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ARCHIVED - Management of the Risks Related to Consumption of Donairs and Similar Products1 (Gyros, Kebabs, Chawarmas and Shawarmas)

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Prepared by the Federal/Provincial/Territorial (FPT) Donair Working Group:

Health Canada
Canadian Food Inspection Agency
Public Health Agency of Canada
British Columbia Centre for Disease Control
Alberta Health and Wellness
Calgary Health Region
Capital Health (Edmonton and area)
Ontario Ministry of Agriculture, Food and Rural Affairs
Nova Scotia Department of Agriculture and Fisheries

May 2008

1 For the purposes of this document the term 'donair' refers to all other similar products including Gyros, Kebabs, Chawarmas, and Shawarmas.

Contents

1. Objective

2. Background

3. Scope

4. Food-borne Illness Outbreaks linked to Donairs

5. Food-borne Illness Risks

6. Recommendations

6.1 Donair Cone Production
6.2 Cooking and Serving
6.3 Cooling and Storage

1. Objective

The Federal/Provincial/Territorial (FPT) Donair Working Group was formed in the spring of 2005 in response to the first documented outbreak of food-borne disease in Canada linked to the consumption of donairs. In 2005 and 2006 there were three subsequent food-borne illness outbreaks in Canada also linked to the consumption of donairs. The working group reports to the FPT Food Safety Committee2 which is a government committee that provides leadership, advice and recommendations on food safety policy in Canada.

The purpose of the FPT Donair Working Group is to:

  1. evaluate current Canadian processing, preparation and handling procedures for donairs prepared at both manufacturing facilities and food service establishments;
  2. evaluate relevant Canadian and international research, reported food-borne disease outbreaks and existing guidance to industry;
  3. identify possible factors that may contribute to the risk of development of food-borne illness associated with these products; and,
  4. develop recommendations for the safe processing, cooking and handling of donairs.

2 http://www.hc-sc.gc.ca/ahc-asc/branch-dirgen/hpfb-dgpsa/fd-da/bfriia-braaii/interagenc-eng.php

2. Background

In Canada, donairs are usually made with beef, though chicken and lamb donairs are also common. There are two distinct types of donairs. The first type of product (commonly referred to as donairs or gyros) is made with ground meat that is formed into a cone shape and frozen. The second type of product (commonly referred to as chawarmas or shawarmas) is made with thin, whole cuts of meat that are marinated before being stacked on a vertical skewer. The hazards associated with both types of products are considered similar because thin layers of sliced meats stacked on top of one another have increased surface areas resembling that of ground product. For the purposes of this document, all of these products are collectively referred to as donairs.

Donairs are produced at manufacturing facilities and at restaurants or other food service establishments that cook and serve the product. The processing conditions for donairs, whether prepared in a manufacturing facility or a restaurant, vary according to factors such as the company size, production volume, level of facility automation, and the presence or absence of a recognized food safety control system. These factors may influence the final product characteristics including the consistency of the meat emulsion during cone formation, the cone size, and the microbiological quality.

Regardless of the type of facility or method of manufacture, raw donair cones are cooked at restaurants on vertical broilers which may be gas powered or electric. The typical counter top broiler consists of vertical heating elements protected by a stainless steel housing. The heating unit is enclosed around the rear of the cooker and the cone sits on an open rotating meat skewer in front of the heat source. Counter top broilers observed in use in Canadian restaurants vary significantly in relation to their dimensions, number of heating elements, burner power, and the presence or absence of a temperature control dial (providing the operator the ability, or lack thereof, to regulate the amount of heat).

3. Scope

The scope of the risks and recommendations presented are limited to those products that are cooked from a raw state using a broiler. This includes donairs made from ground or whole cuts of beef, chicken, lamb, pork, or any combination thereof, produced at all levels of trade.

Some donairs prepared at the manufacturing level are fully cooked in either smokehouses or ovens (in loaves), or in water vats (in cones) before being distributed for sale to food service operators. These cooking processes are controlled so that adequate internal temperatures are reached to ensure pathogens (disease-causing bacteria) are destroyed. The distribution of fully-cooked donair meat from a manufacturing facility to restaurants poses similar food safety considerations to that of other cooked meat products such as meatloaf or cooked ham. Therefore this type of donair product is excluded from the scope of the following food safety risks and recommendations.

4. Food-borne Illness Outbreaks linked to Donairs

In September 2004, the Calgary Health Region identified an outbreak of 84 cases (43 confirmed, 41 probable) of Escherichia coli O157:H7 infections. Of the identified cases, eight (8) required hospitalization and two (2) developed Hemolytic Uremic Syndrome (H.U.S.)3 . The ensuing epidemiological and environmental public health investigation identified beef donairs prepared and cooked at two related local restaurants as the probable vehicle of transmission.

