Tag Archives: norovirus

Hank Lambert, Pure Bioscience

Tech Spotlight: How Chipotle Fights Norovirus

By Food Safety Tech Staff
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Hank Lambert, Pure Bioscience

Watch another video: Antimicrobial Technology Mitigates Pathogen Risk Throughout the Supply ChainChipotle was plagued with several foodborne illness outbreaks in 2015. Norovirus was one of them. As part of the company’s commitment to addressing its food safety issues, it enlisted the help of technology from Pure Bioscience. In the following video, Hank Lambert, CEO of Pure Bioscience, explains how and where Chipotle is using the Pure Hard Surface technology in its establishments to mitigate the risk of norovirus.

Dave Shumaker, GoJo
Retail Food Safety Forum

Navigating the Complexities of Common Foodborne Illnesses

By Dave Shumaker
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Dave Shumaker, GoJo

Did you know there are more than 250 different types of foodborne illnesses? And while that number may seem daunting, especially when one in six Americans become ill from consuming contaminated foods or beverages each year, there are a few foodborne germs that are responsible for the majority of illness outbreaks, according to the CDC.1 What are these illnesses? What are their symptoms? What can you do to help reduce the risk of an outbreak happening at your restaurant?

The CDC estimates that approximately 48 million people get sick from a foodborne illness each year, with 128,000 hospitalizations and 3,000 deaths. And of these numbers, there are two common illnesses that stand out—norovirus and Salmonella. In fact, these two pathogens account for nearly 70% of all foodborne illness outbreaks in the United States.

Norovirus

Norovirus is responsible for 58% of domestically acquired foodborne illnesses and nearly half of all foodborne disease outbreaks due to known agents.2 Of these instances, most norovirus outbreaks occur in a food service setting, particularly restaurants.

Oftentimes, infected employees are the cause of these types of outbreaks. For example, individuals who are exhibiting symptoms come to work and contaminate food by touching either ready-to-eat foods or food-contact surfaces with their bare hands, which can lead to cross contamination.

Norovirus spreads easily and quickly, so people can contract it by not only by consuming contaminated foods or beverages, but also from having direct contact with individuals who are infected with the virus or touching surfaces or objects that have norovirus on them as well. In addition, norovirus outbreaks can also occur from foods that are contaminated at their source.2

In this video about Norovirus, I discuss the actions you can take, which includes practicing good hand hygiene, to reduce the risk of a norovirus outbreak negatively impacting your restaurant.

Salmonella

Each year in the United States, Salmonella is responsible for 1 million foodborne illnesses, 19,000 hospitalizations and 380 deaths.3 In fact, the pathogen accounts for 11% of all foodborne illnesses in the United States.

People become infected with Salmonella by either eating contaminated food that has not been properly cooked or has been contaminated after preparation.4 Salmonella is often found in raw food products that come from animals such as eggs, meat, and unpasteurized milk and dairy products.

While Salmonella is fairly common, measures can be taken to help reduce the risk of infection, such as through proper cooking and holding temperatures. In addition, proper disinfection and sanitization of food contact surfaces (i.e., countertops and cutting boards) helps reduce the risk of cross contamination. Practicing good hand hygiene before eating, and before and after preparing food can also help prevent the spread of this bacterium.

No one ever thinks their restaurant will fall victim to a foodborne illness outbreak, but it can happen and these outbreaks are more common than you may think. It is critical for you to share information about foodborne pathogens and prevention with your staff. This type of education and training can have a significant benefit to your restaurant.

References

  1. Centers for Disease Control and Prevention. Foodborne Germs and Illnesses. Accessed May 8, 2016. Retrieved from http://www.cdc.gov/foodsafety/foodborne-germs.html
  2. Centers for Disease Control and Prevention. Burden of Norovirus Illness and Outbreaks. Accessed May 8, 2016. Retrieved from http://www.cdc.gov/norovirus/php/illness-outbreaks.html
  3. Centers for Disease Control and Prevention. Salmonella. Accessed May 17, 2016. Retrieved from http://www.cdc.gov/salmonella/
  4. Vermont Department of Health. Salmonella. Accessed May 23, 2016. Retrieved from http://healthvermont.gov/prevent/salmonella/Salmonella.aspx
Shawn K. Stevens, Food Industry Counsel
Food Safety Attorney

The Criminal Offensive Begins

By Shawn K. Stevens
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Shawn K. Stevens, Food Industry Counsel

FDA intends to pursue criminal investigations against any food company executives or quality assurance (QA) managers involved in cases in which a link is made between a positive sample collected by the agency from a food facility or product and a foodborne illness.

