Food Safety and Inspection Service 

 

□ Children Under 5 Years 

□ Pregnant Women 

□ Transplant Recipients 

□ Cancer and Diabetes

 Patients 

□ People with

 Autoimmune Diseases

 and HIV/AIDS 

 United States Department of Agriculture 

Food Safety

A Need-to-Know Guide for Those at Risk

□ Older Adults 

If You Check ANY of These Boxes, This

Booklet Is Especially for You. 

CHILL 

* 

Food Safety 

A Need-To-Know Guide for Those at Risk 

Food safety is important for everyone— 

but it’s especially important for you. 

That’s why the U.S. Department of Agriculture’s 

Food Safety and Inspection Service (FSIS) 

has prepared this booklet. 

It is designed to provide practical 

guidance on how to reduce your risk 

of foodborne illness. 

In addition to following this practical guidance, 

we encourage you to check with your physician 

or healthcare provider to identify foods you 

should avoid. 

We strongly encourage you to review these 

guidelines with your physician. 
2

I 

What’s Inside: 

Foodborne Illness in the United States 3 

Who Is at Risk? 3 

Food Safety for Cancer Patients 4 

Food Safety Concerns for Children Under 5 Years of Age 5 

Food Safety for Diabetes Patients 6 

Food Safety for HIV/AIDS Patients 7 

Food Safety for Older Adults 8 

Food Safety for People With Autoimmune Diseases 9 

Food Safety for Pregnant Women 10-14 

Food Safety for Transplant Recipients 15 

Major Pathogens that Cause Foodborne Illness 16-17 

Common Foods: Select the Lower Risk Options 18 

Taking Care 19 

Four Basic Steps to Food Safety 19-22 

Recommended Safe Minimum Internal Temperature Chart 22 

Be in the Know 23 

Food Product Dating 24 

Cold Storage Chart 25 

Transporting Your Groceries 26 

Tips for Transporting Food 26 

Foodborne Illness: Know the Symptoms 27 

Foodborne Illness Action Plan 28 

For More Information on Food Safety 29 

Food Safety Questions 31 
3

' I 

Foodborne Illness in the United States 

When certain disease-causing bacteria, viruses, or parasites contaminate 

food, they can cause foodborne illness. Another word for illness-causing 

bacteria, viruses, or parasites is “pathogens.” Foodborne illness, often 

called food poisoning, is an illness that comes from a food you eat. 

• The food supply in the United States is among the safest in the world 

— but it can still be a source of infection. 

• According to the Centers for Disease Control and Prevention (CDC), 

foodborne pathogens cause up to 48 million illnesses, 128,000 

hospitalizations, and 3,000 deaths in the United States each year. 

Many of these people are children, older adults, or individuals with 

weakened immune systems who may not be able to fight infection 

normally. 

Since foodborne illness can be serious—or even fatal—it is important for 

you to know and practice safe food-handling behaviors to help reduce 

your risk of getting sick from contaminated food. 

Who Is at Risk? 

Certain groups of people are more susceptible to foodborne illness than 

others. They are more likely to get sick from contaminated food, and if 

they do get sick, the effects are often much more serious. 

Those at increased risk include: 

• Cancer patients 

• Children under 5 years of age 

• Diabetes patients 

• HIV/AIDS patients 

• Older adults 

• People with autoimmune diseases 

• Pregnant women 

• Transplant recipients 
4

to Foods to 

AVOID EAT 

• Raw or • Meat, poultry, & 

undercooked seafood cooked 

&\I;;) meat, poultry, or to a safe internal 

seafood temperature 

I Unpasteurized r Pasteurized 

or raw milk milk 

-

• Raw or • Cooked eggs 

undercooked with a firm yolk 

eggs 

a Unwashed fresh a Washed fresh or 

produce cooked produce 

~ 

Solt cheeses r 

Hard cheeses or 

made from soft cheese 

unpasteurized made from 

(raw) milk pasteurized milk 

Cold hot dogs & !..~ 

Reheat hot dogs 

deli meats & deli meat to 

steaming hot or 

a ~ Raw sprouts "' 165 'F 

,'i" (alfalfa. bean, Cooked sprouts 

etc) 

I 

Food Safety for Cancer Patients 

If you are a cancer patient, your healthcare provider may have 

recommended that you receive chemotherapy, radiation, or other 

treatments to help fight your disease. A weakened immune system can 

be a side effect of these types of therapies. 

A properly functioning immune system works to clear infection and 

other foreign agents from the body. However, cancer and its treatments 

can weaken your immune system, making you more susceptible to many 

types of infections. These infections include those that can be brought on 

by disease-causing bacteria and other pathogens that cause foodborne 

illness. 

As a cancer patient, you are more likely to have a lengthier illness, 

undergo hospitalization, or even death if you contract a foodborne 

illness. 

To avoid contracting a foodborne illness, you must be especially vigilant 

when handling, cooking, and consuming foods. 

Food safety is important for people with cancer 

because treatment can weaken the immune system. 
5

Raw or 

undercooked 

foods including meat, .......,._ .._ poultry, and eggs 

Unpasteurized 

milk 

or juice 

RaW or · ~ 

undercoo~ 

oysters and seafood 

~ 

~ Strained meats 

andeggs 

• 

Meav 

~etable 

combinations 

~ Homemade '9' babyfoods ltoZ montas 

n 

I 

Food Safety for Children Under 5 Years of Age 

Children under the age of 5 are at an increased risk for foodborne illness 

and related health complications because their immune systems are still 

developing. Young children with developing immune systems cannot 

fight off infections as well as adults can. Additionally, young children

produce less stomach acid that kills harmful bacteria, making it easier 

for them to get sick. Because of this, children under the age of 5 should 

only consume pasteurized dairy products and meats cooked to a safe 

temperature. 

