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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 COVID-19 global pandemic has demanded many individuals remain indoors and isolate from friends and family to keep safe. These long periods of isolation have led to loneliness and an overall shift in the way individuals communicate with each other. Digital media sources have become predominant forms of interaction and entertainment – but how are different age groups, specifically older adults managing this major digital media shift? Keywords older adult(s)

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.

Paralytic shellfish poisoning (PSP) occurs when shellfish contaminated with saxitoxin or equivalent paralytic shellfish toxins (PSTs) are ingested. In British Columbia, Canada, documented poisonings are increasing in frequency based on 62 investigations identified from 1941–2020. Two PSP investigations were reported between 1941 and 1960 compared to 31 since 2001 (p &lt, 0.0001) coincident with rising global temperatures (r2 = 0.76, p &lt, 0.006). The majority of PSP investigations (71%) and cases (69%) were linked to self-harvested shellfish. Far more investigations involved harvests by indigenous communities (24%) than by commercial and recreational groups. Single-case-exposure investigations increased by more than 3.5 times in the decade 2011–2020 compared to previous periods. Clams (47%), mussels (26%), oysters (14%), scallops (6%), and, in more recent years, crabs (4%) were linked to illnesses. To guide understanding of self-harvesting consumption risks, we recommend collecting data to determine when PST-producing algae are present in high concentrations, improving the quality of data in online shellfish harvest maps to include dates of last testing, biotoxin testing results, and a description of bivalve species tested. Over reliance on toxin results in biomonitored species may not address actual consumption risks for unmonitored species harvested from the same area. We further recommend introducing phytoplankton monitoring in remote indigenous communities where self-harvesting is common and toxin testing is unavailable, as well as continuing participatory education about biotoxin risks in seafoods.

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.

Background: Between May 2017 and May 2019, 18 Salmonella outbreaks in Canada were linked to raw chicken, resulting in the recall of 13 chicken products. Most of these products contained frozen raw breaded chicken, such as chicken nuggets, chicken fries, and breaded chicken burgers. (Public Health Agency of Canada, 2019) These products are especially risky for consumers because they may appear precooked, resulting in inadequate food safety measures being taken. (Catford, Ganz, & Tamber, 2017). Due to this concern, as of April 1, 2019, all frozen raw breaded chicken product manufacturers are required to follow one of four Salmonella control measures set out by the Canadian Food Inspection Agency (CFIA). The simplest option for processors is to precook their products to destroy Salmonella bacteria and produce a ready-to-eat product. (Government of Canada, Canadian Food Inspection Agency, & Food Safety and Consumer Protection Directorate, 2019a) Methods: Data was collected from all frozen chicken products available at 14 retail locations in Metro Vancouver that were randomly selected in previous studies carried out in 2018 and 2019 by the British Columbia Centre for Disease Control (BCCDC) and British Columbia Institute of Technology (BCIT) students. The processing status of the products surveyed in this study (n=466) was compared to those collected in the previous studies done in 2018 and 2019, respectively (n=383; n=415). Other information collected included whether product packaging contained statements of internal temperature, requirements for thermometer use, and additional food safety instructions. Data on these parameters collected in the current study (n=466) were compared to similar data collected in 2008 (n=24) and in 2018 (n=67). Photos were taken of all product labels and relevant data from the photos was compiled in Microsoft Excel. Statistical analyses were done using chi-square tests performed using NCSS 2019 software. Results: The proportion of surveyed frozen chicken products that were cooked as opposed to raw increased from 38% in 2018 to 41% in 2019 to 69% in 2020. The proportion of products containing statements regarding required internal temperatures increased from 58% in 2008 to 96% in 2018 and then decreased to 86% in 2020. 0%, 4.5%, and 1.7% of products surveyed in 2008, 2018, and 2020, respectively, included an indication to use a food thermometer. 79%, 57%, and 25% of products surveyed in the same years included additional food safety statements. Conclusions: This study showed that the ratio of cooked to uncooked frozen chicken products available to consumers in the Metro Vancouver area has increased since the CFIA’s Salmonella control measure requirements for frozen breaded chicken manufacturers were implemented in 2019. The 28% and 26% increase since 2018 and 2019, respectively, suggests that many frozen chicken product manufacturers are complying with the CFIA requirements by using a validated cook process to reduce Salmonella in their products. This study also showed that, since 2019, there has been a significant decline in the proportion of frozen chicken products that contain information about internal cooking temperatures and additional food safety information on their packaging.

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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.

Background Harmful algal blooms produce paralytic shellfish toxins that accumulate in the tissues of filter feeding shellfish. Ingestion of these toxic shellfish can cause a serious and potentially fatal condition known as paralytic shellfish poisoning (PSP). The coast of British Columbia is routinely monitored for shellfish toxicity, and this study uses data from the monitoring program to identify spatiotemporal patterns in shellfish toxicity events and their relationships with environmental variables. Methods The dinoflagellate genus Alexandrium produces the most potent paralytic shellfish toxin, saxitoxin (STX). Data on all STX measurements were obtained from 49 different shellfish monitoring sites along the coast of British Columbia for 2002–2012, and monthly toxicity events were identified. We performed hierarchical cluster analysis to group sites that had events in similar areas with similar timing. Machine learning techniques were used to model the complex relationships between toxicity events and environmental variables in each group. Results The Strait of Georgia and the west coast of Vancouver Island had unique toxicity regimes. Out of the seven environmental variables used, toxicity in each cluster could be described by multivariable models including monthly sea surface temperature, air temperature, sea surface salinity, freshwater discharge, upwelling, and photosynthetically active radiation. The sea surface salinity and freshwater discharge variables produced the strongest univariate models for both geographic areas. Conclusions Applying these methods in coastal regions could allow for the prediction of shellfish toxicity events by environmental conditions. This has the potential to optimize biotoxin monitoring, improve public health surveillance, and engage the shellfish industry in helping to reduce the risk of PSP.

Three Salmonella Enteritidis illnesses investigated in British Columbia, Canada, were potentially linked to consumption of sous vide style cooked foods in 2014. In two separate incidents on different days, two illnesses at one restaurant implicated sous vide eggs. The third illness was linked to a different restaurant serving sous vide duck breast. Inspections of the restaurants revealed inadequate sous vide cooking practices that did not fully cook the foods. Although other high-risk foods were also eaten at these premises (raw oysters and tuna in one restaurant, foods with raw egg dressing and mayonnaise in the second restaurant), and although no leftover foods were available for testing from these meals, the investigation suggested improper sous vide style cooking practices amplified the risk and were the most probable cause of illness.

