Norovirus modeling: Stay at home after the barfing and pooping is gone

Duret et al. write in Risk Analysis:

We developed a quantitative risk assessment model using a discrete event framework to quantify and study the risk associated with norovirus transmission to consumers through food contaminated by infected food employees in a retail food setting.

This study focused on the impact of ill food workers experiencing symptoms of diarrhea and vomiting and potential control measures for the transmission of norovirus to foods.

The model examined the behavior of food employees regarding exclusion from work while ill and after symptom resolution and preventive measures limiting food contamination during preparation.

The mean numbers of infected customers estimated for 21 scenarios were compared to the estimate for a baseline scenario representing current practices. Results show that prevention strategies examined could not prevent norovirus transmission to food when a symptomatic employee was present in the food establishment. Compliance with exclusion from work of symptomatic food employees is thus critical, with an estimated range of 75–226% of the baseline mean for full to no compliance, respectively.

Results also suggest that efficient handwashing, handwashing frequency associated with gloving compliance, and elimination of contact between hands, faucets, and door handles in restrooms reduced the mean number of infected customers to 58%, 62%, and 75% of the baseline, respectively.

This study provides quantitative data to evaluate the relative efficacy of policy and practices at retail to reduce norovirus illnesses and provides new insights into the interactions and interplay of prevention strategies and compliance in reducing transmission of foodborne norovirus.

Quantitative risk assessment of norovirus transmission in food establishments: Evaluating the impact of intervention strategies and food employee behavior on the risk associated with norovirus in foods

Risk Analysis, Vol. 37, No. 11, 2017

DOI: 10.1111/risa.12758

Duret et al.


Up to 100 sick with Salmonalla at Eagle’s Roost in Kentucky: Sick employee fingered

The Estill County Judge Executive says the state has identified what they believe the source of a Salmonella outbreak that left nearly 100 in the county sick.

eagle's.roost.kyWKYT reports Judge Executive Wallace Taylor says the state’s investigation found that an employee at Eagle’s Roost had contracted the illness, most likely without knowing they had it.

State officials told Taylor that they believe that is what led to the spread which they say left nearly 100 sick in the county.

At last check health officials say over 70 Estill County residents reported gastrointestinal illness and 51 of them tested positive for Salmonella. Taylor tells WKYT they believe the number of those who got sick may have been higher than the numbers they recorded. Nearly a dozen people were hospitalized.

Protect those who protect our food

Jacob E. Gersen and Benjamin I. Sachs, professors at Harvard Law School, write in the N.Y. Times that every year, 5.5 million people are sickened by norovirus, a highly contagious gastrointestinal bug. According to the Centers for Disease Control and Prevention, norovirus is the leading cause of food-borne illness in the United States and is spread primarily by “infected food workers.” Last year cooks, waiters and other workers were involved in about 70 percent of the outbreaks.

public.healthThis is just one example of the critical role that food workers play in our nation’s economic and public health systems. And yet, while we often tailor employment rules for work that has a special impact on the public, the law has yet to recognize food workers as a distinct class — an approach that harms consumers, the economy and the workers themselves.

Sick restaurant workers provide a particularly vivid example of the kind of legal reform that’s needed. Until recently, very few restaurant workers had the legal right to paid sick time, which meant that many of them went to work very ill (last week voters in Massachusetts and three cities passed paid-sick-leave laws). Federal law can fix this problem by requiring employers to provide their workers with paid time off.

But restaurant workers aren’t the only ones who need special treatment. All food workers are on the front lines of the vast food-production industry, and regularly witness dangerous breaches in safety procedures.

Take farm workers who witness the processing of infected (or “downer”) cows — an illegal but, unfortunately, not uncommon practice that risks spreading a host of diseases to humans. Or workers in poultry-processing facilities, where safety and hygiene regulations are flouted, thus increasing the risk of salmonella, which every year results in more than one million illnesses, more than 350 deaths and over $3 billion in health care and lost productivity costs. Unless we offer specific legal protection for all food workers who come forward to expose such practices — something the law does not do now — we all are at risk.

