Hygienic requirements for pregnant women to protect against food infections Part II


Hygienic requirements for pregnant women to protect against food infections Part II

The Cleaning Theme 

Regular and frequent cleaning of the hands plays a major role.

This is very important during pregnancy and also the time after it (in addition to pregnant women, infants and toddlers are at risk, but also older people with a reduced immune system)

  • Wash hands with soap before and after preparing a meal and before eating. 
  • Especially after contact with eggshells and raw or defrosted meat or fish (wash hands with soap well – and additionally disinfect with an alcohol-based aseptic gel.
  • Thoroughly clean the surfaces and appliances in the kitchen (if possible, with hot water and soap); disinfect them with alcohol if necessary.
  • Of course, also clean hands accordingly well after: visit the toilet, or after cleaning children, after gardening and animal contacts, or after stay in public facilities (e.g. buses, trains, offices, hospitals or medical practices, etc.) and in particular also stays in kinder garden, playground or schools.
  • Salad, fruit, and vegetables should always be thoroughly washed with the water of drinking quality.
  • Dry the salad, as well as the fruit and vegetables after washing. Prolonged wetness can promote the growth of microorganisms. 
  • Defrost and clean refrigerators at least twice a year 
  • Eggs should not be washed, as washing attacks the invisible protective layer on the eggshell and germs are more likely to penetrate the egg. The shelf life could also be reduced in this way.
  • When in contact with raw meat and eggs (eggshells), also use disinfectant for the hands (approximately 1-2 minutes the palms and fingers as well as finger spaces and rub the disinfectants well on the fingernails 

See: http://exploredoc.com/doc/9250326/%C3%B6ffnen---b.brown

Put disinfectant into the hollow, dry hands. After the procedure listed left, rub the product vigorously into the hands up to the wrists. Observe the recommended application time of the respective product.

Perform the movements of each step five times. After completing the 6th step, individual steps are repeated up to the specified rub-in time. If necessary, remove the hand sanitizer again. Make sure that the hands remain moist for the entire rub-in time.

Pregnant women should not consume raw animal foods.

The Heating Theme 
  • Pregnant women should not consume raw milk products such as milk direct from the farm and some cheeses made from it – they are at risk of being infected with listeriosis.  Products made from pasteurized milk are safe; but during pregnancy, soft cheese– even from pasteurized milk - for safety reasons - should also not be consumed.
  • Pregnant women should not consume raw sausages (e.g. raw ham, salami, tea sausages, etc.) 
  • Similarly, pregnant women should avoid raw fish, and other raw marine animals (e.g. sushi and smoked fish,) as well as insufficiently heated eggs or egg products.
  • Fish and meat, as well as eggs and their products (e.g. creams, pudding), are safe only if they have been sufficiently heated to the inside evenly (core temperature for at least 2 minutes at minimum 70°C or even 80°C). In case of salmonella, it is only safe if the entire meat has been heated to over 70°C for more than 10 minutes. The meat must turn from red to grey or brown inside, or in the case of light poultry meat get firm and cooked well inside. 
  • Meat on the bone (e.g. chicken) is certainly sufficiently heated when it is no longer reddish and is visibly cooked.
  • The safest way is to measure the core temperature with a roast thermometer.
  • Roasted meat should best be consumed shortly after preparation. Remains can be stored in closed containers in the refrigerator for 1-2 days after quick cooling down.
  • Cooled meat residues should then be heated quickly to the safe core temperature (see above) before eating it again.
  • Fresh fish should be cooked until it is opaque and can be easily divided into layers with a fork.
  • Mussels and oysters should not be consumed during pregnancy for safety reasons. They should also be considered with caution later, when it should only be cooked in small quantities for at least 10 minutes. Mussels and oysters which remain closed after cooking are not allowed to be opened or consumed.
  • Eggs should only be consumed by pregnant women hard-boiled (must be adequately cooked through at least 5 minutes). Stirred and fried eggs must be roasted (firm).
  • Foods that contain raw or not completely heated eggs (some puddings, creams, tiramisu, and even home-made mayonnaise) should be avoided during pregnancy.
  • Pregnant women should best not consume sandwiches, creams, cream products in refrigerated counters or buffets.
  • More likely to be avoided during pregnancy are certain antipasti or snacks with cream cheese, with pies or marine animals, such as matjes-fish (herring), shrimp, as well as served sandwiches and baked goods with cream and creams from counters or buffets.
  • Caution is required for any fish and meat found in counters, canteens or buffets – they must have been sufficiently heated (and kept warm - see above) or cooled below 10°C for cold dishes (and kept cool – see below) -and preferably consumed within 1-2 hours.
  • Heating such foods in the microwave are often unsuitable, as it can be unevenly heated inside ("cold nests remain") and thus survive pathogens. In the microwave, longer cooking times would have to be set than usual, and the reached temperatures of at least 70 ° C inside should be measured.
  • Baby drink bottles with water and tea should not be heated in the microwave, as the temperatures may not be sufficient to kill germs.
  • Herbal tea, for pregnant women as well as infants and toddlers should always be overcooked with hot, bubbling water, and stay hot for 10 minutes.
  • Instant products (semi-finished foods) must always be prepared shortly before consumption. In particular, instant infant formula (formula milk or porridge) should be prepared with at least 70°C hot water, then quickly cooled to the desired consumption temperature and best consumed immediately – at the latest after 1-2 hours, it should be consumed.
  • Heated foods are not allowed to be kept below 60°C for a longer time. At least 65 °C is required to keep warm, otherwise, too many germs multiply faster. The hours-long keeping food at room temperature allows the propagation of germs and is a common cause of diarrhea or even food intoxication. 
  • Hot food should be consumed within 2 hours of the last heating 
  • In the case of pre-cooked foods intended for storage, the cooling-time between 60°C and 10°C must be kept short. This means that they should be cooled relatively quickly to below 10°C for storage since between 10 and 60° C most germs reproduce best.
  • For larger portions of heated foods intended for storage, divide them into several smaller portions so they can cool down faster.


