Volume 9, 2009Should Human Norovirus Be Considered aPandemic Pathogen?Jason TetroCentre for Research on Environmental Micr...
Influenza Prevention and Control MeasuresAcknowledgement to CHICA-Canada www.chica.orgInfluenza is spread from person to p...
Hand Hygiene in the Food IndustryChristian DesRoches, Regional Sales Manager, Deb CanadaDoes it surprise you that 10 milli...
Deb Canada eLearning                                                                                        Infection Cont...
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Hand Hygiene Newsletter #9

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Hand Hygiene Newsletter #9

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Hand Hygiene Newsletter #9

  1. 1. Volume 9, 2009Should Human Norovirus Be Considered aPandemic Pathogen?Jason TetroCentre for Research on Environmental Microbiology, University of OttawaSince its discovery in 1972, human noroviruses With the data supporting person to personhave emerged as the most commonly identi- transmission, Dr. Dreyfuss has proposed afied foodborne cause of acute gastroenteritis model not unlike that of two known pandem-(AGE). In the United States alone, some 23 mil- ic viruses, influenza and rotavirus. All threelion infections are estimated to occur annually, viruses have similar transmissibility throughalthough this number may be grossly under- saliva, vomit or aerosols. As well they are ableestimated. Transmission of the virus has been to survive, for at minimum, several hours intraditionally attributed to the consumption of the environment and require low infectiouscontaminated food such as oysters, raspber- doses to cause infection. Moreover, the fre-ries, lettuce and other ready-to-eat products. quency of infection of norovirus far exceedsHowever, a closer inspection of these reports the current capacity to accurately detect andshows that the actual transmission of the virus track transmission (ironically, this fact has ledmay have less to do with food and more to do to the recent decision of the World Health Or-with person to person transmission. ganization to stop testing specifically for the pandemic H1N1 virus). Thus, Dr. Dreyfuss sug-Dr. Moshe Dreyfuss at Walden University re- gests that noroviruses may be better thoughtcently attempted to determine if noroviruses of as a pandemic virus than a foodborne one.are strictly foodborne or if they are spreadin the same way as pandemic viruses, such The reality is that we may never hear reportsas influenza and rotavirus. Nearly 12,000 re- of a norovirus pandemic, however, the infor-ported foodborne outbreaks registered with mation presented by Dr. Dreyfuss does high-the Foodborne Diseases Active Surveillance light the importance of good environmentalNetwork eFORS database between 1998 and and hand hygiene in all areas where food is2006 were analyzed to determine the actual handled. Proper handwashing or the use ofsource and transmission of norovirus during each outbreak. Just alcohol based handrubs will effectively remove and/or inactivate theover 23% were attributed to norovirus of which nearly 56% were con- pathogen. In addition, some (but not all) surface disinfectants arefirmed through laboratory diagnosis. The data showed several very effective against norovirus and can prevent indirect spread throughinteresting and thought-provoking outcomes. Most notably was that environmental surfaces. These interventions have already proven tonorovirus was identified in a food product or food ingredient in only be effective in stemming the spread of norovirus during the course11% of cases. In contrast, 80% of cases were directly associated with of outbreak and should be a mandatory component of any food han-an infected food handler. The other 9% of cases were due to cross- dling service. Moreover, the human factor in the spread of norovi-contamination of the virus through environmental surfaces. Another rus can now be put into better focus and the model presented bypoint of interest was the odds ratio (OR) for norovirus outbreaks, Dr. Dreyfuss may assist in both increasing and maintaining hygienewhich was only 0.45 for food yet 3.40 for food workers. This demon- compliance amongst food handlers.strates that the cause of an outbreak is approximately 7.5 times morelikely to be contact from an infected food handler or from environ- References are available upon request.mental transmission than from ingestion of contaminated food. 1
  2. 2. Influenza Prevention and Control MeasuresAcknowledgement to CHICA-Canada www.chica.orgInfluenza is spread from person to person via tended periods of time. In addition, removingdroplets when coughing or sneezing and by your mask incorrectly can spread virus to yourtouching objects and surfaces that are con- hands and face.taminated with the virus (e.g. doorknobs, tele-phones) and then touching their eyes, nose There is no risk of infection from this virusor mouth. The influenza virus may persist for from consumption of well-cooked pork orhours in dried mucus and be transmitted by pork products.direct contact. It is spread very easily indoors,which is why it is so prevalent in the winter Health Care Settingsmonths in northern countries, when peoplespend more time together inside. In health care settings, Routine Practices should be used consistently with all patientsMeasures to Reduce the Spread including:of Influenza • Hand hygiene before and after all patient• Clean hands thoroughly and frequently with contact (hand hygiene information is avail- soap and water or alcohol-based hand rub, able on CHICA-Canada’s Hand Hygiene web- especially after contact with the eyes, nose, site) mouth or secretions • Appropriate use of personal protective• Avoid touching your eyes, nose and mouth equipment (gloves, masks, eye protection) for contact with all patient secretions/excre-• Avoid handling soiled tissues or objects used tions by an ill person • Disinfection of all equipment which is shared• Cover coughs and sneezes with a tissue or between patients with a disinfectant regis- with your sleeve; throw the tissue in the trash tered for use