Friday Feature: A Conversation with Susie Craig on Food Safety and Life with MG

MGA
2 minutes ago
12 min read

This week’s Friday Feature shines a spotlight on Susie Craig, a tenured professor in Food Safety and Health with Washington State University Extension. With a career that spans academia, community nutrition, cognitive behavioral health, and national collaborations with the FDA and USDA, Susie has spent decades translating research into meaningful health practices. In this Q&A, she shares how her professional journey—and personal experience with myasthenia gravis—has shaped her mission to empower others with practical, science-based tools to live safer, healthier lives.

Getting to Know You

Can you tell us about your journey in food safety and health education? What inspired you to pursue this field?

My career path has been eclectic; unexpected detours, incredible opportunities. I studied nutrition and food science at Purdue, my intention was to go to medical school, possibly teaching nutrition. Before title 9, women made up only 3% of the class. Though my MCAT scores exceeded 89% of students, I was not admitted. Thank goodness for Title 9! That was difficult at the time, but I love science, had great mentors at Purdue, and the world is filled with opportunity. After graduate school, I accepted a faculty position with West Virginia University (WVU) teaching nutrition and food science. I was diagnosed during my second year of teaching, then hospitalized missing most of my third year. WVU had a medical school, I felt fortunate in getting a quick diagnosis, probably saved my life. The university supported me through the hospitalization, and I returned to teaching.

One opportunity led to the next, there were closed doors career wise and open ones. I served as a hospital Nutrition and Dietary Director—a position I once said I’d never take. It turned out to be an incredible learning experience. I also worked as a cognitive behaviorist in a lifestyle change program, facilitating over 2,500 hours of closed-group discussions focused on weight loss, self-esteem, positive self-talk, cognitive-behavioral change, and managing stress and transitions.

After a move prompted by my husband’s job change, I returned to academia with Cornell University Extension, where I coordinated a large nutrition research project and began collaborating with the FDA’s national team for Good Agricultural Practices (GAPs) for produce. For the past 27 years, I’ve served as a tenured professor in food safety and health with Washington State University Extension.

I’ve had the privilege of learning from exceptional mentors—both professionally and personally in science and social sciences. Mentorship along with encouragement is something I value and strive to give back most every day.

What has been the most rewarding aspect of your career, particularly when working with communities to improve their health?

Across the food system from farm to table, its wonderful helping people find research-based answers to questions which improve their quality of life. I’ve had leadership for several community-based nutrition education programs. The programs include evaluation, showing effectiveness and changes in behavior. Because of my work, I get to encourage and see personal change and system change. Every day is interesting. Every day I’m learning. It’s also been meaningful work I’ve been able to do with myasthenia gravis even through some serious symptoms. Work helps me find lifestyle balance.

You’ve had such a diverse career—from cognitive-behavioral work to STEM education to agricultural safety. How have these experiences shaped your current work?

I like being a continual learner, being creative, taking advantage of opportunities, being flexible searching for problems to solve others might leave alone. During my years as a cognitive behaviorist, I learned education was not the answer. Clients knew all about healthy lifestyles (nutrition & fitness). They knew what to do, it was making and maintaining changes that was difficult. Very quickly, I learned education was not the answer. Experiences from those five years have shaped everything I’ve done since, professionally and through my personal journey with myasthenia gravis.

My primary area of research is hand hygiene. Poor hand hygiene in health care facilities, schools, commercial produce picking and packing, and home food preparation contributes to so much illness. In western Washington, there was an e. Coli outbreak linked to the world’s fifth largest fair and exposition. Our educational exhibit and experience increased soap usage from 300 to 600 gallons. With funding from the USDA, I developed, implemented and evaluated a program called Germ City, Clean Hands, Healthy People. Four other land-grant universities collaborated with us. The program has been adopted by state health and departments of agriculture, hospitals, medical schools, schools, family and consumer scientists, and state fairs in 39 states. In Washington State, we reached more than a million residents.

What role does storytelling or personal connection play in the way you educate communities about food safety and health?

