Pan American Health Organization · 1st edition, 2024 · 92 pages
Comprehensive guidance for national and local authorities, merchants, and consumers on ensuring food safety and preventing disease transmission in public markets and open-air fairs.
- Issuer
- Pan American Health Organization
- Edition
- 1st edition, 2024
- Audience
- Government officials (food safety, health, environment), market administrators, merchants, intermediaries, inspection personnel, consumers
- Evidence
- Expert consensus, compiled from consultations with countries in the Americas and international standards (Codex Alimentarius)
- Reviewed
- 21 Oct 2026 · GMJ
What this guideline says
GMJ summary
This 92-page manual provides comprehensive recommendations for improving infrastructure, hygiene, and sanitary conditions in traditional food markets across the Americas. Traditional markets are essential food sources for millions but pose significant public health risks through potential transmission of foodborne diseases and zoonoses, particularly when infrastructure is poor, water access is limited, and live animals are sold.
The guide addresses the complete market ecosystem—from legal frameworks and risk-based inspection to specific handling requirements for different food types (fruits and vegetables, grains, eggs, dairy, fish, meat). It emphasizes that proper temperature control (keeping cold foods below 5°C, cooking to above 70°C), access to safe drinking water, handwashing facilities, waste management, pest control, and prohibition of live animal sales are fundamental to market safety.
Structured around a multisectoral “One Health” approach, the manual recognizes that 61% of emerging infectious diseases are zoonotic and that traditional markets have been identified as high-risk environments for disease emergence, including SARS-CoV-1, H5N1 avian influenza, and COVID-19. It provides practical tools including checklists for inspectors, cleaning protocols, communication strategies, and recommendations for capacity building.
Key points
For clinicians — doses and thresholds as stated in the guideline
- Cold chain: refrigerated food must be kept at ≤5°C; frozen food at ≤-18°C; use thermometers and ice made from safe drinking water
- Cooking: food must reach minimum internal temperature of 70°C to ensure safety; ground meat 71°C, whole poultry 82°C, reheated food 74°C
- Danger zone: do not leave food between 5°C and 60°C for >2 hours (rapid microbial growth); hot food kept >60°C for maximum 6 hours
- Handwashing: wash hands for ≥40 seconds with soap before handling food, after touching money, animals, waste, or going to bathroom; establish handwashing stations with drinking water in all markets
- Water safety: only use drinking water for cleaning, food preparation, and ice; markets must have sufficient supply from public network or protected wells meeting potability standards
- Waste management: use covered, pedal-activated containers; separate organic and inorganic waste; ensure dedicated isolated collection areas; public cleaning services must collect waste continuously during operations
- Live animals: prohibit keeping, displaying, marketing, slaughtering live animals (domestic or wild) in markets to prevent zoonotic disease transmission
- Market infrastructure: floors must be smooth, waterproof, non-slip with drainage slope; work surfaces ≥70 cm above floor; stalls protected from sun, rain, dust; toilets and sinks in sufficient number
Recommended temperature and storage period by type of food
Table extracted from the guideline
| Food group | Examples | Refrigeration time at <5°C | Freezing time at <-18°C |
|---|---|---|---|
| Salad spreads | Egg, chicken, ham, tuna | 3–5 days | Avoid—do not freeze well |
| Fresh poultry | Whole chicken or turkey | 1–2 days | 1 year |
| Fresh poultry | Chicken or turkey pieces | 1–2 days | 9 months |
| Hamburgers, ground meats | Beef, turkey, chicken, pork | 1–2 days | 3–4 months |
| Fresh beef, veal, lamb, pork | Meat for roasting | 3–5 days | 4–12 months |
| Fresh beef, veal, lamb, pork | Cutlet | 3–5 days | 4–6 months |
| Fish—fatty | Oily fish, catfish, mackerel, salmon, tuna | 1–3 days | 2–3 months |
| Fish—lean | Cod, whiting, hake, sole, tilapia | 1–2 days | 6–8 months |
| Seafood—fresh | Shrimp, oysters, lobster, squid | 1–2 days | 3–6 months |
| Eggs | Raw eggs in shell | 3–5 weeks | Do not freeze |
| Eggs | Hard-boiled eggs | 1 week | Do not freeze |
| Soups and stews | With vegetables or meat | 3–4 days | 2–3 months |
Source: Pan American Health Organization, Good practices in traditional food markets in the Region of the Americas. Reproduced in summary form.
From the guideline
Verbatim
“Traditional markets have been identified as environments conducive to the transmission and spread of major zoonotic diseases such as acute respiratory syndrome coronavirus 1 (SARS-CoV-1), avian influenza (caused by the H5N1 virus), and, more recently, coronavirus type 2 (COVID-19), caused by the SARS-CoV-2 virus.”
