Hygiene Of Food Handlers Research Articles

Assessment of sanitary and hygienic status of catering establishments of Awassa Town

A cross-sectional survey was conducted to assess the sanitary status and hygienic practices of catering business establishments in Awassa Town, Southern Ethiopia, February to April 1996. Data were collected using standardized questionnaires, free listings, parasitological and bacteriological laboratory analyses. A total of 164 catering establishments were identified and investigated. They had about 1023 workers with daily customer services of about 14,965. Water was found to be available in most (89.7%) of the establishments and sanitation coverage (defined as the presence of latrine) was 98%. The overall prevalence of intestinal parasites among food handlers was 63%, with Giardia Lamblia (33.3%), Entamoeba histolytica (21.5%), Ascaris lumbricoid (18.2%) and hookworm species (10.8%). The water supply and sewerage authority (WSSA) water supply was found to be bacteriologically potable. Inadequate follow-up of catering establishments, absence of optimum standard procedures and guidelines for business operation, poor regular refurbishment practice, inappropriate liquid and solid waste disposal system, and poor personal hygiene of food handlers were the major findings. Multi-lateral and inter-sectoral collaboration and cooperation is mandatory to design the rapidly growing urbanization and industrialization of the Town by involving municipalities, the local administrative council, the health sector, owners of the establishments and the community to work together and comply with the optimum standards and procedures. Recommendations are forwarded to ensure customer expectations, needs, and demands. (Ethiopian Journal of Health Development: 2000, 14(1): 91-98)

An outbreak of hepatitis A associated with an infected foodhandler.

The recommended criteria for public notification of a hepatitis A virus (HAV)-infected foodhandler include assessment of the foodhandler's hygiene and symptoms. In October 1994, a Kentucky health department received a report of a catering company foodhandler with hepatitis A. Patrons were not offered immune globulin because the foodhandler's hygiene was assessed to be good and he denied having diarrhea. During early November, 29 cases of hepatitis A were reported among people who had attended an event catered by this company. Two local health departments and the Centers for Disease Control and Prevention, in collaboration with two state health departments, undertook an investigation to determine the extent of the outbreak, to identify the foods and event characteristics associated with illness, and to investigate the apparent failure of the criteria for determining when immune globulin (IG) should be offered to exposed members of the public. Cases were IgM anti-HAV-positive people with onset of symptoms during October or November who had eaten foods prepared by the catering company. To determine the outbreak's extent and factors associated with illness, the authors interviewed all case patients and the infected foodhandler and collected information on menus and other event characteristics. To investigate characteristics of events associated with transmission, the authors conducted a retrospective analysis comparing the risk of illness by selected event characteristics. To evaluate what foods were associated with illness, they conducted a retrospective cohort study of attendees of four events with high attack rates. A total of 91 cases were identified. At least one case was reported from 21 (51%) of the 41 catered events. The overall attack rate was 7% among the 1318 people who attended these events (range 0 to 75% per event). Attending an event at which there was no on-site sink (relative risk [RR] = 2.3, 95% confidence interval [CI] 1.4, 3.8) or no on-site kitchen (RR = 1.9, 95% Cl 1.1, 2.9) was associated with illness. For three events with high attack rates, eating at least one of several uncooked foods was associated with illness, with RRs ranging from 8 to undefined. A large hepatitis A outbreak resulted from an infected foodhandler with apparent good hygiene and no reported diarrhea who prepared many uncooked foods served at catered events. Assessing hygiene and symptoms s subjective, and may be difficult to accomplish. The effectiveness of the recommended criteria for determining when IG should be provided to exposed members of the public needs to be evaluated.

Impact of changing consumer lifestyles on the emergence/reemergence of foodborne pathogens.

Foodborne illness of microbial origin is the most serious food safety problem in the United States. The Centers for Disease Control and Prevention reports that 79% of outbreaks between 1987 and 1992 were bacterial; improper holding temperature and poor personal hygiene of food handlers contributed most to disease incidence. Some microbes have demonstrated resistance to standard methods of preparation and storage of foods. Nonetheless, food safety and public health officials attribute a rise in incidence of foodborne illness to changes in demographics and consumer lifestyles that affect the way food is prepared and stored. Food editors report that fewer than 50% of consumers are concerned about food safety. An American Meat Institute (1996) study details lifestyle changes affecting food behavior, including an increasing number of women in the workforce, limited commitment to food preparation, and a greater number of single heads of households. Consumers appear to be more interested in convenience and saving time than in proper food handling and preparation.

A generic model for evaluating consumer food safety behaviour

This paper presents a detailed approach that can be used to evaluate the food safety behaviour of consumers. The preparation of a chicken and mushroom meal is used as a model. Hazard analyses were conducted and an audit hazard check-list compiled. A standard measure of hygienic food handling behaviour, a food operation risk (FOR) score, was devised, tested and refined. Additionally, a food safety risk (FSR) score, indicating the degree of likely risk to the consumer was developed. Early results indicate that these techniques are suitable for investigating the food safety behaviour of a larger sample of consumers with a range of home-produced food products. It will be useful to those involved in hygiene auditing and intervention and could benefit small scale caterers attempting to develop HACCP plans for their operations.