Food poisoning can be particularly dangerous for young children because 

one side effect of food poisoning is diarrhea. Because children’s bodies

are small, they can quickly lose a lot of fluid, causing dehydration. Other

symptoms of foodborne illness may include nausea, vomiting, stomach 

pain and cramps, and fever and chills. 

According to the CDC, children younger than 5 have the highest incidence 

rates of any age group for Campylobacter, Cryptosporidium, E. coli, 

Salmonella, Shigella and Yersinia infection. 

In addition to hand washing and good hygiene, young children’s food 

safety is tightly linked to the food safety behaviors of their parents and 

caregivers. 
6

Food Safety for Diabetes Patients 

Complications from diabetes can cause cardiovascular and kidney 

disease, negatively affecting the immune system. These effects leave

you more prone to infectious disease, such as foodborne 

illness. As a diabetics patient, your immune system may not immediately 

recognize harmful foodborne pathogens, increasing your risk for 

infection. 

Glucose Levels 

High glucose levels suppress the function of white blood cells that fight 

off infection, increasing your risk of contracting a foodborne illness. If 

you have diabetes and contract a foodborne illness, your blood glucose 

levels may be affected because foodborne illness impacts what and how 

much you can eat. 

Gastrointestinal (GI) Tract 

Diabetes may cause your stomach to produce low amounts of digestive 

acid. In addition, food may not move through the digestive tract as 

quickly as in non-diabetic persons. When the stomach holds on to 

food longer than necessary, bacteria start to multiply. If the amount of 

harmful bacteria in the stomach gets too high, it can lead to foodborne 

illness. 

Kidneys 

Kidneys usually work to cleanse the body. For many diabetes patients, 

the kidneys may not function properly, giving harmful bacteria the 

opportunity to grow out of control. 
Food Safety for HIV/AIDS Patients 

With recent advances in treatments, people with Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) are 

now living longer—and with a better quality of life—than ever before. If 

you or someone you care for is living with HIV/AIDS, it is important to 

make safe choices. 

EATING WELL IS KEY TO MAINTAINING HIV AND MANY OF ITS TREATMENTS

STRENGTH, ENERGY, AND A HEALTHY CAN CHANGE YOUR BODY’S METABOLISM 

IMMUNE SYSTEM 

FOOD SAFETY TIPS WATER SAFETY TIPS 

Avoid eating raw eggs, meats, or seafood Do not drink water from lakes, ponds, 

rivers, or streams Wash fruits and vegetables thoroughly 

Use a water ÿlter at home Use separate cutting board for raw meats 

You can signiÿcantly reduce risk of Wash hands, utensils, and cutting boards water-borne illness by using boiled water with soap & water after each use for drinking & cooking 

Some conditions related to HIV/AIDS and its treatment (such as wasting, 

diarrhea and lipid abnormalities) increase your susceptibility to many 

types of infections. Individuals living with HIV/AIDS may be subject 

to lengthier illnesses and hospitalization. Safe food handling is crucial 

to prevent infections brought on by disease-causing bacteria and other 

pathogens in food and water. 

People living with HIV/AIDS are especially susceptible to the following 

foodborne pathogens: Listeria monoctyogenes, Salmonella, 

Campylobacter, Cryptosporidium parvum and Mycobacterium 

avium-complex. 

By being especially vigilant when handling, preparing, and consuming 

foods, you can reduce your risk of contracting these illnesses. In addition 

to maintaining a healthy lifestyle and medical regimen, handling food 

properly can help you to reduce your risk of foodborne illness. 

7
8

 

 

a 

I 

Older adults are at elevated risk for hospitalization 

and death from foodborne infections. Why? 

Medication s,de effects 

- (like a weakened 

- immune system) 

Food Safety for Older Adults 

Adults 65 and older are at a higher risk for hospitalization and death 

from foodborne illness. This increased risk of foodborne illness is 

because our organs and body systems go through changes as we age. 

These changes include: 

• The gastrointestinal 

tract holds on to 

food for a longer 

period of time, 

allowing bacteria to 

grow. 

• The liver and 

kidneys may not 

properly rid our 

bodies of foreign 

bacteria and toxins. 

• The stomach may 

not produce enough 

acid. The acidity 

helps to reduce the 

number of bacteria 

in our intestinal 

tract. Without 

proper amounts of 

acid, there is an 

increased risk of 

bacterial growth. 

Underlying chronic conditions, such as diabetes and kidney disease, 

may also increase a person’s risk of foodborne illness. 

• 

Make safe food handling a lifelong commitment to minimize 

your risk of foodborne illness. Be aware that as you age, 

your immunity to infection naturally is weakened. 
9

Food Safety for People 

With Autoimmune Diseases 

People with autoimmune diseases are at a higher risk of foodborne 

illnesses because their immune systems are compromised and may be 

unable to fight off infection. With an autoimmune disease, the immune

system is compromised either by the disease or by medicine taken to 

manage the disease. No matter the reason, individuals with autoimmune 

disease are at an increased risk for contracting foodborne illnesses. 

Common Types of Autoimmune Diseases 

and Risk of Foodborne Illness 

Multiple Sclerosis (MS) 

As treatment for multiple 

sclerosis involves steroids 

and other immunosuppressive drugs, patients 

are at increased risk for 

foodborne infection. 

Inflammatory Bowel Disease (IBD)

Treatment for IBD may include immunosuppressants, steroids, 

and biological therapies—all of which increase susceptibility to 

foodborne illness. Patients taking two or more drugs are at even 

higher risk of foodborne illness. Foodborne pathogens associated with 

immunosuppressant therapy in IBD patients include Salmonella, 

Listeria monocytogenes, and Toxoplasma gondii. 

