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Recovery, Survival and Transfer of Bacteria on Restaurant Menus
Abstract
The objectives of this study were to detect bacteria on restaurant menus, to determine the bacterial transfer from menus to consumers' hands and to determine the survival of bacteria on menu surfaces. Local restaurant menus were sampled at different periods of operation. The average total plate count ( TPC ) was 28 (0–210) cfu /15 cm ² menu sampling area during “busy” periods and 15 (0–85) cfu /15 cm ² menu sampling area during “less busy” periods. The staphylococcal count averaged 6 (0–83) cfu /15 cm ² during busy periods and 2 (0–25) cfu /15 cm ² menu sampling area during less busy periods. E scherichia coli was transferred to menus at 11.17% of the hand population with a high variability between subjects (10.45% standard deviation). Survival of bacteria in menus was 1.40% after 24 h and 1.34% after 48 h, respectively. Bacterial populations found on randomly sampled menus were low; however, bacteria survived and were transferred from menus to a consumer's hands.
Practical Applications
While many food‐contact surfaces are routinely cleaned and sanitized to minimize the presence of contamination, some surfaces such as restaurant menus are not and thus may be a potential contamination risk. The current study revealed that in the relatively small sample size of menus examined, there were some that were contaminated. Furthermore, there was measurable transfer of bacteria present on menus to consumer's hands and bacteria survived on menus at least 2 days. Therefore, to reduce the chance of illness from menus that are touched by many different people, especially food service workers, menus may be considered to be included as part of a standard sanitation operating procedure.
... For up to 24 h following their contact 401 Bacterial crosscontamination with the menu, microorganisms can be transmitted onto the fingers (Sirsat et al., 2013); therefore, the risk of contamination should not be overlooked, and standard operating procedures must be established to control this hazard (Choi et al., 2014). The central question, considered by the limited number of studies conducted over recent years, was whether the cleaning of menus in a restaurant should be included in the daily cleaning protocol (Alsallaiy et al., 2016;Gámez et al., 2016;Sirsat et al., 2013). ...
... The number of published studies evaluating menu hygiene is extremely limited (Alsallaiy et al., 2016;Gámez et al., 2016;Sirsat et al., 2013). To the best of our present knowledge, this study is the first to evaluate the hygienic status of menus in Turkey restaurant. ...
... RLU in display menus left on the tables and menus presented after the customers' arrival, respectively ( p W0.05) (Figure 1). A similar study evaluated microbiological impurity on menus and reported a mean 210 cfu 15 cm −2 total bacteria content in samples obtained during a high traffic period (Alsallaiy et al., 2016). The lower bacteria content found in their study is considered to result from the difference in sampling surface area compared to that used in the present study. ...
... In Brazil, implementation of Good Handling Practices in foodservices has become compulsory since September 2004, when a 180-day deadline was established for companies to comply with the new law (Brazil, 2004). Although more than 10 years has passed since promulgation of the law and the existence of an agency responsible for its supervision, studies show that foodservices in Brazil (Cortese, Veiros, Feldman, & Cavalli, 2016;Da Cunha, Stedefeldt, & Rosso, 2014;Rodrigues & Salay, 2012) and other countries (Alsallaiy et al., 2016;Jianu & Golet, 2014;Knight, Worosz, & Todd, 2007;Lee et al., 2014;Sarter & Sarter, 2012;Sani & Siow, 2014) have difficulty in complying with Good Handling Practices. This reinforces the importance of care for food handling at these establishments. ...
... These difficulties were identified during sanitary inspections carried out by authorities to evaluate compliance with conditions established by current laws and to guide foodservices about needed improvements (Laikko-Rotto, Makela, Lund en, Heikkila, & Nevas, 2015). Through observation of important factors related to sanitary risk, measures should be prioritized so that the safety of prepared food is not compromised, thus protecting public health (Alsallaiy et al., 2016;Gonçalves et al., 2013;Lee et al., 2014;Powell et al., 2013). ...
... Even with a preestablished work routine for inspection of foodservices for protection, prevention, and promotion of health, some authors believe that sanitary inspection teams have failure in their strategies, which may expose the population to risks of FBD outbreaks, economic losses to the owners of the foodservices (Alsallaiy et al., 2016;Laikko-Rotto et al., 2015;Lee et al., 2014;Powell et al., 2013). ...
The purpose of this study was to evaluate the profile of foodservices' in Curitiba, in southern Brazil and the results of health inspections performed at these establishments, with the goal of contributing to improvements in sanitary inspection processes and to the sanitary conditions in foodservices. The study was based on data from sanitary inspections conducted at foodservice establishments from January 2005 to July 2015 found in the Municipal Sanitary Inspection and Environmental Information System. Most of the establishments inspected were restaurants and similar establishments: snack bars, cafes; as well as grocery store, supermarkets and hypermarkets, and most irregularities were found in these sectors. Health inspections in the city are carried out in emergency criteria, and most performed at the request of foodservices that are quest a license or because of a customer complaint. Inspections led to more educational than punitive measures. Even 10 years after passage of a national law governing food handling procedures, when 70% of the foodservices presented improper sanitary conditions. The main irregularities found were related to work procedures and processes, sanitary conditions, and physical structure. These result reinforces the importance that legislators and inspection teams reevaluate their goals, strategies and work processes to prioritize food safety.
Practical applications
This study is important because it offers a diagnosis and a discussion of foodservices and evaluates actions of Sanitary Inspection Agency, to assist in the development of tools and strategies to strengthen the work of sanitary inspectors so that they can be recognized as agents of transformation in public health.
... For up to 24 h following their contact 401 Bacterial crosscontamination with the menu, microorganisms can be transmitted onto the fingers (Sirsat et al., 2013); therefore, the risk of contamination should not be overlooked, and standard operating procedures must be established to control this hazard (Choi et al., 2014). The central question, considered by the limited number of studies conducted over recent years, was whether the cleaning of menus in a restaurant should be included in the daily cleaning protocol (Alsallaiy et al., 2016;Gámez et al., 2016;Sirsat et al., 2013). ...
... The number of published studies evaluating menu hygiene is extremely limited (Alsallaiy et al., 2016;Gámez et al., 2016;Sirsat et al., 2013). To the best of our present knowledge, this study is the first to evaluate the hygienic status of menus in Turkey restaurant. ...
... RLU in display menus left on the tables and menus presented after the customers' arrival, respectively ( p W0.05) (Figure 1). A similar study evaluated microbiological impurity on menus and reported a mean 210 cfu 15 cm −2 total bacteria content in samples obtained during a high traffic period (Alsallaiy et al., 2016). The lower bacteria content found in their study is considered to result from the difference in sampling surface area compared to that used in the present study. ...
Purpose
The purpose of this paper is to evaluate the hygiene of laminated menus.
Design/methodology/approach
The cleanliness of 41 laminated menus from first-class restaurant in Ankara, Turkey, was monitored according to the level of bioluminescence measured using a rapid hygiene monitor (Lumitester PD-20 and LuciPac Pen). Aerobic colonies, Escherichia coli, Enterobacteriaceae spp., and Staphylococcus aureus were enumerated.