Background: Dairy products are consumed by a large portion of the population. The dairy processing plants (DPP) that produce these perishable products may create health hazards (chemical, physical, biological). In order to minimize any health risks from these products, DPP are inspected by regulating authorities. This study examined secondary data derived from the BCCDC dairy program’s semi-quantitative risk ranking tool (RRT) to examine trends over time with DPP inspections, and to assess risk factors within the tool. Methods: RRT based data from individual DPP inspections from 2015 through 2018 were entered into a master spreadsheet. The RRT has two overall risk categories, inherent and measured risk. Inherent risk categories in the tool were sourced from surveys of dairy plants, while measured risks in the tool were sourced from inspection visits (routine and in-depth), environmental and food result submissions from dairy plants and inspectors, and based on compliance and history. In total, 107 items were assessed within the eight categories. Descriptive analyses were conducted, and statistical analyses performed using NCSS 12 software (NCSS, 2018). Results: A total of 128 inspection reports from 30 different DPP were included in this study. From these inspections, 65% were considered low risk, 12% moderate and 23% high risk. DPP that were located on-farm were found to have significantly higher overall inspection risk scores than dairy plants located off-farm (average on-farm inspection risk ranking score = 694; average off-farm inspection risk ranking score = 153; p=0.0003, power=95%). When the microbiological scores category, derived from environmental swabs and food submissions, were compared to the inspection score category, these categories were statistically significantly correlated (p=0.0000, power=100%); when inspection score increases, so too does microbiological score. Higher risk scores were also found in DPP producing more than one category of dairy product (comparing one product versus 6 or 7 products, p=0.009, power=76%). Conclusion: Dairy inspections ensure DPP follow good manufacturing practices and therefore help to protect the population from disease outbreaks or other contaminations. This study demonstrated that there is increased risk of having a dairy processing facility located on-farm, that more complex dairy processing operations that produce more than one type of dairy product have higher risk rating scores and that higher inspection score violations positively correlated to positive microbiological scores. This study further showed that in the absence of microbiological results, a risk score could still be calculated by analyzing the inspection violations alone. The Food Safety Specialists at the BCCDC can use this data to focus their inspection time on higher risk areas and items to maximize time spent out in the field.

Background: Rates of foodborne illness linked to consumers misinterpreting, or lack of proper cooking instructions on frozen food products continue to rise. With many recalls and outbreaks in the recent years surrounding frozen breaded chicken (FBC) products due to consumers not adequately cooking products and in turn becoming ill. However, it is not just frozen breaded chicken to blame, frozen microwavable entrees have also contributed to this problem. Therefore, the purpose of this project was to determine what was actually being displayed on the packaging of these frozen foods. Identifying whether or not frozen food products have clear, specific and consistent cooking instructions for the consumers is critical in identifying the risk of cooking and eating these foods. Methods: Secondary data was obtained from the British Columbia Centers for Disease Control (BCCDC) of cooking instructions on FBC packaging, and primary data was collected through visiting grocery stores in the Metro Vancouver area by surveying cooking instructions on frozen microwavable entrees packaging. Four categories of data were assessed, 2008 and 2018 raw FBC products, 2018 cooked FBC, and 2019 frozen microwavable entrees. Parameters such as inclusion of internal cooking temperature, thermometer usage, microwave instructions, and additional food safety handling was gathered. Chi-square tests were used to analyze the results with the statistical software NCSS12. Results: Of all categories surveyed 87.1% (n=122) said to cook the product to a minimum of 74°C, and 12.9% (n=18) did not state anything. 2018 raw FBC always stated an internal cooking temperature (100%), whereas 58% of the 2008 raw FBC stated an internal temperature and 89% of both the 2019 frozen entrees and 2018 cooked FBC did. Out of all 140 products surveyed across categories only 8% stated to use a thermometer when cooking to ensure food has reached proper internal temperature. The frequency of categories to display food safety was as follows, the 2018 raw FBC (82%) and the 2008 raw FBC (79%), followed by the 2019 frozen entrees (42%) and the 2018 cooked FBC (21%). For the microwave instructions the frozen entrees almost always stated this (81%), whereas the 2008 and 2018 raw FBC both never stated to use a microwave (0%). There was a significant association between products and the inclusion of the statement of internal cooking temperature and thermometer usage. This was based on the food product category itself, frozen breaded chicken or frozen entrees, or based on manufacturer of the product. Conclusions: It was evident that the major gap lies in the consistency of instructions. Almost every manufacturer had their cooking instructions presented differently, which could in turn confuse the consumer. Instructions also rarely stated to use a thermometer to check the internal temperature, although almost always stated a specific temperature to cook to. A small portion of manufactures are diligent about displaying all necessary information to the consumer such as, Kraft, Conagra foods, and Olymel which adequately met all parameters assessed. In order to fix the gaps of inconsistency of instructions this information can be used as educational tools by the BCCDC to inform customers on what to look for in cooking instructions of frozen

Background Recreational water illnesses are not as well known as food borne illnesses in the media. There are several pathogens associated with ingesting surface water including Giardia, Cryptosporidium, and Toxoplasmosis. The use of technology for public health surveillance is also little known to the public and can provide much insight into other illnesses on social media not otherwise reported to public health and medical professionals. Illnesses on social media could represent a portion of unreported cases. These cases could be found on social media as a popular outlet for individual expression. Methods Social media posts were found using a variety of keywords including symptoms of significant waterborne illnesses and terms associated with human and environmental contamination. Social media posts were collected from forums and popular social media platforms such as reddit. The posts were then correlated with beach water quality data for a sampling site as geographically close to a case location as possible. Results Social media and water quality data collected from the Columbia river region were correlated. The correlation coefficient of 0.2335 indicates that there is no correlation between social media posts and beach water quality data. Numerous limitations may have impacted the correlation coefficient. Keywords associated with symptoms were more effective in obtaining quality threads and posts compared to other terms. Conclusions Correlating social media posts to water quality data in the Columbia river region does not provide statistically significant results. Manual gathering of social media data for public health surveillance is found to be inefficient and impractical. Further study is required in order to determine the effectiveness of using social media for public health data gathering. It remains to be seen whether correlating posts about illness on social media to water quality data is an effective method of surveillance for public health.

