APPENDIX VI–PREVENTION OF INFECTIOUS DISEASE FROM CONTAMINATED 1083 FOOD PRODUCTS 4. Cook: Cook food to the proper temperature. The following preventive measures can be implemented to decrease the risk of infec- tion from specific foods. Unpasteurized Milk and Milk Products The American Academy of Pediatrics (AAP) endorses the use of pasteurized milk and recommends that parents be fully informed of the important risks associated with con- sumption of unpasteurized milk.1 Interstate sale of unpasteurized (raw) milk and products made from unpasteurized milk (with the exception of certain cheeses) is banned by the US Food and Drug Administration (FDA). The most vulnerable populations, such as chil- dren, pregnant women, elderly people, and immunocompromised people, should not con- sume unpasteurized milk or products made from unpasteurized milk, including cheese, butter, yogurt, pudding, or ice cream, from any species, including cows, sheep, and goats. Serious infections attributable to Salmonella species, Campylobacter species, Mycobacterium bovis, L monocytogenes, Brucella species, E coli O157:H7, and Y enterocolitica have been linked to consumption of unpasteurized milk. Although some states allow the sale of raw milk that meets specific standards (certified milk), certified raw milk has also been linked to outbreaks. In particular, a number of outbreaks of campylobacter infection among chil- dren have been associated with school field trips to farms that include consumption of raw milk. School officials should take precautions to prevent raw milk from being served to children during educational trips. Cheeses made from unpasteurized milk also have been associated with illnesses attributable to Brucella species, L monocytogenes, Salmonella species, Campylobacter species, Shigella species, M bovis, and STEC. Eggs At-risk populations, including children, should not eat raw or undercooked eggs, unpas- teurized powdered eggs, or foods that may contain raw or undercooked eggs. Ingestion of raw or improperly cooked eggs can result in severe illness attributable to Salmonella species. Examples of foods that may contain raw or undercooked eggs include some homemade frostings and mayonnaise, homemade ice cream, tiramisu, eggs prepared “sunny-side up,” Caesar salad dressing, Hollandaise sauce, cookie dough, and cake batter. Raw and Undercooked Meat Children should not eat raw or undercooked meat or meat products. Various raw or un- dercooked meat products have been associated with harmful bacteria, including Salmonella species and Campylobacter species. Specific meat products have been linked with certain bacterial infections (pathogen-commodity pair): ground beef with STEC and Salmonella species hot dogs with L monocytogenes pork with Trichinella species and wild game with Brucella species, Francisella species, STEC, and Trichinella species. Ground meats should be cooked to an internal temperature of 160°F roasts and steaks should be cooked to an in- 1American Academy of Pediatrics, Committee on Infectious Diseases and Committee on Nutrition. Consump- tion of raw or unpasteurized milk and milk products by pregnant women and children. Pediatrics. 2014 133(1):175-179
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