In fact, the agency and the U.S. Department of Justice just announced that they will be working together to aggressively enforce food safety laws, including the Food, Drug and Cosmetic Act. In prepared remarks at a food safety conference last week, Benjamin C. Mizer, principal deputy assistant attorney, indicated that criminal prosecution of food companies is a priority moving forward. “When it comes to food safety, we have to rely on the companies who manufacture and distribute food to ensure that the food we buy is safe,” Mizer stated in his remarks. “That is why food safety is a priority for the Justice Department.  Our role in protecting consumer safety is at its apex when consumers can least protect themselves.”

In addition, the FDA is exercising nearly limitless authority to access company records during an inspection and investigation—and in many cases doing so without a warrant.

The Park Doctrine. In 1975, the Park Doctrine solidified FDA’s authority to criminally charge corporate executives and high-level managers. The Supreme Court upheld the conviction of the president of a major grocery chain who was found to be criminally liable for unsanitary conditions existing in a company distribution center, notwithstanding the argument that he had delegated the responsibility for maintaining the cleanliness of the site to his subordinates. The Supreme Court concluded that if a company ships adulterated food, the management of that company can be charged, even if they have no direct knowledge or intent. Under this standard, a food industry executive or QA manager can be sentenced to prison if he or she is aware of a circumstance or condition within his or her facility that could lead to a foodborne illness and fails to take action to correct it. If charged with this type of misdemeanor, the executive could be sentenced to up to a year in prison and a $250,000 fine for each count. On a case-by-case basis, FDA will consider the individual’s position within the company, his or her relationship to the violation, and whether in fact he or she was in a position (or had the authority) to correct the violation. The government is demonstrating that it intends to use criminal sanctions to create a deterrent and compel compliance.

Peanut Corporation of America (PCA): Salmonella outbreak (2008). PCA owner Stewart Parnell was sentenced to 28 years in prison for knowingly selling peanut products contaminated with Salmonella. His brother, a peanut broker, was sentenced to 20 years, and Parnell’s QA manager was sentenced to five years.

Quality Egg: Salmonella outbreak (2010). Quality Egg distributed products linked to a Salmonella outbreak that sickened more than 1,000 people. Company executives did not know that their products were sickening consumers but were nevertheless cited by FDA for failing to control Salmonella in the growing and processing  environment.  When the outbreak was over, FDA conducted a criminal investigation, and company executives were sentenced to three months in jail and slapped with significant fines for food safety violations.

Learn new and innovative approaches to Listeria detection & control at Food Safety Tech’s workshop | May 31–June 1, 2016 | St. Paul, MN | LEARN MOREJensen Farms: Listeria monocytogenes (2011). The company distributed cantaloupe contaminated with Listeria monocytogenes and, over a two-month period, the tainted product sickened nearly 150 people and killed more than 30. Company owners were unaware of product contamination, but federal prosecutors brought criminal charges against the company regardless, arguing that Jensen Farms failed to take appropriate steps to reduce Listeria contamination in its facility. Company owners were sentenced to five years’ probation, six months’ home detention, 100 hours of community service, and assessed individual fines of $150,000.

ConAgra: Salmonella (2006­–2007). In 2014 FDA urged criminal charges be brought against ConAgra for distributing Salmonella-contaminated peanut butter, which sickened about 700 people, between 2006 and 2007. The company pled guilty to the charges and paid more than $11 million infines.

On May 2, 2014 FDA announced its intent to pursue “[c]riminal prosecution for falsifying records, lying to FDA, knowingly putting consumers at risk, or in other appropriate cases.”

Blue Bell: Listeria monocytogenes (2010–2015). In 2015, Blue Bell Creameries was linked to an outbreak in which FDA connected positive samples from those taken at retail and those taken at production facilities to seven case patients in the CDC database who carried the same strain of Listeria. Last year the agency urged the company to recall all of its products. What’s most concerning about the investigation is the fact that the first people who became sick fell ill more than five years ago (January 2010); two more illnesses were recorded in 2011, followed by one in 2012, and three in 2014. The final illness was reported January 2015.

