Hand Hygiene Regimens for the Reduction of Risk in Food Service Environments

2012 ◽  
Vol 75 (7) ◽  
pp. 1303-1309 ◽  
Author(s):  
SARAH L. EDMONDS ◽  
ROBERT R. McCORMACK ◽  
SIFANG STEVE ZHOU ◽  
DAVID R. MACINGA ◽  
CHRISTOPHER M. FRICKER
Keyword(s):  
Hand Hygiene ◽  
Food Service ◽  
Hand Washing ◽  
Soil Conditions ◽  
Murine Norovirus ◽  
Human Norovirus ◽  
E Coli ◽  
Log Reduction ◽  
Product Formulation ◽  
The Impact

Pathogenic strains of Escherichia coli and human norovirus are the main etiologic agents of foodborne illness resulting from inadequate hand hygiene practices by food service workers. This study was conducted to evaluate the antibacterial and antiviral efficacy of various hand hygiene product regimens under different soil conditions representative of those in food service settings and assess the impact of product formulation on this efficacy. On hands contaminated with chicken broth containing E. coli, representing a moderate soil load, a regimen combining an antimicrobial hand washing product with a 70% ethanol advanced formula (EtOH AF) gel achieved a 5.22-log reduction, whereas a nonantimicrobial hand washing product alone achieved a 3.10-log reduction. When hands were heavily soiled from handling ground beef containing E. coli, a wash-sanitize regimen with a 0.5% chloroxylenol antimicrobial hand washing product and the 70% EtOH AF gel achieved a 4.60-log reduction, whereas a wash-sanitize regimen with a 62% EtOH foam achieved a 4.11-log reduction. Sanitizing with the 70% EtOH AF gel alone was more effective than hand washing with a nonantimicrobial product for reducing murine norovirus (MNV), a surrogate for human norovirus, with 2.60- and 1.79-log reductions, respectively. When combined with hand washing, the 70% EtOH AF gel produced a 3.19-log reduction against MNV. A regimen using the SaniTwice protocol with the 70% EtOH AF gel produced a 4.04-log reduction against MNV. These data suggest that although the process of hand washing helped to remove pathogens from the hands, use of a wash-sanitize regimen was even more effective for reducing organisms. Use of a high-efficacy sanitizer as part of a wash-sanitize regimen further increased the efficacy of the regimen. The use of a well-formulated alcohol-based hand rub as part of a wash-sanitize regimen should be considered as a means to reduce risk of infection transmission in food service facilities.

SaniTwice: A Novel Approach to Hand Hygiene for Reducing Bacterial Contamination on Hands When Soap and Water Are Unavailable

2010 ◽  
Vol 73 (12) ◽  
pp. 2296-2300 ◽  
Author(s):  
SARAH L. EDMONDS ◽  
JAMES MANN ◽  
ROBERT R. McCORMACK ◽  
DAVID R. MACINGA ◽  
CHRISTOPHER M. FRICKER ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Hand Washing ◽  
Food Handling ◽  
E Coli ◽  
Log Reduction ◽  
Novel Approach ◽  
Standard Application ◽  
Paper Towels ◽  
Foodborne Infections

The risk of inadequate hand hygiene in food handling settings is exacerbated when water is limited or unavailable, thereby making washing with soap and water difficult. The SaniTwice method involves application of excess alcohol-based hand sanitizer (ABHS), hand “washing” for 15 s, and thorough cleaning with paper towels while hands are still wet, followed by a standard application of ABHS. This study investigated the effectiveness of the SaniTwice methodology as an alternative to hand washing for cleaning and removal of microorganisms. On hands moderately soiled with beef broth containing Escherichia coli (ATCC 11229), washing with a nonantimicrobial hand washing product achieved a 2.86 (±0.64)-log reduction in microbial contamination compared with the baseline, whereas the SaniTwice method with 62% ethanol (EtOH) gel, 62% EtOH foam, and 70% EtOH advanced formula gel achieved reductions of 2.64 ±0.89, 3.64 ±0.57, and 4.61 ±0.33 log units, respectively. When hands were heavily soiled from handling raw hamburger containing E. coli, washing with nonantimicrobial hand washing product and antimicrobial hand washing product achieved reductions of 2.65 ± 0.33 and 2.69 ± 0.32 log units, respectively, whereas SaniTwice with 62% EtOH foam, 70% EtOH gel, and 70% EtOH advanced formula gel achieved reductions of 2.87 ±0.42, 2.99 ± 0.51, and 3.92 ± 0.65 log units, respectively. These results clearly demonstrate that the in vivo antibacterial efficacy of the SaniTwice regimen with various ABHS is equivalent to or exceeds that of the standard hand washing approach as specified in the U.S. Food and Drug Administration Food Code. Implementation of the SaniTwice regimen in food handling settings with limited water availability should significantly reduce the risk of foodborne infections resulting from inadequate hand hygiene.

