As the Ebola scare spreads in the United States and threatens the rest of the world, it is a race against time to find an effective vaccine or cure. Until then, the old reliable public health method of contact tracing, patient isolation and quarantine of suspected cases to disrupt transmission remains the only choice out there. The establishment of body temperature monitoring stations at the major airports will only capture elevated temperature symptomatic cases. This implies that infected individuals still within the incubation period of up to 21 days may not have high fever and thus may slip through the system. Examples include the index case from Liberia that arrived Dallas, Texas without elevated temperature or symptoms, and the recently infected Dallas Nurse that was cleared by CDC to fly to Cleveland, Ohio without elevated body temperature.
Apart from airports and hospitals, other public places, including retail food service outlets, have the risk of becoming potential sources of contact for fully bloom symptomatic cases that can indeed transmit the Ebola virus and infect several others. Recently a Doctor under voluntary Ebola quarantine after returning from Liberia broke the quarantine to visit her favorite restaurant.
Some of the Ebola transmission dynamics that should be a source of concern to the retail industry are as follows:
- Ebola virus is transmitted through close contact with body fluids (blood, urine, saliva, sweat, feces, vomit, breast milk, semen, etc.) from a sick Ebola patient.
- Ebola virus can spread through contact with objects likes clothes, bedding, syringes/sharps, medical equipment or contact surfaces contaminated by blood or body fluids of a patient.
- Emergency body fluids incidents are regular occurrence from customers in retail food facilities.
- According to CDC, Ebola virus dried on contact surfaces like door knobs and countertops can survive for several hours, while Ebola virus in body fluids can survive for several days on contact surfaces at room temperature.
- Restrooms at retail outlets are accessible to both customers and the general public, and thus may constitute a hazard in Ebola virus transmission, if not properly cleaned and disinfected (not sanitized!).
- Ebola patients can transmit the virus within the time frame of the first appearance of symptoms before hospital isolation. Patients may visit retail environments during this infectious period before the onset of severe symptoms that will trigger immediate hospitalization.
The foodservice and retail environment is among the vulnerable public places where infection may be possible if appropriate measures, protocols and employee training are not in place. What can retail management do differently to be ready and to proactively safeguard their facilities and protect their customers and the entire public health? The good news is that a lot of these measures are already contained in the Food Code and thus would only need to be reinforced to highlight their importance during these Ebola times.
Some of these proactive measures may include the following:
- Establish proper protocol for cleaning and disposal of body fluids (see previous blog on Combating Norovirus Hazards in Retail Foodservice). The pathogen kill-step is the most important step in any body fluid clean-up process and must be done with a disinfectant grade chemical. Adequate personal protective equipment (PPE) like gloves, disposable aprons, and protective eye goggles is mandatory.
- Compliance with use of gloves and no bare hands contact with ready-to-eat foods.
- Adequate and frequent washing of hands by food handlers while encouraging hand washing by customers through the provision of the necessary accessories in hand wash sinks. According to CDC, Ebola virus is readily killed by using soap and water, bleach or hospital grade disinfectants.
- Handle body fluids in the restroom, grocery store aisles, play areas, dining rooms, and kitchen areas as potential infectious materials.
- Establish and implement an appropriate Employee Health Policy without punitive measures; to encourage hourly paid employees to stay home when sick.
- Introduce a non-residual disinfectant grade chemical (instead of regular sanitizers) for disinfecting restrooms, play areas and high touch points like doors knobs and equipment handles. Note: Disinfectants cannot be used on food contact surfaces.
- Eliminate or put on-hold programs like Back Stage Tours that bring customers in close proximity with food and food preparation areas at the back of the house.
- Buffet style food services should develop a better strategy to completely protect food from self-service customers.
- Proper cleaning and sanitizing of food contact surfaces using best practices like the single use no-rinse cleaning and sanitizing wipes from Sani Professional (see previous blog on Clean Matters). Hand sanitizers should be made available to customers at strategic locations throughout the retail facility to encourage use.
- Training and re-training of employees on best practices cannot be over emphasized in this new era of Ebola scare and confusion.
Finally, retail and foodservice employees should be trained to recognize the obvious signs of sick customers especially if accompanied with vomiting and diarrhea. The affected incident area should be cordoned off and the facility may be closed down depending on the severity of the suspected case. The State and Local Public Health officials and the CDC should be notified immediately. In these Ebola times, it’s better to err on the side of caution than to regret actions on a potentially positive Ebola case.
It is indeed a good time also to rethink the level of food safety culture in your organization and what you can do to ensure that your organization is not in the news for the wrong reasons. Foodservice and retail operations must remain on alert until the US Public Health Service and other relevant US government agencies have a complete handle on this monumental public health emergency.