Business Continuity: Plan, Prepare, Prevent


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  • It is indeed a pleasure to be with you today to participate in this panel discussion, which is a compact version of a workshop that Ecolab conducted jointly with the NRA, Weber Shandwick, and local restaurateurs and university speakers.
  • Business Continuity: Plan, Prepare, Prevent

    1. 1. Business Continuity Plan, Prepare, Prevent Katherine MJ Swanson, PhD Vice President Food Safety May 19, 2008 National Restaurant Association Show Crisis Planning: Business Continuity Workshop for Restaurateurs
    2. 2. Business Continuity <ul><li>Different kinds of business disruptions </li></ul><ul><ul><li>One time event OR on-going disruptions </li></ul></ul><ul><ul><li>Site specific OR regional OR national OR global disruptions </li></ul></ul><ul><ul><li>Impacts employees OR customers OR both </li></ul></ul><ul><ul><li>Perceived OR real </li></ul></ul><ul><ul><li>Etc…. </li></ul></ul><ul><li>Planning, preparation, and prevention are essential to minimize disruption </li></ul>
    3. 3. Example – <ul><li>Perceived issue </li></ul><ul><ul><li>Is the poultry safe for consumption? </li></ul></ul><ul><li>Real issues </li></ul><ul><ul><li>Will poultry be available? </li></ul></ul><ul><ul><li>Will people be coming to restaurants? </li></ul></ul><ul><ul><li>How can transmission be minimized? </li></ul></ul><ul><ul><li>Etc. </li></ul></ul>Avian Influenza versus Pandemic Influenza
    4. 4. Business Continuity <ul><li>Planning is essential! </li></ul><ul><ul><li>Identify potential risks </li></ul></ul><ul><ul><li>Plan for the worst </li></ul></ul><ul><ul><li>Leverage your industry and supplier resources </li></ul></ul><ul><ul><li>Include your team </li></ul></ul><ul><ul><li>Use available tools </li></ul></ul>
    5. 5. Plan, Prepare & Prevent <ul><li>Plan </li></ul><ul><ul><li>a scheme or method of acting, doing, proceeding, making, etc., developed in advance </li></ul></ul><ul><li>Prepare </li></ul><ul><ul><li>to put in proper condition or readiness </li></ul></ul><ul><li>Prevent </li></ul><ul><ul><li>to keep from occurring ; avert; hinder </li></ul></ul>Definitions from
    6. 6. Norovirus Example – Know The Enemy
    7. 7. US Top Confirmed Foodborne Outbreaks Norovirus emerging as leading problem Source: CDC 2006 MMWR 55(SS10):1-34; CDC 2000 MMWR 49(SS1)1-64; and CDC Outbreak Surveillance Data
    8. 8. Why is Norovirus a Concern? <ul><li>The virus is difficult to kill. </li></ul><ul><li>If not controlled, it can spread rapidly in a large population. </li></ul><ul><li>Health departments can institute mandatory closures. </li></ul><ul><li>Outbreaks can lead to negative publicity. </li></ul>Location of US outbreaks Source: CDC 2001 MMWR 50(RR-9):1-24
    9. 9. How is Norovirus Transmitted? Source: CDC 2001 MMWR 50(RR-9):1-24 USA
    10. 10. What is the Source of Norovirus? <ul><li>Feces or vomit of an infected person </li></ul><ul><ul><li>Infectious dose < 10 viral particles </li></ul></ul><ul><ul><li>One vomiting incident may aerosolize 100 billion viral particles. </li></ul></ul><ul><li>Spreads : </li></ul><ul><ul><li>Directly from person to person </li></ul></ul><ul><ul><li>Through unwashed hands </li></ul></ul><ul><ul><li>Via ingestion of contaminated food or water </li></ul></ul><ul><ul><li>Through contact with contaminated surfaces </li></ul></ul><ul><li>An infected person may be contagious for 2 weeks after recovery </li></ul><ul><li>People can contract norovirus and become ill more than once </li></ul>
    11. 11. How is Norovirus Inactivated? <ul><li>Difficult to inactivate </li></ul><ul><ul><li>Persists in chlorinated drinking water </li></ul></ul><ul><li>Persists in the environment </li></ul><ul><ul><li>Survives freezing and refrigeration </li></ul></ul><ul><ul><li>Requires high temperature to inactivate </li></ul></ul><ul><ul><li>Survives in acidic environments </li></ul></ul>Source: Doultree, et. al. 1999. J. Hosp. Infection 41:51-57
    12. 12. How Long Does Norovirus Survive? <ul><li>Initial population >100,000,000 FCV particles/ ml </li></ul><ul><li>Doubletree et al 1999. J. Hospital Infect 41:51-57 </li></ul>Estimated with Feline Calicivirus (FCV) <1 min - 212°F 5 min - 158°F 60 min - 133°F 99°F 68°F 39°F <1d 21-28d >56d Dry ~10d 14-21d >60d Liquid
    13. 13. Norovirus – Learn from the Past
    14. 14. Airborne Outbreak <ul><li>126 people attended a dinner at a large hotel. </li></ul><ul><li>During the meal, a woman vomited onto a polished wooden floor. </li></ul><ul><li>It was immediately cleaned with a mop and disinfectant. </li></ul><ul><li>THE MEAL CONTINUED. </li></ul><ul><li>Within 48 hours, 52 people reported norovirus symptoms. </li></ul>1998 Dinner Party Outbreak Source - Marks. 2000. Epidemiol. Infect. 124:481-487