scholarly journals A mHealth intervention to promote hand-washing and cell phone cleaning in medical residents of a public hospital in Peru

2021 ◽  
Vol 15 (03) ◽  
pp. 428-435
Author(s):  
Maria Lazo-Porras ◽  
Matilde Corante ◽  
Tania De La Cruz-Saldaña ◽  
Ingrid Bohórquez ◽  
Kalina Campos ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Hand Hygiene ◽  
Cell Phones ◽  
Bacterial Colonization ◽  
Hand Washing ◽  
Medical Residents ◽  
Chi Square ◽  
Mhealth Intervention ◽  
Hospital Acquired ◽  
The Impact

Introduction: We explore the limitations to adherence of hand-washing and evaluate the impact of a mHealth intervention for hand hygiene in residents. Methodology: We explore resident's perspectives about Hospital-acquired infections (HAI) and hand washing. In baseline, participants completed socio-demographic characteristics and hand-washing habits survey. The intervention consisted of sending SMS three times a week for two months about hand hygiene and “five moments” for hand washing. The cultures of hands and cell phones were analyzed at baseline, 2 months and 4 months. We used chi-square and adjusted Generalized Estimating Equations. Results: Five physicians were interviewed and 33 participants were included for quantitative analysis. Critical barriers that hinder hand washing were identified. The proportion of Staphylococcus aureus in hands was 54.5% at baseline and was significantly reduced at 2 months follow-up (p = 0.009), but, benefit was lost when the intervention was discontinued; Escherichia coli and Klebsiella sp. were observed in 22.2% of hands, no changes were noted with intervention. In cell phones, there was a tendency to lower values of bacterial colonization after intervention for Staphylococcus aureus growth. Conclusions: High prevalence of contamination in hands and phones in medical residents were found. Serious barriers to compliance with hand washing must be overcome. It is possible that prolonged or continuous interventions could be necessary to optimize hand washing and reduce hand and cell phones contamination.

scholarly journals Attach Me If You Can: Murine Norovirus Binds to Commensal Bacteria and Fungi

Viruses ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 759 ◽  
Author(s):  
Jasmine L. Madrigal ◽  
Sutonuka Bhar ◽  
Samantha Hackett ◽  
Haley Engelken ◽  
Ross Joseph ◽  
...  
Keyword(s):  
Incubation Temperature ◽  
Growth Conditions ◽  
Fungal Species ◽  
Commensal Bacteria ◽  
Murine Norovirus ◽  
Human Norovirus ◽  
Viral Pathogens ◽  
Bacteria And Fungi ◽  
The Impact ◽  
Murine Noroviruses

The presence of commensal bacteria enhances both acute and persistent infection of murine noroviruses. For several enteric viral pathogens, mechanisms by which these bacteria enhance infection involve direct interactions between the virus and bacteria. While it has been demonstrated that human noroviruses bind to a variety of commensal bacteria, it is not known if this is also true for murine noroviruses. The goal of this study was to characterize interactions between murine noroviruses and commensal bacteria and determine the impact of bacterial growth conditions, incubation temperature and time, on murine norovirus attachment to microbes that comprise the mammalian microbiome. We show that murine noroviruses bind directly to commensal bacteria and show similar patterns of attachment as human norovirus VLPs examined under the same conditions. Furthermore, while binding levels are not impacted by the growth phase of the bacteria, they do change with time and incubation temperature. We also found that murine norovirus can bind to a commensal fungal species, Candida albicans.

scholarly journals Scientific Evidence Supports the Use of Alcohol Based Hand Sanitizers as an Effective Alternative to Handwashing in Retail Food and Foodservice Settings When Heavy Soiling is Not Present on Hands

2020 ◽  
Author(s):  
John M. Boyce ◽  
Donald W. Schaffner
Keyword(s):  
Hand Hygiene ◽  
Scientific Evidence ◽  
Food Service ◽  
Hand Washing ◽  
World Health ◽  
Healthcare Personnel ◽  
General Interest ◽  
Healthcare Settings ◽  
Model Food ◽  
Retail Food