Though I do lots of writing, I love interacting with others. Often, I’ll use stories from my personal life and anonymous stories of others. With so many years in food safety, there’s lots of “material.” Humorous and serious.

Outside of your professional life, what hobbies or interests bring you joy and balance?

I’m a pianist and singer and enjoy watercolor painting. My husband and I enjoy traveling, the Seattle symphony, time with our granddaughters and friends, and cooking with one another. Music for both of us is integral in our lives. Playing piano can take a challenging day and bring balance. Though I’m recovering from rotator repair and trying a new MG medication, I’ve been a lap swimmer since college – slow and steady. For now, I walk and talk in the water with a new set of friends at our community pool. I miss being able to hike and snow ski, but swimming is a safe, self-paced activity. I pray when I swim.

Foodborne Illness Awareness

Why is it especially important for people with chronic conditions, like MG, to be vigilant about food safety?

A foodborne illness generally worsens myasthenia gravis, sometimes critically. If you are older and/or getting MG treatment, both weakens the immune system. We’re at a greater risk for contracting foodborne illness with heightened symptoms, requiring a longer time to recover. I was hospitalized after contracting norovirus.

Only a fraction of foodborne illness is diagnosed and reported. The CDC estimates 48 million get sick from foodborne pathogens, with 128,000 hospitalizations, and several thousand deaths. Norovirus, Campylobacter, Salmonella, STEC (type of e. Coli), and Listeria cause the most hospitalizations.

Could you briefly explain the risks posed by pathogens such as Norovirus and pathogenic E. coli, particularly to immunocompromised individuals?

Norovirus is the leading cause of foodborne illness and the 2nd most common viral infection after upper respiratory viruses. It’s often referred to as the stomach flu or by physicians as gastroenteritis. It spreads quickly, especially in places with lots of people in close quarters: schools, health care settings, and cruise ships. If we ingest even 10 viral particles, they’re likely to cause severe vomiting and diarrhea for several days. Even after symptoms subside, infected individuals continue to slough off millions of viral particles through feces. Unlike bacteria which need food/water/temperature to survive, a virus may stay on surfaces for a long time (Bathroom door handles, toilet handles, grocery carts, really any surface). Hand washing is one of the best defenses. Most people don’t know that hand sanitizers are not effective for norovirus.

STEC e. Coli is another serious bacteria that may cause kidney failure and life-long health issues. Unlike most pathogenic bacteria, it takes only a small number to cause severe illness. That’s why it’s important to wash produce under running water and cook ground beef to 160 degrees F. and check using a thermometer. On a date night last week, I ordered a burger, asking waitstaff to cook to 160 degrees F. It came raw/pink in the middle. It was a larger restaurant. They had food safety protocols and plans in place. The manager was very responsive and apologetic. I even volunteered to do some training with them this summer. This is much more frequent than you might think. It isn’t that every ground beef patty has pathogenic e. Coli, but it could. The consequences are severe. Finally, for burgers at home, color is not a guide to doneness. It is important to use a thermometer at home, too!

Hand Hygiene Best Practices

Hand hygiene is often emphasized in preventing foodborne illnesses. What are the most effective practices you recommend for ensuring clean hands, especially when preparing food?

If you’re over five years of age, you’ve learned the basics of how and when to wash your hands. Putting the behavior into practice consistently is the challenge. Wet hands, add soap, wash for 20 seconds, rinse with running water, dry with a paper towel, turn off the faucet and in public restrooms use the paper towel to open the door. Research studies vary, but substantial numbers of people leave restrooms without washing. (Think norovirus). Almost no one washes for twenty seconds. In public restrooms with multiple sinks, about 40% of the time (I keep track for curiosity), another woman will ask as I’m scrubbing for 20 seconds if I’m a doctor or nurse. In our Germ City project, we asked hundreds of children and adults why they didn’t wash.

#1 reason was “It takes too long”.

#2 was “It doesn’t make a difference”.

Another interesting fact, most people do a much better job of washing their non-dominant hand, but it’s the dominant hand primarily handling food, including eating.

Could you share your positive story about Holland America Cruise Line and their approach to hand hygiene?