In October 2005, Windsor-Essex County Health Unit (Ontario) was notified of forty-six (46) illnesses that occurred at a single work site that had ordered chicken shawarma prepared at a local restaurant. Of the forty-six (46) probable cases, eighteen (18) were confirmed with Salmonella thompson and one person was hospitalized.

In May 2006, an increase in the incidence of E. coli O157:H7 gastroenteritis in the Capital Health Region (Edmonton, Alberta and area) was noted during routine surveillance. Nine (9) laboratory-confirmed cases were identified, with seven (7) of those reporting consumption of beef donairs prepared at one of two related local restaurants.

In November 2006, Capital Health identified an outbreak of fourteen (14) confirmed cases (including one case of secondary transmission) of E. coli O157:H7 linked to beef donairs purchased from six (6) unrelated food service establishments located in cities under the jurisdiction of four (4) different Regional Health Authorities in Alberta. Of the identified cases, two (2) required hospitalization for treatment. The implicated beef donairs cooked at these facilities were obtained from a single manufacturer that shipped product inter-provincially. After the source of the outbreak was identified the product was subsequently voluntarily recalled by the manufacturer. There were no similar cases of E. coli O157:H7 illness reported in other provinces but laboratory testing on product recovered from British Columbia tested positive for the same strain of the pathogen responsible for the known cases in Alberta.

The Working Group also examined reports of food-borne illness outbreaks linked to donairs that have occurred in other countries. The largest source of information originates in the United Kingdom where ten (10) outbreaks of intestinal disease linked to kebab restaurants were documented in England and Wales from 1992-2003.

3 Hemolytic Uremic Syndrome (H.U.S.) is a disease characterized by acute renal failure. http://www.cdc.gov/epo/dphsi/casedef/hemolyticcurrent.htm

5. Food-Borne Illness Risks

Epidemiological data based on Canadian outbreaks and outbreaks that occurred in other countries clearly associates E. coliO157:H7, Salmonella spp., and Campylobacter spp. as the primary microbiological risks associated with the consumption of beef, chicken and lamb donairs. These organisms may be introduced into the donair by meat that originated from infected animals or from cross-contamination during preparation.

The potential for food-borne illness to occur due to the consumption of donairs is higher than that of many other meat products because of the cooking method used. In most donair operations meat is removed from the exterior of the donair cone and served to consumers while the interior of the cone is still raw. In so doing, less-cooked portions of the cone are continually exposed to the heat source.

This cooking method is often based on visual cues of doneness (colour of meat and juices) rather than on specific time and temperature measurements. Scientific measurements suggest that the thickness of the cooked portion of a donair cone will vary and uneven surface temperatures between the top, centre and bottom of the donair cone are expected4. If an adequate cooking time is not applied, uneven temperatures across the vertical surface of the donair cone as well as temperature gradients inward can exist. This may lead to cooking temperatures that are not sufficient to kill disease-causing bacteria before meat is sliced from the cone and served to consumers. Additionally, trimming accuracy (ie. removing only that portion of the cone that is fully cooked) will vary based on the experience and training of the operator. These combined factors make it difficult to ensure undercooked meats and juices from the interior of the cone are not present in the served product.

Outbreak investigations in Alberta highlighted that serving product during periods of high consumer demand (such as lunch hour and locations with high customer traffic) was an important contributing factor in the illnesses that have been associated with donairs. The investigation in Ontario also supports the hypothesis that high volume demand is a critical risk factor.

The working group determined that these risks can be minimized through controls implemented during donair cone production, cooking and serving, and cooling and storage procedures followed at the end of the day.

4 Donairs (Gyros) - Potential Hazards and Controls Ewen C.D. Todd, R. Szabo, and F. Spiring, Journal of Food Protection, Vol. 49, No. 5, Pages 369-377, May 1986

6. Recommendations

6.1 Donair Cone Production Recommendations

Since the production of donair cones (including whole cut products such as shawarmas) takes place at both manufacturing facilities and at food service establishments, the following recommendations apply equally to those facilities.

Though freezing will limit the growth of pathogens, there is no step during the cone production process that is capable of inactivating (killing) pathogens. Therefore the final "kill-step" needs to be applied through proper cooking at the food service level.However, attention to food safety controls during cone production will improve the microbiological quality of the raw donair cones.

Recommendation #1 (Ingredient/Supplier Verification)

  • Those donair manufacturers that do not require a recognized food safety system to be in place should ensure that meats come only from sources that are inspected and approved (registered, permitted, or licensed).