Lupus (SLE) 

The use of corticosteroids and other immunosuppressive agents in the 

treatment of SLE increases the risk of contracting foodborne illness. 

Patients under immunosuppressive therapy have been shown to 

more easily contract foodborne illnesses from Salmonella, Listeria 

monocytogenes, Toxoplasma gondii, and E. coli. In SLE patients with 

severe infections, the most frequently identified pathogen was E. coli. 
10

 

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Food Safety for Pregnant Women 

When you become pregnant, your body naturally undergoes hormonal 

changes, some of which also affect your immune system. These changes

make pregnant women more susceptible to contracting a foodborne illness. 

You and your unborn 

child are particularly 

at risk for illnesses 

associated with Listeria 

monocytogenes and 

Toxoplasma gondii. 

• Listeria 

monocytogenes is a 

harmful bacterium 

found in many 

foods. Listeria 

monocytogenes can 

lead to a disease 

called listeriosis. 

Listeriosis can 

cause miscarriage, 

premature delivery, 

and serious 

sickness or death of 

a newborn baby. 

• Toxoplasma gondii is a parasite found in numerous food sources, as 

well as dirty cat litter boxes and other areas where cat feces can be 

found. Toxoplasmosis can cause hearing loss, mental retardation, 

and blindness in babies. 

• These infections can pass to the fetus even if the mother shows no 

symptoms. 

The good news is that you can make an effort to select and prepare

foods to prevent contracting these and other foodborne diseases. This 

section is written especially for you to help show you how to protect 

yourself and your unborn baby from contracting a foodborne illness. 

Make safe food handling a priority while pregnant— 

and make it a lifelong commitment to help protect you 

and your family from foodborne illness. 
11

What You Can Do During Pregnancy 

Choose Your Seafood Carefully 

Fish and other seafood are excellent sources of protein and Omega-3 

fatty acids that are important for fetus development. Fish can be part 

of a healthy diet, but pregnant 

women should avoid fish with

high levels of mercury. High 

levels of mercury act as a 

neurotoxin that can be harmful 

to the nervous system. A fetus’ 

developing nervous system is 

particularly vulnerable. 

The following fish could

potentially contain high levels 

of mercury that could harm 

the development of a baby’s nervous system and should be avoided: 

swordfish, shark, king mackerel, and tilefish (Gulf of Mexico).

Talk with your doctor if you have any questions about how much, and 

which fish, you can eat.

Avoid Raw Seafood

Raw seafood may contain parasites or bacteria, including Listeria, which 

can make pregnant women ill and could potentially harm their babies. All 

seafood dishes should be cooked to 145 °F. This means that you should 

avoid: sushi, sashimi, raw oysters, raw clams, raw scallops, and ceviche. 

Be Selective with Smoked Seafood

Refrigerated smoked seafood presents a very real threat of Listeria. 

Refrigerated smoked seafood, such as salmon, trout, whitefish, cod, 

tuna, or mackerel are often labeled as: Nova-style, lox, kippered, 

smoked, or jerky. 

Refrigerated smoked fish should be reheated to 165 °F before eating. 

It is okay to eat smoked seafood during pregnancy if it is canned, shelf 

stable, or an ingredient in a casserole or other cooked dish. 
12

Avoid Unpasteurized Juice or Cider 

Unpasteurized juice, even fresh 

squeezed juice, and cider can 

cause foodborne illness. In 

particular, these beverages have 

been linked to outbreaks of E. 

coli O157:H7. This strain of E. 

coli can result in liver failure 

and death. Individuals with 

reduced immunity are particularly 

susceptible. To prevent E. coli infection, either choose a pasteurized 

version or bring unpasteurized juice or cider to a rolling boil and boil 

for at least 1 minute before drinking. 

Avoid Unpasteurized Milk 

Milk that has not been pasteurized may contain bacteria such as 

Campylobacter, E. coli, Listeria, Salmonella, or Mycobacterium 

tuberculosis. To avoid foodborne illnesses, drink only pasteurized milk. 

Avoid Soft Cheeses and Cheese Made From Unpasteurized Milk 

Soft cheeses in particular tend to be made with unpasteurized milk. When 

pregnant, a woman should avoid the following cheeses that tend to be 

made with unpasteurized milk: Brie, feta, Camembert, Roquefort, queso 

blanco, and queso fresco. 

Instead of eating soft cheese, eat hard cheese such as Cheddar or Swiss. 

Pregnant women who want to continue to eat soft cheeses should make 

sure to check the label to ensure 

that the cheese is made from 

pasteurized milk. Pregnant 

women should pay particular 

attention at farmers markets to 

make sure that fresh and soft 

cheeses are pasteurized. 
13

Only Consume Cooked Eggs 

Undercooked eggs may contain Salmonella. To safely consume eggs, 

cook them to 160 °F or until the yolks are firm to be sure any Salmonella 

that may be present has been destroyed. If you are making a casserole or 

other dish containing eggs, make sure 

the dish is cooked to a temperature of 

160 °F. The following foods may contain 

raw eggs should be avoided: eggnog, raw 

batter, Caesar salad dressing, tiramisu, 

eggs benedict, homemade ice cream and 

hollandaise sauce. 

Any batter that contains raw eggs, 

such as cookie, cake, or brownie batter, 

should not be consumed uncooked by pregnant women. The batter may 

contain Salmonella, which can make a pregnant woman very sick. To 

safely consume these products, bake them thoroughly. No matter how 

tempting, DO NOT lick the spoon. 

