Report for UK FSA says pre-packaged sandwiches should not be served in hospitals

Stephan Adams of the Daily Mail writes that a new report commissioned by the UK Food Standards Agency concludes pre-packed sandwiches have been responsible for ‘almost all’ hospital outbreaks of listeria since 2003.

listeria4The bug kills around 50 people a year in England, according to official figures, with most deaths thought to be due to food being prepared and stored incorrectly.

Food safety company STS, which advises hospitals and care homes, believes patients may also be dying from eating infected sandwiches at these institutions.

Fiona Sinclair, director of food safety at STS, said: ‘Hospitals and care homes feed the most vulnerable people in society. The last thing these people need is to get something else on top of their illness.’

Pre-packed sandwiches often contain protein-rich fillings such as meat, paté, cheese, prawns and egg, on which listeria can thrive. Days can elapse between preparation and consumption, giving listeria time to multiply, and experts say too few people understand that sandwiches must be kept very cold – below 5C – to stop the bug growing.

The report, written by Ms Sinclair and colleagues, says: ‘Research into previous [listeria] outbreaks in hospitals found that almost all were linked to consumption of pre-packed sandwiches.’

These cases ‘were thought to have been caused by low-level contamination during manufacture in the factory, followed by a breakdown in the control of the cold chain in the hospitals’. During recent inspections, Ms Sinclair found sandwiches were being kept in fridges that were not cold enough, staff were serving packs past their use-by date, and sandwiches were being left on trolleys for lengthy periods before being handed to patients.

The firm’s report, commissioned by the Food Standards Agency, has prompted the FSA to revise its guidance to hospitals and care homes on minimising the risk of listeria.

Measures include cutting maximum fridge temperatures from 8C to 5C.

Welcoming the new rules, STS said: ‘The thought that a loved one should lose their life from eating a sandwich in hospital is ridiculous.’

Ms Sinclair said the research, undertaken with Surrey University, identified nine hospital listeria outbreaks across the UK since 2003. Each case affected between two and seven patients. Ms Sinclair said it was unclear from the data they had seen if anyone died from listeria infection during these outbreaks.

The fact that the bug kills up to 30 per cent of people in ‘vulnerable groups’ – such as pregnant women and the elderly – suggests that some did.

Hugh Pennington, emeritus professor of bacteriology at Aberdeen University, said: ‘If somebody is at death’s door, they could be finished off by a sandwich.

3 weeks in November: 56 hospital outbreaks of norovirus in West Midlands and North East UK hospitals

Outbreak News Today again, citing Public Health England (PHE) as documenting 56 suspected and laboratory confirmed hospital norovirus outbreaks with the West Midlands and North East regions from the week beginning Nov. 3 through the week beginning Nov. 24.

This brings the annual total to 572 hospital norovirus outbreaks through the week of Nov.24.

Bring holiday cheer, not norovirus, into care settings

As North Carolinians (and others) get into the festive season, kids (like mine) are visiting retirement residences and nursing homes to bring holiday cheer.

And they also might be bringing norovirus.Stop-norovirus-warning-sign

Today I brought Sam (below, exactly as shown) to a local care center so he and his preschool classmates could sing carols to residents.

Heightened to noro season and control measures I looked for messages around ill visitors. I didn’t see any but I did see some off-the-shelf hand sanitizer that wouldn’t do much to the non-enveloped virus.

In related news, BBC is reporting that Scottish hospitals are asking visitors who have recently been ill to stay away. Something that I’ll suggest to Sam’s preschool organizers.

NHS Greater Glasgow and Clyde (GGC) said people ignoring the advice could end up passing on symptoms to patients.

FullSizeRenderThe appeal is part of wider attempts to minimise the effects of norovirus in hospitals across the area.

Visitors are also being reminded about the “importance of hand hygiene when entering and leaving” hospitals.

Prof Craig Williams, lead infection control doctor at NHS GGC, said: “We understand that when a relative or friend is in hospital you want to offer them comfort and support by visiting them.

“Unfortunately visiting a loved one if you have experienced sickness and diarrhoea in the last 48 hours can have consequences for the person you are visiting. They would potentially catch whatever infection you have leading to their health being compromised.

“We are asking people not to visit friends or relatives in hospital if they have experienced any sickness or diarrhoea in the last 48 hours.”

Prof Williams added: “Norovirus is particularly prevalent during the winter and it’s not unusual to see this type of virus in the community.

Florida not inspecting food at hospitals, nursing homes

In a few weeks we’ll be leaving for a month of seaside (Gulf-side) writing in Florida.

As food safety dude and axman Roy Costa has pointed out, I sure hope I don’t end up in a Florida hospital, because no one is doing food inspections.

The Department of Health told Associated Press yesterday it’s working with other agencies to figure out who will handle inspections at the state’s 286 hospitals and 671 nursing homes. Meanwhile, the Department of Children & Families is temporarily taking over the inspection of day-care centers, which were also part of the cuts.

The health department had been inspecting facilities four times a year until Gov. Charlie Crist signed a bill (HB 5311) stopping them. Experts say people at these facilities are the most vulnerable for foodborne illnesses.

DCF Secretary George Sheldon said his agency decided to fill the gap at day cares and will temporarily oversee inspections because “it was the right thing to do.”

DCF employees already inspect day-care facilities for safety issues. Sheldon said the Legislature was trying to consolidate inspections to prevent multiple state agencies from visiting the same facilities to inspect different standards.

The health department inspected more than 15,000 day-care centers last year, finding nearly 12,000 violations, including food from unsafe sources, poor hygiene and contaminated equipment.

I don’t really care who inspects as long as there is accountability in the system through — at a minimum — public availability of results and mandatory training for anyone who handles and prepares food.

Drunk on sanitation

At Dorset County Hospital, in the UK, alcohol based hand sanitizing gel is now banned at hospital entrances. The hospital’s Infection Prevention and Control Committee previously placed sanitizing gel at hospital entrances to promote hospital visitor hand hygiene. According to hospital staff, homeless people are now coming into the entrance and drinking the gel, which contains up to 70 percent alcohol.

A spokeswoman from the hospital said, “What we are trying to do is focus people on hand hygiene at the point of care so that they wash or gel their hands on entering wards or at the patient’s bedside.” She further implied the removal of the alcohol gel due to ingestion was only one of many health and safety reasons. The National Patient Safety Agency (NPSA) has advised hospitals to remove alcohol gel from hospital entrances.

Two persons have died from alcohol gel ingestion.

Hand gels alone may not curb infections

Medical workers in a Nebraska hospital nearly doubled their use of alcohol-based gels, but their generally cleaner hands had no bearing on the rate of infections among patients, according to a new study in the January issue of Infection Control and Hospital Epidemiology.

Dr. Mark Rupp, an infectious disease specialist at the University of Nebraska Medical Center pointed to many villains: Rings and fingernails that are too long and hard to clean, poor handling of catheters and treatment areas that aren’t sanitized.

"Hand hygiene is still important, but it’s not a panacea. … There are many factors that influence the development of hospital-acquired infections. It would be naive to think that a single, simple intervention would fix this problem."

The findings of the new study were based on 300 hours of hand hygiene observations of nurses and doctors in two comparable intensive care units over a two-year period.