  • All Food service establishments that produce donair cones should ensure that the meats they receive come only from sources that are inspected and approved and should require proof of that status from their suppliers.

Rationale: Most Canadian meat product manufacturers employ food safety programs to meet federal and provincial inspection requirements, including verification that their own suppliers are providing meat processed using Good Manufacturing Practices (GMP). At the local level, similar food safety programs may also be in place. It follows that all donair facilities (who either manufacture donair cones, or cook cones, or both) should start with meat processed under GMP in order to keep to a minimum the number of bacteria present in raw cones that must be destroyed during cooking.

Recommendation #2 (Hygiene and Sanitation)

  • Donair cone production and handling should be carried out under proper hygienic conditions. An effective and documented cleaning and sanitation program should be in place by both donair cone manufacturers and food service establishments serving donairs.

Rationale: Hygienic conditions result in a working environment that does not constitute a potential health hazard or result in the risk of contaminating the product. The objective of the sanitation program is to provide reasonable assurance that the food premises is being cleaned and sanitized effectively and consistently.

Recommendation # 3 (Temperature control during production)

  • All facilities that do not have mandated temperature requirements for production rooms should keepprocessing or preparation times for raw meats as short as possible. This involves taking out only as much meat as is currently being worked with and returning that product to the refrigerator or freezer as soon as possible (ie. immediately upon completion of formation of the cone).

Rationale: Temperature control during donair cone production is important to reduce the likelihood that bacteria will multiply to dangerous levels or form toxins. This recommendation does not apply to those establishments that have existing production room temperature requirements (eg. CFIA registered meat facilities5) as production time and room temperatures are addressed through ongoing programs in place within the facility.

Recommendation #4 (cone size)

  • Food service establishments should make or purchase donair cones based on the limiting specifications of their cooking unit (ie. no larger than the maximum size and/or dimensions recommended by the broiler manufacturer).

  • If the operator is consistently left with large amounts of product remaining at the end of the day they should reduce the size of the cone being used.

Rationale: Counter top broilers observed in use in Canadian restaurants vary significantly in relation to their dimensions, number of heating elements, and burner power. There is also a significant range of cone sizes produced by manufacturers and food service operators. Matching the size of cone to the cooking capacity of the broiler being used should help to optimize cooking performance. Food service facilities should also identify the appropriate size of cone to use in order to avoid excessive leftovers and therefore reduce reliance on cooling and storage procedures at the end of the day.

Analysis of Alternatives:

The working group considered the use of cone forms or molds in donair cone production. The cone formation method used by large manufacturers usually involves a fine emulsion formed into a cone using a plastic or stainless steel mold under conditions of vacuum. This procedure involves less manual manipulation, and a more uniform, consistent and tightly-packed donair on the spit. Restaurants often produce and shape cones manually without the use of a mold, resulting in a coarser and more loosely-packed end product. Thoroughly cooking a layer of donair meat, regardless of which method is used, can depend on many factors including the distance of the donair surface from the broiler burner, the intensity of the heat applied, the cooking time between slicing, and the shape of the donair (which will change as the operator progressively shaves the donair during cooking) to name a few. As a result of the number of factors involved, the use of cone molds was not considered to constitute a core issue to be addressed at this time.

6.2 Cooking and Serving Recommendations

Recommendation # 5 (secondary cooking step)

  • Portions sliced from a donair cone should undergo a secondary cooking step designed to achieve a temperature of 71°C (160°F) in the case of beef, lamb, and pork containing products or 74°C (165° F) in the case of chicken containing products. The establishment operator should have a process in place to verify the effectiveness of the secondary cooking step, including the use of a suitable thermometer to ensure that the target temperatures are being reached on a consistent basis.

Note: This recommendation does not apply to donair cones that have been fully cooked by a recognized method before slicing.A recognized method is one that is consistent with local regulations or guidelines established by the responsible food safety authority (e.g. Public Health Authority) and should involve verifying that an acceptable internal temperature at the centre of the cone has been reached.

Rationale: The main risk identified with donair cooking and serving is that donair cones may be insufficiently cooked prior to consumption (i.e. the cooking process is not adequate to destroy pathogens). The Working Group has determined the need for precautionary measures, such as internal temperature monitoring, that will ensure that only fully-cooked donair meat is served to the consumer. Though food service operators would not knowingly serve undercooked product, they may unknowingly do so (e.g. raw inner meats torn off during slicing, slicing too soon or too deeply into uncooked layers), or serve product that has been contaminated by raw juices that have migrated from the inner (raw) portion of the cone.