Avoid Premade Meat or Seafood Salad 

Pregnant women should not consume premade ham salad, chicken salad, 

or seafood salad, which may contain Listeria. These items are commonly 

found in delis. Make these salads at home and follow the four steps of 

food safety: clean, separate, cook, and chill (see pages 20-22). 

Do Not Eat Raw Sprouts

Raw or undercooked sprouts, such as alfalfa, clover, mung bean, or 

radish sprouts may contain E. coli or Salmonella. For safety, cook them 

thoroughly. 

Avoid Undercooked Meat and Poultry 

All meat and poultry should be thoroughly cooked before eating. A food 

thermometer should be used to ensure that the meat has reached the 

USDA-recommended safe minimum internal temperature. See the next 

page for the minimum safe cooking temperatures for specific details.

Following the minimum recommended internal temperature is 

important because meat and poultry may contain E. coli, Salmonella, 

Campylobacter, or Toxoplasma gondii. 
14

• Cook meat to the USDA recommended safe minimum internal 

temperature. 

• Freeze meat for several days at sub-zero (0 °F) temperatures before 

cooking. 

• Wash cutting boards, 

dishes, counters, 

utensils, and hands 

with hot soapy water 

after contact with raw 

meat, poultry, seafood, 

or unwashed fruits or 

vegetables. 

Reheat Hot Dogs and 

Luncheon Meats 

While the label on 

these products may say 

“precooked or fully cooked,” 

pregnant women should 

reheat these meats to 

steaming hot or 165 °F 

before eating. These meat 

items may contain Listeria 

and are unsafe to eat if they 

have not been thoroughly 

reheated: hot dogs, 

luncheon meats, cold cuts, 

fermented or dry sausage, 

and any other deli-style 

meat and poultry. 

Be Selective With Meat 

Spreads or Pâté

 Unpasteurized meat 

 spreads or pâté may 

contain Listeria. To consume these products safely when pregnant, eat 

canned versions. Do not eat refrigerated pâtés or meat spreads as they 

have high likelihood of containing Listeria. 
15

Food Safety for Transplant Recipients 

As a transplant recipient, you are probably familiar with the topic of 

transplant rejection. It’s the body’s natural reaction or immune system’s 

response to “foreign invasion.” 

As a transplant recipient, you are more likely to have a lengthier illness, 

undergo hospitalization, or even die, should you contract a foodborne 

illness. To avoid this, you must be especially vigilant when handling, 

preparing, and consuming foods. 

Some foods are more risky for you than others. In general, the foods 

that are most likely to contain harmful bacteria or viruses fall in two 

categories: 

• Uncooked fresh fruits and 

vegetables. 

• Some animal products, such 

as unpasteurized (raw) milk; 

soft cheeses made with raw 

milk; raw or undercooked 

eggs, raw meat, raw poultry, 

raw fish, raw shellfish and 

their juices; and luncheon 

meats and store-prepared deli-salads, such as chicken and seafood. 

Interestingly, the risk these foods may pose depends on the origin or 

source of the food and how the food is processed, stored, and prepared. 

If You Have Questions 

...about safe food choices: 

Be sure to consult with your doctor or healthcare provider. He or she can 

answer any specific questions or help you with your choices.

...about the safety of particular foods: 

If you are not sure about the safety of a food in your refrigerator, don’t 

take the risk. 

The main thing to remember: When in doubt, throw it out. 
Major Pathogens (Bacteria, Parasites, Viruses) that Cause Foodborne Illness 

Pathogen Methods of Transmission Symptoms and Potential Impact 

Campylobacter • Fever, headache, and muscle pain followed by diarrhea (sometimes • Untreated or contaminated water 

bloody), abdominal pain, and nausea. Symptoms appear 2 to 5 days jejuni • Unpasteurized (“raw”) milk 

after eating; may last 2 to 10 days. May spread to bloodstream and • Raw or undercooked meat, poultry, or 

cause a serious life-threatening infection. shellfish

Clostridium • Bacteria produce a nerve toxin that causes illness, affecting the • Improperly canned foods botulinum nervous system. Symptoms usually appear in 18 to 36 hours, but • Garlic in oil 

sometimes in 6 hours to 10 days: double or blurred vision, drooping 

food 

• Vacuum-packed and tightly wrapped 

eyelids, slurred speech, difficulty swallowing, dry mouth, and muscleweakness. If untreated, can lead to muscle paralysis and even death. 

Clostridium • Onset of watery diarrhea and abdominal cramps within about 16 • Food left for long periods on steam perfringens hours. The illness usually begins suddenly and lasts for 12 to 24 tables or at room temperature, and 

time and/or temperature-abused food hours. In the elderly, symptoms may last 1 to 2 weeks. 

• Complications and/or death occur rarely. 

products, and gravy 

• Meats, meat products, poultry, poultry 

• Severe diarrhea that is often bloody, abdominal cramps, and • Undercooked beef, especially Escherichia coli 

vomiting. Usually little or no fever. 

One of several 

hamburger O157:H7 

• Can begin 1 to 9 days after contaminated food is eaten; lasts about 2 

strains of E. coli 

• Unpasteurized milk and juices, like 

to 9 days. 

that can cause 

fresh apple cider 

• Some, especially the very young, may develop hemolytic-uremic 

human illness 

• Contaminated raw fruits and 

syndrome (HUS) that causes acute kidney failure and can lead to vegetables and water permanent kidney damage or even death. • Person-to-person contact 

• Fever, chills, headache, backache, sometimes upset stomach, • Hot dogs, luncheon meats, cold cuts, Listeria 

abdominal pain, and diarrhea. May take up to 2 months to become 

Can grow slowly 

fermented or dry sausage, and other monocytogenes The duration varies. ill. deli-style meat and poultry 
at refrigerator 

temperatures 

• Unpasteurized (raw) milk and soft 

cheeses made with unpasteurized (raw) milk 

• Gastrointestinal symptoms may appear within a few hours to 2 to 3 

days, and disease may appear 2 to 6 weeks after ingestion. 