Findings
Based on the adenosine triphosphate+adenosine monophosphate hygiene monitoring levels, analyses showed impurity in 82.9 percent of the samples. The aerobic colony count on the restaurant menus showed a mean 1.52 log cfu/cm². The study results demonstrated a high-level impurity on the menus in first-class restaurants in Ankara.
Originality/value
This study is the first in Turkey to assess the microbiological load of menus. This paper adds relevant insights into the assessment of menu hygiene and highlights the high contamination of the restaurant menus. Useful information about including the restaurant menus in the daily cleaning protocol is provided.
... The hygiene of certain items in the servicescape (Kotler, 1973) is as important as the general cleanliness of service settings. For instance, in pre-COVID studies (Sirsat et al., 2013;Alsallaiy et al., 2016), the role of conventional restaurant menus (paper and laminated) was identified in terms of the transferability of pathogens from hands to hands, fingertips to fingertips, and other surfaces. Additionally, Bruegel and Lecocq (2020) revealed the first historical unpublished systematic restaurant hygiene research conducted in 1908 in Paris by the French government. ...
The recent COVID-19 pandemic experience intensified the significance of hygiene in the service industry. It is crucial to measure how service practice adaptations and technology adoptions in servicescapes have been perceived by customers regarding hygiene in the post-COVID era. However, the extant hygiene scales do not serve the purpose to measure hygiene contributions of technology-specific and service practice-specific changes. Thus, the purpose of this research is to develop a multi-item unidimensional perceived hygiene construct. Sequential mixed-methods research (Qual-Quan) was employed. Participants were sampled among restaurant patrons. A four-item perceived hygiene development (pHd) construct was successfully developed. Hospitality and service researchers and practitioners can utilize this scale to measure perceived hygiene improvements of particular technology adoptions and service practice adaptations in service settings.
Citation:
Iskender, A., Sirakaya-Turk, E., & Cardenas, D. (2023). Multi-item Unidimensional Measurement Scale Construct: Perceived Hygiene Development (pHd). Family and Consumer Sciences Research Journal, ahead-of-print. 10.1111/fcsr.12476
... The ambient conditions in the sanitation environment are ideal for microorganism survival and proliferation, thereby increasing faecal-oral exposure (Kagan et al., 2002;Kay et al., 2006). Survival of microorganisms on surfaces such as plastics and metals has been reported extensively (Alsallaiy et al., 2016;Barker & Bloomfield, 2000;Curtis et al., 2003;Neely & Maley, 2000). ...
Shared sanitation facilities have been hailed as an innovative approach to solve the challenge with sanitation access. However, these facilities may act as hotspots for disease transmission due to unhygienic conditions. In this study we used quantitative (based on Escherichia coli contamination) techniques to assess the health risks associated with the use of community ablution blocks (CABs). The most contaminated surfaces were the cistern handle (5.7 Log10 cfu/cm²) and internal pull latch (5.8 Log10 cfu/cm²). Based on the E. coli contamination, at least two people out of 100 CAB users might be potentially infected when they touch “hot” surfaces. These risks were modelled assuming transfer of potentially pathogenic E. coli from these surfaces to the mouth. The incorporation of risk-reduction measures, such as wiping of these surfaces or washing of hands, could potentially result in significant reduction of infection risks. The most significant risk-reduction intervention was determined to be wiping of the contact surfaces, especially twice prior to contact. A combination of risk-reduction interventions could further reduce the risks. This study shows that contamination of contact surfaces within shared CABs could lead to increased risks of infections, requiring measures aimed at reducing the associated risks. The risk assessment framework used in this study could therefore be applied in similar settings to estimate associated health risks with the use of such facilities.
... Previous studies have highlighted the importance of correct hygienic practices and routinely cleaning protocols to prevent menus contamination (Alsallaiy, Dawson, Han, & Martinez-Dawson, 2016;Gámez, Lombar, Carcedo, Lopez, & Álava, 2016, Bilici, Mortas, Köse, Varli, & Ayhan, 2017Choi et al., 2014;Sirsat et al., 2013). However, emenus haven not been considered from this perspective and the risk of microbial contamination of touch screen devices has been mainly evaluated in the healthcare environment (Howell et al., 2014;Muzslay, Yui, Ali, & Wilson., 2018). ...
The use of electronic menus has become frequent, with numerous advantages for customers and the restaurateur. As a result, mobile technological devices including tablet computers are increasingly used to replace the classic paper menu. This trend raises questions about control measures to avoid the transmission of pathogens through this new technology as it has been shown that tablet computers can frequently harbor pathogenic bacteria. We propose that the risks associated with contamination of electronic menus in restaurants and the efficacy of cleaning protocols should be evaluated.
... Considering tourism expansion, there has been an increase in the number of meals served, which, allied to the lack of control during meal's preparation, can be compromising to the food's hygienic and sanitary conditions and increase the risk of foodborne disease (Alsallaiy, Dawson, Han, & Martinez-Dawson, 2016;Oliveira et al., 2014). Foodborne disease is a syndrome usually consisting of anorexia, nausea, vomiting, and/or diarrhea, with or without fever, related to the ingestion of contaminated food or water, which can be safety a major challenge for the foodservice, including the food and beverage areas of hotels (Kuo, 2009). ...
The study evaluated to implement good handling practices in the food and beverage areas of hotels under guidance of an outsourced professional and to evaluate the investments needed for their implementation and maintenance. A checklist for good handling practices was applied and a plan of action was developed to correct the nonconformities found. After 22 months, the checklist was applied again and a survey was conducted of the initial financial investments, and the investments for maintenance of the program and of the number of guests served during the implementation. After the financial investments and the accompaniment by an outsourced professional were made, the hotels had significant improvements (p = .0051) in the hygienic‐sanitary conditions. In relation to costs, the requirement that had the highest initial investment was for buildings, installations, equipment, furniture, and utensils ( 34,002.57). There was significant improvement between the first and second evaluations, which demonstrates the importance of skilled outsourced professionals to assist in the changes and investments made in the implementation of good handling practices.
Practical applications
This study is important because it evaluates to implement good handling practices in the food and beverage areas of hotels under guidance of an outsourced professional and the investments needed for their implementation and maintenance, to assist in the development of tools and strategies to improve hygienic‐sanitary conditions and to make the owners and other professionals involved in the segment aware of the importance of investing in order to reduce the risk of foodborne disease.
