Less food poisoning associated with employee paid sick time?

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I refer to parenting as hypocrisy disease.

And there’s been more than a few times when Amy has said to me, practice what you preach.

Like barfing and going to work.

People should not work when they are sick.

But in the world of food, people are going to lose their jobs if they don’t show up.

Hsuan et al. write in the American Journal of Preventative Medicine that:

Previous studies suggest an association between paid sick leave (PSL) and better population health, including fewer infectious and nosocomial gastrointestinal disease outbreaks. Yet few studies examine whether laws requiring employers to offer PSL demonstrate a similar association. This mixed-methods study examined whether laws requiring employers to provide PSL are associated with decreased foodborne illness rates, particularly laws that are more supportive of employees taking leave.

Methods:

The four earliest PSL laws were classified by whether they were more or less supportive of employees taking leave. Jurisdictions with PSL were matched to comparison jurisdictions by population size and density. Using difference-in-differences, monthly foodborne illness rates (2000-2014) in implementation and comparison jurisdictions before and after the laws were effective were compared, stratifying by how supportive the laws were of employees taking leave, and then by disease. The empirical analysis was conducted from 2015-2017.

Results:

Foodborne illness rates declined after implementation of the PSL law in jurisdictions with laws more supportive of employees taking leave, but increased in jurisdictions with laws that are less supportive. In adjusted analyses, PSL laws that were more supportive of employees taking sick leave were associated with an adjusted 22% decrease in foodborne illness rates (p=0.005). These results are driven by campylobacteriosis.

Conclusions:

Although the results suggest an association between more supportive PSL laws and decreased foodborne illness rates, they should be interpreted cautiously because the trend is driven by campylobacteriosis, which has low person-to-person transmission.

Association of paid sick leave laws with foodborne illness rates

Am J Prev Med. 2017 Sep 1. pii: S0749-3797(17)30359-8. doi: 10.1016/j.amepre.2017.06.029. [Epub ahead of print]

Hsuan C, Ryan-Ibarra S, DeBurgh K, Jacobson DM

https://www.ncbi.nlm.nih.gov/pubmed/28870665

Norovirus modeling: Stay at home after the barfing and pooping is gone

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Duret et al. write in Risk Analysis:

We developed a quantitative risk assessment model using a discrete event framework to quantify and study the risk associated with norovirus transmission to consumers through food contaminated by infected food employees in a retail food setting.

This study focused on the impact of ill food workers experiencing symptoms of diarrhea and vomiting and potential control measures for the transmission of norovirus to foods.

The model examined the behavior of food employees regarding exclusion from work while ill and after symptom resolution and preventive measures limiting food contamination during preparation.

The mean numbers of infected customers estimated for 21 scenarios were compared to the estimate for a baseline scenario representing current practices. Results show that prevention strategies examined could not prevent norovirus transmission to food when a symptomatic employee was present in the food establishment. Compliance with exclusion from work of symptomatic food employees is thus critical, with an estimated range of 75–226% of the baseline mean for full to no compliance, respectively.

Results also suggest that efficient handwashing, handwashing frequency associated with gloving compliance, and elimination of contact between hands, faucets, and door handles in restrooms reduced the mean number of infected customers to 58%, 62%, and 75% of the baseline, respectively.

This study provides quantitative data to evaluate the relative efficacy of policy and practices at retail to reduce norovirus illnesses and provides new insights into the interactions and interplay of prevention strategies and compliance in reducing transmission of foodborne norovirus.

Quantitative risk assessment of norovirus transmission in food establishments: Evaluating the impact of intervention strategies and food employee behavior on the risk associated with norovirus in foods

Risk Analysis, Vol. 37, No. 11, 2017

DOI: 10.1111/risa.12758

Duret et al.

http://onlinelibrary.wiley.com/doi/10.1111/risa.12758/epdf

 

Raw is risky: Norovirus in raw oysters sickens 10 in Denmark

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Joseph James Whitworth of Food Quality News writes 10 people have been sickened by norovirus after eating raw oysters at Danish restaurants.

Fødevarestyrelsen (Danish Veterinary and Food Administration) said oysters are from Lemvig.

The agency has closed the area in Lemvig for commercial harvest of mussels and oysters and is monitoring it.

Illnesses can be avoided if oysters are cooked to an internal temperature of 90° Celsius/194° Fahrenheit for a minimum of 90 seconds.

3 members of NZ family stricken with botulism from wild boar: 1 has begun to ‘mouth words’

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The oldest member of a South Waikato family struck down by suspected botulism poisoning has begun to mouth words, a spokesman says.