The U.S. Department of Justice (DOJ) confirmed that FDA and the DOJ are making criminal sanctions “a priority” when companies “fail to live up to their obligations to protect the safety of the food that all of us eat.” The DOJ, working with FDA, has served federal grand jury subpoenas to Blue Bell, and is likely scanning food company records and executive emails to justify any criminal charges. If criminal charges are indeed brought against Blue Bell, FDA will likely argue that the company was periodically finding LM in its facilities over the past five years and failed to take sufficient action to correct the condition, which (as proven by the seven matching cases in PulseNet ),  resulted in human illness. Although this seems like an extreme approach, given the ubiquitous nature of LM, it is the approach the agency is aggressively pursuing.

Chipotle Mexican Grill: Norovirus (2015). For several months last year, Chipotle was unable to contain and manage numerous foodborne illness outbreaks. In a public filing the national restaurant chain confirmed that it received a federal grand jury subpoena from the DOJ in connection with a norovirus outbreak that occurred at a location in which more than 200 customers became ill.

According to reports, Chipotle executives became aware that numerous employees had reported being sick in August 2015, yet they waited a few days before informing the local health department of the illnesses and closing the restaurant. In turn, it appears that FDA and the DOJ initiated a criminal investigation and served the grand jury subpoenas in order to gain access to corporate emails and determine whether company executives waited “too long” after learning about the illnesses to take action. On January 28, officials from Chipotle confirmed that the restaurant chain was served with a subpoena that broadened the scope of the initial criminal investigation by the U.S. Attorney’s office for the Central District of California. This subpoena requires Chipotle to produce documents and information related to company-wide food safety matters dating back to January 1, 2013, and supersedes the subpoena served in December 2015 that was limited to a restaurant in Simi Valley, California. Although FDA is trying to uncover how the recent outbreaks occurred, the agency is also engaging in a broader “fishing expedition” to determine whether there is further justification to bring criminal sanctions as a result of any of the company’s broader food safety conduct.

Multiple Non-public Cases

The DOJ, in cooperation with FDA, is currently pursuing criminal investigations against many other companies connected to other reported illnesses. As these are ongoing investigations, the underlying facts cannot be disclosed publicly. However, the most important lesson to be learned is that food companies must be prepared to better control pathogens in their environment in order to protect themselves from criminal prosecutions. My subsequent column will discuss these strategies.

Maria Fontanazza, Editor-in-Chief, Innovative Publishing Co. LLC
From the Editor’s Desk

Will It All Come Tumbling Down for Chipotle?

By Maria Fontanazza
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Maria Fontanazza, Editor-in-Chief, Innovative Publishing Co. LLC

As of late, the problems for Chipotle have been endless. 2015 was a year of several Salmonella, norovirus and E. coli outbreaks for the restaurant chain. With the first full week of the new year wrapped up, 2016 is off to perhaps an even rockier start, with news of the company being hit with both a class action lawsuit and a federal grand jury subpoena.

Company stockholder Susie Ong filed a civil complaint against Chipotle on January 8, stating that the company made false or misleading statements and failed to disclose that its “quality controls were inadequate to safeguard consumer and employee health.” Filed in the U.S. District Court for the Southern District of New York, the complaint calls out a norovirus outbreak that occurred in August in Simi Valley, California; a Salmonella outbreak in Minnesota that sickened 64 people; the closure of all company restaurants in Portland, Oregon and Seattle, Washington in November following an E.coli outbreak; and the highly-publicized norovirus outbreak that sickened more than 140 students from Boston College in Brighton, Massachusetts last month.

Ong’s complaint also mentions the federal grand jury subpoena, which Chipotle made public two days prior (January 6) in an SEC filing. Served in December, the subpoena is part of a criminal investigation by FDA and the U.S. Attorney’s Office for the Central District of California into the Simi Valley norovirus outbreak, which sickened about 100 patrons and employees (some reports state that more than 200 people fell ill). Ong’s lawsuit states that health inspectors found “dirty and inoperative equipment, equipment directly linked to the sewer, and other sanitary and health violations” at the Simi Valley restaurant.

With December’s norovirus outbreak in Brighton and the CDC’s announcement that it was further investigating five new cases of E. coli that were reported the month prior, restaurant sales were down 30% for the month, according to the SEC filing. Ong adds up all of these unfortunate events in the lawsuit, stating, “As a result of defendants’ wrongful acts and omissions, and the precipitous decline in the market value of the Company’s securities, Plaintiff and other Class members have suffered significant losses and damages.”