Contact surfaces within shared sanitation facilities could lead to disease transmission due to contamination. In this study, we applied metagenomics, by targeting the 16S rRNA gene region using illumina sequencing to determine the common bacterial communities on key contact surfaces in shared sanitation facilities within a metropolitan municipality area. The common bacterial phyla identified on these surfaces were Actinobacteria, Firmicutes, Proteobacteria, and Bacteriodetes, with average counts up to 12 Log10 and a prevalence of 100% for each of these phyla. Known diarrhoeal pathogens like, Salmonella enterica, Bacillus cereus, Campylobacter jejuni, Campylobacter coli, Yersinia pestis, Yersinia pseudotuberculosis, Vibrio cholerae, Vibrio parahaemolyticus and Vibrio vulnificus were detected on almost all surfaces. Cistern handles, tap handles and toilet seats had the highest number of potentially pathogenic bacteria, such as S. enterica. Additionally, uncommon and very rarely pathogenic bacteria such as Cedeceae neteri, Enterobacter hormaechei, Klebsiella michiganensis, Pluralibacter gergoviae, Kosakonia cowanii and Raoutella ornithinolyitca were also detected. Many of these can be considered as environmental commensals. These results show that contact surfaces within shared sanitation facilities could have been contaminated with faecal matter as well as soil. In conclusion, being the first study to apply metagenomics in profiling bacterial communities on contact surfaces in shared sanitation facilities in South Africa, this study shows the potential of disease transmission via the use of these shared facilities. Additionally, the results also show the application of 16S rRNA-based metagenomics in determining the potential role of shared sanitation in disease transmission.
The transfer of gram-positive bacteria, particularly multiresistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), among patients is a growing concern. One critical aspect of bacterial transfer is the ability of the microorganism to survive on various common hospital surfaces, The purpose of this study was to determine the survival of 22 gram-positive bacteria (vancomycin-sensitive and -resistant enterococci and methicillin-sensitive and -resistant staphylococci) on five common hospital materials: smooth 100% cotton (clothing), 100% cotton terry (towels), 60% cotton-40% polyester blend (scrub suits and lab coats), 100% polyester (privacy drapes), and 100% polypropylene plastic (splash aprons), Swatches were inoculated with 10(4) to 10(5) CFU of a microorganism, assayed daily be placing the swatches in nutritive media, and examining for growth after 48 h, All isolates survived for at least 1 day, and some survived for more than 90 days on the various materials. Smaller inocula (10(2)) survived for shorter times but still generally for days, Antibiotic sensitivity had no consistent effect on survival, The long survival of these bacteria, including MRSA and VRE, on commonly used hospital fabrics, such as scrub suits, lab coats, and hospital privacy drapes, underscores the need for meticulous contact control procedures and careful disinfection to limit the spread of these bacteria.
Food-borne diseases are of major concern worldwide. To date, around 250 different food-borne diseases have been described, and bacteria are the causative agents of two thirds of food-borne disease outbreaks. Among the predominant bacteria involved in these diseases, Staphylococcus aureus is a leading cause of gastroenteritis resulting from the consumption of contaminated food. Staphylococcal food poisoning is due to the absorption of staphylococcal enterotoxins preformed in the food. Here, we briefly review the latest data on staphy-lococcal enterotoxins and some papers exemplifying the interactions between S. aureus and the food matrix; environmental factors affecting staphylococcal enterotoxin production are discussed.
Members of the Staphylococcus genus, especially Staphylococcus aureus, are the most common pathogens found in hospitals and in community-acquired infections. Some of their pathogenicity is associated with enzyme and toxin production. Until recently, S. aureus was the most studied species in the genus; however, in last few years, the rise of infections caused by coagulase-negative staphylococci has pointed out the need for further studies on virulence factors that have not yet been completely elucidated so as to better characterize the pathogenic potential of this group of microorganisms. Several staphylococcal species produce enterotoxins, a family of related proteins responsible for many diseases, such as the toxic-shock syndrome, septicemia and food poisoning. To this date, 23 different enterotoxin types have been identified besides toxic-shock syndrome toxin-1 (TSST-1), and they can be divided into five phylogenetic groups. The mechanism of action of these toxins includes superantigen activity and emetic properties, which can lead to biological effects of infection. Various methods can detect genes that encode enterotoxins and their production. Molecular methods are the most frequently used at present. This review article has the objective to describe aspects related to the classification, structure and regulation of enterotoxins and toxic-shock syndrome toxin-1 detection methods.
Observations of food handlers’ practices have many uses. Describes the use of a notational analysis technique to monitor and analyse specific food safety actions of caterers. A total of 115 food handlers from 29 catering businesses were observed carrying out 31,050 food preparation and hygiene actions in their workplace. Notational analysis was found to offer little advantage, compared to traditional observation methods. However, this technique did allow tracking of sequential events and was successful in identifying and recording a greater number of cross-contamination events than would have been highlighted using traditional approaches. The results demonstrated that, based on hygiene guidelines, food handlers were required to implement de-contamination actions on a large number of occasions. These de-contamination actions were frequently inadequately conducted. To improve standards of food hygiene in catering there is a need to minimise the requirements for de-contamination activities thereby reducing the potential for cross-contamination.
Purpose
The goals of this study were to study consumer perceptions of food safety at restaurants and to compare these results to those of other food system actors.
Design/methodology/approach
The data for this study were gathered from telephone interviews conducted with 1,014 randomly selected US adults.
Findings
The main findings were that a substantial number of consumers think about food safety in general and particularly when eating at restaurant establishments; and while a majority of consumers stated that restaurants were doing a good job, were capable, and were committed to food safety, in comparison to other actors, restaurants ranked significantly lower than farmers, food processors and manufacturers, and grocery stores and supermarkets.
Research limitations/implications
A limitation of this study was that distinctions were not made between fast food and sit‐down restaurants or other types of restaurants, e.g. chains, independent, and ethnic. These results highlight the need for more comprehensive studies on how food safety issues affect consumer perceptions of restaurants and how these perceptions affect consumer behavior.
Practical implications
The findings reinforce the importance of food safety behaviors at restaurants, particularly in the areas of personal hygiene and workplace sanitation, food handling, and food preparation.
Originality/value
This paper helps restaurant managers to better understand consumer perceptions of food safety and highlights the importance of instituting and monitoring food safety practices.
The survival of two hygienically relevant bacteria, Escherichia coli pIE639 and Enterococcus faecium , was followed on wooden sawdust of seven different European woods (pine, spruce, larch, beech, maple, poplar, and oak) versus polyethylene chips by using cultivation-dependent and molecular-based methods in parallel. The survival of the bacteria on wood was dependent on various factors such as the wood species, the type of the inoculated bacterium, the ambient temperature, and humidity. The bacterial titre decreased fastest on pine followed by oak compared to the other woods and plastic. Cultivation-independent analysis employing DNA extraction, Southern blot hybridisation, and PCR-based detection of marker genes of the test bacteria confirmed this result. The decline in bacterial numbers correlated with the decrease of bacterial DNA in the samples. Amounts of DNA of E. coli and E. faecium recovered from pine and oak-wood sawdust were generally lower compared to the other woods and plastic.
The presented study shows that pine and oak exhibit substantially better hygienic performance than plastic and indicates an antibacterial effect caused by a combination of the hygroscopic properties of wood and the effect of wood extractives.
This paper explores the ways in which consumers assess the safety of food in restaurants and other eating-out establishments, and the resulting impact on restaurant choice. The analysis builds on the existing literature on restaurant choice more generally and a growing body of studies on the impact of official inspection information on the perceived safety of restaurants. Based on a two-stage consumer study in the City of Hamilton in Ontario, Canada, involving focus groups and a postal survey, the research highlights how consumers base their assessment of food safety in restaurants using a range of visible indicators of the experience and/or credence characteristics associated with foodborne illness. These include their observed judgments of restaurant hygiene, the overall quality of the restaurant, external information, including official inspection certificates, and the level of patronage. The use of these broad groups of indicators varies across consumer subgroups according to gender, age, level of education and recollections of past incidences when a restaurant was closed and/or convicted for food safety reasons.
