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Kombucha is a sweetened tea beverage fermented by bacterial and yeast cultures. Sweeteners, such as glucose, sucrose, fructose, and others are converted by yeasts into ethanol and then by Acetobacter and other bacterial species into a weak acetic acid solution that is diluted, flavored, and packaged into glass or aluminum cans for consumer consumption. Naturally, fermented kombucha contains 0 to 3% alcohol by volume (ABV). However, kombucha containing ethanol is concerning for pregnant women and young children for whom low levels of ethanol consumption (3% ABV) create adverse medical outcomes. In the province of British Columbia (BC), Canadian beverages containing1% ABV are regulated as liquor. This study assessed ethanol concentrations in kombucha collected from processors and purchased at retail venues in BC. Ethanol values were compared with the place of manufacture (country or province) and place of purchase (grocery stores, restaurants, farmers' markets, recreational centers, and processors). Ethanol (n = 684) levels were measured by using a headspace gas chromatography-mass spectrometry method with a detection limit of 0.0002% ABV for ethanol. Overall, teas contained mean and median ethanol of 0.77 and 0.62% ABV, respectively, ranging from nondetectable up to 3.62% ABV. Four kombucha teas (0.6%) made by BC processors tested over 3% ABV, and 31.5% of samples contained ethanol that exceeded the BC regulatory limits for nonalcoholic beverages of 1% ABV. Kombucha manufactured in BC had significantly higher mean ethanol values (1.16% ABV) in comparison to all other places of manufacture. Similarly, mean ethanol tea values obtained from BC processors (1.2% ABV) and restaurants (1.01% ABV) were significantly higher than those obtained at other retail venues. This study demonstrates the potential for alcohol harm to at-risk populations consuming kombucha teas sold in BC.

The incidence of Salmonella enterica infection resulting from consumption of chicken products has historically been elevated in British Columbia compared with the rest of Canada. Raw frozen breaded chicken products are often implicated as the source of infection as there is a potential for consumers to not cook these products adequately. This occurs because the production process for these foods involves par-frying, a step which lends a cooked appearance to the product surface without reaching the internal temperatures required to fully inactivate potential pathogens. A survey of frozen chicken products from 10 retail stores of various sizes was conducted in order to determine the type and source of frozen chicken products that are available for purchase in British Columbia. Information on 391 individual products was collected and 50 were sampled for microbiological testing. Raw frozen breaded chicken products represented 59% of the frozen chicken products available to consumers at retail; 34% of these raw products were made by a single processor. The same processor was also found to have the highest proportion (33%) of samples testing positive for Salmonella. Whole genome sequencing of isolates obtained during this study revealed that majority of these isolates were phylogenetically related to clinical isolates of Salmonella. A substantial reduction of risk and increased consumer protection may be achieved by implementing a kill step (e.g., cook process that has been validated to achieve a 7-log reduction) during production of these products.

Background: Water kefir is an up-and-coming beverage similar to kombucha involving the fermentation of water, sugar, fruits, and cultured microorganisms. The fermentation process develops various metabolites including lactic acid, carbon dioxide, and ethanol. These products need to be controlled to prevent unsafe overproduction, particularly of ethanol, as it can be dangerous to consume alcohol unknowingly. This study examined (i) whether water kefir and kombucha beverages are at-risk of containing elevated levels of alcohol, and (ii) the labelling practices of these products. Methods: 31 samples of water kefir were collected in various markets in Vancouver, British Columbia to be compared to 107 samples of kombucha previously collected by the British Columbia Centre for Disease Control (BC CDC). The samples were tested using gas chromatography mass spectroscopy (GCMS/D) to determine the concentration of alcohol in each. The data was analyzed using the statistical package NCCS. Two-tailed t-tests assessed differences in alcohol content between the two products, as well as whether kombucha and/or water kefir exceeded the regulatory standard of 1% ABV (alcohol by volume), as set under the Liquor Control and Licensing Act. Results: Based on the collected data, 53% of kombucha samples and 19% of water kefir samples exceeded 1% ABV for ethanol. There was a statistically significant difference in ethanol concentrations between the water kefir and kombucha samples p = 0.00002, power = 100%. More specifically, the kombucha products had a higher alcohol level. Two t-tests compared the kombucha and the water kefir to the standards which resulted in mean kombucha samples being greater than the 1% ABV while mean water kefir samples were less than the 1% ABV regulatory level. Conclusions: The results indicated that kombucha products had a higher mean alcohol concentration when compared to water kefir samples. However, some samples of water kefir exceeded the 1% ABV level and also lacked an alcohol warning label. Therefore, it is recommended that manufacturers for both kombucha and water kefir products label potential alcohol contents to protect the safety of their consumers – especially vulnerable groups including pregnant women, children, and recovering individuals.