Suboptimal food worker health and hygiene has been a common contributing factor in foodborne disease outbreaks for many years. Despite clear FDA Model Food Code recommendations for hand washing and glove use, food worker compliance with handwashing recommendations has remained poor for more than 20 years. Food workers’ compliance with recommended handwashing is adversely impacted by a number of barriers, including complaints of time pressure, inadequate number and/or location of handwashing sinks and handwashing supplies, lack of food knowledge and training regarding handwashing, the belief that wearing gloves obviates the need for hand washing, insufficient management commitment, and adverse skin effects caused by frequent handwashing. While many of the issues related to poor handwashing practices in food service facilities are the same as those in healthcare settings, a new approach to healthcare hand hygiene was deemed necessary over 15 years ago due to persistently low compliance rates among healthcare personnel. Evidence-based hand hygiene guidelines for healthcare settings were published by both CDC in 2002 and by the World Health Organization in 2009. Despite similar low handwashing compliance rates among retail food establishment workers, no changes in the Food Code indications for handwashing have been made since 2001. In direct contrast to healthcare settings, where frequent use of alcohol-based hand sanitizers (ABHSs) in lieu of handwashing has improved hand hygiene compliance rates and reduced infections, the Food Code continues to permit the use of ABHSs only after hands have been washed with soap and water. This general interest manuscript provides clear evidence to support modifying the FDA Model Food Code to  allow the use of ABHS as an acceptable alternative to handwashing in situations where heavy soiling is not present . Emphasis on the importance of handwashing when hands are heavily soiled and appropriate use of gloves are still indicated.

Persistence of Escherichia coli on Injured Iceberg Lettuce in the Field, Overhead Irrigated with Contaminated Water

2009 ◽  
Vol 72 (3) ◽  
pp. 458-464 ◽  
Author(s):  
FIONA BARKER-REID ◽  
DEAN HARAPAS ◽  
SIEGFRIED ENGLEITNER ◽  
SIMONE KREIDL ◽  
ROBERT HOLMES ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Management Practices ◽  
Microbiological Quality ◽  
Contaminated Water ◽  
E Coli ◽  
Log Reduction ◽  
Iceberg Lettuce ◽  
Quality Of Water ◽  
Plant Injury ◽  
The Impact

Fresh produce is increasingly implicated in food-related illnesses. Escherichia coli can survive in soil and water and can be transferred onto plant surfaces through farm management practices such as irrigation. A trial was conducted to evaluate the impact of field conditions on E. coli persistence on iceberg lettuce irrigated with contaminated water, and the impact of plant injury on the persistence of E. coli. Lettuce heads were injured at 14, 7, 3, 2, 1, and 0 days before inoculation, with uninjured heads used as a control. All lettuce heads (including controls) were overhead irrigated with a mixture of nonpathogenic E. coli strains (107 CFU/ml). E. coli counts were measured on the day of inoculation and 5 days after, and E. coli was detected on all lettuce head samples. Injury immediately prior to inoculation and harvest significantly (P = 0.00067) increased persistence of E. coli on lettuce plants. Harsh environmental conditions (warm temperatures, limited rainfall) over 5 days resulted in a 2.2-log reduction in E. coli counts on uninjured lettuce plants, and lettuce plants injured more than 2 days prior to inoculation had similar results. Plants with more recent injuries (up to 2 days prior to inoculation) had significantly (P = 7.6 × 10−6) greater E. coli persistence. Therefore, growers should postpone contaminated water irrigation of lettuce crops with suspected injuries for a minimum of 2 days, or if unavoidable, use the highest microbiological quality of water available, to minimize food safety risks.

scholarly journals Hand-hygiene mitigation strategies against global disease spreading through the air transportation network

2019 ◽  
Author(s):  
Christos Nicolaides ◽  
Demetris Avraam ◽  
Luis Cueto-Felgueroso ◽  
Marta C. González ◽  
Ruben Juanes
Keyword(s):  
Public Health ◽  
Hand Hygiene ◽  
Infectious Diseases ◽  
Transportation Network ◽  
Air Transportation ◽  
Mitigation Strategies ◽  
Hand Washing ◽  
World Health ◽  
The World ◽  
The Impact