Contamination of food and individuals by food workers has been identified as an important contributing factor during foodborne illness investigations. Physical and chemical barriers to prevent microbial contamination of food are hurdles that block or reduce the transfer of pathogens to the food surface from the hands of a food worker, from other foods, or from the environment. In food service operations, direct contact of food by hands should be prevented by the use of barriers, especially when gloves are not worn. Although these barriers have been used for decades in food processing and food service operations, their effectiveness is sometimes questioned or their use may be ignored. Physical barriers include properly engineered building walls and doors to minimize the flow of outside particles and pests to food storage and food preparation areas; food shields to prevent aerosol contamination of displayed food by customers and workers; work clothing designated strictly for work (clothing worn outdoors can carry undesirable microorganisms, including pathogens from infected family members, into the work environment); and utensils such as spoons, tongs, and deli papers to prevent direct contact between hands and the food being prepared or served. Money and ready-to-eat foods should be handled as two separate operations, preferably by two workers. Chemical barriers include sanitizing solutions used to remove microorganisms (including pathogens) from objects or materials used during food production and preparation and to launder uniforms, work clothes, and soiled linens. However, laundering as normally practiced may not effectively eliminate viral pathogens.
Transmission of viruses, bacteria, and parasites to food by way of improperly washed hands is a major contributing factor in the spread of foodborne illnesses. Field observers have assessed compliance with hand washing regulations, yet few studies have included consideration of frequency and methods used by sectors of the food service industry or have included benchmarks for hand washing. Five 3-h observation periods of employee (n = 80) hand washing behaviors during menu production, service, and cleaning were conducted in 16 food service operations for a total of 240 h of direct observation. Four operations from each of four sectors of the retail food service industry participated in the study: assisted living for the elderly, childcare, restaurants, and schools. A validated observation form, based on 2005 Food Code guidelines, was used by two trained researchers. Researchers noted when hands should have been washed, when hands were washed, and how hands were washed. Overall compliance with Food Code recommendations for frequency during production, service, and cleaning phases ranged from 5% in restaurants to 33% in assisted living facilities. Procedural compliance rates also were low. Proposed benchmarks for the number of times hand washing should occur by each employee for each sector of food service during each phase of operation are seven times per hour for assisted living, nine times per hour for childcare, 29 times per hour for restaurants, and 11 times per hour for schools. These benchmarks are high, especially for restaurant employees. Implementation would mean lost productivity and potential for dermatitis; thus, active managerial control over work assignments is needed. These benchmarks can be used for training and to guide employee hand washing behaviors.
An assessment of lectin-binding analysis for the characterization of extracellular glycoconjugates as part of the extracellular polymeric substances in environmental microbial communities was performed using fully hydrated river biofilms. The applicability of the method was evaluated for single, dual and triple staining with a panel of fluor-conjugated lectins. It was shown that lectin-binding analysis was able to stain glycoconjugates within biofilm communities. Lectin staining also demonstrated spatial heterogeneity within the biofilm matrix. Furthermore, the application of two or even three lectins was possible if suitable combinations were selected. The lectin-binding analysis can be combined with general nucleic acid stains to collect both nucleic acid and glycoconjugate signals. The effects of incubation time, lectin concentration, fluor labelling, carbohydrate inhibition, order of addition and lectin interactions were studied. An incubation time of 20 min was found to be sufficient for completion of lectin binding. It was not possible to ascertain saturating concentration for individual lectins, therefore a standard concentration was used for the assay. Carbohydrate inhibition tests indicated that fluorescein isothiocyanate (FITC)-conjugated lectins had more specific binding characteristics than tetramethyl rhodamine isothiocyanate (TRITC)- or cyanine dye (CY5)-labelled lectins. The order of addition and the nature of the fluor conjugate were also found to influence the binding pattern of the lectins. Therefore the selection of a panel of lectins for investigating the EPS matrix must be based on a full evaluation of their behaviour in the biofilm system to be studied. Despite this necessity, lectin-binding analysis represents a valuable tool to examine the glycoconjugate distribution in fully hydrated biofilms. Thereby, chemical heterogeneities within extracellular biofilm locations can be identified in order to examine the role (e.g. sorption properties, microenvironments, cell-extracellular polymeric substance interactions) of the extracellular polymeric substances in environmental biofilm systems.
This study sought to determine the usefulness of restaurant inspections in predicting food-borne outbreaks in Miami-Dade County, Fla.
Inspection reports of restaurants with outbreaks in 1995 (cases; n = 51) were compared with those of randomly selected restaurants that had no reported outbreaks (controls; n = 76).
Cases and controls did not differ by overall inspection outcome or mean number of critical violations. Only 1 critical violation--evidence of vermin--was associated with outbreaks (odds ratio = 3.3; 95% confidence interval = 1.1, 13.1).
Results of restaurant inspections in Miami-Dade County did not predict outbreaks. If these findings are representative of the situation in other jurisdictions, inspection practices may need to be updated.
Infections with methicillin-resistant Staphylococcus aureus (MRSA) are increasingly community acquired. We investigated an outbreak in which a food handler, food specimen, and three ill patrons were culture positive for the same toxin-producing strain of MRSA. This is the first report of an outbreak of gastrointestinal illness caused by community-acquired MRSA.
Escherichia coli O157:H7 cells survived for up to 77, >226, and 231 days in manure-amended autoclaved soil held at 5, 15, and 21°C, respectively.
Pathogen populations declined more rapidly in manure-amended unautoclaved soil under the same conditions, likely due to antagonistic
interactions with indigenous soil microorganisms. E. coli O157:H7 cells were inactivated more rapidly in both autoclaved and unautoclaved soils amended with manure at a ratio of 1
part manure to 10 parts soil at 15 and 21°C than in soil samples containing dilute amounts of manure. The manure-to-soil ratio,
soil temperature, and indigenous microorganisms of the soil appear to be contributory factors to the pathogen's survival in
manure-amended soil.
Prokaryotic biofilms that predominate in a diverse range of ecosystems are often composed of highly structured multispecies communities. Within these communities metabolic activities are integrated, and developmental sequences, not unlike those of multicellular organisms, can be detected. These structural adaptations and interrelationships are made possible by the expression of sets of genes that result in phenotypes that differ profoundly from those of planktonically grown cells of the same species. Molecular and microscopic evidence suggest the existence of a succession of de facto biofilm phenotypes. We submit that complex cell-cell interactions within prokaryotic communities are an ancient characteristic, the development of which was facilitated by the localization of cells at surfaces. In addition to spatial localization, surfaces may have provided the protective niche in which attached cells could create a localized homeostatic environment. In a holistic sense both biofilm and planktonic phenotypes may be viewed as integrated components of prokaryote life.