We should also adjust many of our standard workplace rules to take account of the special nature of food production. To avoid the transmission of bovine spongiform encephalopathy, which causes mad cow disease, workers involved in the processing of beef must fully and carefully remove the dorsal root ganglion, a part of the spinal nerve, from all cattle that are 30 months old or older. That’s because these dorsal root ganglia can contain the infective agent behind B.S.E.

public_restroom_rulesThis is high-stakes stuff, and we should make absolutely sure that the workers responsible for doing it aren’t too worn out, or working too fast, to do it right. That means rethinking rules about line speeds, paid break time, union-organizing protections, vacations and, of course, training requirements. The same is true for agriculture workers who are ultimately responsible for making sure that we don’t get salmonella, or for workers in supermarkets who monitor refrigeration protocols.

The basic problem is, neither state nor federal law today recognizes “food work” or “food workers” as legal categories. The Food Safety Modernization Act, which President Obama signed in 2011, gave whistle-blower protections to some food workers, but not to those who work in critical areas like beef and poultry. At the same time, many states have so-called ag-gag laws, which criminalize audio and video recording of agricultural production facilities, making it harder for certain food workers to blow the whistle. In any case, none of these laws recognize food work and food workers as distinct, comprehensive legal categories.

Once federal law recognizes food workers as a distinct legal category, it could then regulate food work and offer distinct protections to food workers. Such a move would not be entirely unprecedented in the law: We already treat nuclear workers, airline pilots and truck drivers differently because of the special nature of their work.

When it comes to food workers, some of the new protections would extend to everyone in the industry: Whistle-blower protections, for example, should be available to all food workers who report on practices related to food safety. Other protections might be more relevant to some food workers than others: Paid break and vacation time along with maximum hours, for example, seem potentially more critical in slaughterhouses than in restaurants, while paid sick leave might be more relevant in restaurants than in slaughterhouses.

Food workers are distinct from other workers in ways that are critical to food safety and public health, and they ought to be protected by the law in new ways. Otherwise, we run the risk that workers — charged with producing our food — will be unable to protect public safety.


Restaurant workers bring risk when sick on the job

In the absence of paid sick days and health insurance, many food service workers show up sick.

restaurant_food_crap_garbage_10Sonia Cohen has worked in the fast food business for the last 10 years. Cohen said even missing one day of work hurts her family budget. And she’s not alone.

According to the Centers for Disease Control, 1 in 5 restaurant workers admits having reported to work while sick with diarrhea and vomiting, which are the two main symptoms of Norovirus.

Health inspectors and restaurant owners both watch for these symptoms.

“Always our inspections are a snapshot in time. We may walk in and someone may have a cold. That’s not a reportable symptom,” said Paula Cox, Health Educator with the Guilford County Department of Public Health.

The North Carolina Food Code spells out specific illnesses and symptoms that restaurant employees cannot bring with them to work. And restaurant owners are responsible for drafting and enforcing employee health policies to make sure employees don’t get patrons sick.

“There is not a customer in the world that wants to sit at a table that is being waited on by a sick person. There is not a customer in the world that wants to have food from a kitchen with sick employees,” said Eric Porter, owner of the Porterhouse Bar and Grill in Greensboro.

These food workers have to work while sick – a risk to all of us

“Stay home if you’re sick.”

That’s the message to food industry workers from the nation’s public health watchdog, the Centers for Disease Control and Prevention.

vomit(7)The problem is staying home isn’t an option for food industry workers — 70% of whom are low wage employees with no paid sick days.

But for most workers, taking off when sick means no pay, and at worse a lost job.

“If I don’t get paid I get behind on rent and I have to go to the food bank,” said Martin Ayala, a clerk in the meat department of a large Los Angeles supermarket that caters to a booming Hispanic market.

For Ayala, working sick is a way of life. The Mexican immigrant, who has been in the United States for 25 years, admits that he’s unintentionally sneezed and coughed on food and has seen his co-workers do the same even while sick.

But with an hourly wage of $11.36 with which he supports a family, he says he can’t afford to miss a day.