The Cooling Theme 
  • Insufficient cooling is one of the main causes of food-transmitted infections.
  • Many processed foods and particularly perishable foods (e.g. most fish-, meat-, dairy- products) intended for storage should be put in the refrigerator as quickly as possible.

Setting the refrigerator

The refrigerator should be set to below 7-8°C; if possible perishable and risky foods should be stored at a maximum of 4-6°C at 0-2°C.

Modern refrigerators have different temperature ranges at different levels.

As follows, the main compartments (door see below) can be stored in an optimized way:

  • Cheese and eggs should be at the top compartment (5 - 8 °C) - also for cakes and some ready meals this compartment is well suited 
  • Milk and dairy products store more in the middle compartment (4 °C)
  • Fruits/vegetables/salads store best in the fruit-vegetable drawer at the bottom (8 -10 °C)
  • Meat/sausage/fish and other marine animals always store in the coldest area of the refrigerator (0 - 2 °C)on the glass plate above the fruit-vegetable drawer
  • Some refrigerators also have a separate 0° C drawer. 
  • The temperature on the back wall of the refrigerator is usually significantly cooler (frost can form there).

In the refrigerator door further up, the temperature can be higher (10 to 12°C), which is why other conditions must be taken concerning the door.

As follows can be stored in the door:

  • Butter and less perishable cheese on top
  • Sauces (industrially manufactured high heated) and jam in the middle
  • Drinks below (milk and yogurt rather not in the door, but the middle compartment at approx. 4°C) an used milk bottle (if the milk is fresh and even longer durable) can also be in the lower door compartment but should be consumed within 1-2 days. 
  • The freezer should be set to -18 to -20° C.
  • Store the meat and fish products in the refrigerator at 2-4°C -open for a maximum of 2-3 days.
  • Raw meat or raw fish should be stored at 1-0°C only very briefly (in the extra compartment if available, or on the glass patty (at the backside) above the vegetable compartment.
  • If possible, minced meat should be processed on the same day of purchase and cooked well.
  • For all perishable foods, make sure that the cold chain (cooling box/cooler bag with cooling ice packs) is adhered to and that you transport things quickly from shopping to the refrigerator at home.
  • Cold dishes and desserts or juices and smoothies must be offered in a sufficiently cooled delivery and should still be considered with caution; they should be consumed or replaced within 1-2 hours.

Caution should also be given with less chilled ice cream (especially soft ice cream). Eggs should always be stored in the refrigerator.


