Category Archives: Handwashing

Food safety lessons of the COVID-19 pandemic

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While it is, perhaps, premature to look at the COVID-19 pandemic through the rearview mirror only, there is, according to Max Teplitski of The Packer, enough data to extract some useful lessons. 

There has been an 80-95% drop-off in the cases of norovirus infections in the U.S. (and a similar trend in England and Wales) during the COVID-19 pandemic, and another study focusing on a decline in foodborne bacterial infections. 

Similarly, studies in Israel and Spain report a 30-80% decline in reported cases of salmonella, shigella and campylobacter infections. Even though the healthcare system was stressed, authors point out that under-reporting of cases could be ruled out.  

While it is beyond doubt that SARS-CoV2 is not a foodborne pathogen, what can we learn from the measures that were put in place to control COVID-19 that also had a positive impact on food safety?

Even though we cannot eliminate the possibility that lockdowns minimized interpersonal interactions and that limited the spread of some foodborne illnesses, other factors were also likely at play. 

From the first days of the pandemic we were all reminded of the importance of hygiene: washing hands, using alcohol-based sanitizers and doing so often. While hand hygiene is something that is commonplace in the produce and, more broadly, food industry, it was the first time that consumers went to great lengths to sanitize hands before coming into public places and after leaving them.  

The authors of the Israeli study, in fact, make a direct link between an increase in handwashing and a reduction in shigella infections. I firmly believe that continuing handwashing and hand sanitizing habits learned over the past 18 months is the single most effective intervention that the food industry and consumers can implement to reduce the burden of foodborne illness. 

Disinfecting shopping carts was a new practice implemented during the pandemic. While it was put in place to sanitize high-touch surfaces (such as cart handlebars), I have no doubt that this was the second most effective practice in reducing transmission of foodborne pathogens. 

Hand washing only spiked temporarily during pandemic, hospital finds

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European Cleaning reports that a US hospital study has revealed that while healthcare hand hygiene compliance soared early on in the pandemic, it fell back to pre-pandemic levels after just four months.

Woman washing her hands at the kitchen sink. There are vegetables out of focus in the background.

The University of Chicago Medical Centre used an automated hand hygiene monitoring system to track how often staff washed their hands or used sanitiser when entering and exiting a patient’s room between September 2019 and August 2020. Compliance trends were then analysed by researchers at the hospital.

In September 2019, baseline monthly hand hygiene compliance levelled out at 54.5 per cent across all units, peaking at 75.5 per cent. On March 29, 2020 – when anxiety about the pandemic was running high – hand hygiene compliance hit a daily peak of 92.8 per cent across all hospital units. And it hit 100 per cent across those units that were temporarily given over for the exclusive use of COVID-19 patients.

However just four months later in August 2020, monthly compliance levels had dropped back to 56 per cent, researchers found.

The results of the study, published in JAMA Internal Medicine, considered various factors that may have contributed to the March 2020 jump in compliance including staff members’ increased awareness of the importance of hand washing during the pandemic.

Hand hygiene in Nepal

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Background: Hand hygiene is one of the most effective preventive measures in the transmission of infection. Proper hand hygiene strategies in health care facilities can reduce nosocomial infections and antimicrobial resistance.

Objectives: This study aims to assess the baseline hand hygiene skills among health care workers and the impact of education and training on it. Design: Interventional cross-sectional single center study.

Method: It was conducted among 181 health care workers of Alka Hospital Pvt. Ltd. During both pre and post-test, participants were asked to perform hand hygiene with soap and water as per WHO guidelines. Pretest was conducted to assess baseline skills of health care workers regarding hand hygiene. An observer would score whether each of the steps were performed correctly, using a checklist. It was followed by intervention in the form of training, education and demonstration of hand hygiene. Post-test was conducted to assess the changes in skills after intervention. Results: There was an overall improvement in the hand washing skills post intervention indicated by an increase in median score, which was 8 for pre-intervention and 9 for post-intervention.

Doctors and nurses had better practice regarding hand hygiene in comparison to other participants. Those participants who had prior training on infection prevention and control, were found to have better hand hygiene skills post-intervention.

Conclusion: Training and educational interventions are the effective tools to improve hand hygiene skills of the health care workers. Performing such interventions at regular intervals can be helpful. Keywords: hand hygiene, health care workers, training and education.

