Microbial counts of tested food samples
Microbes are ubiquitous and varied in nature and can be found in diverse surroundings thriving under varying conditions [36, 37]. Though microbes pose different levels of threat to food safety, there are thresholds to which their presence should not exceed. Accordingly, the Intenational Commission on Microbiological Specification for Food (ICMSF) [38] and Health Protection Agency (HPA) [39] stipulate that, for any food sample to be considered wholesome or satisfactory for consumption, it must meet the standard requirement for microbial quality. Unfortunately, majority of the food sampled and tested in this study detected unacceptable high levels of bacterial contamination in varying degrees for cooked and ready-to-eat foods. The presence of microorganisms signal immediate food safety concerns. The findings of this study corroborates the results of previous studies which found high bacterial counts in food samples tested in South Africa [40], Nigeria [41] and other parts of Ghana [42].
The mean bacterial counts in salad in all the three categories of hotels were high (Table 1). Salad dishes are mainly prepared from fresh vegetables, subjected to minimal cooking or could be consumed raw, hence, their microbial content may present a high risk to the health of consumers [43]. The presence of microbes could be due to contamination from farms where human sewage or untreated manure have been used for enriching the soil to enhance vegetable growth and or from water used for irrigation. In addition, the contamination may be due to the food handlers who do not adequately wash the vegetables before cooking. For instance, a study by [44] in Upper East Region of Ghana revealed high levels of bacteria loads in vegetables and irrigated water above the ICMSF [38] and HPA [39] standard of and for food. Furthermore, [45] observed that unsafe water used for pre- and post-harvest production or for washing and sprinkling vegetables to maintain their freshness are possible means of contamination. Thus, vegetables need to be washed sufficiently under running water before processing and also kept cool at holding temperatures of 1ᵒC-5ᵒC before and during service. Our findings agrees with that of some previous ones [26, 30, 31, 46, 47].
The findings further revealed that plain boiled rice served in all the categories of the hotel had high levels of microbial loads. The contamination could be attributed to bacteria spores which may be heat resistant and proliferate even after the rice is cooked. The heavy presence of microbes in the plain rice tested is likely to compromise consumer’s health. This finding is comparable to that of [47, 48] who reported heavy bacterial presence in plain boiled rice served at food service establishments. Moreover, hot pepper sauce recorded high observable bacteria counts above the acceptable limits of [38, 39]. The presence of microbes in the sauce could be ascribed to the use of unwholesome ingredients, insufficient washing of ingredients and inadequate hygiene practices. Thus, should all the bacteria introduced into the sauce at the time of preparation survive, they will proliferate if held for too long at an ambient temperature. So, wholesome ingredients are preferable in preparing these sauces which can be kept at an appropriate temperature after preparation and during service [47, 48, 49, 50].
The findings further indicated that grilled fish and grilled chicken, though cooked at high temperatures, recorded high observable bacteria counts. Fish is highly susceptible to spoilage and can easily become contaminated by pathogens from humans, the fish itself and other environmental factors during processing. Similarly, meat (chicken) typically contains the nutrients needed for both microbial growth and their metabolism, thus, it is more likely to be contaminated by microbes [27]. The contamination of fish and chicken may come from the point of purchase, use of same cutting board and knives for other purposes and or the use of rusty and unclean equipment for grilling. The findings of this study again supports that the previous studies [40, 51, 52] which reported the presence of microbes in grilled fish and chicken.
Furthermore, our findings showed that jollof rice, fried rice, fried fish, banku and shito recorded high levels of microbial loads. The presence of microbes in these food samples could be due to other ingredients used such as spices and condiments, vegetables, poor food handling practices, the equipment used in handling the food, holding temperature and poor hand hygiene practices. For instance, some previous studies have found heavy microbial loads in jollof rice and fried rice samples tested and attributed their unwholesomeness to mycelium fragments from the environment and bacteria spores [48, 53]. Moreover, “banku”, a dish prepared by mashing corn and cassava dough and cooked at high temperature, ideally should record no microbial load. However, the process of rolling the banku into sizeable and presentable shapes by the use of the bear hands and water or wrapping it with single use polyethene or uncontrolled fermentation and inappropriate hygiene practices can contaminate the cooked dish. Likewise, fried fish which is prepared under high temperature also recorded heavy microbial loads above the acceptable limit. According to [52, 54, 55], fresh fish carries large microbial contaminants, 107 on the skin and up to 109 in the gills and guts. These microbes are mostly Gram-negative of the Pseudomonas, Vibrio and Flavobacterium species in addition to other Gram-positive micrococci and coryneform variants. Consequently, the contamination of the fried fish is attributed to poor storage, excessive handling and the transmission of pathogenic microbes through poor hygiene practices [50, 52].
Isolation of Salmonella
The purpose of isolating only Salmonella from the food samples was to establish the causes in the upsurge of typhoid infestation in the study areas as reported by the surveillance data and annual reports of the Regional Health Directorate and the Environmental Health and Sanitation Unit. The results on the enumeration of total Salmonella counts (Fig. 1) showed that all the food samples tested were contaminated with Salmonella. For instance, salads from all the hotels indicated the presence of Salmonella, making such ready-to-eat foods easily susceptible to contamination. The isolation of Salmonella spp in the food indicates a major food safety violation, rendering the food microbiologically unsafe for human consumption and public health risk. Salmonella may be linked to unclean food contact surfaces, as it is able to form biofilms which protects the microbes from chemical, mechanical and physical stressors resulting in long-term survival leading to contamination of food in the process. Therefore, is it imperative to keep work surfaces clean and to train food handlers on regular basis to adhere to the WHO food safety guidelines [56, 57]. This may be very apparent especially for ready-to-eat foods like salads to ensure they are safety for public consumption. Similar findings were reported by [26, 58, 59] of high Samonella presence in salads served at food service establishments.