Biofouling is referred to as the unwanted deposition and growth of biofilms. This phenomenon can occur in an extremely wide range of situations, from the colonisation of medical devices to the production of ultra-pure, drinking and process water and the fouling of ship hulls, pipelines and reservoirs. Although biofouling occurs in such different areas, it has a common cause, which is the biofilm. Biofilms are the most successful form of life on Earth and tolerate high amounts of biocides. For a sustainable anti-fouling strategy, an integrated approach is suggested which includes the analysis of the fouling situation, a selection of suitable components from the anti-fouling menu and an effective and representative monitoring of biofilm development.
Epidemiological data from Europe, North America, Australia, and New Zealand indicate that a substantial proportion of foodborne disease is attributable to improper food preparation practices in consumers' homes. International concern about consumer food safety has prompted considerable research to evaluate domestic food-handling practices. The majority of consumer food safety studies in the last decade have been conducted in the United Kingdom and Northern Ireland (48%) and in the United States (42%). Surveys (questionnaires and interviews), the most frequent means of data collection, were used in 75% of the reviewed studies. Focus groups and observational studies have also been used. One consumer food safety study examined the relationship between pathogenic microbial contamination from raw chicken and observed food-handling behaviors, and the results of this study indicated extensive Campylobacter cross-contamination during food preparation sessions. Limited information about consumers' attitudes and intentions with regard to safe food-handling behaviors has been obtained, although a substantial amount of information about consumer knowledge and self-reported practices is available. Observation studies suggest that substantial numbers of consumers frequently implement unsafe food-handling practices. Knowledge, attitudes, intentions, and self-reported practices did not correspond to observed behaviors, suggesting that observational studies provide a more realistic indication of the food hygiene actions actually used in domestic food preparation. An improvement in consumer food-handling behavior is likely to reduce the risk and incidence of foodborne disease. The need for the development and implementation of food safety education strategies to improve specific food safety behaviors is reviewed in this paper.
To assess the socio-economic impact of infectious intestinal disease (IID) on the health care sector, cases and their families, cases of IID ascertained from a population cohort component and those presenting to general practices were sent a socio-economic questionnaire 3 weeks after the acute episode. The impact of the illness was measured and the resources used were identified and costed. The duration, severity and costs of illness linked to viruses were less than those linked to bacteria. The average cost per case of IID presenting to the GP was Pound Sterling253 and the costs of those not seeing a GP were Pound Sterling34. The average cost per case was Pound Sterling606 for a case with salmonella, Pound Sterling315 for campylobacter, Pound Sterling164 for rotavirus and Pound Sterling176 for SRSV. The estimated cost of IID in England was Pound Sterling743m expressed in 1994/5 prices. The costs of IID are considerable and the duration of the illness was found to be longer than previous reports have suggested.
Food-borne diseases are of major concern worldwide. To date, around 250 different food-borne diseases have been described, and bacteria are the causative agents of two thirds of food-borne disease outbreaks. Among the predominant bacteria involved in these diseases, Staphylococcus aureus is a leading cause of gastroenteritis resulting from the consumption of contaminated food. Staphylococcal food poisoning is due to the absorption of staphylococcal enterotoxins preformed in the food. Here, we briefly review the latest data on staphylococcal enterotoxins and some papers exemplifying the interactions between S. aureus and the food matrix; environmental factors affecting staphylococcal enterotoxin production are discussed.
Inadequate hand washing by food workers is an important contributing factor to foodborne disease outbreaks in retail food establishments (RFEs). We conducted a survey of RFEs to investigate the effect of hand washing training, availability of hand washing facilities, and the ability of the person in charge (PIC) to describe hand washing according to the Minnesota Food Code (food code) on workers' ability to demonstrate food code-compliant hand washing. Only 52% of the PICs could describe the hand washing procedure outlined in the food code, and only 48% of workers could demonstrate code-compliant hand washing. The most common problems observed were failure to wash for 20 s and failure to use a fingernail brush. There was a strong positive association between the PIC being a certified food manager and being able to describe the food code hand washing procedure (odds ratio [OR], 5.5; 95% confidence interval [CI], 2.2 to 13.7), and there was an even stronger association between the PIC being able to describe hand washing and workers being able to demonstrate code-compliant hand washing (OR, 15; 95% CI, 6 to 37). Significant associations were detected among correct hand washing demonstration, physical infrastructure for hand washing, and the hand washing training methods used by the establishment. However, the principal determinant of successful hand washing demonstration was the PIC's ability to describe proper hand washing procedure. These results suggest that improving hand washing practices among food workers will require interventions that address PIC knowledge of hand washing requirement and procedure and the development and implementation of effective hand washing training methods.
Although health departments routinely inspect restaurants to assess compliance with established hygienic standards, few data are available on the effectiveness of these efforts in preventing foodborne disease. The study reported here assessed the impact on foodborne-disease hospitalizations in Los Angeles County of a restaurant hygiene grading system that utilized publicly posted grade cards. The grading systm was introduced in January 1998. Hospital discharge data on foodborne-disease hospitalizations were analyzed for Los Angeles County and, as a control, for the rest of California during the period 1993-2000. Ordinary least-squares regression analysis was done to measure the effect of the grading progam on these hospitalizations. After baseline temporal and geographic trends were adjusted for, the restaurant hygiene grading program was associated with a 13.1 percent decrease (p < .01) in the number of foodborne-disease hospitalizations in Los Angeles County in the year following implementation the program (1998). This decrease was sustained over the next two years (1999-2000). The results suggest that restaurant hygiene grading with public posting of results is an effective intervention for reducing the burden of foodborne disease.
This study was conducted by the Environmental Health Specialists Network (EHS-Net), a network of environmental health specialists and epidemiologists at federal and state health agencies, whose mission is to improve environmental health practice. One of EHS-Net's primary goals is to improve the understanding of the underlying causes of foodborne illness using a system-based approach. As part of this ongoing effort, EHS-Net analyzed data from a telephone survey of food service workers designed to increase our understanding of food preparation practices (a cause of foodborne illness) in restaurants. Results indicated that risky food preparation practices were commonly reported. Respondents said that at work they did not always wear gloves while touching ready-to-eat (RTE) food (60%), did not always wash their hands or change their gloves between handling raw meat and RTE food (23% and 33%), did not use a thermometer to check food temperatures (53%), and had worked while sick with vomiting or diarrhea (5%). Several factors were associated with safer food preparation practices. Workers responsible for food preparation reported washing their hands and wearing gloves when handling RTE food more often than workers not responsible for food preparation. Workers who cooked reported changing their gloves more often than workers who did not cook. Older workers and managers reported washing their hands more often than younger workers and non-managers. Workers in chain restaurants more frequently reported using thermometers than workers in independently owned restaurants. This study provides valuable information concerning the prevalence of food preparation practices and factors that may impact those practices. Additional research is needed to better understand those factors.
In November 2003, a large hepatitis A outbreak was identified among patrons of a single Pennsylvania restaurant. We investigated the cause of the outbreak and factors that contributed to its unprecedented size.