Chipotle has not yet publicly commented on the lawsuit.

Earlier in December, Chipotle called attention to improvements it was making to its food safety program by bringing in IEH Laboratories and Consulting Group to reevaluate its processes in an effort to prevent future outbreaks. Clearly that was not enough.

Food companies take heed. 2016 is off with a bang, and not in a good way. Last week industry was also buzzing about the DOJ’s investigation into Blue Bell Creameries over the deadly Listeria outbreak. FDA and the other federal powers-that-be are making it very clear that negligence will no longer be tolerated (Or should I say, alleged negligence, in this case). Compliance, accountability, and above all, ethical behavior are at the heart of the matter.

Will it all come tumbling down for Chipotle? It remains to be seen whether the company will be able to recover from these issues. And maybe an even bigger question is, who will be next?

Dan Okenu, Ph.D., Food Safety Manager, H-E-B
Retail Food Safety Forum

Combating Norovirus Hazards in Retail Food Service – Part 3

By Dan Okenu, Ph.D.
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Dan Okenu, Ph.D., Food Safety Manager, H-E-B

In the past two weeks, this blog has covered how Norovirus is the leading cause of foodborne illness worldwide, some potential sources of outbreak, and the importance of proper handwashing, developing an employee health policy, building a comprehensive food safety program, and training of employees. One critical aspect of Norovirus management is proper attention paid to cleaning and disposal of body fluids.

Proper cleaning and disposal of body fluids

The food code requires that retail foodservice establishments have proper procedures in place for emergency body fluids clean-up. Body fluids incidents in the dining room, play areas or back of the house are arguably the single most important source of Norovirus cross contamination in the restaurant, if clean-up and disposal are not performed according to standard operating procedures. The components of an effective and compliant SOP for emergency body fluids clean-up may include the following:

  • Written step by step procedure to contain, isolate, clean and disinfect affected areas;
  • Ready and easily accessible emergency body fluid clean-up kit;
  • Use of PPEs like disposable aprons, gloves and protective eye glasses;
  • Norovirus approved disinfectant as a kill step before and after clean-up;
  • Containment of body fluids spill using absorbent yellow spill pads to reduce aerosols;
  • Affected area should be isolated to avoid accidental dispersal by guests;
  • Discard all affected open food and decontaminate all affected surfaces;
  • Stop all food prep until body fluids are contained, cleaned and affected area disinfected;
  • Perform clean-up with disposable towels and yellow spill pads for easy disposal;
  • Wear triple gloves to avoid contaminating the clean-up kit and storage area;
  • Dispose clean-up trash straight in outside dumpster without passing through kitchen; and
  • Employee must wash hands twice, first in the bathroom and then in the kitchen.

The pathogen kill-step is the most important step in the body fluid clean-up process. The preferred option is to use a disinfectant grade chemical instead of regular sanitizers.

Ecolab’s Insta-Use Multi-purpose Disinfectant Cleaner is effective against Norovirus (and other viruses), mold, mildew and bacteria. It cleans, deodorizes and disinfects in one labor saving step and packaged in an easy to use compact cartridge with less storage space requirement. Caution: Disinfectant is not approved for food contact surfaces and cannot be used as a replacement for regular sanitizers on food contact surfaces.

Proper training of team members and associates is required before use to encourage compliance.

In conclusion, Norovirus is still a major infectious pathogen associated with foodservice operations in spite of several regulatory control and technological advances to curtail its occurrence and prevalence. Until a viable vaccine or an effective drug becomes available against Norovirus, rigorous implementation of food safety procedures, behavioral changes and continuous training of both foodservice workers and customers will remain the industry’s best practices at prevention and control. Overall, it makes a lot of business sense to do all that it takes to protect your customers against the threat of Norovirus infection, and by so doing, equally protect your business brand and the entire public health.

Dan Okenu, Ph.D., Food Safety Manager, H-E-B
Retail Food Safety Forum

Combating Norovirus Hazards in Retail Food Service – Part 2

By Dan Okenu, Ph.D.
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Dan Okenu, Ph.D., Food Safety Manager, H-E-B

Last week, in this blog we discussed that Norovirus is the leading cause of foodborne illness worldwide, some potential sources of outbreak, and the importance of proper handwashing and cleaning and disposal of body fluids. In this second part of the blog, we will cover developing an employee health policy, building a comprehensive food safety program, and training of employees.

