People say they go to work, even when they shouldn’t

Rae Ellen Bichell of NPR writes that a majority of working adults say they still go to work when they have a cold or the flu. There are some jobs where doing that can have a big effect on health.

sea-sickness1At least half of people who work in very public places, like hospitals and restaurants, report going to work when they have a cold or the flu. Those were among the findings of a poll conducted by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health.

They are some of the last people you’d want to go to work sick, because they tend to have a lot of contact with people. And that helps spread disease.

“It’s one of the biggest food safety problems that there is, and we’ve known about it forever,” says Kirk Smith, who oversees foodborne outbreak investigations with the Minnesota Department of Health. But he says it’s really hard to get people to stop doing it.

When it comes to food handling, there’s one illness that’s particularly concerning: norovirus. “It is by far the most common cause of foodborne illness,” says Smith. According to the Centers for Disease Control and Prevention, the virus is responsible for 35 percent of them.

That’s because there are billions of virus particles per gram in stool and vomit. It only takes about 20 of those to get someone sick. And norovirus can hitchhike from surface to surface. It takes a high concentration of bleach to kill it.

“And so it just takes microcontamination of your hands, if you don’t do a perfect job washing, to be able to contaminate food with enough of the virus to infect lots and lots of people,” says Smith.

The same virus has plagued restaurant customers across the country. Last winter, 140 people — including much of the Boston College basketball team — got sick from eating at a Chipotle in Boston where one person had gone to work sick.

“It’s definitely the norm to go into work sick. That’s what I and most of my co-workers usually do,” says Anthony Peeples. He used to work at an Olive Garden restaurant. Now he’s a bartender at a casino in Michigan City, Ind.

The CDC has found that 1 in 5 food service workers has reported working while sick with vomiting and diarrhea.

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.

Go back to sleep: 29 sick; multistate outbreak of shiga toxin-producing Escherichia coli O26 linked to raw clover sprouts at Jimmy John’s appears over

A total of 29 persons were infected with the outbreak strain of STEC O26 linked to clovers sprouts served on sandwiches served at Jimmy John’s in 11 U.S. states.

The Centers for Disease Control reports in its final update today that among 29 ill persons, illness onset dates ranged from December 25, 2011 to March 3, 2012. Ill persons range in age from 9 years to 57 years old, with a median age of 26 years. Eighty-nine percent of ill persons are female. Among the 29 ill persons, 7 (24%) were hospitalized. None have developed HUS, and no deaths have been reported.

Based on previous outbreaks associated with sprouts, investigation findings have demonstrated that sprout seeds might become contaminated in several ways. They could be grown with contaminated water or improperly composted manure fertilizer. They could be contaminated with feces from domestic or wild animals, or with runoff from animal production facilities, or by improperly cleaned growing or processing equipment. Seeds also might become contaminated during harvesting, distribution, or storage. Many clover seeds are produced for agricultural use, so they might not be processed, handled, and stored as human food would. Conditions suitable for sprouting the seed also permit bacteria that might be present on seeds to grow and multiply rapidly.

In 1999, FDA released guidance to help seed producers and sprout growers enhance the safety of their products. Specific measures recommended in the guidelines include a seed disinfection step and microbiologic tests of water that has been used to grow each lot of sprouts. The microbiologic tests currently recommended under this guidance would not identify the presence of STEC O26.

Don’t let parrotheads or infected workers serve margaritas; 14 sickened with norovirus after cocktails at Vegas restaurant

On October 18, 2011, the Southern Nevada Health District (SNHD), Office of Epidemiology received reports of gastrointestinal illness from two independent groups of patrons of Restaurant A located in Las Vegas. People from both groups ate during dinner hours at the restaurant on October 14, 2011. Of the eight people from the two groups, seven reported symptoms of diarrhea and/or vomiting after they consumed food from Restaurant A.

In response to these illness reports, the SNHD initiated an investigation. symptoms, and identical norovirus (NoV) genetic sequences were detected from ill persons of two independent dining parties. No ill person was hospitalized, and no death occurred.

NoV can spread via direct contact with NoV?containing fecal matter or aerosolized vomitus, or by indirect contact with them via environmental surfaces. The high propensity of NoV for person?to?person spread might explain illnesses among primary?cases and their household contacts. The outbreak appeared to have been confined to Restaurant A and did not spread to the general community.

Ice water and margaritas were significantly more likely to be consumed among primary cases when compared to controls diners, and were consumed by nearly all primary?case diners.

Drinking water or ice contaminated with NoV has resulted in outbreaks in food?service settings. However, the contamination of frequently served food items such as water and ice (also a main ingredient for margarita) in a high?volume restaurant would have resulted in numerous diners becoming ill, and cannot explain the relatively small number of diners who complained of illness after eating at Restaurant A on and after October 14. An alternative explanation may be that infected staff member(s) might have contaminated the food prior to serving them to customers.