“Yesterday and today I had the flu. It’s very simple for me with four kids – I have to work,” said the 47-year-old father, who has worked at the El Super food market for five years.

Multiple outbreaks of a novel norovirus GII.4 linked to an infected post-symptomatic food handler in NZ

Thornley et al write in the current issue of Epidemiology and Infection that multiple norovirus outbreaks following catered events in Auckland, New Zealand, in September 2010 were linked to the same catering company and investigated.

Retrospective cohort studies were undertaken with attendees of two events: 38 (24·1%) of 158 surveyed attendees developed norovirus-compatible illness. Attendees were at increased risk of illness if they had consumed food vomit(7)that had received manual preparation following cooking or that had been prepared within 45 h following end of symptoms in a food handler with prior gastroenteritis. All food handlers were tested for norovirus. A recombinant norovirus GII.e/GII.4 was detected in specimens from event attendees and the convalescent food handler. All catering company staff were tested; no asymptomatic norovirus carriers were detected.

This investigation improved the characterization of norovirus risk from post-symptomatic food handlers by narrowing the potential source of transmission to one individual. Food handlers with gastroenteritis should be excluded from the workplace for 45 h following resolution of symptoms.

After norovirus outbreak, California steakhouse set to reopen

County health types closed Fleming’s Steakhouse in Walnut Creek, California, Wednesday after confirming that the restaurant was the source of a norovirus norovirus-21outbreak that had made several diners ill earlier in the week.

An employee at the restaurant tested positive for norovirus.

Fleming’s Steakhouse will open Friday at 5 p.m. after getting a clean bill from the health department.

In January, a deli in Concord was closed because of norovirus.

Burger King fires Ohio employee in lettuce photo posted online

The employee at an Ohio Burger King who posted a photo of him/herself standing in tubs of lettuce to anonymous Internet playground 4chan with the caption "This is the lettuce you eat at Burger King," has been fired.

Burger King’s Manager of Global Communications, Denise Wilson, sent Fox 8 News the following statement:

“Burger King Corp. has recently been made aware of a photo posted on a social networking site that allegedly shows a Burger King® restaurant employee violating the company’s stringent food handling procedures. Food safety is a top priority at all Burger King® restaurants and the company maintains a zero-tolerance policy against any violations such as the one in question.

“The restaurant where this photo was allegedly taken is independently-owned and operated by a Burger King® franchisee. The franchisee has taken swift action to investigate this matter and terminated the employee involved in this incident.”

Eat fresh: 90 sick with norovirus linked to Indiana Subway

The Blackford County Health Department got Subway to close this week after many people complained of flu-like symptoms that even hospitalized some. More than 90 people were affected, according to Linda Briles, the local environmental health officer.

The Muncie Free Press reports the confirmation of norovirus came after testing of stool samples and interviews with people who dined there. Both the Blackford County Board of Health and the Indiana Board of Health participated in the investigation.

Briles said the contamination was traced to a human, but she could not be more specific until the state offered its report. She re-inspected the restaurant and Subway reopened Friday. That was after a week of investigation.

E. coli O157 outbreak linked to worker at Michigan eatery

The Western Upper Peninsula Health Department in Michigan is, according to the Minning Gazette, investigating a cluster of E. coli O157 cases that originated at a Houghton restaurant.

Dr. Terry Frankovich, WUPHD medical director, told the Mining Gazette the incidence of E. coli O157:H7 occurred at the Ambassador Restaurant on Shelden Avenue during Christmas. Seven people became ill and four were hospitalized with no deaths occurring. The seven people who became ill were not sitting together. Two of the people were from Dickinson County and Wisconsin, with the rest from the Copper Country.

Frankovich said the O157:H7 strain when found in laboratory testing is reportable to the health department.

Frankovich said after getting the information about the E. coli illnesses, health department environmental health staff went to the Ambassador Restaurant to talk to the managers and to determine whether the source was food or an employee.

"What we identified as a source was an ill food handler," Frankovich said.
The restaurant is open for business, and there is no anticipated risk for further exposure, she said.