Many opportunities to work with food processors and commercial produce packers were aided by my husband. He worked for a chemical company – providing cleaning and sanitation chemicals to food processing plants across the US. Holland America brought their quality assurance officers together for a review of their procedures related to norovirus. They were doing lots of great things. At the time, they had buffet service, passengers served themselves, including beverage service. To reduce the risk of norovirus after our collaboration, they began directly serving customers in the buffet line. Now, ships have even more procedures in place to reduce the risk of norovirus and minimize exposure during outbreaks with cleaning and sanitation practices throughout the ship and isolating sick passengers and crew.

Outbreaks do happen. So far in 2025, the CDC has issued notifications on 16 cruise ship outbreaks. Most were linked to norovirus. If you’re cruising, report illness to the ship crew, wash your hands frequently, move away from infected people, and personally, we avoid bare hand contact with food – using utensils for eating. If you want to learn more about norovirus and cruise ships, visit the CDC Ship Vessel Sanitation Program.

Safe Food Storage and Waste Reduction

How can proper food storage help individuals reduce waste while also ensuring safety? Are there any specific tips MG patients might find particularly useful?

The FoodKeeper App is one of my favorite resources: https://www.foodsafety.gov/keep-food-safe/foodkeeper-app.

It has recommended storage times for freshness and quality. Available online with mobile applications for Android and Apple devices. You’re able to browse by category (Baby Food to Shelf Stable Foods, even search for a specific food.

Are there any common myths about food safety and storage that you’d like to debunk for our readers?

Yes, there are many. You can listen to nine of them in my Food Safety in a Minute podcast. https://news.cahnrs.wsu.edu/podcasts-category/food-safety-myths-separating-truth-from-myth/.

Here’s one of the worst myths:

Food is Safe to Eat if it Looks, Smells, and Feels OK. So widely believed. It’s a myth. With the momentum of food waste reduction programs, its’s seen in food safety posts, national magazines, and across social media. Reducing food waste is important for food security and solid waste management. However, we may reduce food waste and increase cases of foodborne illness.

The appearance, smell, and taste of food does give indications about its’ quality, which doesn’t mean it is safe to eat. Truth: Disease-causing pathogens like bacteria and viruses do NOT change the smell, appearance, or taste of food. Conversely, bacteria that spoil food are generally not disease-causing. Stay healthy, don’t believe food that looks and smells good is necessarily safe to eat.

Empowering with Knowledge

What are some simple, actionable behaviors or practices that individuals can adopt to reduce their risk of foodborne illnesses?

Every time we return home or when staying in a hotel, after opening the door, we wash our hands, drying with a paper towel.
Know and apply the safe minimum internal temperatures for food.
https://www.foodsafety.gov/food-safety-charts/safe-minimum-internal-temperatures. Always use a thermometer.
Practice the Core Practices of Food Safety: Clean, Separate, Cook, Chill. https://fightbac.org/food-safety-basics/the-core-four-practices/

Can you recommend any resources (such as your podcast, "Food Safety in a Minute") for individuals to learn more about food safety in a practical, approachable way?

Food Safety in a Minute Podcasts – I encourage you to Visit the Website (https://news.cahnrs.wsu.edu/cahnrs-podcasts/food-safety-in-a-minute/ ) I’ve been recording weekly food safety podcasts for six years. The podcasts offer easy-to-apply tips to avoid foodborne illness, microbiology, and emerging technologies. The podcasts meet new Federal guidelines for digital accessibility. You can sign up for weekly podcasts, listen online, read episodes, or choose episodes to download. Think of using just an hour a year listening to this podcast and learning about food safety.

Selected Categories from the Index of 340 Episodes:

Food Coloring
Food Storage
Food Safety thru Life Cycle
Food Safety Myths
Labeling
Produce Safety
Food Additives
Food Waste Reduction
Camping, Boating, Picnics
Kitchens Safety
Emergency Preparedness
Holiday Food Safety
Travel and Food Safety
Technology and Food Safety
Hand Hygiene
Foodborne Pathogens
Food Preservation: Canning, Freezing, Pickling, Drying, Fermenting, Jams/Jellies

Food Preservation

The list of research-based resources with tested recipes for canning is short:

If you are a food preserver, always use research-based resources and recipes.