• Those at-risk patients (including pregnant women) may later 

develop more serious illness; death can result from this bacteria. 

• Can cause problems with pregnancy, including miscarriage, fetal 

death, or severe illness or death in newborns. 

Salmonella (over 2,300 types) 

• Raw or undercooked eggs, poultry, and 

meat 

• Unpasteurized (raw) milk or juice • Cheese and seafood • Fresh fruits and vegetables 

• Stomach pain, diarrhea (can be bloody), nausea, chills, fever, and/ 

or headache usually appear 6 to 72 hours after eating; may last 4 to 7 days. 

• In people with a weakened immune system, such as people with 

cancer, the infection may be more severe and lead to serious complications, including death. 

Staphylococcus aureus 

• Contaminated milk and cheeses • Salty foods; e.g., ham • Sliced meat • Foods made by hand that require no 

reheating; e.g., puddings, sandwiches 

• Foodworkers who carry the bacteria 

and contaminate food 

• Nausea, vomiting, stomach cramps, and diarrhea usually occur 

within 30 minutes to 6 hours after eating contaminated food. 

• Symptoms typically last 1 to 3 days; the young and the elderly may 

have a more severe illness. 

Toxoplasma gondii 

• Accidental contact of cat feces through 

touching hands to mouth after gardening, handling cats, cleaning cat’s litter box, or touching anything that has come in contact with cat feces 

• Raw or undercooked meat 

• Flu-like illness usually appears 10 to 13 days after eating; may last 

months. Those with a weakened immune system, including people with cancer, may develop more serious illness. 

• Can cause problems with pregnancy, including miscarriage and 

birth defects. 

Trichinella spiralis 

• People get trichinellosis (trichinosis) 

by consuming raw or undercooked meats such as pork, wild boar, bear, bobcat, cougar, fox, wolf, seal or walrus infected with Trichinella larvae 

• Abdominal symptoms may appear within 1 to 2 days after eating 

contaminated meat. The first symptoms are nausea, diarrhea,

vomiting, fever, fatigue, and abdominal pain, followed by headaches, eye swelling, aching joints (eye swelling, aching muscles, and joints); may begin 2 to 8 weeks after infection. 
18

 

Common Foods: Select the Lower Risk Options 

 Type of Food Higher Risk Lower Risk

Meat and • Raw or undercooked meat or • Meat or poultry cooked to 

poultry a safe minimum internal 

temperature 

Poultry 

TIP: Use a food thermometer to check the internal temperature of meat, poultry, eggs, and 

seafood. See the chart on page 22 for specific safe minimum internal cooking temperatures.

Seafood • Any raw or uncooked fish or • Previously cooked seafood

shellfish or food containing heated to 165 °F 

raw or undercooked seafood; • Canned fish and seafood

(e.g., sashimi, sushi or • Seafood cooked to 145 °F 

ceviche). Refigerated smoked

fish

• Partially cooked seafood, 

such as shrimp and crab 

Milk • Unpasteurized (raw) milk • Pasteurized milk 

Eggs Foods that contain raw/ 

undercooked eggs, such as: 

• Homemade Caesar salad 

dressings 

• Homemade raw cookie 

dough 

• Homemade eggnog 

At home: 

• Use pasteurized eggs/egg 

products when preparing 

recipes that call for raw or 

undercooked eggs 

When eating out: 

• Ask if pasteurized eggs 

were used 

TIP: Most premade foods from grocery stores, such as Caesar salad dressing, 

premade cookie dough, or packaged eggnog are made with pasteurized eggs. 

Sprouts • Raw sprouts (alfalfa, bean, • Cooked sprouts 

or other sprouts) 

Vegetables • Washed fresh vegetables, • Unwashed fresh vegetables, including salads including lettuce/salads • Cooked vegetables 

Cheese • Soft cheeses made from 

unpasteurized (raw) milk, 

such as: 

– Feta 

– Brie 

– Camembert 

– Blue-veined 

– Queso fresco 

• Hard cheeses 

• Processed cheeses 

• Cream cheese 

• Mozzarella 

• Soft cheeses that are 

clearly labeled “made 

from pasteurized milk” 

Hot Dogs • Hot dogs, deli meats, and • Hot dogs, luncheon meats, 

and Deli luncheon meats that have and deli meats reheated to

Meats not been reheated steaming hot or 165 °F

• Unpasteurized, refrigerated • Canned or shelf-stable

Pâtés pâtés or meat spreads pâtés or meat spreads 

TIP: You need to reheat hot dogs, deli meats, and luncheon meats before eating 

because Listeria monocytogenes grows at refrigerated temperatures 

(40 °F or below). This bacterium may cause severe illness, hospitalization, 

or even death. Reheating these foods until steaming hot destroys this 

dangerous bacterium and makes these foods safe for you to eat. 
19

Taking Care 

Handling and Preparing Food Safely 

Foodborne pathogens are sneaky. You cannot tell by looking, smelling, or 

even tasting food whether it contains pathogens. But these pathogens— 

like disease causing bacteria, viruses, or parasites—can make you sick. 

You should never taste food to determine if it is safe to eat. 

It is especially important that you—or those preparing your food—are 

always careful with food handling and preparation. The easiest way to do 

this is to Check Your Steps: Clean, Separate, Cook, and Chill. 

Four Basic Steps for Food Safety 
20

 

 

1. CLEAN: Wash hands and surfaces often 

Bacteria can spread throughout the kitchen and get onto 

cutting boards, utensils, countertops, and food. 