Background: Sous vide cooking is popular method of cooking involving a water bath with immersion circulator or a steam convection oven. This process is also known as low-temperature long-time method (LTLT), where food is held at a lower temperature over extended time for cooking (1). Plastic is the more commonly used medium with sous vide cooking. Glass and silicone are an environmentally alternative to plastic, since they are reusable mediums. These alternative mediums have not been studied and may affect the time to reach pasteurization. The purpose of this experiment is to determine how plastic, silicone, and glass influence time in sous vide cooking of gravy to 56.5°C. Methods: Four of each medium: plastic, silicone, and glass containing 500 mL of gravy with SmartButton data loggers at 4°C were introduced into a 56.5 °C water bath for 150 minutes. The data loggers recorded the temperature at one minute intervals. The data was used to run a One-Way Analysis of Variance (ANOVA) to analyze if there were any statistically significant differences between the three mediums and time, and a Scheffe’s test to compare the mean time of each of the mediums. Results: There was a difference in time of sous vide cooking for gravy at 56.5°C between the mediums: plastic, glass, silicone. The p-value was 0.00, therefore rejecting Ho and accepting there is a difference in time of sous vide cooking gravy at 56.5°C between the different mediums: plastic, glass, silicone. Comparing the mediums among each other, it showed that there was a difference between glass and silicone, glass and plastic and no significant difference between plastic and silicone medium. Conclusion: The results indicate that there is a statistically significant difference in time that it took for gravy to reach 56.5°C between the mediums: plastic, silicone, and glass. The mean time for each medium to reach 56.5°C differed; 65 minutes for plastic, 68 minutes for silicone, and 129 minutes for glass. This shows that a more environmentally friendly alternative to plastic sous vide pouches can be used. Silicone pouches show to be the best alternative, least compromising of the come-up and pasteurization time. If sous vide users opt to use glass, the come-up time almost doubles in time.

Background: False Creek is a small inlet centered within Vancouver, British Columbia. Its long and narrow shape facilitates the build-up of contaminants and limits dilution of fresh water. The lack of flushing coupled with sources of fecal contamination results in high levels of Escherichia coli particularly in the summer months. High levels of E. coli in recreational water pose a health hazard to the public. Two organizations Metro Vancouver and Fraser Riverkeeper monitored E. coli levels in False Creek over the 2018 summer season. Methods: Data collected by Metro Vancouver and Fraser Riverkeeper over the 2018 summer season was collected and compared. The secondary data was analyzed from July 8, 2018 to September 29, 2018 from thirty-day geometric means. Each organization sampled on a weekly basis in False Creek, Metro Vancouver sampled from twelve locations and Fraser Riverkeeper sampled from seven locations. Both organizations used similar methodologies in the collection of data with both analyzing for microbiological enumerations of most probable number [MPN] of E. coli per 100/mL samples. All sample sites were divided into three locations representative of False Creek: West, Central and East. The data was then analyzed in terms of overall weekly samples by organization, locational weekly samples by organization and locational weekly samples overall. Results: The data was analyzed using an Aspin Welch Unequal Variance T-test to compare the overall weekly E. coli counts between the organization. Where p = 0.000 and power = 1.00. An Equal Variance T-test was used to compare the locational weekly E. coli counts from the West, Central and East regions of each organization. This yielded a p = 0.000 where power = 1.00. A Kruskal Wallis One-Way ANOVA was used to compare the locational weekly E. coli counts from the West, Central and East regions. This found p = 0.000 and power = 1.00. A MANOVA was used as a reiteration to compare the weekly E. coli counts at each location (West, Central and East) when collected by each organization. This confirmed the same p-value and power results from the three previous tests. Conclusions: There is a statistically significant difference between the two organizations. Not only in overall samples but there is a statistically significant difference between the two organizations when E. coli is amalgamated by location. When accounting for location only, the East region obtained statistically higher E. coli counts as the mean E. coli count for West was 90.8, Central was 248 and East was 1040.

Background: Frozen meals are popularized in recent years due to their ease of preparation. This convenience factor greatly benefits busy workers who simply lack the time to cook a full meal. However, the risk of misidentifying these frozen products as cooked when they are in fact, raw, can lead to devastating consequences. This is important especially when the products are improperly prepared and undercooked. Some significant examples in recent years includes the Salmonella cases associated with frozen raw breaded chicken. These cases are partly due to the inadequate cooking of the product, as a result of misidentifying them as cooked even though they are raw. The purpose of this project is to determine how well the public can determine if a frozen product is cooked or raw based on the front side of the packaging, which is the first visuals that will be presented to the consumers in store. Methods: An electronic survey was conducted for Canadian residents to determine whether they can accurately interpret if a product is cooked or raw based on the front packaging. The survey also determines if the respondent’s age, gender, average number of supermarket visits in a week, and level of education will affect the accuracy of their interpretations. The survey was created and hosted online with SurveyMonkey, and distributed out in Reddit. The results are analyzed using the statistical software, NCSS 12. Results: Chi-square tests indicated no significant difference between the demographics groups and the accuracy of the label interpretations by the respondents. Five different products; chicken pot pie, fish fillets, breaded chicken wings, poutine bites, and tourtiere pie, were chosen for identification, each with their own label statements, respectively; “cook thoroughly”, “uncooked”, “fully cooked”, “heat thoroughly” and one with no label statement. The fish fillets, poutine bites and the tourtiere pie had the most varied answers from the respondents. The poutine bites and tourtiere pie had the majority of the respondents selecting the wrong answer or being unsure. The fish fillets had the majority choosing the correct answer, but given the simplicity of the label “uncooked”, it was surprising that only 45% of the respondents chose “require additional cooking”. Additionally, a few of the open ended comments from respondents indicate some desire for labels clarity in regards to fonts and color on the packaging, as well as having clear, standardized statements that clearly identifies the products as cooked or raw. However, there are some comments that indicate the current labels are adequate, and some comments mentioning about labelling on the back of the box. Conclusion: Based on the results of the study, it would appear that the demographic groups selected have no effect on the accuracy of label identifications of frozen products. The study also indicates that there is preference from the public to favours clear and straightforward labelling statements. The study identifies potential problems with some ambiguity in the label statements (or lack of label statements), and some potential issues with the noticeability of the statements to the consumers.