against influenza A viruses after use and clean your hands • Cleaning/disinfection of all patient contact• Get an influenza immunization surfaces after patient leaves an examining room or area with a disinfectant registered• Stay home from work or school when ill and for use against Influenza A viruses. limit contact with others to keep from infect- ing them Emergency Departments should apply screening to all patients who present with• Follow the recommendations of your local respiratory symptoms. Laboratory testing public health unit. for Pandemic H1N1 2009 virus is not recom- mended for patients with mild illness. Speci-There is no evidence to suggest that wear- mens should only be submitted for testinging masks will prevent the spread of infection where lab results are required for clinical man-in the general population. Improper use of agement of hospitalized cases of influenza-masks may in fact increase the risk of infec- like illness (ILI) or where patients are at hightion. Masks do not act as an effective barrier risk for complications from influenza.against disease when they are worn for ex- 2
  3. 3. Hand Hygiene in the Food IndustryChristian DesRoches, Regional Sales Manager, Deb CanadaDoes it surprise you that 10 million bacteria can fit on an object as washed when working in a food processing environment. This in-small as a pinhead? And given the right conditions, those 10 million cludes after touching body parts; using a restroom; coughing, sneez-bacteria can double every 20 minutes and spread rapidly. Hands (and ing or using a tissue; changing tasks, especially if switching betweenthe people to whom they belong) are responsible for the dissemina- working with raw meat and ready to eat or cooked foods; handlingtion of an estimated 80 per cent of common infectious disease in the money, garbage, tools or equipment; touching dirty surfaces; pick-community, and 40 percent of food-borne illness. ing up something from the floor; and engaging in any activity that contaminates hands.The Public Health Agency of Canada reports approximately 10 mil-lion people suffer food-related illness each year. The majority of Agentthese illnesses last a short time and cause minor symptoms, such When soap and water are not available or hands are not visiblyas nausea, vomiting and diarrhea. Controlling food-related illness soiled, use an alcohol-based hand sanitizer to cleanse hands. In ad-is difficult because bacteria may survive food processing and foods dition to improved spreadability, foaming formulations have beenmay become contaminated during preparation, cooking or storage. shown to provide superior compliance and efficacy. When combinedWhile there are many instances in which food contamination can oc- with hand washing, the effectiveness of alcohol hand sanitizers is in-cur during processing, almost half of all food-borne illness outbreaks creased and can reduce the risk of infection by, on average, 20 to 40are a direct result of hand contamination. For this reason, food safety per cent.experts advise handwashing procedures Compliancebe implemented and Education and trainingstrictly monitored. are vital to the successWhen done correctly, of a good food safetyhand hygiene is the program. In any orga-single most effective nization, regardlessway to prevent the of size, the instructorspread of communi- must ensure all em-cable diseases. ployees understand the basic principlesCorrect hand hygiene of food safety as wellrequires proper pro- as their responsibilitytocol, an appropriate in keeping food safe.hand washing or cleansing agent, and compliance. High risk areas, Food handling staff should receive additional instruction in personalfor instance where food is processed or prepared, require the strictest hygiene and be required to undergo a test of their knowledge onlevel of compliance. the subject. Refresher courses should be given periodically. Also, par- ticular attention should be drawn to the need to report illness to aTo effectively cleanse hands: supervisor as soon as it occurs.• Place hands under water and apply soap;• Rub hands together for at least 15 seconds; Although most people recover, the Canadian Partnership for Con-• Wash hands thoroughly, including wrists, palms, back of hands and sumer Food Safety Education reports food-borne illness can result under fingernails, removing all dirt; in chronic health problems in two to three per cent of cases. Health• Rinse with potable water from wrist to fingertips; Canada estimates the annual cost related to these illnesses is as high• Dry hands completely with clean, good quality, absorbent paper as $14 billion and growing. The good news is infection control prac- towel as it helps remove germs. Rather than rubbing, pat skin dry tices and programs are not difficult to implement and manage and to avoid chapping and cracking. are proven to work. When it comes to food safety and reducing the risk of food-borne illness, education and awareness remains the bestProtocol defense.While common sense dictates hands should be washed before han-dling food, there are many other occasions when hands must be 3
  4. 4. Deb Canada eLearning Infection Control in the Workplace ! Watch a presentation on infection con- trol in the workplace practices. ! !Influenza Prevention Hand Washing For Kids!- Is Your Business Ready? This 2-minute video helps teach kids theWatch a 6-minute presentation on Influ- importance of hand washing and properenza Prevention strategies for your work- technique. For more information andplace. resources, visit the Education Learning Zone section of this web site. Point of Care eLearning ! Watch a presentation on infection con- trol in the healthcare environment. Deb Food Industry ! Skin Safety Program Watch a presentation on the Deb Food Available through the Learning Zone at www.debgroup.com Industry Skin Safety Program. 42 Thompson Road West, PO Box 730, Waterford, Ontario CANADA NOE 1YO Tel: 519 443 8697 Toll Free: 1-888-332-7627 Fax: 519 443 5160 Toll Free 1-800-567-1652 • Email: debcanada@debcanada.com • www.debgroup.com 4

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