Twenty-three Salmonella enterica serovar Weltevreden (S. Weltevreden) illnesses occurred in a Victoria, British Columbia, Canada, restaurant following consumption of fermented vegan cheese. Three clusters of illness over 2 days were traced to a single batch of fermented cashew cheese spread. S. Weltevreden was detected in 11 clinical samples and in the cashew cheese spread. An inspection of the restaurant and review of the food processes revealed high-risk practices, such as use of rejuvelac as a starter culture for fermentation and poor temperature control. Three of five vegan and natural food restaurants in the Victoria area were using similar methods, indicating this type of product was common. Procedures to safely ferment vegan cheese spreads are presented. We also discuss higher-risk food items and practises noted in this event that inspectors should be aware of during inspections.

There has been a steady increase in illness incidence of Vibrio parahaemolyticus (Vp). The majority of illnesses are associated with consumption of raw oysters. In the summer of 2015, Canada experienced the largest outbreak associated with the consumption of raw oysters harvested from British Columbia (BC) coastal waters. Case investigation of laboratory-confirmed cases was conducted to collect information on exposures and to assist traceback. Investigations at processors and oyster sampling were conducted. Eighty-two laboratory-confirmed cases of Vp infection were reported between January 1 and October 26, 2015. The majority of the cases were reported in BC, associated with consumption of raw BC oysters in restaurants. Sea surface temperatures were above the historical levels in 2015. This outbreak identified the need to improve surveillance and response to increases in human cases of Vp. This is of particular importance due to the potential for increasing water temperatures and the likelihood of additional outbreaks of Vibrio.

Two outbreaks of norovirus and acute gastroenteritis took place in Canada between November 2016 and April 2017. Both outbreaks were linked to oysters from British Columbia (BC) coastal waters. This paper describes the multi-agency investigations to identify the source and control the outbreak. Public health officials conducted interviews to determine case exposures. Traceback was conducted by collecting oyster tags from restaurants and analyzing them to determine the most common farms. Oyster samples were collected from case homes, restaurants, and harvest sites and tested for the presence of norovirus. Potential environmental pollution sources were investigated to identify the source of the outbreak. Four hundred and 49 cases were identified as part of the two outbreak waves. The oysters were traced to various geographically dispersed farms in BC coastal waters. Twelve farms were closed as a result of the investigations. No environmental pollution sources could be identified as the cause of the outbreak. Similarities in the timeframe, genotype, and geographic distribution of identified oyster farms indicate that they may have been one continuous event. Genotype data indicate that human sewage contamination was the likely cause of the outbreak, although no pollution source was identified.