ABSTRACTHand hygiene is considered as an efficient and cost-effective way to limit the spread of diseases and, as such, it is recommended by both the World Health Organization (WHO) and the Centres for Disease Control and Prevention (CDC). While the effect of hand washing on individual transmissibility of a disease has been studied through medical and public-health research, its potential as a mitigation strategy against a global pandemic has not been fully explored yet. In this study, we investigate contagion dynamics through the world air transportation network and analyze the impact of hand-hygiene behavioural changes of airport population against the spread of infectious diseases worldwide. Using a granular dataset of the world air transportation traffic, we build a detailed individual mobility model that controls for the correlated and recurrent nature of human travel and the waiting-time distributions of individuals at different locations. We perform a Monte-Carlo simulation study to assess the impact of different hand-washing mitigation strategies at the early stages of a global epidemic. From the simulation results we find that increasing the hand cleanliness homogeneously at all airports in the world can inhibit the impact of a potential pandemic by 24 to 69%. By quantifying and ranking the contribution of the different airports to the mitigation of an epidemic outbreak, we identify ten key airports at the core of a cost-optimal deployment of the hand-washing strategy: increasing the engagement rate at those locations alone could potentially reduce a world pandemic by 8 to 37%. This research provides evidence of the effectiveness of hand hygiene in airports on the global spread of infectious diseases, and has important implications for the way public-health policymakers may design new effective strategies to enhance hand hygiene in airports through behavioral changes.

Evaluation of Murine Norovirus Persistence in Environments Relevant to Food Production and Processing

2011 ◽  
Vol 74 (11) ◽  
pp. 1847-1851 ◽  
Author(s):  
S. FALLAHI ◽  
K. MATTISON
Keyword(s):  
Stainless Steel ◽  
Food Production ◽  
Room Temperature ◽  
Potable Water ◽  
Plaque Assay ◽  
The Other ◽  
Murine Norovirus ◽  
Human Norovirus ◽  
Log Reduction ◽  
Virus Survival

Human norovirus (NoV) causes outbreaks of acute gastroenteritis associated with many ready-to-eat foods, including fresh produce. Effective inactivation procedures must consider virus survival under conditions of produce production and processing. This study aimed to investigate the persistence of NoV in a variety of environments, using murine NoV (MNV) as a surrogate for NoV. MNV was incubated for up to 42 days at room temperature on stainless steel disks, on lettuce, on soil, and in potable water and titers determined by plaque assay. A 1-log reduction of MNV infectivity was observed after 29 days in water, 4 days on lettuce, 12 days on soil, and 15 days on stainless steel disks. MNV survived longer in water than in any of the other environments, indicating that drying may contribute to NoV inactivation. MNV genomes were not significantly reduced for up to 42 days, suggesting that genomic detection is not a reliable indicator of viability. Overall, our findings provide valuable information regarding the potential for NoV transmission in the food supply.

A Crossover Trial of Antimicrobial Scrubs to Reduce Methicillin-Resistant Staphylococcus aureus Burden on Healthcare Worker Apparel

2012 ◽  
Vol 33 (3) ◽  
pp. 268-275 ◽  
Author(s):  
Gonzalo M. L. Bearman ◽  
Adriana Rosato ◽  
Kara Elam ◽  
Kakotan Sanogo ◽  
Michael P. Stevens ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Hand Hygiene ◽  
Healthcare Worker ◽  
Crossover Trial ◽  
Prospective Trial ◽  
Bacterial Burden ◽  
Log Reduction ◽  
Hygiene Practices ◽  
And Control ◽  
The Impact

Background.The impact of antimicrobial scrubs on healthcare worker (HCW) bacterial burden is unknown.Objective.To determine die effectiveness of antimicrobial scrubs on hand and apparel bacterial burden.Design.Prospective, crossover trial.Setting and Participants.Thirty HCWs randomized to study versus control scrubs in an intensive care unit.Methods.Weekly microbiology samples were obtained from scrub abdominal area, cargo pocket, and hands. Mean log colony-forming unit (CFU) counts were calculated. Compliance with hand hygiene practices was measured. Apparel and hand mean log CFU counts were compared.Results.Adherence measures were 78% (910/1,173) for hand hygiene and 82% (223/273) for scrubs. Culture compliance was 67% (306/460). No differences were observed in bacterial hand burden or in HCWs with unique positive scrub cultures. No difference in vancomycin-resistant enterococci (VRE) and gram-negative rod (GNR) burden was observed. A difference in mean log mediicillin-resistant Staphylococcus aureus (MRSA) CFU count was found between study and control scrubs for leg cargo pocket (mean log CFUs, 11.84 control scrub vs 6.71 study scrub; P = .0002), abdominal area (mean log CFUs, 11.35 control scrub vs 7.54 study scrub; P = .0056), leg cargo pocket at die beginning of shift (mean log CFUs, 11.96 control scrub vs 4.87 study scrub; P = .0028), and abdominal area pocket at die end of shift (mean log CFUs, 12.14 control scrubs vs 8.22 study scrub; P = .0054).Conclusions.Study scrubs were associated witfi a 4–7 mean log reduction in MRSA burden but not VRE or GNRs. A prospective trial is needed to measure die impact of antimicrobial impregnated apparel on MRSA transmission rates.Infect Control Hosp Epidemiol 2012;33(3):268-275