Hand hygiene skills of the health care workers and the effect of training and educational intervention: A single center cross-sectional study

Bangladesh Critical Care Journal

Gentle Sunder Shrestha*1 , Manjit Shrestha2 , Roshan Sharma2 , Ramchandra KC3 , Bibeka Shrestha4 , Rojika Pradhan5 , Pankaj Joshi

DOI: https://doi.org/10.3329/bccj.v9i1.53050

http://scholar.google.com/scholar_url?url=https://www.banglajol.info/index.php/BCCJ/article/view/53050/37517&hl=en&sa=X&d=8568963706660951838&ei=DtaKYKCLJMyWywTm8KLQDA&scisig=AAGBfm3SJ7-dM6dRbRQx-R7lj-8CAuBnUA&nossl=1&oi=scholaralrt&hist=5kxqCikAAAAJ:5428478285509672052:AAGBfm0um7xNxqfVpArKOWnp4NG6xAm5og&html=&folt=cit&fols=

Coronavirus outbreak bumps hand hygiene compliance

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Hand hygiene is a cornerstone of infection control,1,2 yet compliance remains low, averaging 50% across hospitals nationwide.1 Audit and feedback can improve compliance,3 but audits traditionally occur using direct observation, capturing few events and leading to inaccurate measurements.4 To address this, some institutions have implemented automated monitoring.1,4 

Woman washing her hands at the kitchen sink. There are vegetables out of focus in the background.

To further validate hand hygiene compliance measurements from automated monitoring and estimate the upper bound of compliance achievable with such systems, we describe changes in compliance during the COVID-19 pandemic as measured by the automated system at our institution, one of the largest such deployments nationally.

Hand hygiene compliance rate during the COVID-19 pandemic

JAMA Internal Medicine

Sonya Makhni, MD, MBA1,2; Craig A. Umscheid, MD, MS1,2,3; Jackie Soo, MPH, ScD3; Vera Chu, MS, MLS(ASCP)CM4; Allison Bartlett, MD, MS2,4,5; Emily Landon, MD1,2,4; Rachel Marrs, DNP, RN, CIC4

doi:10.1001/jamainternmed.2021.1429

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2779293

TikTok user goes viral with story about pinworms in her butt

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I have always checked my kids for pinworms – when they were asleep, usually – if they complained about an itchy butt.

Jackie Salo of the New York Post reported a few months ago that a woman’s horrifying tale about discovering “squiggly white” worms in her anus has gone viral on TikTok.

Mercedes Edwards recounted in graphic detail how she came down with a pinworm infection as a child in a video, which has racked up more than 1.7 million views on the platform.

“If you don’t know what that is, it’s these little white worms and they live in your butthole. They come out at night to lay eggs around your anus.”

She said that she knew something was wrong when her anus became “so itchy.”

“So I got a little mirror because I wanted to look to see like what was going on down there, you know?” she told viewers while snacking on edamame (hopefully not edamame from Tesoros Trading Co. in Las Vegas and sold at some Trader Joe’s which was recently recalled for a potential Listeria risk) https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/tesoros-trading-company-recalls-product-because-possible-health-risk

“And I saw all these squiggly white things moving on and I freaked the f–k out.”

She said her mom got a piece of tape to stick on her anus to get a sample for the doctor, who confirmed that she had a pinworm infection.

“I had to take this medication that made all the pinworms like die and I remember sitting on the toilet crying — so scared to s–t because when I did s–t all the dead worms were like in my poop,” she said.

Pinworm infections are typically found in school-age children and can be caused by accidentally swallowing or breathing in the eggs, according to the Mayo Clinic.

This can happen when food, drinks or someone’s fingers are contaminated with the parasite.

Edwards encouraged viewers to practice good hygiene — warning them they don’t want to have the same fate as her.

“It was traumatizing, do not recommend getting pinworms. Wash your hands people,” Edwards said.

FoodNet Canada, 2019

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The Public Health Agency of Canada’s (PHAC) FoodNet Canada surveillance system (no, not that one, right, that’s the Canadian television network that wanted to sue me over video associated with 2004’s cooking show paper) is pleased to present this tables and figures report which provides the annual results of our surveillance activities conducted in 2019. The report is based on findings from its sentinel sites in British Columbia, Alberta, and Ontario. It also provides preliminary findings from Quebec, representing a partial year due to their implementation part way through the year in July 2019. The report focuses on trends in enteric pathogen disease rates, as well as trends in the prevalence of these pathogens found on potential disease sources: retail meats, manure from food producing animals and water. It is our hope that this report will be used to inform and shape discussions on food safety issues regarding enteric diseases and their sources.

