Are there special procedures we must follow if we make food for highly susceptible populations?

First of all, it is important to understand who is classified as highly susceptible to foodborne illness. According to the U.S. Food Code (2005), highly susceptible population means persons who are more likely than other people in the general population to experience foodborne disease because they are:

(1) Immunocompromised; preschool age children; or older adults; and

(2) Obtaining food at a facility that provides services, such as custodial care, health care, or assisted living, such as a child or adult day care center, kidney dialysis center, hospital or nursing home, or nutritional or socialization services such as a senior center.

Therefore, most foodservice operations under the guidance of Child Nutrition Services are technically not serving highly susceptible populations. The exceptions to this are facilities that are serving special needs children. For these types of facilities, additional safeguards must be in place. The additional safeguards that must be in place for these individuals are described below.

JUICE. Fresh squeezed juice cannot be served. All juice that is served must be prepackaged and obtained pasteurized or in a commercially sterile, shelf-stable form in a hermetically sealed container. Juice that is prepared from concentrate using safe, potable water can also be prepared as long as safe food handling practices are stringently followed.

The definition of a juice means it is served as such or used as an ingredient in beverages. Puréed fruits and vegetables, which are commonly prepared as food for service to highly susceptible populations, are not juices and so can be served as long as they are properly handled according to the standards outlined in 2-5: Safe Food Handling. One might wish to use canned fruits and vegetables to make pureed items as a means of enhancing food safety.

PASTEURIZED EGGS OR EGG PRODUCTS. Substitute pasteurized eggs or egg products for raw eggs when making recipes calling for lightly cooked eggs, such as Caesar salad, hollandaise or Béarnaise sauce, mayonnaise, meringue, eggnog, ice cream, and egg-fortified beverages. Also, all eggs and egg dishes must be cooked to at least 145 degrees F or hotter.

Salmonella can survive traditional preparation techniques. It survives in a lightly cooked omelet, French toast, stuffed pasta, and meringue pies. In 1986 there was a large multistate outbreak of Salmonella Enteritidis traced to stuffed pasta made with raw eggs and labeled fully cooked. Eggs remain a major source of these infections, causing large outbreaks when they are combined and undercooked as was the case in the 1986 outbreak linked to stuffed pasta.

All raw eggs to be cooked must come from a permitted supplier. Adequate time and temperature controls must also be in place within the establishment to minimize the risk of a foodborne illness outbreak relating to Salmonella Enteritidis.

OTHER HANDLING PRACTICES TO KEEP FOOD SAFE.

Do not service Partially cooked animal foods, such as lightly cooked fish, rare meat, soft-cooked eggs that are made from raw eggs, and meringue; and
Do not serve raw seed sprouts. Since 1995, raw seed sprouts have emerged as a recognized source of foodborne illness in the U.S.
No bare hand contact of any exposed, ready-to-eat foods.
Time only, as the public health control, cannot be used for raw eggs.
No foods can be reserved.
No leftovers or advanced preparation of potentially hazardous foods.