Epidemiology of Viral Foodborne Disease

Virus transmission via foods begins with fecal shedding of viruses by humans. Foodborne viruses infect perorally: These same agents have alterative fecal-oral routes, including person- to-person transmission and the water vehicle. No zoonotic viruses are transmitted via foods in North America. Viruses rank high among foodborne disease agents in the United States, even though observation, diagnosis, and reporting of foodborne viral disease are inefficient. Risk assessment in developed countries considers viral infection rates and personal hygiene of food handlers, as well as the opportunities for contamination of shellfish and other foods by untreated sewage. Licensing of a vaccine against hepatitis A that could be administered to food handlers in North America would provide an important means of preventing foodborne viral disease. However, the most general concern in preventing all foodborne viral disease is to keep all human fecal contamination out of food.

Pathogens transmitted in food contaminated by infected food-handlers

Section 103(d) of the Americans with Disabilities Act directed the Secretary of Health and Human Services to annually review and publish a list of pathogens transmitted in food contaminated by infected food-handlers. Purposes of this project were to 1) determine the incidence of these pathogens in foodborne disease outbreaks attributed to food-handlers, 2) identify the foods most frequently involved in these outbreaks and 3) suggest ways to prevent the spread of these pathogens. Information was obtained from AGRICOLA, Food Science and Technology Abstracts, MEDLINE, and Science Citation Index and articles published in public health, medical and food science journals. Poor personal hygiene of food-handlers was the factor most frequently responsible for outbreaks of Shigella spp. (91%), hepatitis A (96%), Norwalk virus (78%) and Giardia lamblia (100%) reported between 1973 and 1987. The majority of outbreaks attributed to Shigella spp. and Norwalk virus have been associated with salads, while salads and sandwiches are usually the vehicles for outbreaks involving hepatitis A and G. lamblia. Most outbreaks of Staphylococcus aureus result from the combined effects of infected food-handlers and holding food at improper temperatures; protein-rich foods are usually implicated. The principle source of infection attributed to nontyphoidal Salmonella is contaminated poultry, beef or pork that had been improperly held or inadequately cooked. Streptococcus pyogenes, Escherichia coli 0157:H7, Enterotoxigenic Escherichia coli, rotavirus, Salmonella typhi, Campylobacter jejuni, Yersinia enterocolitica, Taenia solium, Entamoeba histolytica and Vibria cholera 01 are uncommonly reported. Good hygiene, both personal and in food-handling practices, coupled with education and training are needed to prevent the transmission of pathogens from food-handlers to food and ultimately to the consumer. The importance of proper and frequent hand-washing must be stressed by dietitians.

Investigation of a food borne outbreak of salmonehlosis among hospital employees

An explosive outbreak of Salmonella enterocolitis developed in 27 hospital employees in an acute-care community hospital in Rhode Island in 1987. Salmonella typhimurium was isolated from the stools of 19 employees during the outbreak. In each patient the implicated organism had an identical antibiotic susceptibility pattern, biotype, plasmid profile, and restriction endonuclease digestion pattern. The outbreak was limited to health care workers and other hospital employees; there were no cases in hospitalized patients. Of the afflicted employees 96% ate in the hospital cafeteria on July 11 or 12, 1987. Food-specific attack rates, based on the dietary histories of ill employees and 50 healthy employees who ate in the cafeteria that weekend, indicated an association between the ingestion of salads and illness ( p < 0.01). One food service employee, in whom symptoms of abdominal cramping and diarrhea had developed 6 days earlier, had prepared the implicated foods. S. typhimurium with the identical characteristics of the outbreak strain was isolated from the stools of this food service employee. Environmental cultures and cultures of meat, poultry, and dairy sources for the cafeteria all showed negative results. Food service employees need to be counseled against working during any symptomatic enteric illness and require thorough instruction on hygienic food handling. ( Am J Iinfect Control 1989;17:141–147)

VIBRIO PARAHÆMOLYTICUS OUTBREAKS IN THE UNITED STATES

Vibrio parahœmolyticus has only lately been recognised as a significant cause of gastroenteritis outbreaks in the United States. By 1972, thirteen outbreaks have been reported, and the epidemiological, clinical, bacteriological, and environmental aspects of these outbreaks are reviewed here. Outbreaks were reported from eight States, ranging from the Atlantic seaboard to the Gulf of Mexico, Pacific northwest, and Hawaii. Crab, shrimp, lobster, and oysters were involved as vehicles. Cooked seafood was responsible for all but two of the outbreaks. A variety of different serotypes of the organisms were involved. Errors in refrigeration, cooking, or food-handling hygiene contributed to the incidents.