Key findings:

  • In 2019, Campylobacter and Salmonella remained the most common causes of human enteric illness in the FoodNet Canada sentinel sites.
  • Travel continues to be an important factor in the burden of enteric disease. In 2019, approximately 30% of all cases of enteric disease were associated with travel outside of Canada.
  • Exposure to retail meat products remains a potential source of infection for human enteric illness. However, decreases in the prevalence of certain pathogen-food combinations were observed in 2019. For example, Salmonella on frozen breaded chicken products significantly decreased in 2019 compared to 2018 and is likely associated with interventions implemented at the industry level in 2019.
  • Other exposures, such as the farm environment and water, are also possible sources of infection for human enteric illness, with differences noted between the sites. For example, Salmonella is commonly found in broiler chicken manure, however, the prevalence significantly increased in BC whereas it significantly decreased in the AB site in 2019, resulting in an overall significant decrease in the combined sites.
  • The majority of clinical cases of shigatoxigenic Escherichia coli (STEC) were domestically acquired in 2019, with a significant increase in both travel and endemic incidence rates, which is primarily driven by the AB sentinel site who test all STEC-confirmed stool samples for non-O157 serogroups.
  • In 2019, surface water sampling was initiated for the first time in the ON site for STEC testing. The prevalence of STEC in the ON site (27%) was similar to the combined BC and AB irrigation water prevalence in 2019 (28%). · Continued monitoring of human illness and the potential exposures is important to ensure the continued health and safety of Canadians. The collection and integration of information across all of FoodNet Canada surveillance components (human, retail, on-farm, and water) in an enhanced and standardized way allows for the analysis of subtype distributions among human cases and potential exposure sources over time. This report will be followed by a comprehensive annual report, which will include more extensive analyses of temporal trends and subtyping information for an integrated perspective on enteric disease from exposure to illness.

Assessment of food safety compliance to federal, state and local regulations within NYS capital region farmers markets: An investigation of current facilitators, barriers, and future opportunities to increase food safety, 2020

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Patricia Miller of the State University of New York at Albany writes in her Doctor of Public Health dissertation that within the United States there are over 8,000 farmers markets, that sell directly to consumers. New York State has the second-largest number of markets, at 637, with the capital region host to 114 markets.

Over the years the selections of offerings have grown to include not only produce but ready-to-eat foods, eggs, dairy products, crafts, beer, and wine. The increasing popularity of farmers markets coupled with inadequate regulatory oversight of these markets, can contribute to incidences of foodborne illnesses.

The Centers for Disease Control identified 95 foodborne illness outbreaks in the United States potentially associated with fairs, festivals, and temporary mobile services from 1988-2007, which resulted in almost 4,000 illnesses, including 144 hospitalizations (Centers for Disease Control, 2008). Of these markets, six are held year-round.

This research undertook a needs assessment to identify gaps in food safety as it related to compliance with regulations required by federal, state, and local government by farmers markets and their vendors. This was a multimethod study utilizing content of each farmers markets rules compared to regulations, direct observations of vendor behaviors, and data collection through observation of physical characteristics of the markets, and interviews with market managers. Market compliance was measured by analysis of market rules to key rules and regulations required through the Federal Food Code, and by the New York State Temporary Food Service Establishments Regulations. These rules included adherence to minimal cooking of foods, maintaining and monitoring temperatures of foods, hand hygiene requirements, prevention of cross-contamination, and storage of food. These regulations address transportation of food to the markets, into the markets, display of food, and serving of food.

Data collection through observation of each markets was done to assess market facilities, and direct observations were made of vendors during market operations on multiple occasions. Results showed many markets lacked clearly defined rules, and resources, including handwashing stations, as regulated, were not in evidence. Observational data collection showed that these markets did not comply with the New York State Department of Health Temporary Establishments Regulations and that the vendor behaviors did not meet food code requirements. In addition, this study looked to identify facilitators and barriers to safe food handling behaviors. A lack of handwashing facilities and thermometers were found to be barriers to safe food handling at these markets.

While implementing more rules or changing policies may improve these behaviors, enforcement of the required rules would be a better method to decrease these barriers. Inspection by local authorities may improve compliance to regulations as may providing resources to the vendors.

