06 Activity 1 (Application Process Control)

I. CASE STUDY
A typical suburban Hill City, Kansas (USA), family has been stricken by a number of
illnesses during the past several years, most or all of which may have been foodborne
illnesses resulting from foods prepared in their home. The Knight family, the father,
Winston, age 61; the mother, Margaret, age 35; the daughter, Penelope, age 12; and
the son, Charles, age 10, can recall three recent episodes in particular that seem to
have been food related:
a) Three of the family members began vomiting within 2 hours of eating a meal that
included Himalayan Nut Pilaf. Penelope, the only member who did not become ill,
had not eaten the Pilaf.
b) All family members experienced repeated diarrhea within 14 hours of eating a
winter holiday meal that included a dressed and roasted 4 kg goose. Because this
meal was a family tradition, all members ate heartily.

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c) Two family members and three of four visiting neighbours experienced
simultaneous vomiting and diarrhea within a day of feasting at an outdoor barbeque

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that included grilled chicken and Caesar salads.

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The Knight family began to discuss their newfound information about food-handling
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practices and began to develop hypotheses about the unexpected and, at the time,
mysterious illnesses that had affected them and their neighbours. Additional online
searching and attempted reconstruction of events surrounding the potentially
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incriminated meals and suspect foods led them to the following conclusions:
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a) It seemed rather clear that the first series of illnesses involved the Himalayan
Rice Pilaf, as it had not been eaten by Penelope, the only family member who
had not become ill. Margaret re-called cooking rice the evening before the
Pilaf was prepared and served. She spooned the hot cooked rice into a
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rectangular plastic storage dish, which she covered and placed in the
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refrigerator door. It is likely that the episodes of vomiting were caused by the
growth of Bacillus cereus in the rice, which required many hours to cool
below ambient temperature. B. cereus spores are normally present in rice.
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The spores survive the cooking process and are able to grow rapidly if the rice
is not consumed or adequately chilled within several hours. During growth, B.
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cereus produces a heat-stable emetic toxin, which induces vomiting within

several hours of consumption.

b) The dressed goose served for the holiday meal had been purposely roasted at an
oven temperature lower than the recommended 163◦C to retain the succulence of
the meat. Winston learned online that C. perfringens, also a spore-forming
microorganism, was often the cause of diarrheal illness in meat and poultry products,
particularly those involving dressing or gravy. It can grow very rapidly at
temperatures up to about 50◦C in foods that are roasted too slowly or held too long
during serving. Following growth, it produces spores in the food. After consumption,
the spores germinate in the host’s intestine and produce toxins, which cause

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 diarrhea typically within 8–24 hours. In this episode, the family’s illnesses could have
been caused by the growth of C. perfringens in the dressing during slow roasting, or
in the gravy, which had been made from the goose drippings and held for many
hours at an ambient temperature during the long holiday meal.

c) Reconstruction of the third illness episode led to two plausible causes; perhaps
both were involved to differing extents in the five illnesses. The same tongs had been
used to handle grilled chicken pieces. It is possible that grilled chicken could have
been recontaminated with Salmonella or Campylobacter, both common
contaminants of raw poultry. It is perhaps more likely that the Caesar salad was the
cause of the illnesses, as it was made with two potential sources of contamination.
Whole chickens were cut on a cutting board that was not washed and disinfected
before being used to cut salad ingredients. Furthermore, the salad dressing was
prepared with fresh, raw egg yolks, which have frequently been responsible for
illnesses caused by Salmonella Enteritidis. Salmonella infections are typically
characterized by vomiting and diarrhea, while Campylobacter infections do not

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always involve vomiting. Therefore, it is more likely that the illnesses were caused by
Salmonella, though it could not be determined whether the raw chicken or raw egg

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yolks were responsible for the contamination. In any case, both are serious food-
handling mistakes which are needed to be prevented.

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KNIGHT FAMILY FOOD SAFETY TEAM AND ACTION PLAN:
Equipped with this knowledge about foodborne illnesses and their likely mistakes
that caused the illnesses, the Knight family agreed to work together to avoid future
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occurrences. Each member assumed responsibility for specific aspects of the

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resulting family action plan:

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 Penelope became the team leader. She wanted to be the keeper of the collected
data, which she intended to use in a school project. She was also responsible to
monitor refrigerator temperatures at least weekly and make adjustments when
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necessary.
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 Charles agreed to monitor cooking and roasting temperatures as necessary, and

to supervise prompt and proper refrigeration of foods.
 Margaret agreed to monitor food-handling practices and regularly clean and
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sanitize kitchen counters to minimize opportunities for food contamination.

 Winston agreed to continue online monitoring of safe food-handling information
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and to inform the entire family about useful practices.

 Were the process control effective?

- Yes, because the Knight family have not experienced any foodborne illness after
this study. The above case study can be used to improve the system of safe food-
handling procedures in our respective homes, and even outside, effectively.

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