Background: Food Distribution Organizations (FDOs), such as food banks, community kitchen, and meal programs, are essential resources to relieve food insecurity in British Columbia. FDOs collect, process, store, and distribute donated food to the needy population. The BC Centre for Disease Control (BCCDC) published the Guidelines for Food Distribution Organizations with Grocery or Meal Programs in 2016 with purpose to educate FDOs on food safety and assist with their operational challenges. The guideline plays an important role especially for food bank operators who are not required to take food safety training. The purpose of this study was to evaluate the extent of the guideline use among food bank operators and assess its usefulness. This study also determines if the guideline use had a statistically significant association with higher knowledge in food safety. Methods: Self-administered electronic surveys created on Survey Monkey Canada were distributed to Foodbanks BC members by weekly online newsletter and email. The survey assessed the extent of usage of the guideline, current issues and knowledge level of FDO operators in BC. The survey response was collected over three weeks long period. Results: Among 37 FDO operators participated, 30 completed the survey. The majority of the operators was from BC, worked in food banks and had longer than 5 years long experience. 47% of participants did not know about the guideline. Among the guideline users, 83% agreed or strongly agreed that the guideline was useful. While retailers and groceries were the most common food donors, caterers and restaurants were the least common. Assessing each food item for safety was the most commonly encountered issue for FDOs. The least commonly encountered issue was having another FDO taking our donation from the donor. There was no association between the guideline use and level of food safety knowledge according to the Chi-square test (p= 0.89). There was no association between the years of experience and level of food safety knowledge (p= 0.23). The results did not show a statistically significant result potentially due to small sample size (n= 30). Conclusion: The results indicated while the guideline is useful among the users, the extent of its use should be widened. There is a need to improve accessibility of the guideline by modifying the content to address current practical issues, formatting it in a more user-friendly way, and utilizing better distribution means.

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 The efficacies of disinfection by sodium hypochlorite, accelerated hydrogen peroxide (AHP), and quaternary ammonium compound (QUAT) commonly used in health care facilities were determined using the surrogate viruses murine norovirus (MNV-1) and feline calicivirus (FCV). Methods A virus suspension of known concentration (with or without a soil load) was deposited onto stainless steel discs under wet or dry load conditions and exposed to defined concentrations of the disinfectant/cleaning agent for 1-, 5-, or 10-minute contact time using the quantitative carrier test (QCT-2) method. Virus inactivation was determined by plaque assay. Results At an exposure time of 1 minute, sodium hypochlorite at 2,700 ppm was able to inactivate MNV-1 and FCV with a >5 log 10 reduction. After 10 minutes, MNV-1 was inactivated by AHP at 35,000 ppm, whereas FCV was inactivated at 3,500 ppm. MNV-1 was not inactivated by QUAT at 2,800 ppm. A QUAT-alcohol formulation containing 2,000 ppm QUAT and 70% ethanol was effective in inactivating MNV-1 after 5 minutes, but resulted in only a 10 reduction of FCV after 10 minutes. Conclusions AHP and QUAT products were less effective than sodium hypochlorite for the inactivation of MNV-1 and FCV.

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.

Background: In the culinary industry, sous vide is a popular cooking method in which lower temperatures are used to cook food to retain more desirable organoleptic characteristics. However, this technique may compromise food safety as the temperature may not be sufficient enough to eliminate pathogens that may be present. The BCCDC’s Guidelines for Restaurant Sous Vide Cooking Safety in British Columbia advises when too many food items are placed in the sous vide water bath, inadequate water circulation may occur with the result that process lethality, measured by calculation of log10 reductions, may not be achieved. The purpose of this study was to determine how overcrowding a sous vide water bath would impact the thermal process of pork loins. Methods: Each pork loin sample had a SmartButton inserted and was vacuum sealed in a plastic bag. The water bath was preheated to 60˚C by an immersion circulator. Under normal conditions, six pork loin samples were held in the water bath for 1 hour and the process was repeated four more times. Under overcrowded conditions, two runs were conducted for 1.5 to 2 hours, each consisting of 15 samples stacked in three layers. SmartButton temperature values were used to calculate whether a 6.5 log10 reduction for Salmonella spp. was achieved, using the American Meat Institute’s formula. Results: Using a 31-minute cook time, pork loins in normal conditions reached an average log reduction of 8.85 (range: 0.51 to 21.07), which was significantly higher than the 6.5 log10 reduction objective (p = 0.006). Conversely, pork loins in overcrowded conditions reached an average log reduction of 1.76 (range: 0.05 to 7.93), which was significantly lower than the 6.5 log10 reduction objective (p = 0.000). Furthermore, cooking lethality between the two conditions, pork loins in crowded and overcrowded conditions, were found to be significantly different from each other (p = 0.000). No differences were found in the mean log10 reductions between the pork loins placed in each of the three layers in an overcrowded water bath at 31 minutes (p = 0.094). Conclusion: Overcrowding sous vide water baths does impact on the thermal process of pork loins. Food products cooked under overcrowded conditions require a longer cook time, (approximately 30 minutes longer) to achieve at least 6.5 log10 reductions. Therefore, it is advised that food handlers using sous vide techniques should avoid overcrowding sous vide water baths. Further research using more samples is recommended to determine potential cold spot patterns in overcrowded water baths due to inadequate water circulation.

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.