Editor’s perspective
Why this matters for Georgia and the region
Prof. Giorgi Pkhakadze, MD, MPH, PhD
Editor-in-Chief, Georgian Medical Journal · Chair, Public Health Institute of Georgia · WHO consultant, health and migration
As someone who has worked extensively on health systems strengthening in Georgia and the region, I recognize that traditional markets remain the backbone of food access for most Georgian families, particularly in rural areas and smaller cities where supermarkets are scarce. This PAHO manual addresses the exact challenges we see in Tbilisi's Deserter Bazaar, Kutaisi markets, and hundreds of smaller weekly fairs: inadequate cold chain, limited handwashing facilities, live poultry sales despite avian influenza risks, and fragmented oversight between municipal and national sanitary inspection services. The recommendation I would most stress to Georgian public health colleagues is the establishment of risk-based inspection systems with trained personnel using standardized checklists—our current approach is often punitive closure rather than capacity building, which drives vendors into the informal sector and away from any oversight. The realistic implementation caveat is that Georgia's municipalities vary enormously in capacity and resources; while Tbilisi or Batumi might implement comprehensive market upgrades, smaller municipalities will need phased approaches starting with the most critical interventions: safe water access, handwashing stations, waste management, and prohibition of live animal sales, supported by national financing mechanisms similar to those used in our hepatitis C elimination programme.
ORCID 0000-0001-7609-4515 · Perspective written for the GMJ Guidelines Library, 21 Oct 2026
Applicability
Georgia and the South Caucasus
This guidance is highly relevant for Georgia and the South Caucasus region, where traditional markets (bazaars) remain the primary source of fresh food for most households, particularly outside major cities. Georgia’s markets face many challenges addressed in this manual: limited cold chain infrastructure, variable access to safe water in rural areas, informal vending, and cultural practices of live poultry sales. National food safety programmes would need to adapt the recommendations to local governance structures (municipal vs. national authority), consider seasonal temperature extremes affecting food storage, address the specific foods sold in Caucasus markets (tkemali, churchkhela, fresh herbs, unpasteurized dairy products), ensure Hazard Analysis and Critical Control Points (HACCP) principles are applied proportionately to small vendors, and integrate market safety into Georgia’s ongoing universal health coverage reforms and primary healthcare strengthening. The zoonotic disease prevention measures are particularly pertinent given avian influenza risks from backyard poultry and the region’s position on migratory bird routes.
Questions this guideline answers
Quick answers
What temperature should refrigerated food be kept at in markets?
Refrigerated food must be kept at or below 5°C. Frozen food must be kept at or below -18°C. If electrical refrigeration is unavailable, use clean coolers with flake ice made from drinking water. Check temperatures with calibrated thermometers daily and keep records for cold rooms.
How should vendors wash their hands correctly?
Wet hands with running water, apply sufficient soap to cover entire surface, rub all surfaces (palm, back, between fingers, under nails) for at least 40 seconds, rinse thoroughly under running water, and dry with single-use paper towel. Wash after touching money, animals, waste, body, wounds, or going to bathroom, and before handling food.
Why should live animals not be sold in food markets?
An estimated 61% of emerging infectious diseases are zoonotic (animal origin). Live animal sales increase risk of disease transmission through direct contact or food contamination. Traditional markets have been linked to SARS-CoV-1, H5N1 avian influenza, and COVID-19 outbreaks. National policies should prohibit marketing of live animals unless dependably effective regulations control zoonotic transmission based on adequate risk assessment.
What are the minimum infrastructure requirements for a safe market?
Markets need: sufficient drinking water from public network or protected wells; toilets and sinks in adequate number for staff and customers; floors that are smooth, waterproof, non-slip with drainage slope; work surfaces ≥70 cm above floor; adequate lighting and ventilation with screened openings; walls covered with smooth washable material; covered waste containers with pedal activation; and dedicated isolated areas for waste collection.
Related on GMJ
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- ASF Hospital — Standard 18 — Sustainable Care
- ASF Hospital — Standard 5 — Safety & Emergency Preparedness
- ASF Medical Transport — Standard 5 — Infection Prevention & Control
- ASF Laboratory — Standard 7 — Examination: Process & Safety
- ASF Hospital — Standard 11 — Critical Care
- ASF Medical Transport — Standard 6 — Emergency Response During Transport
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- Framework for the Response of Integrated Health Service Delivery Networks to COVID-19
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- Considerations for Regulatory Oversight of Clinical Trials in the COVID-19 Pandemic
- Issuer
- Pan American Health Organization
- Type
- Procedures, manuals, guidelines
- Edition
- 1st edition, 2024
- Status
- Current
- Published
- 2024-01-01
- Languages
- English, Spanish, Portuguese
- Scope
- Public markets and open-air fairs selling fresh food in the Americas
- Audience
- Government officials (food safety, health, environment), market administrators, merchants, intermediaries, inspection personnel, consumers
- Pages
- 92
- Licence
- CC BY-NC-SA 3.0 IGO
- Evidence
- Expert consensus, compiled from consultations with countries in the Americas and international standards (Codex Alimentarius)
- Record history
- Created 21 Oct 2026 · updated 21 Oct 2026 · next check Apr 2027
Pan American Health Organization. Good practices in traditional food markets in the Region of the Americas. Washington, DC: PAHO; 2024. (PAHO/CDE/AFT/22-0016).GMJ Guidelines Library records are original summaries written by the GMJ editorial team from the issuer’s published document and reviewed by a physician. They do not replace the full guideline. The document is the copyright of its issuer and is linked, not hosted. Spotted an error or a newer edition? Tell the Guidelines Desk.
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