Demographic and clinical outcome data were collected from patients with laboratory confirmation of hepatitis A, and restaurant workers were tested for hepatitis A. A case-control study was conducted among patrons who dined at the restaurant between October 3 and October 6, 2003. Sequence analysis was performed on a 315-nucleotide region of viral RNA extracted from serum specimens.
Of 601 patients identified, 3 died; at least 124 were hospitalized. Of 425 patients who recalled a single dining date at the restaurant, 356 (84 percent) had dined there between October 3 and October 6. Among 240 patients in the case-control study, 218 had eaten mild salsa (91 percent), as compared with 45 of 130 controls (35 percent) (odds ratio, 19.6; 95 percent confidence interval, 11.0 to 34.9) for whom data were available. A total of 98 percent of patients and 58 percent of controls reported having eaten a menu item containing green onions (odds ratio, 33.3; 95 percent confidence interval, 12.8 to 86.2). All restaurant workers were tested, but none were identified who could have been the source of the outbreak. Sequences of hepatitis A virus from all 170 patients who were tested were identical. Mild salsa, which contained green onions grown in Mexico, was prepared in large batches at the restaurant and provided to all patrons.
Green onions that were apparently contaminated before arrival at the restaurant caused this unusually large foodborne outbreak of hepatitis A. The inclusion of contaminated green onions in large batches that were served to all customers contributed to the size of the outbreak.
Escherichia coli O157:H7 carried on plant surfaces, including alfalfa sprouts, has been implicated in food poisoning and outbreaks of disease
in the United States. Adhesion to cell surfaces is a key component for bacterial establishment and colonization on many types
of surfaces. Several E. coli O157:H7 surface proteins are thought to be important for adhesion and/or biofilm formation. Therefore, we examined whether
mutations in several genes encoding potential adhesins and regulators of adherence have an effect on bacterial binding to
plants and also examined the role of these genes during adhesion to Caco-2 cells and during biofilm formation on plastic in
vitro. The genes tested included those encoding adhesins (cah, aidA1, and ompA) and mediators of hyperadherence (tdcA, yidE, waaI, and cadA) and those associated with fimbria formation (csgA, csgD, and lpfD2). The introduction of some of these genes (cah, aidA1, and csg loci) into an E. coli K-12 strain markedly increased its ability to bind to alfalfa sprouts and seed coats. The addition of more than one of these
genes did not show an additive effect. In contrast, deletion of one or more of these genes in a strain of E. coli O157:H7 did not affect its ability to bind to alfalfa. Only the absence of the ompA gene had a significant effect on binding, and the plant-bacterium interaction was markedly reduced in a tdcA ompA double mutant. In contrast, the E. coli O157:H7 ompA and tdcA ompA mutant strains were only slightly affected in adhesion to Caco-2 cells and during biofilm formation. These findings suggest
that some adhesins alone are sufficient to promote binding to alfalfa and that they may exist in E. coli O157:H7 as redundant systems, allowing it to compensate for the loss of one or more of these systems. Binding to the three
types of surfaces appeared to be mediated by overlapping but distinct sets of genes. The only gene which appeared to be irreplaceable
for binding to plant surfaces was ompA.
Restaurants are important settings for foodborne disease transmission. The Environmental Health Specialists Network (EHS-Net) was established to identify underlying factors contributing to disease outbreaks and to translate those findings into improved prevention efforts. From June 2002 through June 2003, EHS-Net conducted systematic environmental evaluations in 22 restaurants in which outbreaks had occurred and 347 restaurants in which outbreaks had not occurred. Norovirus was the most common foodborne disease agent identified, accounting for 42% of all confirmed foodborne outbreaks during the study period. Handling of food by an infected person or carrier (65%) and bare-hand contact with food (35%) were the most commonly identified contributing factors. Outbreak and nonoutbreak restaurants were similar with respect to many characteristics. The major difference was in the presence of a certified kitchen manager (CKM); 32% of outbreak restaurants had a CKM, but 71% of nonoutbreak restaurants had a CKM (odds ratio of 0.2; 95% confidence interval of 0.1 to 0.5). CKMs were associated with the absence of bare-hand contact with foods as a contributing factor, fewer norovirus outbreaks, and the absence of outbreaks associated with Clostridium perfringens. However, neither the presence of a CKM nor the presence of policies regarding employee health significantly affected the identification of an infected person or carrier as a contributing factor. These findings suggest a lack of effective monitoring of employee illness or a lack of commitment to enforcing policies regarding ill food workers. Food safety certification of kitchen managers appears to be an important outbreak prevention measure, and managing food worker illnesses should be emphasized during food safety training programs.
The importance of clean food contact surfaces has been recognized; however, the importance of cleanliness on nonfood contact surfaces such as menus may be underestimated. The aim of the study described in this article was to determine the cleanliness of restaurant menus, evaluate typical cleaning methods used in a restaurant, and provide recommendations for improving menu cleanliness. The authors' study used an adenosine triphosphate meter to assess the cleanliness of the menus. A pretest identified the most commonly touched areas of the menu by consumers. Based on the results of the pretest, menus were collected from casual-family dining restaurants and analyzed for cleanliness. Results suggested that menus should be cleaned after each shift and that menus distributed by the staff when guests are seated are cleaner than those kept on the table.
Advances in computer and telecommunication technologies have made mobile
computing a reality. In a mobile computing environment, users can access
information through wireless connections regardless of their physical
location. In the last decade, this new kind of computing paradigm has
gained great development and posed new challenges to databases. Mobile
data management has attracted considerable attention. Moving objects
databases that include the management of location information, has
become an enabling technology for many location-based services
applications. In this chapter, we introduce some background of moving
objects management, including mobile computing and positioning
technology, and then describe some applications in location-based
services and mobile data management. Finally, we present the main
content of moving objects databases technologies.
To assess the socio-economic impact of infectious intestinal disease (IID) on the health care sector, cases and their families, cases of IID ascertained from a population cohort component and those presenting to general practices were sent a socio-economic questionnaire 3 weeks after the acute episode. The impact of the illness was measured and the resources used were identified and costed. The duration, severity and costs of illness linked to viruses were less than those linked to bacteria. The average cost per case of IID presenting to the GP was £253 and the costs of those not seeing a GP were £34. The average cost per case was £606 for a case with salmonella, £315 for campylobacter, £164 for rotavirus and £176 for SRSV. The estimated cost of IID in England was £743m expressed in 1994/5 prices. The costs of IID are considerable and the duration of the illness was found to be longer than previous reports have suggested.
Food safety compliance amongst ethnic minority food retail businesses has been identified as being less than satisfactory. In order to identify barriers to compliance, a research project was undertaken which identified 40 food retail businesses which had a record of nonconformance to acceptable food safety standards. These businesses were risk assessed by environmental health officers (EHOs) and given an appropriate category commensurate with their performance. Over a six month period the businesses were offered advice and cultural and communication issues were addressed. Seminars and one to one support were offered to the businesses. After a six month period a further risk assessment was undertaken. The results showed 26 (65%) of businesses had improved their risk assessment, 6 (15%) had remained the same, 4 (10%) exhibited some deterioration in standards and 4 (10%) had deteriorated a full category. In conclusion, the research recognizes that language difficulties and lack of knowledge and understanding of the principles of food safety are a major barrier to promoting food safety however when support is offered it can make a significant difference to working practices.