The low inoculums (≥18 viral particles) required for transmission of NoV, and prolonged period of fecal shedding of the virus can enable infected food handlers to contaminate food products . Additionally, the majority of interviewed staff at Restaurant A admitted to pouring and serving drinks, and frequently placing garnishes (e.g. lemons, limes, and other fruits) into beverages prior to serving them to customers. Coupled with EH observations that employees handled ready?to?eat food using bare hands, the contamination of beverages with NoV could have occurred via infected worker(s) using bare hands to dispense or garnish beverages. Minimizing bare hand contact with ready?to?eat food is recommended as a mean of interrupting disease transmission. Workers whose job duties include preparing food and beverages must minimize bare hand contact with ready?to?eat food, including items used as garnishes for food and drinks.

Abstract below:
We describe an investigation of an outbreak of norovirus infection at a restaurant in Las Vegas, Nevada that was suspected to be associated with restaurant staff using bare hands to place garnishes into beverages. We conducted a case?control study and surveillance for additional illnesses, performed inspections of the restaurant, and collected stool specimens to test for norovirus. Eight ill restaurant patrons and 23 control subjects were interviewed.
Univariate analysis showed several food items were associated with illness, but only ice water and margarita were consumed by members of all affected dining groups. Four stool specimens were positive for norovirus by real?time reverse transcriptase?polymerase chain reaction, with all four sequenced specimens being identical and closely related to norovirus strain GII.4J Apeldorn NLD07. To prevent such outbreaks, restaurant workers whose job duties include
preparing food and beverages must minimize bare hand contact with ready?to?eat food, including items used as garnishes for food and drinks.


Who serves raw milk to kids in grade 4; at least 16 sick

At least 16 people have been sickened by an outbreak of foodborne illness which started at North Cape Elementary School in Wisconsin.

"We are in the process of doing an investigation," said Cheryl Mazmanian, director and health officer for the Western Racine County Health Department.

The incident apparently began about June 3 when a number of foods were served at a celebration for fourth-graders. Symptoms – diarrhea and similar gastrointestinal problems – were first reported about June 6, she said.

"Raw milk was served. We have not pinpointed it as that."

The 16 people infected includes family members who contracted the germs brought home from the school.

Mazmanian the public health type, actually said, As in similar cases, prevention comes down to washing hands and practicing good hygiene.

How about don’t serve raw milk to little kids?

Forget chicks; water frogs sicken 217 with salmonella since 2009

The U.S. Centres for Disease Control reports that as of April 5, 2011, a total of 217 individuals infected with the outbreak strain of Salmonella Typhimurium have been reported from 41 states since April 1, 2009. These infections are associated with contact with water frogs, specifically, African dwarf frogs.

A single water frog breeder in California has been identified as the source of African dwarf frogs associated with human infections. This breeding facility was first identified as the source of African dwarf frogs associated with human infections in 2010. Past information about this investigation in 2009-2010 can be found on the CDC Salmonella page.

In late March 2011, local health department staff visited the frog breeder and collected environmental samples. These samples were tested in CDC laboratories and were found to be positive for Salmonella bacteria; additional testing is ongoing to determine if this Salmonella strain is the outbreak strain.

The complete writeup is available at:

Eat here and barf: seven Jimmy John’s union workers fired

Jimmy John’s launched a new ad campaign earlier this month stressing speed instead of safety after making 130 or so people barf with salmonella-in-sprouts-on-sandwiches in two separate outbreaks.

Over the past two days, seven core members of the Jimmy John’s Workers Union were fired at five Minneapolis-area locations for distributing hundreds of posters claiming that eating at Jimmy John’s Gourmet Sandwiches puts customers at risk of food-borne illness.

The poster shows identical sandwiches, one labeled as being made by a healthy worker and one by a sick worker. The poster asks if customers can spot a difference between the two. “We hope your immune system is ready because you’re about to take the sandwich test,” it reads.

I would have gone with the sprout and ingredient angle, what with all the sick people, but having sick sandwich artists work is an excellent way to spread norovirus, salmonella and lots of other nasties.

According to The Minnesota Daily, the posters were in response to the union’s unmet demands for paid sick days, which “force” employees to come in sick, putting customers at risk, they said.’’

Union supporter David Boehnke, said, “We were fired for saying we want better working conditions for ourselves. We were standing up for ourselves.”

Boehnke said their activities were legally protected because the employees were organizing for higher wages. However Franchise Owner Mike Mulligan of MikLin Enterprises disagrees.

According to a statement from MikLin, the posters disparaged the company’s reputation and showed “extreme disloyalty and malicious intent to damage” the company.

If you want to preserve the company’s reputation, try not to make customers barf – it’s bad for business.

The workers currently have a four-point system, in which workers are deducted one point for missing work without finding a replacement and half a point for coming to work 10 minutes late.