Background: Data from poison centers have the potential to be valuable for public health surveillance of long-term trends, short-term aberrations from those trends, and poisonings occurring in near-real-time. This information can enable long-term prevention via programs and policies and short-term control via immediate public health response. Over the past decade, there has been an increasing use of poison control data for surveillance in the United States, Europe, and New Zealand, but this resource still remains widely underused. Objective: The British Columbia (BC) Drug and Poison Information Centre (DPIC) is one of five such services in Canada, and it is the only one nested within a public health agency. This study aimed to demonstrate how DPIC data are used for routine public health surveillance in near-real-time using the case study of its alerting system for illness related to consumption of shellfish (ASIRCS). Methods: Every hour, a connection is opened between the WBM software Visual Dotlab Enterprise, which holds the DPIC database, and the R statistical computing environment. This platform is used to extract, clean, and merge all necessary raw data tables into a single data file. ASIRCS automatically and retrospectively scans a 24-hour window within the data file for new cases related to illnesses from shellfish consumption. Detected cases are queried using a list of attributes: the caller location, exposure type, reasons for the exposure, and a list of keywords searched in the clinical notes. The alert generates a report that is tailored to the needs of food safety specialists, who then assess and respond to detected cases. Results: The ASIRCS system alerted on 79 cases between January 2015 and December 2016, and retrospective analysis found 11 cases that were missed. All cases were reviewed by food safety specialists, and 58% (46/79) were referred to designated regional health authority contacts for follow-up. Of the 42% (33/79) cases that were not referred to health authorities, some were missing follow-up information, some were triggered by allergies to shellfish, and some were triggered by shellfish-related keywords appearing in the case notes for nonshellfish-related cases. Improvements were made between 2015 and 2016 to reduce the number of cases with missing follow-up information. Conclusions: The surveillance capacity is evident within poison control data as shown from the novel use of DPIC data for identifying illnesses related to shellfish consumption in BC. The further development of surveillance programs could improve and enhance response to public health emergencies related to acute illnesses, chronic diseases, and environmental exposures. [JMIR Public Health Surveill 2018;4(1):e17]

BACKGROUND Data from poison centers have the potential to be valuable for public health surveillance of long-term trends, short-term aberrations from those trends, and poisonings occurring in near-real-time. This information can enable long-term prevention via programs and policies and short-term control via immediate public health response. Over the past decade, there has been an increasing use of poison control data for surveillance in the United States, Europe, and New Zealand, but this resource still remains widely underused. OBJECTIVE The British Columbia (BC) Drug and Poison Information Centre (DPIC) is one of five such services in Canada, and it is the only one nested within a public health agency. This study aimed to demonstrate how DPIC data are used for routine public health surveillance in near-real-time using the case study of its alerting system for illness related to consumption of shellfish (ASIRCS). METHODS Every hour, a connection is opened between the WBM software Visual Dotlab Enterprise, which holds the DPIC database, and the R statistical computing environment. This platform is used to extract, clean, and merge all necessary raw data tables into a single data file. ASIRCS automatically and retrospectively scans a 24-hour window within the data file for new cases related to illnesses from shellfish consumption. Detected cases are queried using a list of attributes: the caller location, exposure type, reasons for the exposure, and a list of keywords searched in the clinical notes. The alert generates a report that is tailored to the needs of food safety specialists, who then assess and respond to detected cases. RESULTS The ASIRCS system alerted on 79 cases between January 2015 and December 2016, and retrospective analysis found 11 cases that were missed. All cases were reviewed by food safety specialists, and 58% (46/79) were referred to designated regional health authority contacts for follow-up. Of the 42% (33/79) cases that were not referred to health authorities, some were missing follow-up information, some were triggered by allergies to shellfish, and some were triggered by shellfish-related keywords appearing in the case notes for nonshellfish-related cases. Improvements were made between 2015 and 2016 to reduce the number of cases with missing follow-up information. CONCLUSIONS The surveillance capacity is evident within poison control data as shown from the novel use of DPIC data for identifying illnesses related to shellfish consumption in BC. The further development of surveillance programs could improve and enhance response to public health emergencies related to acute illnesses, chronic diseases, and environmental exposures.

Background: Mobi is a bike-sharing program in Vancouver, BC that provides helmets for use with each bike. There is little research documenting risks associated with helmet-sharing, but an evidence review has shown that there is the potential for transmission of diseases that are known or presumed to be transmitted via fomites. This study attempted to ascertain public opinion of helmet-sharing and whether concern over the cleanliness of shared helmets affected likelihood of wearing them. Method: A survey was conducted to determine if there is a relationship between concern with helmet cleanliness and likelihood of wearing shared helmets. The researcher conducted surveys in-person at randomly chosen Mobi docking stations. An online (SurveyMonkey) survey was also distributed using Facebook, Twitter, Reddit and email. Results: Chi-square tests performed using NCSS determined that there was a statistically significant association between helmet use on personal bikes and use of Mobi helmet when riding Mobi bikes (p=0.00029). There was also an association between whether users found cleanliness the most important factor in their decision to wear the Mobi helmet (of cleanliness, aesthetics, legal requirement, safety and comfort/fit) and likelihood of wearing the Mobi helmet (p=0.02038). There was no association found between level of concern for cleanliness of the helmet and likelihood of wearing it (p=0.54995). Conclusions: Based on the results, there is an association between concern with the cleanliness of shared helmets are and how likely users are to wear them. Users that were most concerned about safety were more likely to use the Mobi helmet during every ride. Those that were most concerned about cleanliness were least likely to wear the Mobi helmet. However, this study also concluded that some users chose not to wear the provided helmets for reasons other than concern for cleanliness. Further research is required to determine how this will affect the health and safety of Mobi Bike users.

Background: The recent Vibrio parahaemolyticus outbreak in the summer of 2015 highlighted that shellfish tags are one of the key pieces of information used to trace back and determine the source of a foodborne outbreak or illness associated with raw or uncooked shellfish. According to the Canadian Food Inspection Agency, all shellfish tags must meet the requirements stated in the Section 7.3 of the Canadian Shellfish Sanitation Program (CSSP). Non-compliant tags may hinder national and regional regulatory agencies from identifying problems in harvest locations and at the processors, and further impede provincial control measures. As a result of the national outbreak, the BC Center for Disease Control (BCCDC), Ministry of Agriculture and the Canadian Food Inspection Agency (CFIA), as well as health authorities and Environmental Health Officers (EHO) have been involved in a variety of actions and interventions to improve compliance. These include efforts to promote education and to improve control and surveillance of V. parahaemolyticus and other shellfish associated illnesses. This study examined the effectiveness of health agencies’ interventions to improve shellfish tag compliance rates to Section 7.3 of the CSSP by comparing the numbers of shellfish tags in compliance before and after the interventions that were implemented in 2016. Methods: 120 randomly selected shellfish tags were grouped into “Before” and “After” interventions. By assessing the date of processing, 60 tags collected before September 2016 were placed into the “Before” group. Another 60 tags collected after September 2016 were placed into the “After” group. Within each group, shellfish tags were individually analyzed to determine whether the tag met or exceeded the required quality, information, and type and quantity criteria. Shellfish tags were considered “Compliant” if they completely fulfill 10 components embodied in the criteria, whereas shellfish tags that failed to meet all the components were labeled “Non-compliant”. Results: Based on the statistical analysis conducted on the data, there was a greater proportion of compliant shellfish tags post-intervention compared to pre-intervention. The Pearson’s Chi-square test confirmed that there was a statically significant association (p-value = 0.000) between the numbers of shellfish tags in compliance and the interventions that were implemented after the outbreak. Conclusion: The results have demonstrated that the interventions implemented by numerous regulatory authorities resulted in greater compliance to Section 7.3 of the CSSP. Public health regulators including the Ministry of Agriculture and the CFIA, as well as BCCDC and EHOs should continuously be involved in a variety of actions, such as promoting education at the processor and retail level and also implementing interventions to improve compliance. By doing so, successful interventions and increased compliance rates will lead to rapid identification of shellfish-related illnesses or outbreaks and facilitate control measures that can expeditiously remediate public health issues.

