Identify and explain in the Case study below;

• What process controls (microbiological, chemical, and physical) were observed to address thescenario/s
• Were the process controls used effectively? If not, what other process/es can you suggest to address the identifiedhazards?

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 - father, Winston, age 61; mother, Margaret, age 35; daughter, Penelope, age 12; and son, Charles, age 10 - can recall three recent episodes in particular that seem to have been food related:

1. 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.
2. 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.
3. Two family members and three of four visiting neighbors experienced simultaneous vomiting and diarrhea within 1 day of feasting at an outdoor barbeque that included grilled chicken and Caesar salads.

ORIGIN OF THE KNIGHT FAMILY HOME FOOD SAFETY PROGRAMME

The Knight family's growing awareness that some of their memorable bouts of illness might have been associated with food-handling practices was gradually reinforced with information gained by each family member from different sources. Margaret's suspicions were raised while watching a public television programme about the causes and nature of foodborne illnesses. Penelope and Charles learned simple facts about safe food handling in their school's health classes. In particular, they learned about the importance of proper refrigeration temperatures. Winston learned more about foodborne illness symptoms than he imagined possible after Googling 'diarrhea, eating chicken' (http:scholar.google.com).

RETROSPECTIVE ANALYSIS OF PREVIOUS ILLNESSES

The Knight family began to discuss their newfound information about food-handling practices and began to develop hypotheses about the unexpected and, at the time, mysterious illnesses that had affected them and their neighbors. Additional online searching and attempted reconstruction of events surrounding the potentially incriminated meals and suspect foods led them to the following conclusions:

1. 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 recalled cooking rice the evening before the Pilaf was prepared and served. She spooned the hot cooked rice into a rectangular plastic storage dish, which she covered and placed in the 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. 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. cereus produces a heat-stable emetic toxin, which induces vomiting within several hours of consumption.

1. The dressed goose served for the holiday meal had been purposely roasted at an oven temperature lower than the recommended 163C to retain the succulence of the meat. Winston learned online that C. perfringens, also a spore-forming micro-organism, 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 50C 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 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 ambient temperature during the long holiday meal.

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

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 occurrences. Each member assumed responsibility for specific aspects of the resulting family action plan:

• 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 necessary.

• 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 sanitize kitchen counters to minimize opportunities for food contamination.

• Winston agreed to continue online monitoring of safe food-handling information and to inform the entire family about useful practices. At this writing, the Knight family has experienced no additional known cases of foodborne illness.