Develop an employee health policy

It is important to develop an employee health policy with detailed guidelines for sick employees. Sick foodservice workers are required to stay off work until fully recovered and cleared by their Doctor. When an employee becomes sick at work, such an employee must report to the immediate supervisor, and be allowed to leave work to attend to the ill-health. Reportable diseases must be reported upon diagnosis to enable the Local Health Department and affected foodservice establishment take necessary actions to protect the public health. There should be a crisis management plan in case the media gets involved in any such reportable infectious disease situations. To enable ill-health reporting compliance by employees, foodservice establishments are encouraged to adopt an employee health policy that is not punitive in nature.

Managers and supervisors should also be trained to recognize abnormal behaviors and tell-tale signs of ill-health in employees who may choose not to report due to the potential of losing hourly wages. Employee health policy training should be mandatory – to report injuries, ill-health and to follow the exclusion policy from food prep until fully certified and cleared to return to work by the Doctor.

For more resources on employee health policy, please see FDA’s Employee Health and Personal Hygiene Handbook for practices and behaviors of food service workers that can help reduce the spread of infectious diseases in retail food operations.

Self-auditing of food safety procedures

Active managerial control will enable verification of the food safety program for potential corrective actions that may be required including retraining of staff. A self-auditing system will ensure that risk mitigation is applied at every stage of foodservice operations with HACCP plans implemented and verified. In addition, a third party auditing will identify the weak links in the system and help prepare the establishment for Local Health inspections. Proper cleaning and sanitation of contact surfaces, observing the temperature rule – keeping cold food cold and hot food hot or routine cleaning and sanitizing of high touch points surfaces are examples of food safety procedures that managers can evaluate and verify on daily basis to continue serving safe quality food to customers. Effective implementation of these food safety standard will have a direct correlation with reduction in cross-contamination including Norovirus prevention.

Comprehensive supplier food safety program

Food can get contaminated at any point during the farm to fork journey. A robust supplier food safety program will ensure better control of potential risk transfer in retail food operations. A system that ensures that approved certified suppliers are continuously verified will capture any potential system failure and implement corrective action both at the supplier and retail levels. The use of approved suppliers is an important risk mitigation step that should be mandatory and verified to ensure that all deliveries are of the highest food safety and quality standard. Since risk burden may be accentuated at retail foodservice due to multiple operational processes in the kitchen, it is important to assess the risk burden at the supplier level, to enable effective mitigation. Thus, a dedicated supplier food safety monitoring, evaluation and verification is absolutely required at retail foodservice to assist in eliminating any food safety weak link in the supply chain. The safe quality food outcome will remain complementary and supportive of the supply chain’s mission of “never run out”.

Training of employees on standard operating procedures

Proper and continuous training of employees is fundamental to a successful food safety program in retail food operations. We may have the best food safety program in place but if these important SOPs are not properly implemented at every operational step as a result of training gap, it may in fact introduce a greater risk into the system. Since most hourly foodservice workers are young adults with a higher than normal turn-over rate, effective communication and continuous training will help keep a good handle on the food safety know-how of each batch of employees. Consequently, it is absolutely necessary to have a certified food safety manager as the person-in-charge to oversee foodservice operations. Training the trainers, managers and training directors will assist in meeting the training needs of all employees including hourly and temporary workers and for compliance with food code requirements.

Online food safety courses and training is the preferred method of instruction for most large retail foodservice chains. These training materials can be accessed anywhere in handheld devices and can be updated in real time. Online training however should not be a replacement for personalized one-on-one onsite training on the job. Hand washing compliance, no bare hands contact with RTE foods, clean-up of body fluids, separating high risk raw chicken, beef and sea foods from RTE foods using a color coded system, and observing critical control points in the food prep process are some of the SOPs that require continuous training and verification to ensure compliance.

In conclusion, Norovirus is still a major infectious pathogen associated with foodservice operations in spite of several regulatory control and technological advances to curtail its occurrence and prevalence. Until a viable vaccine or an effective drug becomes available against Norovirus, rigorous implementation of food safety procedures, behavioral changes and continuous training of both foodservice workers and customers will remain the industry’s best practices at prevention and control. Overall, it makes a lot of business sense to do all that it takes to protect your customers against the threat of Norovirus infection, and by so doing, equally protect your business brand and the entire public health.