Although the taro plant, Colocasia esculenta, is commonly consumed throughout Asia, Africa, the Pacific Islands, and the Caribbean, its consumption is less common in North America. Exposure to raw or improperly prepared taro is associated with oropharyngeal irritation and swelling and, rarely, airway obstruction. Although cases of toxicity in countries where taro is a staple have been reported, cases in North America have not been described. Here, two cases of oral irritation and swelling in BC residents who ate raw taro leaf, were reported to the British Columbia Drug and Poison Information Centre (BC DPIC) and triggered an investigation involving a regional health authority and the Canadian Food Inspection Agency. Investigators found that the vendor, a chain of ethnic supermarkets, offered no point of sale preparation instructions. The vendor responded initially by posting instructional signage and later by voluntary product withdrawal. Analysis of BC DPIC records between 1 November 2011 and 20 December 2013 identified 11 cases of symptomatic taro exposure, five to the leaf and six to the corm. The two index cases and subsequent investigation illustrate how new foods or foods in unfamiliar contexts may present as calls to a poison control centre and that prevention requires collaboration among public and corporate stakeholders.

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.

Evidence for shellfish toxin illness in British Columbia (BC) on the west coast of Canada can be traced back to 1793. For over two hundred years, domestically acquired bivalve shellfish toxin illnesses in BC were solely ascribed to paralytic shellfish poisonings caused by algal blooms of Alexandrium. This changed in 2011, when BC experienced its first outbreak of diarrhetic shellfish poisoning (DSP). As a result of this outbreak, Canada’s first DSP symposium was held in November, 2012, in North Vancouver, BC. Three of the objectives of the symposium were to provide a forum to educate key stakeholders on this emerging issue, to identify research and surveillance priorities and to create a DSP network. The purpose of this paper is to review what is known about shellfish poisoning in BC and to describe a novel volunteer network that arose following the symposium. The newly formed network was designed for industry shellfish growers to identify harmful algae bloom events, so that they may take actions to mitigate the effects of harmful blooms on shellfish morbidity. The network will also inform public health and regulatory stakeholders of potentially emerging issues in shellfish growing areas.

In 2011, a Diarrhetic Shellfish Poisoning (DSP) outbreak occurred in British Columbia (BC), Canada that was associated with cooked mussel consumption. This is the first reported DSP outbreak in BC. Investigation of ill individuals, traceback of product and laboratory testing for toxins were used in this investigation. Sixty-two illnesses were reported. Public health and food safety investigation identified a common food source and harvest area. Public health and regulatory agencies took actions to recall product and notify the public. Shellfish monitoring program changes were implemented after the outbreak. Improved response and understanding of toxin production will improve management of future DSP outbreaks.

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.

Objectives: There is an increasing desire in the culinary industry to use sous vide to prepare meals at low internal temperatures to enhance flavour, texture, and quality. The sous vide method uses specific time and temperature combinations to allow for sufficient microbial destruction. The BCCDC’s Guidelines for Restaurant Sous Vide Cooking Safety in British Columbia suggests time and temperature combinations to help ensure that the required log10 reductions of pathogens are achieved. Concerns for public safety arise when chefs deviate from the guidelines, and therefore may not achieve the appropriate log10 reductions. This study looked at a commonly used sous vide duck breast recipe and determine whether appropriate the appropriate log10 reductions were met. It also examine the efficacy of the sear step and resting period in achieving the log10 reductions. Methods: After calibration, two batches of 15 duck breasts were prepared using the sous vide method for 80 minutes at 58ºC, the breasts were then seared on a 200°C frying pan for 2 minutes each side, and then subjected to a 4 minute rest period at room temperature. The internal temperature of the breasts was continuously measured using SmartButton thermometers. This data was entered into the AMI Process Lethality Determination Spreadsheet to calculate the log10 reductions. The log10 reductions were analyzed using a one-sample t-test to assess whether the recipe achieved the required 7.0 log10 reductions. Results: The results showed 14% of the 29 duck breasts achieved a 7.0 log10 reduction after the sous vide step of 80 minutes at 58 ºC. The null hypothesis (Ho: measured log10 reductions of duck breasts = 7.0 log10 reductions) was rejected with 100% power and a p-value of 0.00. The mean was 5.13, therefore it seems as though the log10 reductions were significantly lower than 7.0 log10 reductions. After the sear and the resting period, 52% of 27 duck breasts achieved a 7.0 log10 reduction. Statistical analyses showed that the null hypothesis could not be rejected. The p-value was 0.97 and the power was 0.413. Disregarding cumulative effects, the median log10 reductions achieved only by the sear step was 0.43, and the median log10 reductions achieved solely by the resting period was 0.35. Conclusion: Due to lack of normality one cannot confidently say this recipe will achieve 7.0 log10 reductions. However, due to the high log10 reductions achieved, it seems plausible for another recipe to provide adequate log10 reductions while maintaining acceptable quality. The sous vide step should be used for the majority of the log10 reductions. Due to a wide variability in the results, the sear and resting period should only be used for small increases in log10 reductions.