The National Center for Home Food Preservation including their recipe books and recipes online, land-grant universities including Washington State University, and the current version (2024) of the Ball Blue Book. They are based on USDA guidelines and tested recipes. Both recipes and processing are tested for safety and for quality.

Do not use cookbooks, cooking shows, YouTube, the internet for recipes or food preservation processes. During recipe testing at the USDA and university laboratories, a thermocouple is placed in the center (coldest spot) of the food inside a jar. It monitors the exact internal temperature during the canning process to ensure it stays hot enough, for long enough, to destroy dangerous bacteria—especially Clostridium botulinum. There’s microbiological testing and review by food scientists typically at universities or USDA labs.

Photo from National Center for Home Food Preservation – showing thermocouple temperature monitoring.

National Center for Home Food Preservation: https://nchfp.uga.edu

The center is maintained by the University of Georgia for the USDA: Freezing, canning, fermenting, drying, pickling, and Jams and Jellies. They cover everything from FAQ’s, identifying and handling spoiled canned food, canning fruit-based baby foods, causes and solutions for common problems, equipment and methods not recommended, preserving quality foods during processing, and storage. No cost for online materials. They have a cookbook called So Easy to Preserve and a children’s book called Preserve It and Serve it.

If you preserve food, especially water bath and pressure canning, it’s vital to use a tested recipe. That’s an intensive laboratory process with follow-up microbiological testing. You can purchase their cookbook or use recipes from the Ball Blue book (2024 edition). Avoid other cookbooks and online recipes. It isn’t safe.

Balance and Lifestyle

You mentioned the importance of maintaining balance with MG. How have you incorporated food safety and wellness into your own lifestyle to manage your health?

Food safety is a way of life. That’s a win-win given it’s my work focus and its health positive. My husband and I have had food poisoning twice and together. Once, when we took a bottle of salad dressing on a three-day camping trip. Though in a cooler, a cooler with ice isn’t the same as a refrigerator, a picnic table workspace is not a kitchen. We should have thrown it out. The rest is history.

Do you have any advice for MG patients on how to make gradual, positive changes in their habits for long-term health benefits?

There’s a saying, Life is a marathon, not a sprint. Honestly, I’ve never been able to do either of those things! For me, a quality, well-lived life requires endurance, effort, and resilience – with or without myasthenia gravis. Health is more than exercise, nutrition, and food safety. It’s relationships, connections, a positive attitude most of the time.

Pick one thing, for instance exercise. I’m not a proponent of setting a huge goal, making plans on New Year’s Day. That is important, but often after a few days you’re back at ground zero. Or, you have a flare-up with MG and you’re back to ground zero. Instead, identify what’s reasonable and find things you’re already doing – they may be small, they’re still positive. Reinforce those. It’s a much different mind-set, more positive. Self-talk is automatic, often negative, stripping our motivation for change. If there’s a change you want to make, start by taking a piece of paper, write 40 sentences of things you might be saying to yourself about that change. Initially, that might seem difficult. It gets easier. The opposite is true as well – positively reinforcing yourself gets easier too. I’m older and was diagnosed with MG fifty years ago. My everyday life theory is “It’s not how much you do, it’s doing.”

Your Work and Impact

Could you share more about your work on Good Agricultural Practices and how it impacts consumer food safety?

Consumers would be amazed at the food safety practices of commercial growers and farmers in the United States and internationally. From soil preparation, planting, growing, harvesting, packing and transporting to stores, farm stands, and farmer’s markets. They write a food safety plan for their growing operation. Ask your grocery produce manager or a local farmer at your farmer’s market. Learn more from Cornell University.

https://cals.cornell.edu/national-good-agricultural-practices-program

Are there any upcoming projects or initiatives you’re working on that our community might find interesting?

STEM Food Science curriculum for Middle and High School Students with the National 4-H Council
Food Waste Reduction Keeping Food Safety in Mind – Under Development. Reducing food waste with food safety in mind saves money, about $2,000 annually.