NRA virus confab frames contagious workers as leading food safety threat

Nation's Restaurant News, August 27, 2007 by Peter Romeo

ATLANTA -- The restaurant industry may have to rethink its sick-leave policies because the usual, current procedures pose a significant risk to public health, operators learned during a conference here on the runaway dangers of viral infections.

The research behind those findings could foster support for measures long resisted by the industry, including paid sick leave and viral inoculations of all food handlers--if not all young people. Researchers' conclusions also are likely to rescript the conversations that take place between restaurant managers and employees who say they're sick, with employers asking questions about staffers' bathroom habits, participating experts agreed.

"You're going to have to do things differently," said Dr. Alan Harris, an epidemiologist for Rush-University Medical Center in Illinois and a food-safety advisor to McDonald's Corp.

The near-indictment of prevailing sick-leave practices was just one of the scientific discussions that seemed to startle the restaurant operators, suppliers and regulators attending "Viruses." Co-hosted by the National Restaurant Association and its educational sister, the NRA Educational Foundation, the two-day conference is believed to be the first industry gathering devoted to viruses, which participants invariably cited as the gravest food-safety issue now confronting the industry.

In particular, they noted the surge in restaurant-related infections from norovirus. The bug, also known as the cruise-ship or Norwalk virus, is hands-down the leading cause today of food contaminations, accounting for about 23 million of the 30.9 million cases of foodborne illness that are now tabulated annually by government agencies. About 39 percent of those persons afflicted with vomiting, diarrhea and other symptoms of the infections are sickened in foodservice establishments, said Christine Moe, a viral expert and researcher at Emory University.

An official with the U.S. Centers for Disease Control and Prevention attributed 41 percent of the nation's norovirus outbreaks to restaurants and delis, citing the agency's updated data.

"There is no reduction noticed in the incidence," said Carol Selman, senior environmental health officer for the CDC. "Eating outside the home is a risk factor for foodborne disease."

Jan Vinje, head of the CDC's National Calicivirus Laboratory, noted that the end of 2006 was a particularly "enormous winter" for the norovirus, which falls within the larger classification of calicivirus. During the last few months of the year, outbreaks affecting about 1,500 restaurant customers were reported in Syracuse, N.Y.; Lansing, Mich.; and Indianapolis. Three restaurants in total were implicated.

Yet, as many speakers observed, norovirus was viewed until recently as much less of a restaurant threat than bacterial pathogens like E. coli, salmonella and listeria. The industry's leading defense against foodborne illness, the ServSafe training and certification program, focuses on microbes of that sort.

"A lot of what we'd been doing is geared to bacteria," said Jim Mann, executive director of a safety advocacy group called the Handwashing Institute for Life. "We have to change that, because this new bug is coming in through both doors."

As Mann indicated, the prevalence of norovirus in restaurants can be attributed in part to the potential for contamination from guests as well as employees. As few as 10 particles of the virus can result in an infection, and the virus is extremely difficult to eradicate.

Attendees learned just how difficult from Moe's presentation. A study conducted under her auspices determined that norovirus can survive on kitchen and bathroom surfaces for three to six weeks. The potential for infection can persist in water for 61 days or longer.

The audience seemed particularly stunned by Moe's finding that employees who contract norovirus can pose a significant threat of contamination to guests and co-workers for weeks after symptoms disappear. As several speakers and attendees noted, virtually every restaurant operator prohibits employees from working if they've shown those classic signs of a noroviral infection and then order them to stay home for two or three more days as a measure of safety. By that time, according to the prevailing wisdom, the risk of spreading the virus has passed.

But employees showing no symptoms may still "shed" the norovirus, or excrete it in large quantities in their feces, for 20 to 35 days afterward, Moe determined in her studies. A gram of feces could contain tens of millions of norovirus. With just 10 organisms needed to infect someone, the smallest residue on a food worker's hand could be sufficient to contaminate a large number of guests.

"Hand washing and the wearing of gloves is the only way to control it," Moe said.

Yet, as others noted, neither of those remedies is fail-safe.

Alan Tart, a regional food specialist for the U.S. Food and Drug Administration, calculated that the feces of a food worker shedding norovirus would contain 10 million of the microbes.