This study examines the effect of an increase in product quality information to consumers on firms' choices of product quality. In 1998 Los Angeles County introduced hygiene quality grade cards to be displayed in restaurant windows. We show that the grade cards cause (i) restaurant health inspection scores to increase, (ii) consumer demand to become sensitive to changes in restaurants' hygiene quality, and (iii) the number of foodborne illness hospitalizations to decrease. We also provide evidence that this improvement in health outcomes is not fully explained by consumers substituting from poor hygiene restaurants to good hygiene restaurants. These results imply that the grade cards cause restaurants to make hygiene quality improvements. © 2001 the President and Fellows of Harvard College and the Massachusetts Institute of Technology
Since 1973, CDC has maintained a collaborative surveillance program for collection and periodic reporting of data on the occurrence and causes of foodborne-disease outbreaks (FBDOs) in the United States.
This summary reviews data from January 1993 through December 1997.
The Foodborne-Disease Outbreak Surveillance System reviews data concerning FBDOs, defined as the occurrence of two or more cases of a similar illness resulting from the ingestion of a common food. State and local public health departments have primary responsibility for identifying and investigating FBDOs. State, local, and territorial health departments use a standard form to report these outbreaks to CDC.
During 1993-1997, a total of 2,751 outbreaks of foodborne disease were reported (489 in 1993, 653 in 1994, 628 in 1995, 477 in 1996, and 504 in 1997). These outbreaks caused a reported 86,058 persons to become ill. Among outbreaks for which the etiology was determined, bacterial pathogens caused the largest percentage of outbreaks (75%) and the largest percentage of cases (86%). Salmonella serotype Enteritidis accounted for the largest number of outbreaks, cases, and deaths; most of these outbreaks were attributed to eating eggs. Chemical agents caused 17% of outbreaks and 1% of cases; viruses, 6% of outbreaks and 8% of cases; and parasites, 2% of outbreaks and 5% of cases.
The annual number of FBDOs reported to CDC did not change substantially during this period or from previous years. During this reporting period, S. Enteritidis continued to be a major cause of illness and death. In addition, multistate outbreaks caused by contaminated produce and outbreaks caused by Escherichia coli O157:H7 remained prominent.
Current methods to detect FBDOs are improving, and several changes to improve the ease and timeliness of reporting FBDO data are occurring (e.g., a revised form to simplify FBDO reporting by state health departments and electronic reporting methods). State and local health departments continue to investigate and report FBDOs as part of efforts to better understand and define the epidemiology of foodborne disease in the United States. At the regional and national levels, surveillance data provide an indication of the etiologic agents, vehicles of transmission, and contributing factors associated with FBDOs and help direct public health actions to reduce illness and death caused by FBDOs.
A four-part study assessing cleanliness in up to 113 environmental surfaces in an operating theatre and a hospital ward is reported. Surfaces were assessed visually, using microbiological methods and ATP bioluminescence. Results from a preliminary random survey indicated variability in cleanliness. These results were then used to select sites for monitoring before and after routine cleaning, over a 14-day period. Using published microbiological and ATP specifications 70 and 76% of these sites were unacceptable after cleaning. Visual assessment was a poor indicator of cleaning efficacy with only 18% considered unacceptable. Sites most likely to fail in the ward were in the toilet and kitchen, areas which are frequently implicated in the spread of infectious intestinal disease. Operating theatre sites had lower ATP results but 61% of sites would be considered unacceptable. There was no significant difference in general microbiological or ATP results overall before and after routine cleaning. Although some important hand contact sites showed no significant difference, overall there was a significant decrease in staphylococcal and enterobacteria counts in the ward but not in the operating theatre after cleaning. The routine cleaning programmes used did not include a biocide and cleaning using a hypochlorite based sanitizer gave much lower values. The results are discussed in relation to infection control, cleaning audits and cleaning schedules: an integrated cleaning monitoring programme using ATP bioluminescence in conjunction with visual and microbiological assessments is recommended.
A biofilm is a community of microorganisms attached to a surface. Based on studies of single-species communities, biofilm formation follows a progression from initial attachment to a mature form composed of pillar-like multicellular structures interspersed with fluid-filled channels. The developmental progression leading to a mature biofilm requires changes in gene expression. With recent technological advances for visualizing biofilm growth, gene expression can be directly monitored during biofilm development. Hence, analyses of surface-induced and biofilm-induced changes in gene expression have begun in earnest. Recent studies have identified regulatory pathways that are important for biofilm formation and have focused on genetic responses to environmental stimuli in mature biofilms. These findings are providing new insights into biofilm development and physiology.
The majority of local health departments perform routine restaurant inspections. In Los Angeles County (LAC), California, approximately $10 million/year is spent on restaurant inspections. However, data are limited as to whether or not certain characteristics of restaurants make them more likely to be associated with foodborne incident reports. We used data from the LAC Environmental Health Management Information System (EHMIS), which records the results of all routine restaurant inspections as well as data regarding all consumer-generated foodborne incidents that led to a special restaurant inspection by a sanitarian (investigated foodborne incidents [IFBIs]). We analyzed a cohort of 10,267 restaurants inspected from 1 July 1997 to 15 November 1997. We defined a "case restaurant" as any restaurant with a routine inspection from 1 July 1997 to 15 November 1997 and a subsequent IFBI from 1 July 1997 to 30 June 1998. Noncase restaurants did not have an IFBI from I July 1997 to 30 June 1998. We looked for specific characteristics of restaurants that might be associated with the restaurant subsequently having an IFBI, including the size of restaurant (assessed by number of seats), any previous IFBIs, the overall inspection score, and a set of 38 violation codes. We identified 158 case restaurants and 10,109 noncase restaurants. In univariate analysis, middle-sized restaurants (61 to 150 seats; n = 1,681) were 2.8 times (95% confidence interval [CI] = 2.0 to 4.0) and large restaurants (>150 seats; n = 621) were 4.6 times (95% CI = 3.0 to 7.0) more likely than small restaurants (< or =60 seats; n = 7,965) to become case restaurants. In addition, the likelihood of a restaurant becoming a case restaurant increased as the number of IFBIs in the prior year increased (chi2 for linear trend, P value = 0.0005). Other factors significantly associated with the occurrence of an IFBI included a lower overall inspection score, the incorrect storage of food, the reuse of food, the lack of employee hand washing, the lack of thermometers, and the presence of any food protection violation. In multivariate analysis, the size of restaurant, the incorrect storage of food, the reuse of food, and the presence of any food protection violation remained significant predictors for becoming a case restaurant. Our data suggest that routine restaurant inspections should concentrate on those establishments that have a large seating capacity or a poor inspection history. Evaluation of inspection data bases in individual local health departments and translation of those findings into inspection guidelines could lead to an increased efficiency and perhaps cost-effectiveness of local inspection programs.