The 3 Ws: A public health Thanksgiving

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Friend of the barfblog, Michéle Samarya-Timm, MA, HO, MCHES, REHS, health educator and registered environmental health specialist at the Somerset County Department of Health in Somerville, New Jersey, has graciously made time from the public health front lines to continue her U.S. Thanksgiving tradition of contributing to the barfblog.

It’s the 10th month  of COVID-19 response for public health professionals in the U.S.

That’s 46 straight weeks (and counting) of conducting public testing clinics, providing COVID-19 information and test results, contact tracing, and educating on prevention.    

 In addition, public health has been proactive with regular disease prevention work, holding COVID-safe flu clinics, providing guidance to food establishments, schools and workplaces, and planning for the herculean task of vaccinating 70% of the population (twice) for COVID-19 as soon as the vaccine is delivered. 

 We do what we’ve been trained to do, and what needs to be done to protect our residents. It’s the prime directive of public health: prevent disease and save lives.

Be thankful, as I am, for their dedication and efforts as you pass the turkey…and pass the hand sanitizer.

This year, in addition to food safe practices to assure a disease-free meal, remember to add 3 W’s:

  • Watch your distance (keep 6 feet apart)
  • Wear a mask 
  • Wash your hands 

 Be safe, my friends.  And THANKS for all you do.

Proper handwashing requires proper tools: Soap vs. COVID-19

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I don’t like the militarization of terms to discuss foodborne or other bugs. The bugs are there, be cool, take steps to reduce risk.

UNSW academics have released a 3D visualisation of soap destroying the coronavirus to remind Australians that simply washing your hands can help stem the pandemic.

(There is nothing simple about handwashing when almost all public restrooms contain blow-dryers instead of paper towels and have controlled water flow rates that would dislodge nothing. It is the friction that helps reduce microbial loads on hands, which is why hospitals are over-flowing with paper towel dispensers.)

Soap counts too.

There’s too much self-aggrandizing in the PR piece, below, but it has pretty pictures.

This scientifically accurate simulation — a collaboration between UNSW Art & Design and UNSW Science — shows soap acting on contaminated skin covered with tiny coronavirus particles.

“With the threat of the second wave upon us, simple hygiene is something everyone can do to prevent the spread of the virus,” UNSW Science’s Professor Pall Thordarson said.

“Soap can destroy the virus on your skin.”

The simulation uses a cinematic approach and evocative animation to deliver a message that’s accessible to adults and children.

“One of the very few pieces of good news about this virus is that it’s actually very fragile — if you wash your hands with soap, the whole virus basically collapses like a house of cards,” Professor Thordarson said.

The simulation was created by UNSW’s 3D Visualisation Aesthetics Lab, which explores arts- and design-led visualisations of complex scientific and biomedical data. The Lab creates immersive platforms that play out scientific phenomena, such as drug interactions with cancerous cells or interactive personalised scans of strokes to help patients understand their treatment.

“3D visualisations make complex science comprehensible. The creative industries are in a unique position to be able to offer these kinds of innovative educational simulations,” said Associate Professor John McGhee who created the simulation with UNSW 3D Visualisation Aesthetics Lab post-doctoral researcher Dr Andrew Lilja.

Hundreds of drones take to the South Korea sky to send message of social distancing and handwashing

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South Korea has done everything big on coronavirus.

Now, over 300 drones have taken to the sky in South Korea to remind people of the importance of practicing social distancing and handwashing.

This resulted in a spectacular display over the Han River on Saturday.

The drones formed a white face mask and red circles were used to symbolize coronavirus particles, which has claimed the lives of almost 300 people in the country.

Messages of support and images of medical workers also appeared in the 10-minute display that was organized by the Ministry of Land, Infrastructure, and Transport.

One of the displays said “ThanksToChallenge”, which made reference to a South Korean social media campaign that was created to show thanks to healthcare workers in the county.

There were no crowds watching the event because it was not advertised ahead of time.

The government captioned a video of the event on YouTube: “Thank you for the efforts of the people and medical staff.

“We express our gratitude and respect to all who suffer from Covid-19.”

This display comes after South Korea was praised for its response to the virus, quickly containing the initial outbreak, although the country has experienced sporadic cases since – caused by small gatherings and door-to-door sales practices.

According to the Mirror, South Korea has reported just 68 cases of coronavirus today and 33 of them are imported.

However, the country is preparing itself for a potential second wave of infections and this drone display was undoubtedly a timely reminder to its citizens that they are not out of the woods yet.

Vietnam too.