An Epidemic of Food-Associated Pharyngitis and Diarrhea

The infected food handler can be responsible for the transmission of infectious intestinal diseases (IID) caused by foodborne pathogens. It is believed that personal hygiene practices with varying levels of complexity can help prevent foodborne pathogens from entering the food chain. Overall, it has been difficult to reach a consensus among stakeholders on precisely which intervention measures should be employed in food handling environments to effectively reduce IID rates. Through a study of over 300 reports of outbreaks attributed to ill or asymptomatic food handlers, hazards and contributory factors responsible for foodborne illness outbreaks were identified. With the use of the risk analysis software platforms of Analytica®, @Risk, and GoldSim®, models were created to explore measures of hygiene effectiveness. Through the use of appropriate models, results of various personal hygiene intervention measures were explored for the development of preventive management strategies, designed to improve food‐handling practices at various levels of the food chain. These included exclusion of ill food handlers, vaccination for hepatitis A virus, handwashing combined with drying, wearing of gloves, and use of instant hand sanitizers and fingernail brushes. This was accomplished by modeling pathogen transfer and transmission routes from food handler via foods, beverages and common contact surfaces using GoldSim® and Monte Carlo simulations. A lottery model was also created to understand risk as an interrelated overlapping extremes driven system, comprised of the three components of hygiene frequency, efficacy and cross‐contamination. Data gaps were identified with respect to areas where considerable variability and uncertainty exists in order to establish research priorities.

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“…Other handling practices were peeling shrimp and shelling eggs (Hill et al . 1969; Elsea et al . 1971; Lossos et al .…”

Section: Resultsmentioning

confidence: 99%

Prevention of food worker transmission of foodborne pathogens: risk assessment and evaluation of effective hygiene intervention strategies

Michaels¹,

Keller²,

Blevins

et al. 2004

Food Serv Technol

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“…Sixteen outbreaks occurred where food, primarily produce, was harvested and shipped from another country. For the United States, the countries of origin were Mexico (basil (30), green onions (10), parsley (34), and strawberries (23)); Guatemala (raspberries (20) and mamey (25)); Thailand (coconut milk (8)); and India (shrimp (16)). Parsley contaminated by both O6:H16 enterotoxigenic E. coli (34) and Shigella sonnei originated from Mexico (9).…”

Section: Secondary Spreadmentioning

confidence: 99%

Outbreaks Where Food Workers Have Been Implicated in the Spread of Foodborne Disease. Part 1. Description of the Problem, Methods, and Agents Involved

Greig

Todd

Bartleson³

et al. 2007

Journal of Food Protection

234

138

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Food workers in many settings have been responsible for foodborne disease outbreaks for decades, and there is no indication that this is diminishing. The Committee on Control of Foodborne Illnesses of the International Association for Food Protection was tasked with collecting and evaluating any data on worker-associated outbreaks. A total of 816 reports with 80,682 cases were collected from events that occurred from 1927 until the first quarter of 2006. Most of the outbreaks reviewed were from the United States, Canada, Europe, and Australia, with relatively few from other parts of the world, indicating the skewed set of data because of availability in the literature or personal contact. Outbreaks were caused by 14 agents: norovirus or probable norovirus (338), Salmonella enterica (151), hepatitis A virus (84), Staphylococcus aureus (53), Shigella spp. (33), Streptococcus Lancefield groups A and G (17), and parasites Cyclospora, Giardia, and Cryptosporidium (23). Streptococcal, staphylococcal, and typhoid outbreaks seem to be diminishing over time; hepatitis A virus remains static, whereas norovirus and maybe nontyphoidal Salmonella are increasing. Multiple foods and multi-ingredient foods were identified most frequently with outbreaks, perhaps because of more frequent hand contact during preparation and serving.

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“…For example, a Salmonella spp. outbreak in shrimp was previously linked to facilities where hand-processing of shrimp is used in India (Elsea et al, 1971). Cross-contamination during industrial shrimp processing and consumer handling and contact with kitchen surfaces was not considered, however, contamination of processing equipment surfaces and transfer to shrimp can play an important role in pathogen risks (Guobjoernsdottir et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

Salmonella risks due to consumption of aquaculture-produced shrimp

Hamilton

Chen

Johnson

et al. 2018

Microbial Risk Analysis

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The use of aquaculture is increasing to meet the growing global demand for seafood. However, the use of aquaculture for seafood production incurs potential human health risks, especially from enteric bacteria such as Salmonella spp. Salmonella spp. was the most frequently reported cause of outbreaks associated with crustaceans from 1998 to 2004. Among crustacean species, shrimp are the most economically important, internationally traded seafood commodity, and the most commonly aquaculture-raised seafood imported to the United States. To inform safe aquaculture practices, a quantitative microbial risk assessment (QMRA) was performed for wastewater-fed aquaculture, incorporating stochastic variability in shrimp growth, processing, and consumer preparation. Several scenarios including gamma irradiation, proper cooking, and improper cooking were considered in order to examine the relative importance of these practices in terms of their impact on risk. Median annual infection risks for all scenarios considered were below 10−4, however 95th percentile risks were above 10−4 annual probability of infection and 10−6 DALY per person per year for scenarios with improper cooking and lack of gamma irradiation. The greatest difference between microbiological risks for the scenarios tested was observed when comparing proper vs. improper cooking (5 to 6 orders of magnitude) and gamma irradiation (4 to 5 orders of magnitude) compared to (up to less than 1 order of magnitude) for peeling and deveining vs. peeling only. The findings from this research suggest that restriction of Salmonella spp. to low levels (median 5 to 30 per L aquaculture pond water) may be necessary for scenarios in which proper downstream food handling and processing cannot be guaranteed.

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An Epidemic of Food-Associated Pharyngitis and Diarrhea

Cited by 12 publications

References 1 publication

Prevention of food worker transmission of foodborne pathogens: risk assessment and evaluation of effective hygiene intervention strategies

Prevention of food worker transmission of foodborne pathogens: risk assessment and evaluation of effective hygiene intervention strategies

Outbreaks Where Food Workers Have Been Implicated in the Spread of Foodborne Disease. Part 1. Description of the Problem, Methods, and Agents Involved

Salmonella risks due to consumption of aquaculture-produced shrimp

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