas:

1. Ensure the daily management of food allergies in individual children.
2. Prepare for food allergy emergencies.
3. 为员工提供专业发展的食物过敏。
4. Educate children and family members about food allergies.
5. 创造并保持健康和安全的教育环境。

Does your center have an allergy plan? If so, are any of these five areas in your plan? Make the following resource,CDC Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Programsavailable for use at your facility.

• CDC在学校和早期护理和教育方案中管理食物过敏的自愿准则

See

防御部儿童护理中心如何处理食物过敏？文件和跟踪食物过敏涉及的一些步骤是什么？在为食物过敏儿童准备食物时使用的一些过程是什么？交叉接触的最小化如何？观看这些视频剪辑，其中登记的营养师（或食品服务总监）解释了追踪和管理儿童护理厨房食物过敏的最佳实践。

Allergens

Do

How much do you know about preventing foodborne illness from unsafe food handling in your facility? Use theFoodborne Illness Self-Assessment Tool下面确定您的设施的风险。回答调查中的每个项目。如果您不知道答案，请与您的主管联系。后来，与您的主管讨论如何使您的做法适应更好地防止食物造成的疾病。

• Foodborne Illness Self-Assessment Tool