Shibu Kochummen, 35, his wife Subi Babu, 33, and his mother Alekutty Daniel, 62, ate a wild boar curry for dinner two weeks ago at their Putaruru home.

Within minutes of eating, Babu and Daniel collapsed, vomiting. Kochummen called an ambulance but collapsed while on the phone.

The trio have been in a serious but stable condition in Waikato Hospital for the past two weeks and at the weekend Daniel became “slightly responsive”, having co-ordinated eye movement and the ability to focus.

“No one has spoken but we are beginning to get focus on movement,” family spokesman Joji Varghese earlier told Belinda Feek of the New Zealand Herald.

He confirmed today that Daniel was now beginning to mouth words but she wasn’t yet talking.

Subi Babu was also making progress but not as much as her mother-in-law.

Shibu Kochummen has yet to respond.

Varghese said doctors did not know if Daniel’s ability to follow an object with her eyes meant she was comprehending yet and they were still awaiting results of tests being conducted in Brisbane to definitively diagnose botulism.

Hucksterism fail: Ells out as CEO at Chipotle

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Joe Rubino of The Denver Post writes the man who turned a tiny burrito shop near the University of Denver into an international brand will soon be out as Chipotle Mexican Grill’s CEO.

Steve Ells, the founder of the Denver-based fast-casual chain, will leave his post as chairman and CEO to become executive chairman after a replacement has been found, the company announced Wednesday.

A committee that includes Ells and directors Ali Namvar and Robin Hickenlooper, wife of Colorado Gov. John Hickenlooper, has been formed to find a leader with demonstrated turnaround expertise, the company said.

Whoever takes the job will be tasked with helping the chain climb out of protracted market malaise caused, in part, by outbreaks of foodborne illness linked to some of its restaurants, first in 2015, then again earlier this year. 

Co-CEO Monty Moran stepped down in December, leaving Ells with control of the company as it faced pressures from activist investor Bill Ackman, whose Pershing Square Capital hedge fund took a nearly 10 percent stake in September 2016. Ackman said then that he wanted improvement in Chipotle’s “operations, cost structure, management and strategy.”

E. coli: Flour fights not such a good idea

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In June, 2009, an outbreak of shiga-toxin producing E. coli (primarily O157:H7) in Nestle Toll House cookie dough sickened at least 77 people in 30 American states. Thirty-five people were hospitalized – from cookie dough.

The researchers could not conclusively implicate flour as the E. coli source, but it remains the prime suspect. They pointed out that a single purchase of contaminated flour might have been used to manufacture multiple lots and varieties of dough over a period of time as suggested by the use-by dates on the contaminated product.

The study authors concluded that “foods containing raw flour should be considered as possible vehicles of infection of future outbreaks of STEC.”

So it wasn’t much of a surprise when 56 people fell sick from with the outbreak strain of E. coli O121 from Dec. 2015 to Sept. 2016 were linked to raw General Mills flour.

The peer-reviewed summary of the outbreak investigation was published last week in The New England Journal of Medicine.

Abstract below:

In 2016, a multijurisdictional team investigated an outbreak of Shiga toxin–producing Escherichia coli (STEC) serogroup O121 and O26 infections linked to contaminated flour from a large domestic producer.

Methods

A case was defined as infection with an outbreak strain in which illness onset was between December 21, 2015, and September 5, 2016. To identify exposures associated with the outbreak, outbreak cases were compared with non-STEC enteric illness cases, matched according to age group, sex, and state of residence. Products suspected to be related to the outbreak were collected for STEC testing, and a common point of contamination was sought. Whole-genome sequencing was performed on isolates from clinical and food samples.

Results

A total of 56 cases were identified in 24 states. Univariable exact conditional logistic-regression models of 22 matched sets showed that infection was significantly associated with the use of one brand of flour (odds ratio, 21.04; 95% confidence interval [CI], 4.69 to 94.37) and with tasting unbaked homemade dough or batter (odds ratio, 36.02; 95% CI, 4.63 to 280.17). Laboratory testing isolated the outbreak strains from flour samples, and whole-genome sequencing revealed that the isolates from clinical and food samples were closely related to one another genetically. Trace-back investigation identified a common flour-production facility.

Conclusions

This investigation implicated raw flour as the source of an outbreak of STEC infections. Although it is a low-moisture food, raw flour can be a vehicle for foodborne pathogens.