To ensure that your hands and surfaces 

are clean, be sure to:

 • Wash hands in warm soapy water for at least 20 seconds before and 

after handling food and after changing diapers, handling pets, or 

using the bathroom. 

• Wash cutting boards, dishes, utensils, and counter tops with hot 

soapy water between the preparation of raw meat, poultry, and 

seafood products and preparation of any other food that will not 

be cooked. As an added precaution, sanitize cutting boards and 

countertops by rinsing them in a solution made of 1 tablespoon of 

unscented liquid chlorine bleach per gallon of water. Alternatively, 

run the plastic board through the wash cycle in your automatic 

dishwasher. 

• Use paper towels to clean up kitchen surfaces. If using cloth towels, 

wash them often on the hot cycle of the washing machine. 

• Wash produce. Rinse fruits and vegetables and rub firm-skin fruits 

and vegetables under running tap water, including those with skins 

and rinds that are not eaten.

 • Remember to clean the lids of canned goods before opening. 

2. SEPARATE: Don’t cross-contaminate 

 Cross-contamination occurs when bacteria are spread 

from one food product to another. This is especially 

common when handling raw meat, poultry, seafood, and 

eggs. The key is to keep these foods and their juices away 

from ready-to-eat foods. 

To prevent cross-contamination, remember to: 

• Separate raw meat, poultry, seafood, and eggs from other foods in 

your grocery shopping cart, grocery bags, and refrigerator. 
21

 

 

 

 

I 

• .' 

 • Never place cooked food on a plate that previously held raw meat, 

poultry, seafood, or eggs. If you have to use the same plate, wash it 

with hot soapy water first before using it to hold cooked food.

• Don’t reuse marinades used on raw foods unless you bring them to 

a boil first.

• Consider using one cutting board only for raw foods and another 

only for ready-to-eat foods, such as bread, fresh fruits and 

vegetables, and cooked meat.

3. COOK: Cook to safe temperatures 

Foods are safely cooked when they are heated to the 

recommended safe minimum internal temperatures, as 

shown on the “Is It Done Yet?” chart (see next page). 

To ensure that your foods are cooked safely, 

always: 

• Use a food thermometer to measure the internal temperature of 

cooked foods. Check the internal temperature in several places 

to make sure that the meat, poultry, seafood, or egg products are 

cooked to safe minimum internal temperatures. 

• Cook ground beef to at least 160 °F and ground poultry to a 

safe minimum internal temperature of 165 °F. Color of food is not a 

reliable indicator of safety or doneness. 

• Reheat fully cooked hams packaged at a USDA-inspected plant to 

140 °F. For fully cooked ham that has been repackaged in any other 

location or for leftover fully cooked ham, heat to 165 °F. 

• Cook seafood to 145 °F. Cook shrimp, lobster, and crab until 

the shells turn red and the flesh is pearly opaque. Cook clams, 

mussels, and oysters until the shells open. If the shells do not 

open, do not eat the oyster inside. 

• Cook eggs until the yolks and whites are firm. Use only recipes in 

which the eggs are cooked or heated to 160 °F. 

• Cook all raw beef, lamb, pork, and veal steaks, roasts, and 

chops to 145 °F with a 3-minute rest time after removal from the 

heat source. 

• Bring sauces, soups, and gravy to a boil when reheating. Heat 

other leftovers to 165 °F. 
22

Use a food thermometer to be most accurate. You can't always tell by looking. 

145°F 

wi1h a $.minute rinl lime 

Beef, Pol1<, Veal & Lamb 

Sleaks, Roasts & Chops 

USDA Recommended Safe Minimum Internal Temperatures 

145°F 

Fish 

160°F 

Beef. Pork. Veal & Lamb 

Ground 

160°F 

Egg Dishes 

165°F 

Tul1cey, Chicken & Duck 

Whole, Pieces & Ground 

• Reheat hot dogs, luncheon meats, bologna, and other deli 

meats until steaming hot or 165 °F. 

• When cooking in a microwave oven, cover food, stir, and rotate 

for even cooking. If there is no turntable, rotate the dish by hand 

once or twice during cooking. Always allow standing time, which 

completes the cooking, before checking the internal temperature 

with a food thermometer. Food is done when it reaches the USDA 

and the Food and Drug Aministration recommended safe minimum 

internal temperature. 

4. CHILL: Refrigerate promptly 

Cold temperatures slow the growth of harmful bacteria. 

Keeping a constant refrigerator temperature of 40 °F or 

below is one of the most effective ways to reduce risk of 

foodborne illness. Use an appliance thermometer to be 

sure the refrigerator temperature is consistently 40 °F or 

below and the freezer temperature is 0 °F or below. 

To chill foods properly: 

• Refrigerate or freeze meat, poultry, eggs, seafood, and other 

perishables within 2 hours of cooking or purchasing. Refrigerate 

within 1 hour if the temperature outside is above 90 °F. 

• Raw or cooked meat, poultry or egg products, as any perishable 

foods, must be kept at a safe temperature during thawing. Never 

thaw food at room temperature, such as on the countertop. It is safe 

to thaw food in the refrigerator, in cold water, or in the microwave. 

If you thaw food in cold water or in the microwave, you should cook 

it immediately. 

• Divide large amounts of food into shallow containers for quicker 

cooling in the refrigerator. 
23

 

these leftovers still good?" 

pp for that. 

Be in the Know 

Becoming a Better Shopper 

Follow these safe 

food-handling practices 

while you shop. 

• Carefully read food 

labels while in the 

store to make sure 

food is not past its 

“sell-by” date. (See 

Food Product Dating on the next page.) 

