School Meal Program:

Few Instances of Foodborne Outbreaks Reported, but Opportunities Exist to Enhance Outbreak Data and Food Safety Practices

GAO-03-530: Published: May 9, 2003. Publicly Released: Jun 5, 2003.

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More than 28 million children receive meals daily through the federal school meal programs. Providing meals that are safe is especially important because young children have a higher risk of complications from some foodborne illnesses. GAO examined (1) the frequency and causes of reported foodborne illness outbreaks associated with the federal school meal programs and (2) the practices that federal, state, and local governments as well as other food providers find useful for safeguarding meals.

GAO found that 195, or about 3 percent, of the total of 7,390 foodborne outbreaks that were reported nationwide, between 1990 and 1999, occurred in schools. Specific national data on whether these outbreaks were related to the federal school meal programs do not exist; however, GAO's survey of state health officials provided information on 40 large outbreaks involving these programs. Nearly half of these large outbreaks resulted from improper food preparation and handling practices in school kitchens. Most commonly, foods involved in the outbreaks were contaminated with Norwalk-like viruses, which cause a mild gastrointestinal illness. However, data limitations make comprehensive assessment of the safety of school meal programs difficult. In particular, the reporting mechanism that states use to voluntarily report outbreaks to the Centers for Disease Control and Prevention (CDC) does not distinguish between outbreaks in schools involving the school meal programs and those involving food from other sources, such as brought from students' homes. Federal, state, and local governments, as well as other food providers use a variety of practices to safeguard meals. Some of them may have national applicability to the federal school meal programs. For example, having key food service personnel trained and certified in food safety would address the improper food preparation and handling practices that caused most of the outbreaks reported in GAO's survey. Purchasing precooked or irradiated meat and poultry products could reduce the risk of foodborne illness in schools. Furthermore, the U.S. Department of Agriculture requires that some of the commodities it donates to schools be purchased under more stringent safety standards than the agency's regulatory requirements for meat and poultry processors. Currently, these more stringent procurement requirements are not readily accessible for school districts' use. While the practicality of applying these food preparation/handling and purchasing practices to the nation's schools has not been assessed, several food safety experts believe that applying these practices in all schools would enhance the safety of federal school meals. Some of these practices would likely lead to increased food costs for schools.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: USDA is issuing guidance to the state agencies and the school food authorities to develop training programs and is working closely with the National Food Service Management Institute to tailor and deliver training to assist the school food authorities in constructing and implementing their food safety programs.

    Recommendation: To enhance the safety of the federal breakfast and lunch programs in participating school districts, the Secretary of Agriculture should direct the Administrator of the Food and Nutrition Service to further promote training and certification of key school food service personnel in food safety practices by, for example, publicizing the range of food safety training and certification opportunities available to school food service personnel from the American School Food Service Association, the National Restaurant Association, and other sources.

    Agency Affected: Department of Agriculture

  2. Status: Closed - Not Implemented

    Comments: USDA has not taken action on this recommendation. They have concerns about developing a Web page highlighting instances where USDA has established more stringent product safety specifications for school commodities than commercial standards. According to USDA, such a Web page could be misinterpreted as implying that current commercial standards, as well as the food safety standards imposed by the Food Safety Inspection Service and the Food and Drug Administration, are inadequate for these products. AMS' Web site, as well as FNS' Food Distribution Division Web site and USDA's Commodity Food Network Web site currently contain links to detailed commodity specifications and standards that can be accessed by schools and the public

    Recommendation: To assist schools in their efforts to purchase safer food, the Secretary of Agriculture should direct the Administrator of the Agricultural Marketing Service to highlight on AMS's Web page the more stringent product safety specifications the United States Department of Agriculture (USDA) uses when purchasing foods it donates to schools.

    Agency Affected: Department of Agriculture

  3. Status: Closed - Implemented

    Comments: In July 2003, CDC reported that it had taken the following actions to implement GAO's recommendation: (1) drafted a school-associated outbreak questionnaire that can be used to collect additional information through the Electronic Foodborne Outbreak Reporting System (EFOR); (2) prepared office staff to routinely monitor reports of school-associated outbreaks; (3) met with FNS to further discuss how to review the additional school-associated outbreak questions; and (4) expanded the scope of work with a programming contractor for the addition of a pop-up screen to EFOR that would prompt public health officials to collect additional information on school meal outbreaks.

    Recommendation: To improve nationwide data on the frequency and causes of foodborne illness associated with the federal school meal programs, the Secretary of Health and Human Services should require the Director of the Centers for Disease Control and Prevention to revise the reporting mechanism that states use to voluntarily report foodborne outbreaks. Specifically, states should be prompted to specify whether reported outbreaks involved foods served through the federal school meal programs.

    Agency Affected: Department of Health and Human Services

  4. Status: Closed - Implemented

    Comments: In response to our recommendation, USDA has considered the feasibility of offering only precooked or irradiated poultry and meat products to schools and has opted for offering a combination of products. The department is however, phasing in National Master Processing Agreements which encourage states to use more of their commodity entitlement for processed products. USDA continues to provide a basic offering of processed precooked products and has add new products. The department is planning on testing several new precooked offerings including turkey crumbles, pork patties, and pork links. USDA also offered irradiated ground beef and ground beef patties to schools in school year 2004-2005 and in 2005-2006. However, no state has ordered the product to date.

    Recommendation: To reduce the risk of bacterial contamination of food products USDA donates to schools, the Secretary of Agriculture should direct the Administrators of the Food and Nutrition Service and the Agricultural Marketing Service to study the advantages and disadvantages, including costs, of USDA donating only precooked or irradiated meat and poultry products to schools. Depending on the results of the study, the Secretary should consider whether to adopt these practices.

    Agency Affected: Department of Agriculture

 

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