Food Poisoning, Foodborne Illness Information and Research : International Food Safety Network : BarfBlog

Amy brought up the question of how to handle barfing in class, when one of her students vomited during an exam. She said the student cleaned most of it, but she participated in the cleaning too.

At Kansas State University, students and faculty are advised to notify the custodial department immediately and to avoid coming into contact with vomit, according to John Woods, director of Facilities Services.

“Custodians are supposed to be trained to go in and handle vomit,” Woods said. “We will be limiting the number of staff authorized to handle vomit.”

Woods explained that custodians are required to wear gloves, goggles, and a mask. They are supposed to spray the area, wait a few minutes, and scoop the vomit in a plastic bag with paper towels. They turn in the plastic bag to public safety.
 

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I used to steal toilet paper.

As an undergraduate 25 years ago, and once my girlfriend showed me how to get at the theft-proof rolls in the university centre, the supplies of toilet paper in our household became one less student expense.

My hockey bag is still filled with those little soaps and shampoos from hotel rooms around the globe.

I was the kind of student -- and apparently I'm not alone -- University of Guelph administrators in Canada were worried about when they said that residence students should provide their own handwashing soap.

In 2005, the university switched to sanitizers instead of soap and paper towels in the residence washrooms because soap dispensers, paper towels and garbage cans went missing.

That was before a 2006 norovirus outbreak sickened over 150 students, primarily in one university residence.

The university subsequently returned soap and paper towels to all residences to help control the outbreak.

Students at Georgetown University are now being implored to wash their hands after a norovoirus outbreak linked to the school’s dining hall caused 175 students to vomit their way to the hospital. Said one university official, “Handwashing is going to be our mantra for a very long time around here.”

That’s great. A little late, but better than before. The U.S. Centers for Disease Control and Prevention estimates that up to 25 per cent of the 76 million annual cases of foodborne illness in the U.S. could be eliminated with proper handwashing.

That's a lot fewer sick people.

But, as Jon Stewart quipped in 2002, “If you think the 10 commandments being posted in a school is going to change behavior of children, then you think ‘Employees Must Wash Hands’ is keeping the piss out of your happy meals. It's not.”

So why don't more people wash their hands?

While some practice a Howard Hughes-like paranoia, study after study shows that many are lazy when it comes to handwashing. The proclamations to practice proper handwashing, on restroom posters, in daycare facilities, in media scare stories, will always fail to register with those who are impervious to risk -- that bad things happen to someone else, not me.

But as the Guelph example demonstrates, anything that can even slightly encourage proper handwashing and hygiene in general needs to be encouraged -- and that means ready availability of soap, water and paper towels.

Once available, the facilities have to actually be used, whether in the workplace, the home, the university residence, or, the farm.

The steps in proper handwashing, as concluded from the preponderance of available evidence, are:

• wet hands with water;
• use enough soap to build a good lather;
• scrub hands vigorously, creating friction and reaching all areas of the fingers and hands for at least 10 seconds to loosen pathogens on the fingers and hands;
• rinse hands with thorough amounts of water while continuing to rub hands; and,
• dry hands with paper towel.

Water temperature is not a critical factor -- water hot enough to kill dangerous bacteria and viruses would scald hands -- so use whatever is comfortable.

The friction from rubbing hands with paper towels helps remove additional bacteria and viruses.
The next time you visit a bathroom that is missing soap, water or paper towels, let someone in charge know. And next time you see someone skip out on the suds in the bathroom, look at them and say, “Dude, wash your hands!”

Don’t eat poop.
 

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Molly Redden of the Georgetown Voice in Washington, D.C. does an excellent job going beyond the soundbites of talking health-heads to capture the impact of foodborne illness, in the case on a bunch of university students who dined at Leo O’Donovan Cafeteria or Leo’s.

At least 96 students were treated by the Georgetown University Hospital or the Student Health Center for gastroenteritis from Tuesday night and Wednesday. …

Neil McGroarty (NHS `12), arrived at the emergency room at around 10:30 p.m., only hours after eating a roast beef sandwich from Grab N’ Go. He said within hours of arriving at the Hospital, the emergency room was backed up to the point that students who weren’t receiving medical attention began vomiting in the waiting room.

“I know that some people in the waiting room had been there for three hours. There was a boy yelling ‘help me, help me!’ but there were no doctors,” Kathrin Verestoun (SFS `11), who accompanied her roommate to the emergency room, said. “They ran out of rooms and set up stretchers in the hall. Some people were so dehydrated that they couldn’t find their veins for IVs. They were just bleeding. [My roommate] bled all over her stretcher.” …

A Food Establishment Inspection Report obtained by the Voice through a Freedom of Information Act request reveals that in June, the D.C. Bureau of Community Hygiene determined that Leo’s’ handwashing facilities were not up to code, although this was “corrected on-site.” According to the report, sinks used for handwashing in the service area lacked handsoap. …

The actual number of students who have fallen ill may be far higher than reported. Interviews have revealed that many students who fell ill did not get medical help, like Katie O’Niell (COL `11), who began to vomit about three hours after eating a burrito at Leo’s.

“I didn’t feel like I could make it any further than from my bed to the bathroom,” she said.

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As I was beginning the listening section of an introductory French exam today, several students suddenly jumped up. Desks were screeching and I thought there must have been a cockroach or mouse in the room (both things have happened to me in the past at other universities). But no. A student in the front row was only vomiting on the floor and some of his neighbors happened to get hit. The students were all very cool and helpful – getting water and paper towels for the sick classmate. I sent the sick one home but he cleaned up most of his mess. I notified administration, sprayed the floor with some chemical spray, wiped up, and directed the students to another classroom. I went and washed my hands and facilities came within the next 15 minutes to mop the floors.

But what’s the protocol for handling other people’s puke? When I told Doug what happened he reminded me that if the student was sick with a virus like Noro, the germs could be aerosolized and make the rest of us ill. This particular student believed it was a problem with medicine, but to be safe … Washoe County Nevada Health Department suggests:

•    Staff should wear disposable gloves and aprons when cleaning up after ill guests, especially when handling vomit, diarrhea, or other bodily wastes. It is recommended that persons who clean areas substantially contaminated by feces and/or vomitus wear masks because spattering or aerosols of infectious material might result in disease transmission. Use of cleaning cloths and other items used to clean toilets should only be used for that purpose and should not be used from room to room. Do not use these items to clean other surfaces. Effective virucides should be used in bathrooms and high hand-contact areas in guest rooms such as taps, faucets, door and drawer handles, door latches, toilet or bath rails, telephones, rails on balconies, light and lamp switches, thermostats, remote controls, curtain pulls and wands, covers on guest information books, alarm clock buttons, hair dryers, irons, and pens.
•    Staff should promptly bag and clean soiled linens or dispose of them as infectious waste. Linens soiled with vomit or feces should be washed in a hot wash and dried at high temperature (drier temperature >170º F).
•    When responding to a Public Vomiting Incident (PVI), the area within at least a 25-foot radius should be cleaned and disinfected using the above procedures.
•    Staff should wash hands thoroughly using soap and water and then dry them thoroughly after completing the clean-up procedure and again after completing the disposal procedure.

A teacher named “Koko” blogged that when this happened in her classroom in China, she used dirt to cover the vomit, made sure it was dry, then swept, threw out the waste, and mopped afterwards. She made her students participate in the cleaning.

 

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• Trips to the bathroom for vomiting = 2
• Trips to the bathroom for diarrhea = 6
• Stomach cramps = lots

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