The often asked question
TO LABEL OR NOT TO LABEL?

By Dan Titus

I am often asked: "Dan, do we need to heat-treat and/or provide a warning label on each glass of fresh-squeezed juice that we sell in our juice/smoothie bar, or restaurant?"

This is a good question and moreover, a very important issue. Therefore, let's take a look at the history, and government rules, and how these elements effect food safety.

A few years ago the FDA mandated that all unpasteurized packaged juice carry a warning label, as a direct result of contamination found in fresh-squeezed packaged juice. The company previously known as Odwalla (now merged with Fresh Samantha), in the wake of its 1996 E. coli outbreak, set a precedent to drive the FDA to act. It was determined that Odwalla fresh-packaged apple juice sickened people and even killed some children because of E. coli contamination. It was found that cattle feces had contaminated apples that were on the ground. These apples then got into the production process. The FDA warned people about drinking unpasteurized juice products.

The FDA Center for Food Safety and Applied Nutrition announced that, "unpasteurized cider and juice can contain bacteria that make children; older adults; and people with weakened immune systems, such as those with HIV, AIDS, or cancer sick, and that people in these high-risk groups should drink only pasteurized cider and juice. Some kinds of juice and cider have not been pasteurized and may contain harmful bacteria. Unpasteurized juice and cider may not be labeled with a statement saying they are unpasteurized and warning of the risk of unpasteurized juice. Frozen concentrate, shelf-stable juice in hermetically sealed containers, and canned juice are processed to eliminate harmful bacteria. Fresh unpasteurized juices normally are found in the groceries' refrigerated sections. Unpasteurized apple cider may also be found at cider mills and farm markets."

Specific language now required on all packaged unpasteurized juice products must read as: "WARNING: This product has not been pasteurized and therefore may contain harmful bacteria that can cause serious illness in children, the elderly, and persons with weakened immune systems."

For a juice producer to avoid the warning label, juice must be pasteurized, (or equivalent treatment) or sold by the cup, glass or sample. The FDA has not required warning labels to be placed on free samples, or juice sold by the cup or glass, largely due to the fact that it chooses to refrain jurisdiction in the area of "retail" and "restaurants," not because juice sold by the cup, or glass or sample is any safer than that sold in bottles. Therefore, restaurants, including juice and smoothie bars are exempt from FDA labeling regulations.

What is E. coli?

E. coli are bacteria that normally live in the intestines of humans and animals. Although most strains are harmless, several are known to produce toxins that can cause diarrhea. One particular E. coli strain called O157:H7 can cause severe diarrhea and kidney damage.

Who gets E. coli O157:H7 infection?

Anyone of any age can become infected with E. coli O157:H7, but the very young and the elderly are more likely to develop serious complications.

How is it spread?

E. coli O157:H7 can be acquired by eating contaminated food. The bacteria live in the intestines of some healthy cattle and contamination of the meat may occur in the slaughtering process. Deer meat (venison) may also be infected with the organism. Eating meat that is rare or inadequately cooked is the most common way of getting the infection. Fresh vegetables, unpasteurized fruit juices and raw milk have also caused outbreaks. With careless food handling any food product eaten raw can be contaminated by raw meat juices. Person-to-person transmission, especially in childcare settings, can occur if infected people do not wash their hands after using the toilet or diapering children. Contaminated drinking water and swimming in contaminated shallow lakes may also cause infection.

What are the symptoms?

Some infected people have mild diarrhea or no symptoms at all. Most identified cases develop severe diarrhea and abdominal cramps. Blood is often seen in the stool. Usually little or no fever is present. Symptoms generally appear three to four days after exposure, but can take as long as nine days to appear. Persons experiencing these symptoms should contact their physician.

How is E. coli O157:H7 infection diagnosed?

Infection with E. coli O157:H7 can only be diagnosed by a special stool culture that is not performed in all laboratories. Public health authorities advise doctors and laboratories to consider performing a special stool culture test for E. coli O157:H7, particularly in people with bloody or severe diarrhea.

What is the treatment?

Symptoms generally go away without antibiotics or other specific treatment in five to 10 days. Studies have not yet been conducted to determine if antibiotics are useful or harmful in the treatment of E. coli O157:H7 infection. It is recommended that antibiotics and diarrhea medicines not be given.

What serious complications can result from E. coli O157:H7 infection?

In some people, particularly children under five years of age, the infection can cause a complication called hemolytic uremic syndrome (HUS). This is a serious disease in which red blood cells are destroyed and the kidneys fail. Transfusions of blood or blood clotting factors, as well as kidney dialysis, may be necessary. A prolonged hospital stay is often required. Fortunately, most people with HUS recover completely, but it can be fatal.

What can I do to prevent infection?

Do not eat undercooked hamburger or other ground beef products. Cook roasts to at least 130 degrees F and other ground beef to 155 degrees F. Venison should be cooked to 165 degrees F. Make sure cooked ground beef is brown throughout (not pink) and the juices run clear. Foodservice personnel must carefully wash all produce, kitchen utensils and countertops. Wash hands carefully with soap after using the toilet to reduce the risk of spreading disease. Wash hands with hot, soapy water, rubbing hands together for 20 seconds. Adhere to compliance of local, and county foodservice certification programs. Consult with your local government health office.

Therefore, we have seen how history, and government rules can effect food safety programs. Ounce the cause of the problem is identified (in this case, E. coli), then the appropriate remedy can be applied: Mandating labeling for all unpasteurized juice.
Dan Titus is president of Juice Gallery MultiMedia, a restaurant consulting and publishing firm , and chief banana peeler of The Juice & Smoothie Association, a marketing company dedicated to promoting the juice and smoothie business worldwide. He may be reached @ (909) 597-0791, www.juicegallery.com .