Partnering with Health Departments

An important ally for foodservice operations in the battle against foodborne illness and communicable diseases is—believe it or not—health departments. 

Contrary to popular belief, the mission of a health department is not to make life miserable for businesses in their area. Health departments are becoming more proactive when it comes to dealing with foodservice operations and operators are becoming more receptive to the idea. 

“We're not here to be a pain or to harass you,” states Eric Pessell, director of the Barry-Eaton District Health Department, which services Barry and Eaton Counties in Michigan. “We just want customers to be as healthy when they leave your restaurant as when they came in.” 

Pessell adds, “one thing we're attempting to do is visit restaurants. We go there for consultation not for inspection.” 

HEALTH SERVICES COMPANIES

Pessell also suggests that foodservice operations should enlist the help of third-party providers to round out the trifecta in the battle against foodborne and health issues. 

One such company is Corporate Wellness, which oversees the workplace medical needs of mid-size and larger companies. The company’s mission is to focus first on prevention and second on response in the event of an outbreak. “We provide health services where you need them, and when you need them. We're your company health services without walls,” said Roslyn Stone, COO of Corporate Wellness. 

Pessell states that companies such as Mount Kisco, N.Y.-based Corporate Wellness are essential when it comes to supporting medical crisis prevention and response services for the foodservice industry. 

“Corporate Wellness has the resources and ability to respond and react,” he notes. “They put restaurants on heightened alert. It's almost like emergency preparedness with color coded levels.” 

TOP 10 HEALTH ISSUES

Providing research is one of the services Corporate Wellness offers. A ranking of the top 10 health issues that affect foodservice operations is compiled annually by the company. Norovirus comes in at number one on this list for 2006. Pessell stresses the importance of not confusing norovirus with foodborne outbreaks. “We have to be careful we don’t use norovirus and foodborne simultaneously,” he states. 

According to the Michigan Department of Community Health, the number of norovirus outbreaks reported in the state in 2006 was 144. This is drastically increased from 2004 and 2005 with 48 and 34 cases respectively. 

“Our district health department had 10 out of the 144 cases,” said Pessell. He notes that his area seemed to get the most attention. “Maybe it’s because we decided to go to the media first,” he said. “Maybe by doing that we shed more light on the issue.” 

‘TRAINING INSPECTIONS’

In addition to being proactive with the media, health departments have ramped up their efforts when it comes to approaching restaurants and other foodservice operations to provide consultation or “training inspections.” 

“We were surprised at the number of times incidents of vomiting were reported in restaurants,” said Pessell. “It’s more the norm than the exception.” He said that waiting for test results takes too long so most every incident has to be responded to as if it was norovirus. 

Pessell and his group have created a “Say NO To Noro-Bugs” campaign for local foodservice operators. “We set up an appointment at their convenience to meet one-on-one with a laptop presentation,” said Pessell. “Then we suggest that they incorporate our points into their training program,” he adds, noting that the program has been extremely well received. 

One of the slides in the PowerPoint norovirus presentation poses the question “So Whose Problem Is It?” The choices are: state and local health agencies, the foodservice industry or customers? It’s no surprise that the answer comes up as “Everyone has a critical role to play!” 

Something restaurants can’t control are the people coming in. They can only oversee their employees and their environment. “The restaurant is a victim of that as well,” notes Pessell. He points to one outbreak that had to be customer related because “we had zero illness among the employees.” 

“One thing we learned,” he said “is just because the incident occurred in the restaurant doesn’t mean it was the fault of the restaurant.” 

 

Insert: 

The Food Safety ‘Noro-Net’ Triangle

Customer Role:

• Staying home when feeling ill.
• Notifying the manager of “questionable” employee health practices observed.
  

Health Agencies Role:

• Education of foodservice operators/public.
  • Formal/onsite training opportunities.
  •  Foodservice newsletters/newspaper articles.
  • Brochures, fact sheets, media library.
• Evaluation of foodservice operations and standard operating procedures.
  • Food safety audits.
• Consultation with management on issues of concern or risk control.
  