Background & Purpose: The seasonal demand for shellfish such as oysters is on the rise. Shellfish are nutritious foods that may be enjoyed in a variety of ways, from slurping raw oysters to cooking oysters by means of boiling, steaming, pan frying and baking. Most consumers of oysters are aware of potential food safety issues with shellfish. Raw or undercooked shellfish can carry bacteria, viruses and toxins, potentially resulting in foodborne illness. Past outbreaks associated with the consumption of raw and undercooked oysters, prompted the British Columbia Centre for Disease Control (BCCDC) to develop guidelines for those preparing, cooking and consuming shellfish. The recommended cooking temperature and time from the guideline was compared with the temperature and time of standard cooking methods from the Fanny Bay Oyster Market restaurant. The purpose of this project was to determine whether standard cooking methods from restaurants attain the guideline’s recommended 90oC for 90 seconds. Method: Four common cooking methods of Oysters were chosen based on recommendation from Chef Chris Andraza and BCCDC researcher Lorraine McIntyre. Oysters were pan fried, deep fried, baked and grilled. Internal temperatures of cooked oysters were then measured with a probe thermometer. Results for each method were analyzed and compared with the standard of 90oC using the one sample t-test from the statistical software package, NCSS11. Results: One sample t-tests showed statistically differences from the deep fried, baked and grilled methods when compared to the standard of 90oC (p = 0.000). The power for all three methods was 100%, therefore there is confidence that the findings reflect the truth. Experimental temperatures were consistently less than the standard. The pan fried method showed no statistically significant difference when compared to the standard of 90oC (p = 135). The power for pan fried method was 29.2%, therefore there is limited confidence that the findings reflect the truth. Therefore the deep fried, baked and grilled methods required additional cooking time to raise internal temperatures of the oysters. Whereas the pan fried method had achieved the standard but further experimentation is required to eliminate the chance of a type II error. Conclusion: It can be concluded that three out of the four cooking methods (deep fried, baked and grilled) can have significantly different mean temperatures. However, different thermal preparation methods prior to final thermal processing requires consideration to determine cooked oyster consumption safety. One out of the four cooking methods (pan fried) attained the standard temperature 90oC. Therefore, it is recommended for deep fried, baked and grilled cooking methods that the cooking time be extended to achieve an internal temperature of 90oC or higher.

Objective: Sous vide is a relatively new cooking method introduced in restaurants in British Columbia. Sous vide cooking involves placing vacuum sealed food inside a temperature controlled water bath or steam convection oven. Unlike conventional cooking, sous vide cooking involves cooking food at a lower temperature (usually < 65°C) with a longer cook time. The low temperature allows chefs to precisely control the changes within the food. Thus sous vide cooked dishes have consistent texture and color, with retained flavor, moistness and nutrients. With all the benefits, sous vide cooking does have some disadvantages. Lower cooking temperature may not be sufficient for bacterial count reduction, resulting in unsafe food. In addition, every validated sous vide menu requires chefs to precisely follow the cooking temperature and cook time. Any deviation can cause the food to not reach the required 6.5 log reduction in bacterial count. The purpose of this experiment was to determine the effect on the internal temperature of cooking-in-process pork loin packages when additional chilled pork loin packages with an internal temperature of 4°C are submerged into the water bath. Methods: Two groups of pork loin packages with data loggers inside (SmartButton) at approximately 4°C were introduced into a 60°C water bath at different intervals. The first group (6 packages) was immersed inside the water bath at time = 0 minute, while the second group (6 packages) was immersed inside the water bath at time = 10 minutes. Both groups were taken out when they were cooked for 31 minutes (at time = 31 minutes and 41 minutes respectively). Water bath temperature was recorded using SPER Scientific 8000024 data logger. Temperature data for pork loin packages was used to calculate the mean lethality achieved by each group. One sample t-test and two sample t-test were used for statistical analysis. Results: There was a more than 3 mean log lethality difference in group A and group B pork loins. Pork loins cooked sous vide style in group A achieved a mean lethality of 5.12 at 31 minutes (range 0.42 to 12.78) while group B pork loins achieved a mean lethality of 8.44 at 31 minutes (range 3.35 to 11.87). With the same cook time, group A had a statistically significantly lower mean lethality than group B pork loins with p value = 0.003. Although statistically inconclusive whether group A pork loins achieved a mean lethality of 6.5, group B pork loins did reach the recommended mean lethality of 6.5. Conclusion: The result indicated when new cold pork loin packages at 4°C are introduced into a cooking-in-process sous vide water bath at 60°C, the lethality of the original pork loin packages in the bath will be lowered if the cook time remains unchanged. However, it is inconclusive on whether the original pork loin packages will reach 6.5 lethality recommended by BCCDC. The new pork loin packages will reach 6.5 lethality if the original cook time is used.