Dan Okenu, Ph.D., Food Safety Manager, H-E-B
Retail Food Safety Forum

Combating Norovirus Hazards in Retail Foodservice

By Dan Okenu, Ph.D.
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Dan Okenu, Ph.D., Food Safety Manager, H-E-B

Norovirus is the number one cause of foodborne disease outbreaks worldwide. It makes people sick causing nausea, stomach cramping, vomiting and diarrhea or “stomach flu” and leads to a lot of discomfort and even death, especially in vulnerable populations like children and the elderly. Elevated risk of infection is associated with certain foods that are served raw, like fruits and vegetables, contaminated ready-to-eat (RTE) foods, or improperly cooked Oysters from contaminated waters. According to the CDC, Norovirus is the leading cause of illness and outbreaks from contaminated foods in the United States, especially in retail foodservice settings like restaurants.

Some of the potential sources of Norovirus outbreaks in retail foodservice are as follows:

  • Infected food handlers
  • Infected non-food workers and guests
  • Bare hands contact with RTE foods
  • Contamination of food deliveries at source
  • Improper cleaning and disposal of body fluids
  • Training gap on sanitizer and disinfectant use
  • Aerosolized vomitus around food and people
  • Contaminated food contact and non-food contact surfaces
  • Improper hand washing by food handlers
  • Cross contamination from restrooms
  • Cross contamination from high touch points in the back of the house

It is apparent from the statistics that Norovirus constitutes a major hazard to the retail foodservice industry. The good news, however, is that there are a lot of cost-effective strategies that can be implemented in a proactive manner to reduce its spread and impact on businesses, protect customers and the bottom line. Some of these preventive measures will be discussed here and in next week’s blog post.Norovirus_thumb

Proper Hand Washing by Foodservice Workers

Proper hand washing is the most cost-effective method for preventing cross-contaminations including Norovirus in a retail foodservice environment. Hand wash sinks should be appropriately located to encourage compliance by both foodservice workers and guests. For example; the food code requires handling dry clean dishes with clean hands during the dish washing process. Thus, it makes a lot sense to install a hand wash sink in close proximity to an automated dishwasher. This will enhance hand washing compliance by Team Members before handling and stacking dry clean dishes. Adequate soap and hand sanitizers should be provided at all hand washing stations including restrooms. Whereas the use of hand sanitizers is not a replacement for proper hand washing with soap, there is evidence that hand sanitizers are effective against Norovirus. Proper hand washing remains the preferred option however, since the use of soap can indeed get rid of other cross contaminating organic matter and dirt. Incentive programs may be used to encourage frequent and proper hand washing by foodservice workers. More resources may be found at handwashingforlife.com to help foodservice establishments update their hand washing culture.

While enforcing proper hand washing among foodservice employees is desirable, it is also advisable to encourage hand washing among guests. Norovirus can be transmitted by infected guests to the foodservice establishment especially in buffet style restaurants where guests come in very close proximity with RTE foods. Facility design that encourages hand washing by guests was elegantly captured by the Florida based PDQ restaurant chain that installed a hand wash sink in their main dining room with a strong brand statement that “quality and clean go hand in hand”. The strategic location of a hand wash sink encourages hand washing by guests, especially among children in the full view of their parents, and with less cross contaminating contact surfaces as found in the restrooms.

Restroom Cleaning and Sanitation

Color coded cleaning and sanitizing tools are recommended for restrooms to prevent cross contamination. Tools will be dedicated for use in restrooms only and stored in a dedicated storage or closet to avoid accidental use in other areas of the foodservice establishment. The restroom can be the most important part of the restaurant with opportunities to prevent infections. Guests may also use the cleanliness of the restroom as a measure of food safety commitment by the retail food establishment (see my previous blog on “Clean Matters”). Thus, extra efforts are required to maintain and keep restrooms in a clean and sanitary condition all the time. Use of disinfectant grade chemicals for disinfecting restrooms, body fluids clean-up and high touch point areas is recommended. The alternative of preparing high concentration sanitizers is laborious and prone to mistakes by foodservice workers. In addition, such high concentrated sanitizers like 1000 – 5000 ppm chlorine-based sanitizer can be a safety concern to employees when used without PPEs. Frequent cleaning, disinfecting and replenishing of hand soap and sanitizers in the restroom are effective measures against restroom infections and cross contaminations including Norovirus.

Stay tuned for more preventative measures to be discussed in next week’s blog post…