Background and the purpose: British Columbia’s Guideline for the Sale of Foods at Temporary Food Markets is a document that Environmental Health Officers’ (EHOs) and farmers’ market managers will have to consult with when determining what food products are allowed to be sold in farmers’ markets. This guideline plays a vital role because it indirectly influences EHOs’ and farmers’ market managers’ judgments and the public’s risk exposure to potentially hazardous foods (PHFs) in farmers’ markets. It is necessary to evaluate and compare BC’s guideline with other provinces’ to see where it sits in the spectrum with respect to its permissibility in allowing the sale of PHFs in farmers’ markets, perhaps contributing to the further revision or development of the farmers’ markets guideline or policy. Methods: An online Google Docs survey consisting of 20 questions was created to ask farmers’ market managers from British Columbia and other provinces in Canada whether their farmers’ markets allow the sale of the five food types: poultry, shell egg, sauerkraut, unpasteurized juice/cider and cheese and how these foods are handled and stored. Results: There were 56 farmers’ market managers who participated in this survey (46% from BC and 54% from outside BC). Chi-square results had p-values greater than 0.05 for all the five surveyed categories. Two-tail t test results had p-values less than 0.05 in the raw poultry and sauerkraut categories. Discussion: Although no association between the location of farmers’ markets in Canada and the sale of the five surveyed food categories, BC farmers’ market managers disallowed the sale of raw poultry and unpasteurized juice more often than markets outside BC whereas fewer BC farmers’ market managers disallowed the sale of eggs and cheese when compared to markets outside BC. A significant difference in the handling and storage practices of raw poultry and sauerkraut was identified between farmers’ market managers in BC and outside BC. Also, BC’s managers were shown to have safer food handling practices to raw poultry, sauerkraut and unpasteurized juice than managers from outside BC. Conclusion: The types of foods sold in BC and outside BC appeared similar as this survey found no differences between the five surveyed PHF categories allowed for sale. However, handling practices of these foods did vary, and that might be associated with guidelines, or with farmers’ market manager knowledge. Of concern, BC farmers’ market indicated that eggs and juices were sourced and made on farms. These two categories required more attention and food safety awareness from both EHOs and farmers’ market managers. Overall, the survey responses reaffirmed that review and approval for the sale of potentially hazardous food from EHOs and scrutiny from farmers’ markets managers must be in place to ensure public’s safety as well as minimizing public’s risk exposure to improperly handled PHF sold in farmers’ markets.

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

Background: Water quality in live retail shellfish holding tanks are vital in increasing shellfish quality and reducing risk of shellfish-associated outbreaks. Poor holding tank water conditions may not only cause mortality of shellfish, but also allow for harmful pathogens to contaminate the shellfish, proliferate in the holding tanks, and ultimately potentially affect consumer health. Shellfish are processed and handled at a variety of levels at the retail stage. Therefore, the purpose of this research project is to compare water quality in live retail shellfish holding systems between processing plants and retail food markets. Differences may indicate a need for attention at a particular level in order to effectively and efficiently reduce mortality and disease among shellfish, and thus potentially humans as well. Methods: 30 water samples were taken from the two types of locations with the help of the Department of Fisheries and Oceans (DFO), Ministry of Agriculture, and the BCCDC. These samples were tested for parameters including temperature, pH, nitrites, turbidity, and dissolved oxygen using a LaMotte Fresh Water Aquaculture Kit and a HACH 2100P turbidimeter. A two-tailed t-test was used to compare the means of each of the parameters among the two types of locations with live shellfish holding tanks. Results: The mean values for all parameters in both retail and processing met the requirements set by the BCCDC. However, temperature and dissolved oxygen showed statistically significant differences between retail markets and processing facilities. Nitrites, pH, and turbidity showed no statistically significant differences between the two types of locations. Conclusion: Differences in dissolved oxygen may have been due to salt levels, failing recirculation systems, or high levels of organic matter from sanitation issues. Differences in temperature may have been due to differences in holding tank size, or inconsistencies from using two different thermal measuring devices. High levels of nitrites were a concern as well due to overcrowding of holding tanks. More attention may be needed for these issues, especially during certain seasons such as Chinese New Years, in order to lower the risk to public health.

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.

Background: In British Columbia, community care facility is a broad term that covers many different type of facilities including residential care and child care facilities. These facilities are inspected and audited by the BC regional health authorities to ensure that they are operating in compliance with the BC Community Care and Facilities Act and its respective regulations. These facilities house population groups that are at higher risk of injury or illness due to their physiology and behaviour. Therefore, it is crucial that these facilities are operating in compliance with the prescribed legislation to minimize the risk of illness and injury to the users of these facilities. Objective: The purpose of this study was to determine if there were any differences in the number of violations in residential care and child care facilities between the different health authorities in BC. Methods: Inspection data were randomly selected and extracted from each of BC’s five health authority’s websites and assessed for the number of violations found in these inspections. Violations were tallied and an ANOVA analysis was performed to identify if there were any differences in the number of violations between the health authority regions. Results: Statistical analysis was performed using Microsoft Excel 2013 and NCSS. There was a statistically significant difference of violations between child care and residential care facilities located in the Interior Health Authority region and Northern Health Authority region. Interior Health Authority child care and residential care facilities have more violations than Northern Health Authority child care and residential care facilities. Conclusion: Violations in child care and residential care facilities varied among the five BC HA region. The IHA facilities were found to have the overall highest number of violations for both child care and residential care facilities whereas the NHA facilities were found to have the lowest number of violations. This suggests that patrons of child/residential care facilities in IHA have a higher potential of getting injured or ill compared to patrons in facilities located in NHA.