The purpose of this study was to examine the effectiveness of food handler retraining. The food safety knowledge of handlers who had been previously certified by the FOODSAFE training programme in British Columbia, Canada was compared prior to and nine months following FOODSAFE retraining. The previously FOODSAFE trained food handlers were selected from participants of a 2009 survey. Food safety knowledge scores were compared between (1) previously FOODSAFE trained food handlers who received retraining (the intervention group), (2) previously FOODSAFE trained food handlers who did not receive retraining (the control group), and (3) untrained food handlers (the untrained group). Data gathered in a telephone survey demonstrated knowledge scores were significantly higher in the intervention group when compared with the control group, and when compared with the untrained group. No differences in food safety knowledge scores were found based on English as a first language or receiving food safety training other than FOODSAFE. These results support a requirement for periodic recertification of trained food handlers and demonstrate a need for education of untrained food handlers with a food safety training programme.

The purpose of this study was to examine food safety knowledge of trained food handlers certified under the FOODSAFE training program in British Columbia, Canada and to evaluate food safety knowledge, attitudes and self-reported hand washing practices in trained and untrained food handler groups. Data gathered in a telephone survey demonstrated knowledge scores significantly decreased in FOODSAFE trained workers over a 15 year period post-certification. Knowledge scores were significantly higher in trained compared with untrained food handlers. No differences were noted between groups based on sex. Supervisory status and years of experience resulted in improved knowledge scores in both trained and untrained groups, but increasing age was important for improved knowledge in only the untrained group. Food handlers' place of employment and level of education were also associated with significantly improved knowledge scores. FOODSAFE trained food handlers' reported significantly better hand washing practices and attitudes compared with the untrained food handler group. These results support a requirement for recertification of trained food handlers and demonstrate a need for education of untrained food handlers with a food safety training program such as FOODSAFE.

Background and Purpose: Foodborne illness associated expenditures cost the health care system an estimate of $100 million per year (1). Although the best approach in handling foodborne illnesses is through prevention, it becomes a challenge when it involves choosing between food associated risk or food quality. Take out pho (traditional Vietnamese noodle soup) poses a significant food safety concern when the raw beef and broth are packaged separately. The decreasing temperature of the broth presents a questionable critical control step. If the raw beef is not properly cooked, potential pathogens like E.coli can survive and cause foodborne illness. The following study examines the risk of foodborne illnesses associated with takeout pho and determines whether the broth can achieve an adequate temperature of 70°C to completely pasteurize the raw beef after twenty minutes. Methods: Thirty samples of takeout pho were collected from thirty Vietnamese restaurants within Vancouver and Burnaby, BC. Statistical analysis was performed using a Z-test to compare the median mixed temperature with the cooking standard of 70°C using a Z-test after twenty minutes. Results: Based on the results, the median pho temperature was 62.25°C with a standard deviation of 6.69°C. The range was 30.3°C with the minimum temperature of 42.7°C and the maximum temperature of 73°C. The mode was 62.5°C. The results generated a p-value of

In January 2004, an increase in gastrointestinal illness following oyster consumption was reported in British Columbia. An investigation was initiated to explore the association between norovirus infection and consumption of British Columbia oysters and to identify the source of oyster contamination.The outbreak investigation included active surveillance for human cases, two cohort studies, trace-back of oysters, and laboratory testing of oysters and human stools.Enhanced surveillance identified 26 confirmed and 53 clinical cases over 3 months. Oyster consumption was associated with illness in one cohort and suggestive in the other. Oysters were traced to 14 geographically dispersed harvest sites, 18 suppliers, and 45 points of purchase. Norovirus BCCDC03-028 (genotype I.2) was detected in 50% of human specimens. Experimental methods detected norovirus in 12 oyster samples. Sequencing identified mixed clonal patterns in the oysters with one direct sequence match between an oyster sample and the associated human specimen.The consumption of raw oysters led to norovirus infection. The source of oyster contamination remained unidentified. The geographical dispersion of implicated harvest sites was unusual.This outbreak is unlike most shellfish outbreaks that can be traced back to a common source and challenges conventional thinking that all oyster-related norovirus outbreaks of are a result of point source contamination.