The Theme About Frozen Foods Thawing
  • Especially from frozen meat from poultry, but also from wild animals, the thawing water can contain salmonella.
  • If possible, such meat should only be washed very carefully, as germs can spread in the kitchen.
  • After washing and processing meat (preferably on smooth stone slabs), the sink and its surroundings must be thoroughly cleaned immediately (see above).
  • Moist meat surfaces can be pre-drained with disposable kitchen paper, which must then be disposed of safely in the garbage without contaminating other surfaces.
  • For thawing the frozen meat should be safely covered in the refrigerator (in a container), where the draining water is collected in a separate container (without contact with the meat). This thawing water should be disposed of immediately – preferably in the toilet and not in the sink (rinse the toilet immediately with plenty of water). The dishware should be immediately sprayed with soap and rinsed hot for longer. The same applies to all other objects that have contact with them.
  • The thawing of meat and fish should not be done at room temperatures or in a warm water bath, but always in the refrigerator, or if there is too little space in the refrigerator, in microwave ovens with suitable programs.
  • To reduce contamination of the hands, disposable gloves, made of latex or vinyl, should be used for this work -and immediately afterward also thoroughly clean the hands with soap water as well as disinfect with alcohol (e.g. in gel form).
  • Similarly, the packaging material of frozen meat and poultry should be carefully removed and disposed of without having contact with any other food or kitchen utensils or surfaces.
  • The same applies to precautions when handling eggshells.
  • In general, other work surfaces and dishes should be used for ready-to-eat food, as for raw meat, fish, and marine animals or raw eggs. If this is not possible, cleaning and disinfection must be guaranteed even better.
  • Vegetables and salads as well as fruit should have contact with other foods (especially ready-to-eat foods) only after thorough washing (good watering).


Further Tips on Infection And Hygiene Issues
  • For the processing of raw meat or fish, it is best to use stone slabs (e.g. marble), since wood-cutting boards cannot be cleaned into the wood fibers and often also recommended plastic boards can leave microplastics traces in the food, which, especially when heated, form toxic substances that can cause a long-term strain on the organism.
  • The stone slabs used for meat processing should be cleaned under hot water immediately after use. In the dishwasher, this would also have to happen immediately and only with programs that heat above 70°C.
  • Dishrags, sponges, hand and dishtowels should be changed more often, and the dishes brushes should be added daily with the dishes in the dishwasher so that they are cleaned at the hot program.
  • Sponges of any kind are usually germ-sources, as they are difficult to clean.
  • Modern synthetic washing rags should often be replaced and washed in the washing machine under the cooking program; make sure that the washing machine is also cleaned more often (in certain chambers, which are poorly ventilated and where remains standing water, can be contaminated by mold).
  • Good washing of fruits and vegetables is always recommended. 
  • For leaf salads, it is better to choose those that do not have a large outer contact surface (rather prefer salads with closed leaves). Organic salads should also be well washed - watered.
  • Always care should be taken to ensure good quality (fresh, flawless products). In this respect, it is advantageous to buy only small quantities that have a safe transport and safe cold chain(also use cooling boxes or insulated coolers with cooling ice packs for your transport).
  • The food should usually be stored in the refrigerator and it should be processed and consumed or frozen within 1-2 days.
  • You should pay attention to the best-before date or the consumption date. During pregnancy, it is best to choose always the packaging for perishable foods that have a longer shelf life date.
  • For pregnant women, the safest food and drinks are always technically correct, freshly prepared, which are consumed immediately.


Theme Storage

For some fruits (tropical fruit) and vegetables such as tomato, zucchini, cucumber it is advantageous in terms of aroma if the storage temperature is not below 8-10°C. In any case, care should be taken to ensure that a cover keeps flies away, as these can transmit infection germs to them. The same applies to other foods stored outside the refrigerator.

Vacuum-packed foods are not necessarily better protected. Insofar as contamination had taken place before, listeria, for example, can multiply even in vacuum packaging and refrigerator storage. The long-term storage of such products even promotes the selective propagation of listeria.

So even if they are vacuum-packed foods, they should be purchased as far as possible before the stated minimum shelf life has expired and then consumed quickly – if possible, with sufficient heating.

Prof. Dr. Werner Seebauer is Dean of Studies – Association of German Preventologists, Head of Preventive Medicine Department of Institute of Transcultural Health Sciences (European University Viadrina) and Head of Preventive Medicine – NESA (The New European Surgical Academy). Since 2000, prof. dr. Werner Seebauer worked only in preventive medicine, after ten years spent at the Frankfurt University Hospital. He is also involved in the medical professionals training for nutrition and prevention.