• Put raw packaged meat, poultry, or seafood into a plastic bag before 

placing it in the shopping cart, so that its juices will not drip on and 

contaminate other foods. 

• If the meat counter does not offer plastic bags, pick some up from 

the produce section before you select your meat, poultry, and 

seafood. 

• Buy only pasteurized milk, cheese, and other dairy products 

from the refrigerated section. When buying fruit juice from the 

refrigerated section of the store, be sure that the juice label says it is 

pasteurized. 

• Purchase eggs in the shell from the refrigerated section of the store. 

(NOTE: Store the eggs in their original carton in the main part of 

your refrigerator once you are home.) For recipes that call for eggs 

that are raw or undercooked when the dish is served, use either shell 

eggs that have been treated to destroy Salmonella by pasteurization 

or pasteurized egg products. 

• Never buy food that is displayed in unsafe or unclean conditions. 

• When purchasing canned goods, make sure that they are free of 

dents, cracks, or bulging lids. Once you are home, remember to 

clean each lid before opening the can. 

• Purchase produce that is not bruised or damaged. 

When shopping for food, it is important to read the label carefully. 
24

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Food Product Dating 

Read the label for food safety information on raw foods. 

Types of Open Dates 

Open dating is found on most foods including meat, poultry, egg, and 

dairy products. 

• A “Sell-By” date tells the 

store how long to display the 

product for sale for inventory 

management. It is not a safety 

date 

• A “Best If Used By” (or 

Before) date indicates when a 

product will be of best flavor or 

quality. It is not a purchase or 

safety date. 

• A “Use-By” date is the last 

date recommended for the 

use of the product while at 

peak quality. The date has 

been determined by the 

manufacturer of the product. 

Closed or Coded Dates 

Closed or coded dates are packing numbers for use by the 

manufacturer. Closed or coded dating might appear on shelf-stable 

products such as cans and boxes of food. 

It is best to follow recommended storage guidelines (see page 25) or 

“keep times” as dates or packages are not primarily safety dates. See the 

FoodKeeper App at www.foodsafety.gov/foodkeeper. 
25

These storage guidelines for home-refrigerated foods will keep them from spoiling or becoming dangerous 

to eat. The guidelines for freezer storage are for quality only. Frozen foods remain safe indefinitely.

 

 

 

 

..... GETITON 

,....... Google Play 

Cold Food Storage

These storage guidelines for home-refrigerated foods will keep them from spoiling or becoming dangerous 

to eat. The guidelines for freezer storage are for quality only. Frozen foods remain safe indefinitely.

Product Refrigerator (40 °F) 

Eggs 

Freezer (0 °F) 

Fresh, in shell 3 to 5 weeks Don’t freeze 

Hard cooked 1 week Don’t freeze well 

Liquid Pasteurized Eggs, Egg Substitute 

Opened 3 days Don’t freeze well 

Unopened 10 days 1 year 

Deli and Vacuum-Packed Products 

Egg, chicken, ham, tuna 

& macaroni salads 3 to 5 days Don’t freeze well 

Hot Dogs 

Opened package 1 week 1 to 2 months 

Unopened package 2 weeks 1 to 2 months 

Luncheon Meat 

Opened package or deli sliced 3 to 5 days 1 to 2 months 

Unopened package 2 weeks 1 to 2 months 

Bacon & Sausage 

Bacon 7 days 1 month 

Sausage, raw — from chicken, 

turkey, pork, beef 1 to 2 days 1 to 2 months 

Hamburger & Other Ground Meats 

Hamburger, ground beef, turkey, veal, 

pork, lamb, & mixtures of them 1 to 2 days 3 to 4 months 

Fresh Beef, Veal, Lamb & Pork 

Steaks 3 to 5 days 6 to 12 months 

Chops 3 to 5 days 4 to 6 months 

Roasts 3 to 5 days 4 to 12 months 

Fresh Poultry 

Chicken or turkey, whole 1 to 2 days 1 year 

Chicken or turkey, pieces 1 to 2 days 9 months 

Seafood 

Lean fish (flounder, 

haddock, halibut, etc.) 1 to 2 days 6 to 8 months 

Fatty fish (salmon, tuna, etc.) 1 to 2 days 2 to 3 months

Soups & Stews 

Vegetable or meat added 3 to 4 days 2 to 3 months 

Leftovers

Cooked meat or poultry 3 to 4 days 2 to 6 months 

Chicken nuggets or patties 3 to 4 days 1 to 3 months 

Pizza 3 to 4 days 1 to 2 months 

www.fsis.usda.gov/apps 

Have more questions about storage timelines? 

Download our Foodkeeper app! It has information on 400+ food and beverage items. 
26

 

Transporting Your Groceries 

Follow these tips for safe transporting of your groceries: 

• Pick up perishable foods last, and 

plan to go directly home from the 

grocery store. 

• Always refrigerate perishable 

foods within 2 hours. 

• Refrigerate within 1 hour if the 

temperature outside is above 90 

°F. 

• In hot weather, take a cooler 

with ice or another cold source to 

transport foods safely. 

Tips for Transporting Food 

• Keep cold food cold, at 40 °F or below. To 

be safest, place cold food in a cooler with 

ice or frozen gel packs. Use plenty of ice 

or frozen gel packs. Cold food should be 

at 40 °F or below the entire time you are 

transporting it. 

• Hot food should be kept hot at 140 °F or 

above. Wrap the food well and place in an 

insulated container. 

Stay “Food Safe” When Traveling Internationally 

Discuss your travel plans with your physician before traveling to 

other countries. Your physician may have specific recommendations 

for the places you are visiting and may suggest extra precautions or 

medications to take on your travels. 

