The owners of a takeaway in Reigate, UK, have been hit with fines and court costs of £3,500 after breaching food health and safety rules.

The Reigate Kebab & Burger House in London Road, which has a food hygiene rating of zero out of five stars, was prosecuted by Reigate and Banstead Borough Council for "a string of serious food and health and safety offences."

The offences included allowing water to leak through a ceiling onto live electronics and storing and handling salad in a way that risked it being contaminated by raw meat.

Councillor Steve Farrer, executive member for safer communities, said, “Prosecution is always seen as a last resort, but unfortunately in this case it was brought due to the council’s previous measures failing to secure any long term improvement in food hygiene and health and safety standards. The council strives to ensure residents can expect the highest standards of food safety when eating out in the borough.”

A study by Kansas State University shows posters can make a difference when it comes to hand hygiene in a health care setting.

The research, based on observations of more than 5,000 patrons at a hospital-based cafeteria, shows that an evidence-based informational poster can increase attempts at hand hygiene. The study appears in the current issue of the American Journal of Infection Control, and was funded by One Health Kansas, a project supported by the Kansas Health Foundation.

The research team included K-State's Katie Filion, a December 2010 master's graduate in biomedical science; Kate KuKanich, assistant professor of clinical sciences; Megan Hardigree, a 2008 master's graduate in kinesiology; and Doug Powell, professor of food safety. Also on the team was Ben Chapman, assistant professor in the department of 4-H youth development and family and consumer sciences at North Carolina State University.

Hand hygiene is important before meals, especially in a hospital cafeteria where patrons may have had recent contact with infectious agents, KuKanich said.

"Few interventions to improve hand hygiene have had measurable success. This study was designed to use a poster intervention to encourage hand hygiene among health care workers and hospital visitors upon entry to a hospital cafeteria," she said.

Over a five-week period, a poster intervention with an accessible hand-sanitizer unit was deployed to improve hand hygiene at the entrance to a hospital cafeteria. An anonymous researcher was able to observe hand hygiene attempts from the adjacent dining area. The study included baseline, intervention and follow-up phases, with each consisting of three randomized days of observation for three hours at lunchtime.

Gains were modest, Powell said. During the 27 hours of observation, 5,551 participants were observed, with hand hygiene attempts increasing from 3.16 per cent to 6.17 per cent.

Hand washing compliance efforts have focused on increasing availability of proper tools for hand hygiene, education and training, and use of prompts such as visual reminders or peer pressure and the presence of others, according to Powell and KuKanich.

"Hand hygiene is still the best way to prevent the spread of infectious diseases. Unfortunately, many of us don't wash our hands as often as we should," KuKanich said.

"Those 'Employees Must Wash Hands' signs in bathrooms may not be the most effective reminder," Powell said. "While improvements in this study were modest, we have set an evaluation framework to work with informational posters that use more graphical messages and reminders that use a shock-and-shame approach."

An abstract of "Observation-based evaluation of hand hygiene practices and the effects of an intervention at a public hospital cafeteria" is available at http://www.ajicjournal.org/article/S0196-6553%2810%2900986-7/abstract
 

On Nov. 13, 2009, a Belgian physician notified authorities about an apparent cluster of Shigella sonnei; ultimately, 52 cases were identified over two months, and most were linked to a canteen in a public institution building. Best guess is that a food handler who travelled to Morocco shortly before detection of the first laboratory-confirmed case, picked up shigella, and then transmitted it through food.

The details can be found in the current issue of Epidemiology and Infection, where researchers report on a matched case-control study to test an association between shigellosis and canteen-food consumption.

The three food handlers working permanently in the canteen responded to the questionnaire. Food handler A travelled to Turkey from 23 September to
4 October 2009. She started working on 7 October. She prepared sandwiches, washed dishes and served food. She fell ill on 20 October, and had been exposed to canteen food during the 4 days prior to disease onset. Food handler B travelled to Morocco from 23 September to 1 October. This person started working on 4 October and was involved in vegetable washing, preparation of hot meals, sandwiches, cold dishes involving vegetables and cleaning the canteen. He did not declare having fallen sick. Food handler C was also involved in all activities except in hot meal preparation. He had not travelled, been absent or fallen sick.

Of the 52 shigella cases found in 708 employees of a public institution in Flemish Brabant province, Belgium, between September and November 2009, seven cases were confirmed as S. sonnei. There was a common PFGE profile which resembled those from archived specimens from Morocco. Cases of
shigellosis were associated with canteen-food consumption.

Investigators worked with three hypotheses: (i) waterborne transmission through a contaminated water dispenser, (ii) person-to-person transmission or via surfaces (toilets), or (iii) foodborne transmission (through previously contaminated food or during the preparation process by a contaminated food handler).

Foodborne transmission through canteen food is supported by the results of the employee survey and by the matched case-control study. This led us to think that a food handler might have been the source of the outbreak. Food handler B returned from Morocco shortly before the appearance of the first confirmed cases. He did not report any symptoms and worked continuously since his return.

Foodborne transmission might have happened had he been an asymptomatic case. Healthy carriers can shed 102 Shigella c.f.u./g of feces during 1 month.
Thus, food handler B could have unintentionally acted as an intermittent source of food contamination during the period of faecal shedding. Conversely, food handler A, who had travelled to Turkey, could not be the source of the outbreak, since her onset of disease happened after the onset of symptoms of some confirmed cases.

The researchers recommend:
• washing hands with soap and water before eating and after defecation for employees and food handlers;
• preventing sick food handlers from working until full recovery or until negative fecal culture in the case of laboratory confirmation;
• maintaining surveillance of further possible cases of shigellosis through the institution’s prevention service; and,
• collecting information on the workplace when interviewing notifiable cases in order to detect infectious disease clusters early.

Shigellosis outbreak linked to canteen-food consumption in a public institution: a matched case-control study
01.feb.11
Epidemiology and Infection
I. Gutiérrez Garitano, M. Naranjo, A. Forier, R. Hendriks, K. De Schrijver, S. Bertrand, K. Dierick, E. Robesyn, and S. Quoilin
http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8024291
Abstract
On 13 November 2009, the authorities of Flemish Brabant, Belgium, received an alert concerning a potential outbreak of Shigella sonnei at a public institution. A study was conducted to assess the extent, discover the source and to implement further measures. We performed a matched case-control study to test an association between shigellosis and canteen-food consumption. Water samples and food handlers' faecal samples were tested. The reference laboratory characterized the retrospectively collected Shigella specimens. We found 52 cases distributed over space (25/35 departments) and time (2 months). We found a matched odds ratio of 3·84 (95% confidence interval 1·02–14·44) for canteen-food consumption. A food handler had travelled to Morocco shortly before detection of the first laboratory-confirmed case. Water samples and food handlers' faecal samples tested negative for Shigella. Confirmed cases presented PFGE profiles, highly similar to archived isolates from Morocco. Foodborne transmission associated with the canteen was strongly suspected.
 

A luxury cruise liner which has been plagued by outbreaks of norovirus has been forced to cut short its latest voyage after hundreds of passengers were struck down by the bug.

Fred Olsen Cruise Lines admitted three passengers were currently in isolation on the Boudicca, but those travelling on the vessel claim as many as 650 of the 900 people onboard have been affected by the norovirus.

It is the sixth time in just sixth months that the ship has suffered problems with the bug, which causes sickness and diarrhea.

Boudicca was on the final leg of a 23-night cruise to the eastern Mediterranean, but has cancelled stops in Malta and Lisbon to dock two days early in Liverpool next week.