Furthermore, all the cooked food tested (hot pepper sauce, grilled fish, jollof rice, plain rice, grilled chicken, fried fish, shito and banku) from hotels were found to be contaminated with Salmonella (Fig. 1). This is very alarming because cooked food is supposed to have no Salmonella or zero cfu/g/cfu/mL according to ICMSF and HPA [38, 39] guidelines. For instance, though banku recorded the least observable microbial load, it was contaminated with Salmonella. The presence of Salmonella in the cooked foods irrespective of their levels poses a great danger to the health of consumers because Salmonella serotypes have a low infectious dosage implying that they can still cause disease even without proliferating in the food [60, 61]. In addition, it was a surprise to know that shito which has been cooked to completely remove moisture from it to enhance its shelf life was also contaminated with Salmonella. This may be due to the nature of ingredients used, preparation environment and storage equipment. For instance, according to [13], Salmonellae have been identified to survive in herbs and spices used for food preparation thereby contaminating the foods to which they have been added. To prevent this,[13] suggested that food product testing should be carried out at each stage of production to identify and eliminate the contaminants before the final product is produced. Likewise, it is important that food handlers pay attention to their personal hygiene practices, keep equipment and surroundings clean and observe appropriate temperature for storring both cooked and raw food properly to prevent food contamination and spread of diseases to consumers [50, 62, 63].
Possible causes of S almonella presence in food samples
Personal hygiene
Salmonella is one of the major causes of foodborne infections and poor personal hygiene practices during food handling is a plausible avenue for the spread of Salmonella in foods. Thus, the isolation of Salmonella in all the tested food samples indicate non-adherence to good hygiene protocols. Our observations showed that food handlers did not proprely comply with personal hygiene regulations. For instance, majority (71.8%) of the food handlers did not wash their hands before and during food preparation, while others were seen coughing or sneezing openly into the food. That is, food handlers play a significant role in food production and service and determine the safety of food serve to consumers. Food handlers are responsible for all food processing and preparation activities and have direct contact with the food and thus, can be a source of contamination if appropriate food safety measures are not observed. For instance, [64, 65] assert that food handlers can indirectly contaminate food by touching cooked food after handling raw food, coughing/sneezing, touching body parts, dirty material/surface and using the washroom without washing hands. Therefore, handwashing with soap and water is a key factor to curb the transmission of Salmonella into food. It is apparent the presence of Salmonella in the sampled food is attributed to poor handwashing practices. Besides, we observed that 59.0% of the food handlers did not wear gloves whiles handling ready-to-eat foods like salads, thereby introducing Salmonella into the food samples. Therefore, it is important that food handlers adhere to good personal hygiene practices while handling food, for consumer protection. Moreover, [41, 42] revealed poor hygiene practices of food handlers are contributory factors for salmonella presence in food samples tested [65].
Cross-contamination
Cross-contamination is a major cause of Salmonella contamination and can occur at any stage during food preparation and service. Our observation revealed that many of the food handlers engaged in activities that lead to cross-contamination in areas such as handwashing in the kitchen sink after using the washroom, use of same cutting board for cooked and uncooked foods and use of kitchen towels to dry hands after using the washroom. The practice of food handlers washing hands in sinks designated for washing utensils and other cooking equipment is a poor practice which can lead to cross-contamination of food and subsequent transmission of Salmonella to consumers. These findings affirmed the reports of [66, 67]. Also, the use of the same cutting board for handling cooked and uncooked food by food handlers was quite worrying. Cross-contamination between food contact surfaces (cutting boards) is harmful because Salmonella is able to stick to the surfaces and form a biofilm which can become a source of contamination. Cutting boards are made of different materials like wood, plastic, glass and stainless steel and these materials determine the ease in cleaning. However, wood cutting boards for example, are difficult to clean and sanitize due to its porous nature thereby making it convenient for microorganisms to form biofilm on it [68]. Thus, the inability of food handler’s to clean and sanitize these surfaces effectively determine the presence of Salmonella proliferation and contamination of sampled food [69].
Time and temperature control
Failure to control time and temperature is one of the most common causes of Salmonella incidents. The findings of this study showed that many (82.6%) of the food handlers refreeze and defrosted foods thaw/defrost meat in a bowl of water overnight, but did not check the internal temperatures of food on fire while some held foods with their bare hands. The WHO five keys to safer food and the golden rules to safer food required that food is stored and cooked at correct temperatures [57, 58]. For instance, whole chicken should be cooked at 180℃ for 2hrs 10 minutes. The inability of the food handlers to check the internal temperature of cooking and held foods with probe thermometers indicates abuse of time and temperature control regulations and the resultant presence of Salmonella in the food samples tested, as also found by [42, 50]. Besides, the recurrent freeze-thaw practices of the food handlers could increase the microbial load of the frozen food, culminating into Salmonella contamination. For example, [67], reported that recurrent freeze-thaw practices of beef resulted in change in taste, colour, texture, and subsequent deterioration of the beef due to increase in microbial load. They recommended the defrosting of food in the refrigerator, in a bowl under running water or bag the meat into manageable pieces needed for each cooking session to prevent the habit of repeated defrosting and refreezing which could extend the time at the temperature danger zone resulting in Salmonella contamination[12, 70, 71].
Limitation
The Salmonella spp identified in the food samples were not confirmed by confirmatory test that identify the specific serovars causing the typhoid fever upsurge within the two regions. In addition, swabs from the kitchen surfaces and food handlers’ hands should have been taken to conduct further tests on the nature and severity of contamination.