This current focus covers a broad range of emerging microbiological issues in food safety, from chronic effects of campylobacterosis and bacterial antimicrobial resistance to microbial survival and growth on fresh fruits and vegetables, and advanced technologies for detection and inactivation of foodborne pathogens.
Outbreaks of human Norwalk virus (NV) and Norwalk-like viruses often originate in food service establishments. No reliable method is available for the detection of these human caliciviruses on food contact surfaces. We describe a simple method for the detection of NV from stainless steel work surfaces using cultivable feline calicivirus (FCV) as a model. Stainless steel surfaces were artificially contaminated with known amounts of FCV, followed by its elution in a buffer solution. Three methods of virus elution were compared. In the first method, moistened cotton swabs or pieces of nylon filter (1MDS) were used to elute the contaminating virus. The second method consisted of flooding the contaminated surface with eluting buffer, allowing it to stay in contact for 15 min, followed by aspiration of the buffer (aspiration method) after a contact period of 15 min. The third method, the scraping-aspiration method, was similar to the aspiration method, except that the surfaces were scraped with a cell scraper before buffer aspiration. Maximum virus recovery (32 to 71%) was obtained with the scraping-aspiration method using 0.05 M glycine buffer at pH 6.5. Two methods (organic flocculation and filter adsorption elution) were compared to reduce the volume of the eluate recovered from larger surfaces. The organic flocculation method gave an average overall recovery of 55% compared to the filter-adsorption-elution method, which yielded an average recovery of only 8%. The newly developed method was validated for the detection of NV by artificial contamination of 929-cm2 stainless steel sheets with NV-positive stool samples and for the detection of the recovered virus by reverse transcription-polymerase chain reaction.
Enteric illness is a common problem worldwide. In Ontario (population of 11.4 million, 2001 Census of Canada), laboratory-confirmed cases of "reportable" enteric diseases are reported to local health units. Public health staff members investigate these illnesses and subsequently report details to the Ministry of Health and Long-Term Care through an electronic reporting system. From 1997 to 2001, 44,451 sporadic cases of illness attributable to eight enteric pathogens (Campylobacter, Salmonella, verotoxin-producing Escherichia coli, Yersinia, Shigella, hepatitis A, Listeria, and Clostridium botulinum) were reported. This number was less than the 56,690 cases reported from 1992 to 1996. Campylobacter accounted for the highest annual average incidence rate at 42.3 cases per 100,000 persons, with Salmonella following at 22.6, verotoxin-producing E. coli at 3.7, Yersinia at 3.0, Shigella at 2.7, hepatitis A at 2.3, and Listeria at 0.3. The 4 months from June to September accounted for almost half (46.5%) of all cases. For 74.0% of the outbreaks associated with these eight enteric pathogens, foodborne contamination was identified as the mode of transmission. Poultry and other meat items accounted for 68.4% of the food items when food was identified as the vehicle. Admittedly, the "foods" and "modes of transmission" identified may have been subject to investigator bias based on previous knowledge. The most common risk setting, which was reported in approximately half of the cases, was private homes; travel-associated illness and restaurants were the second and third most frequently reported risk settings at 24.6 and 14.1%, respectively. Findings from this study suggest that public health efforts should be directed toward safe food handling in the home during the summer months.
A rapid, instrument-free, hygiene monitoring system, based on protein detection, was assessed as a means to evaluate the cleanliness of food contact surfaces within four different food processing environments. Its performance was compared to that of both ATP bioluminescence and a traditional agar-based microbiological method. Each surface was sampled using all three hygiene monitoring systems both before and after each of the production plants had carried out their normal cleaning procedures. In both cases, there was a significant difference (p < 0.05) between the number of surfaces that were passed or failed using each of the tests. In general the number of surfaces that were deemed acceptable for food production increased after cleaning but the level of agreement between test methods differed depending on the type of production facility sampled. Protein detection was most likely to fail surfaces within the baking facility, whereas ATP bioluminescence and traditional microbiology were most likely to fail surfaces within a frozen ready-meal and a cheese production unit respectively. The implications of these results are discussed in relation to plant trials of hygiene monitoring systems, the cleaning process itself, failures in disinfection, as well as the need for a combined methodological approach for monitoring cleanliness.
From 1999-2003, the hygiene of 1061 environmental surfaces from shopping, daycare, and office environments, personal items, and miscellaneous activities (i.e., gymnasiums, airports, movie theaters, restaurants, etc.), in four US cities, was monitored. Samples were analyzed for fecal and total coliform bacteria, protein, and biochemical markers. Biochemical markers, i.e., hemoglobin (blood marker), amylase (mucus, saliva, sweat, and urine marker), and urea (urine and sweat marker) were detected on 3% (26/801); 15% (120/801), and 6% (48/801) of the surfaces, respectively. Protein (general hygiene marker) levels > or = 200 microg/10 cm2 were present on 26% (200/801) of the surfaces tested. Surfaces from children's playground equipment and daycare centers were the most frequently contaminated (biochemical markers on 36%; 15/42 and 46%; 25/54, respectively). Surfaces from the shopping, miscellaneous activities, and office environments were positive for biochemical markers with a frequency of 21% (69/333), 21% (66/308), and 11% (12/105), respectively). Sixty samples were analyzed for biochemical markers and bacteria. Total and fecal coliforms were detected on 20% (12/60) and 7% (4/ 60) of the surfaces, respectively. Half and one-third of the sites positive for biochemical markers were also positive for total and fecal coliforms, respectively. Artificial contamination of public surfaces with an invisible fluorescent tracer showed that contamination from outside surfaces was transferred to 86% (30/ 35) of exposed individual's hands and 82% (29/35) tracked the tracer to their home or personal belongings hours later. Results provide information on the relative hygiene of commonly encountered public surfaces and aid in the identification of priority environments where contaminant occurrence and risk of exposure may be greatest. Children's playground equipment is identified as a priority surface for additional research on the occurrence of and potential exposure to infectious disease causing agents.
Adenosine triphosphate (ATP) bioluminescence and traditional microbiological swabbing culture methods were used for detection of surface hygiene on worktops, cutting boards and equipments at a hospital kitchen. A total of 280 surface samples were collected from the kitchen. The agreement between the two methods (coefficient of Kappa) was statistically significant (corrected chi(2)=30.886; kappa=0.249; p<0.001). Consequently, the ATP monitoring method provides results rapidly with improved benefits in the control of surface contamination and application of corrective action against poor hygiene. However, it is not a substitute for culturing methods, the combination of both methods was emphasized for surface hygiene monitoring. Besides, the results indicate that, for food safety and public health, the hygienic status of the surfaces in the kitchen should be improved and food handlers should be trained well on hygiene.
Foodborne disease is a common, but preventable, burden of illness worldwide. Almost one-half of every dollar spent on food
in the United States is spent on food from restaurants. A growing body of data from foodborne disease outbreaks and studies
of sporadic (non-outbreak-associated) gastrointestinal disease of various etiologies suggest that eating food prepared in
restaurants is an important source of infection. These data suggest a critical need for action that is focused on preventing
disease transmission within the food service industry. Clinicians should report all suspected foodborne disease to public
health authorities to ensure appropriate epidemiologic investigation.
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