Public Health Measures: Food Safety in Hospitals and Other Healthcare Settings

Abstract

In healthcare settings a high proportion of people are particularly susceptible to foodborne illness because of disease, medication, malnutrition, or because their immune system is compromised as a result of age or pregnancy. Meals may be prepared onsite or, in many cases, provided by external caterers. Outbreaks of foodborne illnesses, due to Salmonella, Clostridium perfringens, Listeria monocytogenes, Escherichia coli O157, and norovirus, have been reported in hospitals and care homes. Factors leading to these outbreaks include: food from unsafe sources, inadequate cooking, improper holding temperatures, contaminated equipment and cross contamination, and poor personal hygiene. To prevent such outbreaks, all food suppliers must have in place a Hazard Analysis Critical Control Point system and suitable prerequisite programs. In addition, people who are highly susceptible to infection, including those with a low neutrophil count, should be supplied with a low microbial diet (neutropenic diet) in which higher risk foods are replaced by equally nutritious, lower risk foods. For vulnerable people in general, including transplant recipients, people with cancer, human immunodeficiency virus/acquired immunodeficiency syndrome, diabetes, older adults, and pregnant women, advice such as that given by the US Food Safety and Inspection Service to select lower risk rather than higher risk foods should be publicized more widely.