Salmonella enterica var. Heidelberg was isolated from an unusual food source during routine case follow-up, prompting a case control investigation of frozen chicken nuggets and strips. Most frozen nuggets and strips are raw; however, par-frying lends a cooked appearance. As such, suitable food preparation precautions might not be undertaken by consumers. Cases were confirmed in the laboratory between 1 January and 1 April 2003. Controls were generated through forward-digit dialing and individually matched by age category. Telephone interviews were conducted, and limited sampling of unopened product was performed. Eighteen matched pairs were interviewed. The odds of infection were 11 times higher in individuals who had consumed frozen processed chicken nuggets and strips (95% confidence interval, 1.42 < odds ratio < 85.20). One-third of cases and controls considered frozen nuggets and strips to be precooked, and one quarter used the microwave, an ill-advised cooking method. Consumer misconceptions contributed to the risk of infection. Clear labels identifying nuggets and strips as raw poultry are needed.

Introduction: The use of transglutaminase to restructure loose pieces of meat into a fully intact piece of steak has been a concern for the public because of the potential internalization of contaminated surfaces into the aseptic center. The aim of this study was to examine if restructured steaks are safe to consume when cooked to medium rare, a common option with whole cut steaks Methods: Strips of beef were inoculated with E.coli to induce surface contamination. Steaks were restructured with transglutaminase and the altered meat. These steaks were then cooked alongside fully intact whole-cut steak samples. Each sample was then churned in a stomacher, and the resulting solution was used to detect for potential E.coli bacteria. Samples were then enriched and finally placed into the Hygiena Micro-snap Rapid Coliform and E.coli detection test to look for the presence of E.coli. Results: The Hygiena system showed that all transglutaminase restructured steaks possessed detectable levels of E.coli even after cooking to 55 degrees Celsius. On the other hand, no whole-cut steaks had traces of E.coli even when cooked to this same temperature. Conclusion: The results demonstrated that there is a substantial risk with restructured steaks and they should not be consumed undercooked. As well, proper labelling and guidelines should be developed to enable consumers to be better equipped in making decisions to consume properly consumed altered steaks.

We describe the investigation of a norovirus outbreak associated with raw oyster consumption affecting 36 people in British Columbia, Canada, in 2010. Several genotypes were found in oysters, including an exact sequence match to clinical samples in regions B and C of the norovirus genome (genogroup I genotype 4). Traceback implicated a single remotely located harvest site probably contaminated by ill shellfish workers during harvesting activities. This outbreak resulted in three recalls, one public advisory, and closure of the harvest site.

In British Columbia (BC), Canada, food processing facilities licensed under provincial authority are not required to sample for Listeria monocytogenes in food products or processing environments. In 2009, we conducted a survey of dairy, fish, and meat facilities under BC authority to estimate the prevalence of Listeria spp. and L. monocytogenes in ready-to-eat (RTE) foods and production environments. From August to October, 250 RTE food samples and 258 swabs from the food processing environments of 43 facilities were collected. Standard culture methods were applied to both food samples and swabs. Of swabs collected from all 258 environmental surfaces, 15% were positive for Listeria spp. Significantly (P, 0.001) more fish facilities than dairy and meat facilities had food contact surfaces contaminated with Listeria spp. L. monocytogenes was found in RTE foods from fish facilities alone (5 of 12); in all five of the fish facilities with contaminated product, one or more environmental swabs were also positive for L. monocytogenes. The results suggest that while control of L. monocytogenes in BC-inspected dairy and meat facilities is effective in limiting food contamination, there is a need for provincial inspectors to initiate improved monitoring and management of contamination by L. monocytogenes in RTE fish processing facilities.