Food Industry Role:

• Health and hygiene education of staff.
• Development and routine review of the facility’s health policy with all staff.
• Managerial monitoring and control of employee health and hygiene practices.
• Incident Response Preparedness (having an Emergency Action Plan in place).
• Public health reminders (posting of signage in the kitchen and restrooms).
  

Source: “Say NO To Noro-Bugs,” Barry-Eaton District Health Department

 

‘WRINGING OUR HANDS’

The Barry-Eaton District Health Department works with restaurants in dealing with the industry-wide problem of employees and sick leave. “We’ve all been wringing our hands about this since I’ve been in the business,” states Pessell. “People will come to work with norovirus because they don’t want to lose money,” he observes. 

Training is critical in order to know what to do after the affected staffer returns. Since a person with norovirus is still contagious 72 hours after no longer exhibiting symptoms, they should not be involved with food prep when they return. “Basically they can do every other job in the restaurant including cleaning and serving,” he said. 

He points to a creative idea he heard from Corporate Wellness to keep sick employees out of the workplace. Before a staffer punches in they are asked, either by computer or questionnaire, “Do you or a member of your household have vomiting or diarrhea?” 

If the answer is yes, they are told, “If you stay home, we will schedule those extra hours in another shift,” said Pessell adding that management should do everything possible to make it happen. Greg Cabose, supervisor for the Barry-Eaton District Health Department is quick to add, “That works well for large corporations but not for small restaurants.” 

“[That’s why] a business such as Corporate Wellness is so important,” said Pessell. “We dealt with them with two different issues in January and December—almost a year apart. 

In the last occurrence they had, Corporate Wellness was able to screen out three infectious employees who came to work. Cabose offers another example of a general manager continuing with Corporate Wellness even after they had worked through an outbreak. 

Large companies not only mix and match employees between units but between brands as well. Pessell said that managers have to make sure if an employee is eliminated from their restaurant they’re not going to another unit. “We don’t do it to make life difficult for the restaurant,” he said. “We do it to protect public health through intervention.”

OLD-FASHIONED HANDWASHING

Health departments and companies such as Corporate Wellness can be instrumental in providing information and training on proper handwashing and facility cleaning. 

Good old-fashioned handwashing with warm soapy water for 30 to 40 seconds will help prevent the spread of communicable diseases such as norovirus, influenza and the common cold. 

Managers must make it a culture in restaurants that not washing your hands will not be tolerated. “If somebody doesn’t show up for two or three days they get fired,” he said. “If they don’t wash their hands three times, the manager says, ‘I’ll talk to them.’ “ Not washing your hands should be as important as not showing up Pessell observes. 

HEIGHTENED AWARENESS

When an infected employee finally returns to work there is a heightened awareness among the staff especially regarding cleaning. “I want them to the point that they’re complaining their hands are cracking,” Pessell states. 

One way to lower the risk of norovirus in a foodservice setting is to make sure that proper cleaning is done frequently. Currently, use of quaternary (quat) compounds is not recommended for disinfection against norovirus. When used properly chlorine bleach has proven to be effective against norovirus particles. 

The industry got away from bleachbased products because it can be hard on employees’ hands and stainless steel. “When dealing with norovirus we don’t want to sanitize we want to disinfect,” Pessell states. 

“Even though we hand out information on how to do environmental cleanup,” he said, “unless we’re out there watching we can’t be sure it’s done correctly.” 

RECOMMENDATIONS AND OUTCOMES

At the end of the “Say NO To Noro- Bugs” presentation appears the recommendations and outcomes slide. (See accompanying chart.) The last suggestion reads, “Foster a relationship with your local health department as a valuable partner in food safety.” 

 

Sidepanel: 

Recommendations and Outcomes 

The following findings are provided by the Barry-Eaton Health Department to deal with any norovirus outbreaks. 

• Provide and maintain procedures for cleaning up biohazards (feces, vomit, blood) such as:
  • What to do with exposed food/people
  • How/when to disinfect hard surfaces, reusable foodware, linens, carpet/ upholstered furniture
  • In vomit incidents, response should be immediate and encompass the people and food/food surfaces surrounding the incident site.
• Foster a relationship with your local health department as a valuable partner in food safety.
  

Source: “Say NO To Noro-Bugs,” Barry- Eaton District Health Department