Shiga toxin–producing E. coli infections associated with flour

N Engl J Med 2017; 377:2036-2043, November 23, 2017, DOI: 10.1056/NEJMoa1615910

Samuel J. Crowe, Ph.D., M.P.H., Lyndsay Bottichio, M.P.H., Lauren N. Shade, B.S., Brooke M. Whitney, Ph.D., Nereida Corral, M.P.H., Beth Melius, M.N., M.P.H., Katherine D. Arends, M.P.H., Danielle Donovan, M.S., Jolianne Stone, M.P.H., Krisandra Allen, M.P.H., Jessica Rosner, M.P.H., Jennifer Beal, M.P.H., Laura Whitlock, M.P.H., Anna Blackstock, Ph.D., June Wetherington, M.S., Lisa A. Newberry, Ph.D., Morgan N. Schroeder, M.P.H., Darlene Wagner, Ph.D., Eija Trees, D.V.M., Ph.D., Stelios Viazis, Ph.D., Matthew E. Wise, M.P.H., Ph.D., and Karen P. Neil, M.D., M.S.P.H.

http://www.nejm.org/doi/full/10.1056/NEJMoa1615910

New proposed changes to the Regulations under the Health Protection and Promotion Act in Ontario

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New proposed changes to the Regulations under the Health Protection and Promotion Act (HPPA) in Ontario (Canada) are intended to modernize and ensure public health programs and services remain current to protect the health of Ontarians. A couple of the major highlights to the proposed changes to the Food Premises Regulation include mandatory on-site disclosure of inspections and mandatory food handler training for one person on shift at all times. There are a number of other modifications that include amendments to cleaning and sanitizing, temperature control and food handling.

The Ontario Food Premises Regulation was outdated and a number of concerns, in particular, with cleaning and sanitizing requirements have to come light a number of times in the past by industry and Regulators alike. Glad to see the modernization of the Regulation. However, when reading further into the proposed changes, one proposed amendment to another Regulation under HPPA is to remove the professional qualifications requirements for public health inspectors. Public health inspectors undertake specialized education and training in their field followed by a rigorous process of becoming Certified. Why remove their professional qualifications? They are highly trained on how to conduct food safety inspections, pool inspections and any other public health related inspections. Removing their qualifications in Ontario will not only provide inconsistency in Canada, they will also lose credibility.

In case you’re gonna be near Omemee, Ontario (that’s in Canada) on Dec 1

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You might want to check out the rumored Neil Young concert.

‘In Young’s memoir Shakey, he remembers it as “a nice little town. Sleepy little place. . . . Life was real basic and simple in that town. Walk to school, walk back. Everybody knew who you were. Everybody knew everybody.”’

Sounds like the town I grew up in. 

Anecdote to anecdote

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One of the common conversations held between food safety nerds is about the predictable meme-like sharing of phrases that folks use to explain why they do risky things like eat undercooked foods or wash their poultry and other stuff. It usually goes like: ‘I’ve been doing this for a long time, with no consequence. 

Risk doesn’t work like that. And that’s what I told Brian Handwerk at Smithsonian Magazine.

“I think it’s human nature to live anecdote to anecdote. If I’ve been undercooking my burger for 20 years and I’ve never gotten sick, I’m very comfortable with that. You can tell me about the risk, but I’ve never seen it realized. On the flip side, I know people who’ve lost loved ones to foodborne illness and they look at things drastically differently.”

I also got in a plug for environmental sources of pathogens, and that animals might not always be involved:

There’s also growing evidence that these pathogens can survive for a long time in soil and other environments, says Chapman, citing recent ilness outbreaks stemming from almonds, peanut butter and flour that seem to have no discernible animal sources. “Increasingly we’re opening up our minds and saying the environment might also be a pretty decent source for hosting foodborne pathogens,” he says.

Pop-up turkey thermometers can suck

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I usually pull the pop-up thermometer out of my bird when I cook it. I’m a digital-tip-sensitive thermometer kind of guy. Last Thursday, while roasting this year’s turkey, I left mine in, as a bit of an experiment for my graduate student Minh, like last year’s Consumer Reports pop-up test:

We tested 21 pop-up thermometers in whole turkeys and turkey breasts. Our testing covered pop-up timers bought online and put into place by cooks before sliding the bird into the oven, and models pre-inserted in the meat at the processing plant. To determine the pop-ups’ accuracy, we also measured the internal temperature of the meat with a calibrated reference thermometer. Our findings may make a few eyebrows pop:

Self-inserted and manufacturer-inserted timers generally “popped” in our tests at internal temperatures above 165° F—the minimum safe temperature for all poultry. But three timers popped up when meat was still below that safe zone, one as low as 139.5° F.

Here’s mine (right, exactly as shown). Thanks pop-ups, I was only 20F (and 75 min of roasting) short.