Background: In September 2014, BCCDC developed “Guidelines for Restaurant Sous Vide Cooking Safety in British Columbia” providing Environmental Health Officers (EHO) and sous vide cooking chefs safety knowledge about sous vide cooking. To assess whether the guidelines improved sous vide safety knowledge, a study was conducted to examine and compare knowledge differences between EHOs and chefs who had read the guidelines to those who had not read the guidelines. Methods: An online survey was created and advertised by publishing on the BCCDC website, in newsletters and magazines (Vancouver Costal Health newsletter, Fraser Health news Letter, Chefs Quarterly magazine), and through e-mail distribution lists to EHOs and chefs, including chefs at Vancouver Community College. The questions in this survey were developed based on the guide-lines. T-tests and Chi square analyses were conducted to assess knowledge difference between those who read the guidelines and those who did not. Results: A total of 65 people completed the survey, including 45 EHOs (69.3%), 15 chefs (23%), and 5 others (7.7%). EHOs who read the guidelines had significantly higher average knowledge scores in the multiple choice section of the sous vide safety knowledge survey (p=0.00028, t-test) when compared to EHOs who had never read the guidelines. No differences were found in the true and false section (p=0.43925, t-test). With regard to inspection practices, EHO who read the guide-lines were more likely to frequently check for the internal temperature of sous vide foods, water bath temperature, time/temperature in the recipes, calibration of thermometer and proper labels on sous vide pouched foods than EHOs who never read the guidelines. Chefs who read the guidelines had similar average score as chefs who never read the guidelines in T/F (p=0.79878, t-test) and multiple choice (p=0.97, t-test). With regard to cooking practice, chefs who read the guidelines were more likely to frequently calibrate thermometers than chefs who never read the guidelines. However, chefs who never read the guidelines were more likely to frequently find their sous vide pouch floating dur-ing the cooking process, to check for internal temperature of sous vide food, and to label their sous vide pouch properly. Conclusion: These results show that EHOs who have read the sous vide guidelines have better sous vide knowledge in comparison to EHOs who have never read the guidelines. They are also more likely to have overall better inspection practices. Nevertheless, results show chefs who read the guidelines have similar sous vide knowledge in comparison to chefs who never read the guidelines. In terms of cooking practices, these chefs are likely to have better cooking practices only in certain areas.

Background: Following the 2014 Gort’s Gouda Cheese Escherichia coli O157:H7 outbreak which resulted in one death and 28 illnesses, an examination of dairy processing plants (DPP) within British Columbia (BC) was undertaken. The intent of this examination was to efficiently allocate resources to ensure a lower likelihood of future outbreaks occurring in a BC DPP and to improve current knowledge regarding DPP practices. A risk-based approach to assessing inspection activities for DPPs was undertaken. As such, the purpose of the project was to create a semi-quantitative tool to assess inherent risk factors of DPPs, after which it would be used to determine appropriate inspection frequencies for these plants based on their risk scores. Finally, a comparison between provincially licensed and federally registered dairies was conducted in order to examine if there was a difference in risk between the two licensing statuses. Methods: A semi-quantitative approach was used to characterize responses to a survey (Shi, 2014) conducted by the BCCDC between August and December 2014. This survey was sent to all DPPs (n=54) operating in BC. Each survey question related to increasing information on conditions found in DPPs, after which a semi-quantitative assessment approach was used to assign a total risk inherent to each DPP due to the conditions found in the facility. The DPPs were then ranked against each other with respect to their risk scores in order to assess which facility was considered of higher risk. Facilities were grouped by their licensing status, provincially licensed or federally registered, and then compared against one another using a two variable t-test in NCSS 10. Semi-quantitative risk assessment was done using an Excel tool designed specifically for the present study. Results: Complete data was obtained for 85%(n=46) of DPPs, with an equal number of provincial and federal DPPs used in the evaluation. Dairies were ranked against one another with respect to their total risk score. A statistically significant difference (p=0.036) was found when comparing the inherent risk of provincial and federal DPPs, with federally registered dairies showing a lower total inherent risk score. Conclusion: The information obtained from this study provided the BCCDC with a standardized risk-based inspection approach. Ranking of DPPs with respect to their inherent risk also allows inspectors to gain better understanding of present day dairies and their high risk issues. This reassessment allows for the development of more efficient inspection schedules in order to effectively allocate inspection resources and to increase the ability for inspectors to capture and prevent risks which would lead to foodborne illnesses.

Soft ripened cheese (SRC) caused over 130 foodborne illnesses in British Columbia (BC), Canada, during two separate listeriosis outbreaks. Multiple agencies investigated the events that lead to cheese contamination withListeria monocytogenes (L.m.), an environmentally ubiquitous foodborne pathogen. In both outbreaks pasteurized milk and the pasteurization process were ruled out as sources of contamination. In outbreak A, environmental transmission ofL.m.likely occurred from farm animals to personnel to culture solutions used during cheese production. In outbreak B, birds were identified as likely contaminating the dairy plant’s water supply and cheese during the curd-washing step. Issues noted during outbreak A included the risks of operating a dairy plant in a farm environment, potential for transfer ofL.m.from the farm environment to the plant via shared toilet facilities, failure to clean and sanitize culture spray bottles, and cross-contamination during cheese aging.L.m.contamination in outbreak B was traced to wild swallows defecating in the plant’s open cistern water reservoir and a multibarrier failure in the water disinfection system. These outbreaks led to enhanced inspection and surveillance of cheese plants, test and release programs for all SRC manufactured in BC, improvements in plant design and prevention programs, and reduced listeriosis incidence.

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.

Background: In 2012, mechanically tenderized meat raised public health concern when an E.Coli 0157:H7 outbreak was linked to the tenderization process. It was discovered that the machinery pushed the E.Coli from the surface of contaminated meat products such as steaks and roasts, into the interior, where it was able to survive the cooking process. Concerns were raised by Lorraine McIntyre and the BCCDC about this issue, and their desire to improve their knowledge base in order to adequately assess the risk. Methods: Data was gathered via a survey conducted electronically and by telephone. Questions were asked to determine the proportion of retail establishments that use their own tenderizing equipment. Questions also asked about other industry practices such as current sanitization and labeling practices. Results: The results of this study were that 24% of surveyed establishments mechanically tenderize their meat products. Of these establishments, 33% have a label that states the meat has been tenderized mechanically and 17% provide cooking instructions on this label. An association was found between mechanically tenderizing meat and establishment type, which suggests that grocery stores are more likely to mechanically tenderize than other establishments, such as restaurants. On the other hand, no association was found between operator experience and their level of knowledge regarding the risks of mechanical tenderization. Conclusions: Overall, this study has demonstrated the likelihood is high that consumers purchase and consume beef that has been mechanically tenderized at the retail level. The results from this study can be used to aid public health officials in quantifying the risk of mechanical tenderization at a retail level and aid in the development and implementation of new legislation such as mandatory labeling of all mechanically tenderized meat.