**5. Conclusion**

16 Salmonella – A Dangerous Foodborne Pathogen

Although restaurant inspections by local health departments routinely assess food-safety practices among food handlers in the retail food environment, similar scrutiny of home kitchens are rarely applied in most jurisdictions across the United States. In response to this potential risk in the home setting, the Los Angeles County Department of Public Health launched its Home Kitchen Self-Inspection Program in the spring of 2006 to promote safer food handling and preparation practices among the county's residents, using a voluntary self-inspection and education program. The program included the use of a web-based, selfassessment questionnaire, called the Food Safety Quiz (FSQ) that was based on emerging evidence indicating that online, interactive learning strategies are conducive to problembased learning, improving self-efficacy and increasing self-mastery of selected skills (Kuo et al., 2010). The educational program stressed the importance of such preventive measures as hand washing before, during and after food preparation; refrigerating prepared foods in small containers; thoroughly cooking all foodstuffs derived from animal sources, particularly poultry, pork, egg products and meat dishes; avoiding recontamination within the kitchen after cooking is completed; and maintaining a sanitary kitchen and protecting prepared foods against rodent and insect contamination (Heymann, 2008; Scott, 2003). During its initial program period from 2006-2008, more than 13,000 individuals participated in the program and completed the FSQ. Recent evaluation of program progress revealed that if home kitchens were graded similarly to restaurants in Los Angeles County, 61% would have received an **A** or **B** rating, as compared to 98% for the full-service restaurants based on rating criteria derived from the California Food Safety Code (Kuo et al., 2010). Among the program participants, approximately 27% reported not storing partially cooked food that was not used immediately in the refrigerator before final cooking; 26% reported that their kitchen shelves and cabinets were not clean and free from dust; and 36% said they did not have a properly working thermometer inside their

The program evaluators concluded that even among interested and motivated persons who took the time to participate in the Home Kitchen Self-Inspection Program, food handling and preparation deficiencies were common in the home kitchen setting. This innovative, ongoing educational program in Los Angeles County underscores the importance of educating the public about home kitchen safety. Such programs, which emphasize feedback and interactive teaching about food safety, can complement the efforts of established restaurant hygiene rating programs to reduce foodborne illnesses in

New research on control measures is underway to investigate additional strategies for reducing foodborne illnesses, especially for *Salmonella* prevention. Advances in non-thermal technologies for microbial inactivation of *Salmonella*, such as the use of cold plasma, high pressure, and carbon dioxide are currently being evaluated (Bermúdez-Aguirre et al., 2011). Another approach that is currently being considered is the use of antimicrobial bottle coatings (i.e., packaging for liquid foods) to inactivate *Salmonella* in liquid egg albumen (Jin and Gurtler, 2011). Scientists are also actively exploring an experimental chlorate product that can be introduced into drinking water and feed for hens (McReynolds et al., 2005). Although promising, these innovations are not standalone interventions and are expected to

augment existing control measures at various levels of the food distribution chain.

**4.2.3 Home kitchens** 

refrigerators (Kuo et al., 2010).

jurisdictions across the United States.

**4.3 Exploring new strategies and technologies** 

Salmonellosis caused by nontyphoid strains remains the most common foodborne illness reported in the United States. In spite of effective public health and regulatory efforts to control and prevent this infectious disease, the morbidity, mortality, and years of potential life lost due to this foodborne pathogen continue to be substantial. The overall incidence of laboratory confirmed *Salmonella* infection was 17.6 cases per 100,000 persons in 2010, which remains higher than the Healthy People 2020 objective of 11.4 cases per 100,000 persons (Figure 2). Active surveillance and continual efforts in developing and implementing control policies have helped federal and local health agencies in the United States make significant strides in combating this disease. Lessons learned from these efforts, including ways to work collaboratively across agencies at different levels of the food distribution chain have been invaluable for informing present and future *Salmonella* control policies and preventive measures in the United States. These lessons may have global implications for other jurisdictions abroad.