At four points, the worker is fired.

Salmonella-in-sprouts sick climbs to 125, water sample positive

As soon as Tiny Greens of Illinois was fingered as the source of the suspect sprouts in a salmonella outbreak largely linked to Jimmy John’s sandwiches, an astute public health-type e-mailed me and said, “check out their water supply.”

I’m not sure what water is being used where and for what, but according to the Tiny Greens website, they recycle all water.

“At Tiny Greens, we have one of the only complete systems that we are aware of to clean, improve, and re-use our water. The natural biological processes that are continually present in the undisturbed eco-systems around us are utilized in a controlled environment to clean and re-cycle our water.”

Here’s what looks like the important point:

“Next, the middle layer of clarified wastewater liquid flows out of the septic tank into a sand filter. The sand filter uses outside air, thus further treating the water aerobically (using bacteria requiring oxygen). Sand filters provide a high level of treatment and normally produce effluent that tests 99.9% bacteria and virus-free. … Sand filters are the preferred treatment method at Tiny Greens and their nutrient-rich, disinfected water can be utilized as free fertilizing water for growing plants."

99.9 per cent may sound impressive, but may also mean crap (literally).

On Friday, CDC announced that from Nov. 1, 2010, through Jan. 11, 2011, 125 individuals infected with the outbreak strain of Salmonella serotype I 4,[5],12:i:-, whose illnesses began since November 1, have been reported from 22 states and the District of Columbia. Results of the investigation indicate a link to eating Tiny Greens Alfalfa Sprouts or Spicy Sprouts at Jimmy John’s restaurant outlets.

Testing by the U.S. Food and Drug Administration (FDA) of one environmental (water run-off) sample identified Salmonella serotype I 4,[5],12:i:- that is indistinguishable from the outbreak strain.

Tiny Greens’ owner Bill Bagby criticized testing by the FDA and the Illinois Department of Public Health as not being comprehensive enough.

“The [FDA statement] is misleading. That burns me up! … I learn something from every single inspector that comes here. Looking at all of this in a positive way, this is a chance for us to do something better.”

Will fewer people barf after Obama signs food safety bill? No

Maybe? Who knows? But with all the gushing —"The Food Safety Modernization Act is the most significant food safety law of the past 100 years" – Debora MacKenzie of New Scientist presents me as food safety grump.

It’s accurate.

Margaret Hamburg, head of the FDA, said at a press conference on 3 January that the law will shift the FDA’s approach to food safety "from a reactive to a preventive mode", regardless of funding.

Didn’t that happen years ago?

On 15 December the US Centers for Disease Control and Prevention issued its first estimate since 1999 of the toll of food-borne diseases in the US: 48 million people sick each year, 128,000 hospitalized and 3000 deaths.

This is down from 5,000 deaths in 1999, but it could be even lower if the FDA inspected food producers more often, says Michael Jacobson, head of the Center for Science in the Public Interest, a food-safety pressure group in Washington DC. The FDA, which regulates all foods except meat and eggs in the US, normally inspects producers once every five or 10 years.

The new law gives the FDA more inspectors and mandates more inspections. It also requires producers to have written risk-management plans, requires importers to check the safety of imported products, and excludes foreign producers who refuse FDA inspections. In a food-poisoning emergency it gives the FDA power to inspect producers’ records and to order a recall if a producer refuses to do it voluntarily.

The last measure "is a red herring", says Powell: faced with a public relations disaster, no producer ever refuses to recall suspect food.

The bill gives the FDA the money to do its extra inspections by allowing it to charge for them. The expected bill, $1.4 billion over five years, is far less, the FDA argues, than the cost of poisoning incidents to the food industry.

The most effective way forward, Powell believes, is to make producers list safety procedures and track records on food packaging, and compete for buyers on the basis of safety.

Up to 73 with Druxy’s diarrhea; don’t let sick employees serve food

The Hamilton Spectator (that’s in Ontario, Canada) reports this morning that public health types received 40 calls Friday from people who were sick after eating food from the downtown Druxy’s Famous Deli Sandwiches earlier this week.

All of them ate food from the deli on Tuesday or Wednesday and showed a similar range of symptoms to the 33 people who became sick with gastrointestinal illness or stomach flu at a corporate event catered by Druxy’s Tuesday, said Dr. Chris Mackie, one of the city’s associate medical officers of health.

The symptoms include nausea, vomiting and diarrhea, he said.

Public health temporarily closed the deli at Jackson Square Thursday afternoon after they suspected two ill employees serving at a corporate Christmas party contaminated the food. The department found Druxy’s did not have hot water for workers to wash their hands properly.

The downtown deli has catered three other events since Monday. Some of the new 40 patients had attended one of these functions, Mackie said.

Public health has collected some samples and should know what pathogen is involved likely by Monday, he said.