News that Affects your Business
Clean-up Procedures for Vomit/Fecal Events
As of January 2016 the Texas Department of State Health Services requires that all food establishments have a procedure for responding to vomiting and diarrheal events. This requirement is specified in the Texas Administrative Code. Under Title 1, Health Services, Chapter 228, Retail Food, Subchapter B, Management and Personnel, Rule § 228.45, Contamination Events, it states:
“A food establishment shall have procedures for employees to follow when responding to vomiting or diarrheal events that involve the discharge of vomitus or fecal matter onto surfaces in the food service establishment. The procedures shall address the specific actions employees must take to minimize the spread of contamination and the exposure of employees, consumers, food, and surfaces to vomitus or fecal matter.”
Note: Effective cleaning of vomitus and/or fecal matter accidents in a food service establishment should be handled differently from routine cleaning/sanitizing procedures.
Vomiting and diarrheal accidents should be cleaned up using the following recommended steps:
Minimize the risk of disease transmission through the prompt removal of ill employees, customers and others from areas of food preparation, service, and storage.
Exclude all employees that are experiencing symptoms of vomiting and/or diarrhea and follow the employee health policy of when to restrict/exclude an ill food employee.
Use a chlorine bleach solution with a concentration of 1000–5000 ppm (5–25 tablespoons of household bleach [5.25%] per gallon of water) or other disinfectant registered as effective against norovirus by the Environmental Protection Agency (EPA).
Preventing Norovirus Infection
Have You Ever Heard of Norovirus?
Noroviruses can be found in your vomit or stool even before you start feeling sick. The virus can stay in your stool for 2 weeks or more after you feel better. So, it is important to continue washing your hands often during this time.
Alcohol-based hand sanitizers can be used in addition to hand washing. But, they should not be used as a substitute for washing with soap and water
There is no vaccine to prevent norovirus infection, but research is being done in this area.
Practice proper hand hygiene
Wash your hands carefully with soap and water—
especially after using the toilet and changing diapers, and
always before eating, preparing, or handling food.
Be aware that noroviruses are relatively resistant. They can survive temperatures as high as 140°F and quick steaming processes that are often used for cooking shellfish.
Food that might be contaminated with norovirus should be thrown out.
Keep sick infants and children out of areas where food is being handled and prepared.
When you are sick, do not prepare food or care for others who are sick
You should not prepare food for others or provide healthcare while you are sick and for at least 2 days after symptoms stop. This also applies to sick workers in settings such as schools and daycares where they may expose people to norovirus.
Many local and state health departments require that food workers and preparers with norovirus illness not work until at least 48 hours after symptoms stop. If you were recently sick, you can be given different duties in the restaurant, such as working at a cash register or hosting.
Clean and disinfect contaminated surfaces
Think about how you will handle this type of clean up. Do protection items need to be worn (i.e. gloves, respirator)? How will you contain liquid and airborne substances and remove them? What equipment is needed? How will it be cleaned and disinfected after use? How will you train your staff to properly handle this kind of clean up?
After throwing up or having diarrhea, immediately clean and disinfect contaminated surfaces. Use a chlorine bleach solution with a concentration of 1000–5000 ppm (5–25 tablespoons of household bleach [5.25%] per gallon of water) or other disinfectant registered as effective against norovirus by the Environmental Protection Agency (EPA).
Wash clothes or linens thoroughly
Immediately remove and wash clothes or linens that may be contaminated with vomit or stool (feces).
handle soiled items carefully without agitating them,
wear rubber or disposable gloves while handling soiled items and wash your hands after, and
wash the items with detergent at the maximum available cycle length then machine dry them.
Contamination and Clean-up of Vomit and Diarrheal Events
The use of disinfectants is one of the key approaches to interrupt norovirus spread from contaminated environmental surfaces. Special attention should be given to the areas of the greatest environmental contamination such as bathrooms, and high-touch areas/surfaces, like doorknobs and hand rails.
Sodium hypochlorite (chlorine bleach) is widely recommended to disinfect human norovirus from surfaces, and its ability to produce intended results has been well documented. It should be noted that other chemical compounds such as quaternary ammonia, and triclosan are less effective. When using a chlorine bleach solution a concentration of 1,000 to 5,000 parts per million (ppm), or 5-25 tablespoons of household bleach (5.25%) per gallon of water should be measured.
A Food Establishment shall have written procedures for employees to follow when responding to vomiting or diarrheal events that involve the discharge of vomitus or fecal matter onto surfaces in the food establishment. The procedures shall address the specific actions that employees must take to minimize the spread of contamination and the exposure of employees, consumers, food, and surfaces to vomitus or fecal matter.
Prevention and Control
Appropriate hand hygiene is likely the single most important method to prevent norovirus infection and control transmission. Using plain soap and water reduces the microbes on hands.
Practice Proper Hand Hygiene
Wash your hands with soap and hot water at the appropriate hand washing sink. Norovirus, the most common form of epidemic gastroenteritis is responsible for at least 50% of all gastroenteritis outbreaks worldwide, and it is a major cause of foodborne illness. In the US, approximately 21 million illnesses attributable to norovirus are estimated to occur annually.
Clean and Disinfect Contaminated Surfaces
After throwing up or having diarrhea, immediately clean and disinfect any contaminated surfaces. Use a chlorine bleach solution with a concentration of 1,000 to 5,000 parts per million (ppm), or 5 to 25 tablespoons of household bleach (5.25%) per gallon of water.
Disinfectants registered as effective against Norovirus by the Environmental Protection Agency (EPA) may be used in place of regular household bleach.
Handle soiled items carefully, as to prevent agitating them
Wear rubber or disposable gloves while handling soiled items, and then wash your hands afterwards
Wash the items with detergent at the maximum available cycle length
Noroviruses cause acute gastroenteritis in all people. The illness typicaly begins after an incubation period of 12- 48 hours and is characterized by acute onset, non-bloody diarrhea, vomiting, nausea, and abdominal cramps. Some persons may experience only vomiting or diarrhea. A low-grade fever and body aches may also be associated with infection, and thus the term “stomach-flu” is often used to describe the illness, although there really is no biologic association with influenza. Although symptoms might be severe, they usually resolve without treatment after 1 to 3 days in healthy persons. For high risk populations the illness may last from 4 to 6 days. Of particular concern in the context of outbreaks in long-term care facilities, are Norovirus-associated deaths.
Norovirus is shed primarily in the stool but it can also be found in the vomitus of infected persons. Peak viral shedding occurs 2 to 5 days after infection, although it can be detected in the stool on average, 4 weeks following infection. A single gram of fecal matter may account for up to 100 billion viral copies.
Norovirus is extremely contagious, and humans are the only ones known to become infected by this virus. Transmission only occurs by three general routes: foodborne, waterborne, or person-to-person. Foodborne transmission typically occurs when an infected food handler prepares and/or handles food in a foodservice operation and then serves the food to customers.
Restaurants and Catered Events
Norovirus is the leading cause of foodborne illness in the United States. And, the foodservice industry is the major contributor due to contaminations of the virus that may occur during the flow of food within an operation. For example, during processing, production, distribution, and preparation food may become contaminated. A variety of products may be implicated, such as foods eaten raw, and/or ready-to-eat foods like leafy vegetables, fruits, and shellfish when handled by an infected employee.
Norovirus outbreaks have also resulted from fecal contamination of certain products at the source, such as oysters harvested from feces-contaminated water, and/or raspberries irrigated with sewage-contaminated water.
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