Hydrogen Peroxide Vapor Decontamination in a Patient Room Using Feline Calicivirus and Murine Norovirus as Surrogate Markers for Human Norovirus

2016 ◽  
Vol 37 (5) ◽  
pp. 561-566 ◽  
Author(s):  
Torsten Holmdahl ◽  
Mats Walder ◽  
Nathalie Uzcátegui ◽  
Inga Odenholt ◽  
Peter Lanbeck ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Cell Culture ◽  
Tissue Culture ◽  
Feline Calicivirus ◽  
Murine Norovirus ◽  
Patient Room ◽  
Human Norovirus ◽  
Log Reduction ◽  
Infective Dose ◽  
Hydrogen Peroxide Vapor

OBJECTIVETo determine whether hydrogen peroxide vapor (HPV) could be used to decontaminate caliciviruses from surfaces in a patient room.DESIGNFeline calicivirus (FCV) and murine norovirus (MNV) were used as surrogate viability markers to mimic the noncultivable human norovirus. Cell culture supernatants of FCV and MNV were dried in triplicate 35-mm wells of 6-well plastic plates. These plates were placed in various positions in a nonoccupied patient room that was subsequently exposed to HPV. Control plates were positioned in a similar room but were never exposed to HPV.METHODSVirucidal activity was measured in cell culture by reduction in 50% tissue culture infective dose titer for FCV and by both 50% tissue culture infective dose titer and plaque reduction for MNV.RESULTSNeither viable FCV nor viable MNV could be detected in the test room after HPV treatment. At least 3.65 log reduction for FCV and at least 3.67 log reduction for MNV were found by 50% tissue culture infective dose. With plaque assay, measurable reduction for MNV was at least 2.85 log units.CONCLUSIONSThe successful inactivation of both surrogate viruses indicates that HPV could be a useful tool for surface decontamination of a patient room contaminated by norovirus. Hence nosocomial spread to subsequent patients can be avoided.Infect Control Hosp Epidemiol 2016;37:561–566

scholarly journals Inactivation of human norovirus and its surrogate by the disinfectant consisting of calcium hydrogen carbonate mesoscopic crystals

2019 ◽  
Vol 366 (19) ◽  
Author(s):  
Hidekatsu Shimakura ◽  
Fumihiro Gen-Nagata ◽  
Makoto Haritani ◽  
Koichi Furusaki ◽  
Yusei Kato ◽  
...  
Keyword(s):  
Murine Norovirus ◽  
Human Norovirus ◽  
Viral Capsids ◽  
Log Reduction ◽  
Transmission Electron ◽  
Environmental Surfaces ◽  
Mesoscopic Structure ◽  
Hydrogen Carbonate ◽  
Polymerase Chain ◽  
Inactivation Effect

ABSTRACT Human norovirus is one of the major causes of foodborne gastroenteritis, and it can be easily transmitted from infected person, virus-contaminated foods and environmental surfaces. Effective disinfection method is needed to stop the transmission of human norovirus. CAC-717 is a new disinfectant consisting of calcium hydrogen carbonate mesoscopic crystals. We aimed to evaluate the efficacy of CAC-717 against human norovirus. This study used human norovirus derived from fecal specimens and cultured murine norovirus, which is one of the surrogate viruses for human norovirus. The disinfection effect against murine norovirus was estimated by infectivity assay and transmission electron microscopy. The inactivation effect against human norovirus was assessed by reverse transcription polymerase chain reaction. Disinfection effect of CAC-717 against the infectivity of murine norovirus was shown within 100 s after the CAC-717 treatment, presenting the destruction of viral capsids. The treatment of CAC-717 significantly reduced human norovirus genomic RNA (3.25-log reduction) by the presence of the mesoscopic structure of calcium hydrogen carbonate. CAC-717 stably inactivated human norovirus in stool suspensions. The inactivation effect of CAC-717 against human norovirus was less susceptible to organic substances than sodium hypochlorite. CAC-717 would be a useful alternative for disinfecting human norovirus in contaminated environmental surfaces.

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