    15. 15. Layout Plan of Restaurant Source - Marks. 2000. Epidemiol. Infect. 124:481-487
    16. 16. Foodborne Outbreak <ul><li>Employee returned to work the day norovirus symptoms ended </li></ul><ul><ul><li>Same employee sliced lettuce </li></ul></ul><ul><ul><li>Lettuce food prep sink also used for handwashing </li></ul></ul><ul><li>170 people ill </li></ul><ul><ul><li>3 different lunch events </li></ul></ul><ul><ul><li>Restaurant closed twice for cleaning </li></ul></ul>Source: MMWR 55(14):395-7 Sub Sandwiches – Michigan, 2005
    17. 17. Cruise Outbreak 1988 Relationship between number of people using a communal bathroom and risk of illness Source: The Lancet; Oct. 21, 1989; pp 963 0 10 20 30 40 10 20 30 40 50 60 70 No. of Users per Toilet Attack Rate (%)
    18. 18. Hurricane Katrina Evacuees in Houston Astrodome – 2005 <ul><li>~1200 of ~24,000 total evacuees (18%) had symptoms of acute diarrhea and/or vomiting. </li></ul><ul><li>Less-than-ideal conditions probably contributed to outbreak. </li></ul><ul><ul><li>Crowding </li></ul></ul><ul><ul><li>Insufficient sanitation in bathrooms </li></ul></ul><ul><ul><li>Lack of an adequate number of handwashing facilities </li></ul></ul><ul><ul><li>Delays in cleaning and decontaminating soiled areas and bedding </li></ul></ul><ul><li>Initial isolation procedures were difficult to maintain over time because they separated family members already traumatized by displacement, grief and personal loss. </li></ul>Source – MMWR 54(40):1016-1018
    19. 19. Norovirus – Plan, Prepare, Prevent
    20. 20. Risk Reduction Plan <ul><li>Review current cleaning, hygiene and personnel plans. </li></ul><ul><li>Do not permit infected workers in the establishment: </li></ul><ul><ul><li>For at least 3 days after recovery </li></ul></ul><ul><ul><li>Per FDA Food Code </li></ul></ul><ul><li>Have a hand hygiene plan in place. </li></ul><ul><ul><li>Hands should be washed frequently. </li></ul></ul><ul><li>Discard food that may have been contaminated by an ill person. </li></ul>
    21. 21. Tips for Being Prepared <ul><li>Have appropriate spill kits and other products on hand. </li></ul><ul><li>Have personal protective equipment (PPE) on hand. </li></ul><ul><li>Audit your products and procedures. </li></ul><ul><li>Consult with your local health department to find out what action will be required in the event of an incident or outbreak. </li></ul><ul><li>Post handwashing signage and procedures. </li></ul>
    22. 22. Antimicrobial Regulatory Status <ul><li>Sanitizers </li></ul><ul><ul><li>Food contact surface sanitizers at EPA registered sanitizer concentrations typically not effective against norovirus </li></ul></ul><ul><li>Disinfectants </li></ul><ul><ul><li>EPA accepted a feline calicivirus (FCV) as a surrogate for norovirus in 2005 </li></ul></ul><ul><ul><li>Products passing the FCV protocol can have EPA registered label claims against norovirus </li></ul></ul><ul><li>Hand care products </li></ul><ul><ul><li>There are no anti-viral claims available for hand care products, as they are not recognized by the FDA (CDER) </li></ul></ul>
    23. 23. Spill Kits Are Useful <ul><li>Contains </li></ul><ul><ul><li>Standard Procedures </li></ul></ul><ul><ul><li>Disinfectant </li></ul></ul><ul><ul><li>Gloves </li></ul></ul><ul><ul><li>Absorbent beads </li></ul></ul><ul><ul><li>Scoop </li></ul></ul><ul><ul><li>Bag </li></ul></ul><ul><ul><li>Mask </li></ul></ul><ul><ul><li>Shoe covers </li></ul></ul><ul><ul><li>Wipes </li></ul></ul><ul><ul><li>Apron </li></ul></ul>Be prepared, prevent spread
    24. 24. Prevention <ul><li>Risk reduction and remediation considerations : </li></ul><ul><ul><li>LEVEL GREEN: Standard procedures – maintaining hygiene when norovirus poses no direct threat </li></ul></ul><ul><ul><li>LEVEL YELLOW: Risk reduction – a heightened defensive response to an outbreak in your area/industry </li></ul></ul><ul><ul><li>LEVEL RED: Remediation – a focused response to an outbreak in your facility, designed to break the chain of infection or illness </li></ul></ul><ul><ul><li>INCIDENT CLEAN-UP – How to clean an incident of vomitus or stool contamination </li></ul></ul>
    25. 25. What Can You Do? <ul><li>Review procedures based on levels of risk, as well as incident clean-up. </li></ul><ul><li>Have appropriate products on hand. Check expiration dates where applicable. </li></ul><ul><li>Reinforce proper cleaning, sanitation and hygiene procedures with your employees. </li></ul>
    26. 26. Additional Resources <ul><li> </li></ul><ul><ul><li>Links to WHO & CDC. </li></ul></ul><ul><ul><li>Fact sheets on Public Health topics of concern. </li></ul></ul>