For more information about safe food and water while traveling 

abroad, access the Centers for Disease Control and Prevention website 

at www.cdc.gov/travel. 
27

Foodborne Illness 

Know the Symptoms

Despite your best efforts, you may find yourself in a situation where 

you suspect you have a foodborne illness. Foodborne illness often 

presents itself with flu-like symptoms.

These symptoms include: 

• Nausea 

• Vomiting 

• Diarrhea 

• Fever 

If you suspect that you could have a foodborne illness, there are four 

key steps that you should take. 
28

 

 

Foodborne Illness Action Plan 

If you suspect you have a foodborne illness, follow these general 

guidelines: 

1. Consult your physician or healthcare provider, or seek 

medical treatment as appropriate. 

• Contact your physician immediately if you develop symptoms or 

think you may be at risk. 

• If you develop signs of infection as discussed with your physician, 

seek out medical advice and/or treatment immediately. 

2. Preserve the food. 

• If a portion of the suspect food is available, wrap it 

securely, label it to say “DANGER,” and freeze it. 

• The remaining food may be used in diagnosing your 

illness and in preventing others from becoming ill. 

3. Save all the packaging materials, such as cans, 

labels, and cartons. 

• Write down the food type, the date and time consumed, and when 

the onset of symptoms occurred. Write down as many foods and 

beverages you can recall consuming in the past week (or longer), 

because the onset times for various foodborne illnesses differ.

• Save any identical unopened products. 

• If the suspect food is a USDA-inspected meat, poultry, 

or egg product, call the USDA Meat and Poultry Hotline, 

1-888-MPHotline (1-888-674-6854). For all other foods, call 

the FDA Office of Emergency Operations at 1-866-300-4374 or 

(301) 796-8240. 

4. Call your local health department if you believe you 

became ill from food you ate in a restaurant or other food 

establishment. 

• The health department staff will be able to assist you in 

 determining whether any further investigation is warranted. 

• To locate your local health department, visit 

www.foodsafety.gov. 
29

 

 

I 

For More Information on Food Safety 

You may contact the USDA Food Safety and Inspection Service and 

the Health and Human Services (HHS) Food and Drug Administration 

(FDA) to obtain additional food safety information in both English and 

Spanish. 

Online: 

Information can be accessed on the FSIS website: www.fsis.usda.gov, 

FDA website: www.fda.gov/food or at www.foodsafety.gov. 

• Food Safety Questions? “Ask USDA” 

AskUSDA is an automated response system available 24/7 at 

www.Ask.USDA.gov. 

• Send email inquiries to mphotline@usda.gov or via FDA’s 

webpage http://cfsan.force.com/Inquirypage. 

• Need information about a food recall? Visit www.foodsafety.gov. 

By Phone:

Call the USDA Meat and Poultry Hotline at 1-888-MPHotline 

(1-888-674-6854). 

• This is year-round, toll-free Hotline is available Monday through 

Friday from 10 a.m. to 6 p.m. Eastern Time.

 • An extensive selection of timely food safety messages is also 

available at these same numbers, 24 hours a day. 
30

 

I 

Additional Food Safety Resources 

Gateway to Government Food Safety Information, including all recalls 

and alerts www.foodsafety.gov. 

Centers for Disease Control and Prevention 

1-800-232-4636 (24-hour recorded information) 

www.cdc.gov/foodsafety 

• National Center for Infectious Diseases 

http://www.nc.cdc.gov/travel 

• National Center for Infectious Diseases/Water-Related Diseases 

http://www.cdc.gov/healthywater/disease/type.html 

U.S. Environmental Protection Agency, Office of Water 

http://water.epa.gov 

Partnership for Food Safety Education (Fight BAC!®) 

http://www.fightbac.org
31

I 

Food Safety Questions 

To order this booklet, contact: 

USDA Meat and Poultry Hotline 

1-888-MPHOTLINE 

(1-888-674-6854) 

E-mail: mphotline@usda.gov 

or fsis.outreach@usda.gov 

To chat with our food safety representatives, contact “Ask USDA” 

– USDA’s Web-based automated response system, available 24/7. 

www.Ask.USDA.gov 

Food Safety and Inspection Service 

www.fsis.usda.gov 
I 

32
’

In accordance with Federal civil rights law and U.S. Department of Agriculture 

(USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and 

employees, and institutions participating in or administering USDA programs are 

prohibited from discriminating based on race, color, national origin, religion, sex, 

gender identity (including gender expression), sexual orientation, disability, age, 

marital status, family/parental status, income derived from a public assistance 

program, political beliefs, or reprisal or retaliation for prior civil rights activity, in 

any program or activity conducted or funded by USDA (not all bases apply to all 

programs). Remedies and complaint filing deadlines vary by program or incident.

Persons with disabilities who require alternative means of communication for 

program information (e.g., Braille, large print, audiotape, American Sign Language, 

etc.) should contact the responsible Agency or USDAs TARGET Center at (202) 

720-2600 (voice and TTY) or contact USDA through the Federal Relay Service 

at (800) 877-8339. Additionally, program information may be made available in 

languages other than English. 

To file a program discrimination complaint, complete the USDA Program 

Discrimination Complaint Form, AD-3027, found online at How to File a Program 

Discrimination Complaint and at any USDA office or write a letter addressed to 

USDA and provide in the letter all of the information requested in the form. To 

request a copy of the complaint form, call (866) 632-9992. Submit your completed 

form or letter to USDA by: (1) mail: U.S. Department of Agriculture, Office of the 

Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, 

D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: program.intake@usda.gov. 

USDA is an equal opportunity provider, employer, and lender. 

Revised July 2019 

Slightly Revised March 2020 
FSIS-FSE-AR