Health Canada has established that heating meat (beef, lamb, pork) to an internal temperature of 71°C (160°F) and heating ground or cut-up poultry to an internal temperature of 74°C (165°F) are the only science-based methods presently available to food service operators capable of destroying pathogenic bacteria that are potentially present in these products. The cooking and serving recommendation is, therefore, based on demonstrating that these temperatures and times are achieved in all portions of the meat that is served to consumers.

Analysis of Alternatives:

There were a number of factors studied by the working group that may be considered by industry if they wish to apply a control measure other than the recommended secondary cooking step.

  1. Currently fully cooking the donair cone on a vertical broiler before slicing does not appear to be feasible because the outside of the cone will char or burn before the inside of the cone has reached the targeted temperature. If, from a quality perspective, an acceptable method of cooking the entire cone throughout (before any slicing occurs) was found and verified to be reaching targeted internal temperatures, the working group acknowledges that a secondary cooking step may not be required.

  2. If donair cones were made to a sufficiently small size it should be possible to cook them throughout using conventional broilers before surface charring takes place. Industry has reported that existing donair cone sizes (ranging from 4.5kg to 11.5 kg) are optimal for both their volume of business and specifications of their existing broiler machines. However, smaller cones, in addition to the possibility of being fully cooked before slicing, may also serve to reduce leftovers, thereby reducing cooling times and decreasing food-safety risks associated with leftover raw and/or partially cooked products.

  3. An operator may choose to buy fully cooked donair products (cones or loaves) from manufacturing establishments.

  4. The working group's recommendations were based on heat treatment (cooking) methods currently being used by the industry. As non-thermal processing methods become commercially available (eg. irradiation, high pressure processing), the recommendations should be reconsidered in order to include these new methods.

6.3 Cooling and Storage Recommendations

Recommendation # 6 (cooling and storage)

  • Food service operators should demonstrate that the cooling method and equipment being used at their establishment are capable of lowering a left-over, intact cone from a temperature of 60°C to 20°C within 2 hours after removal from the heat source (broiler) and then from 20°C to 4°C within an additional 4 hours. As the cone has not been fully cooked it should be treated as raw and not stored with ready-to-eat products.

  • If an adequate cooling method for the whole donair cone cannot be demonstrated by the establishment, then one of the following procedures should be followed:

    1. At the end of the day the cooking and slicing process should continue for the remaining partially cooked donair cone until the entire cone is sliced. Prior to storage, all portions removed should undergo a secondary cooking step designed to achieve a temperature of 71°C in the case of beef, lamb, and pork containing donairs or 74°C in the case of chicken-containing donairs.

      or

    2. * In some instances an operator may have a large cone remaining at the end of the day which may take a long time to cook and slice. In these instances the remaining partially cooked donair cone could be sliced until the frozen core of the cone is reached. The slices should undergo a secondary cooking step before storage. If the centre of the cone has thawed, the entire cone should be cooked and sliced. The remaining (frozen)core of the cone should be re-frozen immediately for use the following day.

* Note: Operators using option #2 above should be aware that partially cooked or raw portions of meat nearer the frozen core of the donair cone will require longer secondary cooking times than those used for slices taken from the outer surface of a cooking cone. Therefore operators utilizing this option should take extra care to ensure that the secondary cooking process for these slices consistently achieves 71°C / 74°C respectively.

Rationale: It is common for food service operators to have partially cooked donair cones remaining on the broiler at closing time. The practice of overnight freezing or refrigerating whole donair cones may lead to ineffective cooling and, therefore, unacceptable growth of bacteria. Commercial refrigeration equipment is designed to keep cold foods cold rather than cool large masses of hot food. Reducing the volume of each portion of food being cooled speeds up the cooling process, thus the practice of slicing the cone into smaller pieces before cooling will limit the growth of bacteria during overnight storage.

The working group considered the potential for storing raw or partially cooked slices prior to applying a secondary cooking step. Because of the possibility of cross-contamination during storage and use the following day, and the likelihood that partially cooked slices could be mistaken as being fully cooked, it was decided that this practice should be discouraged. In addition, operators who choose to slice and secondarily cook may benefit by putting the cooked slices into individual small packages which would only require reheating the following serving day.

The Canadian Food Retail and Food Services Code6 (FRFSC) established the following cooling requirements:

3.3.6 Cooling after Cooking
Potentially hazardous foods that have been cooked and are intended to be kept under refrigerated storage prior to serving, are to be cooled from 60°C (140°F) to 20°C (68°F) or less within two hours and then from 20°C (68°F) to 4°C (40°F) or less within 4 hours as outlined in the parameters of Appendix B.

5 Meat Hygiene Manual of Procedures Section 2.6.2.3: Other processing rooms (kitchens, formulation rooms, etc.).
6 http://www.cfis.agr.ca/english/regcode/frfsrc-amendmts/frfsc_idx_e.shtml