research, rumors & realities programs extending lab data into restaurant research august 15,...
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Research, Rumors & RealitiesPrograms extending lab data into restaurant research
Research, Rumors & RealitiesPrograms extending lab data into restaurant research
August 15, 2007National Restaurant Association
Viruses Impacting the Restaurant and Foodservice Industry
Jim Mann
Viral IssuesViral Issues
• Business / Restaurant risk
• Hand sanitizer efficacy against the hard to kill viruses
• Risk reduction without running water
• Restaurant level approaches & compliance
Assessing Your RiskAssessing Your Risk
It is a Growing Risk
It is a Growing Risk
People ServedPeople Served
Break this chain! … manage as if you have an ill employee on every shift.Break this chain! … manage as if you have an ill employee on every shift.
FecalHand
Oral
Where we are …Virus, the Model Food Code & Compliance
Where we are …Virus, the Model Food Code & Compliance
Intervention: Vaccine
Industry Compliance
20092005
Hep A
Small scale usage
Hep A
Increased usage
Model Food Code
Las Vegas: Hand Hygiene Capital of the World
The war on virus - Hep A reportLas Vegas: Hand Hygiene Capital of the World
The war on virus - Hep A report
7664
124
209
273
385
188
110
69
49
2617
7 13 7
0
50
100
150
200
250
300
350
400
450
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Year
Cases
Structural Classification of VirusesStructural Classification of Viruses
EnvelopedNon-Enveloped
Adenovirus
Hepatitis A
Norovirus
Papillomavirus
Poliovirus
Rhinovirus
Rotavirus
Hepatitis B virus
Hepatitis C virus
Herpes Virus
HIV
Influenza viruses
Respiratory Syncitial Virus
SARS-CoV
The Non-enveloped Virus ProblemThe Non-enveloped Virus Problem
• 30.9 million cases of foodborne illnesses/year*
• 23 million from norovirus*
• Lack of new vaccines
• “The majority of viruses for which hand transmission plays a critical role are non-enveloped.” Dr. Macinga
*Mead et. al., Emerging Infectious Diseases, 1999, 5:607.
Where we are …Virus, the Model Food Code & Compliance
Where we are …Virus, the Model Food Code & Compliance
Intervention: Alcohol Hand Sanitizer
Where water is readily available
Industry Compliance
20092005
Only after handwashing
Usage by few
A light soiling alternative to handwashing
(Synergized Alcohol Formulae, min 3 log reduction)
Usage by many
Model Food Code
In vitro Virucidal EfficacyIn vitro Virucidal Efficacy
Method: Quantitative Suspension Test (30 sec)
1E.J. Fendler et. al., “Efficacy of Alcohol-Based Hand Sanitizers Against Fungi and Viruses”; Infection Control and Hospital Epidemiology, Feb. 2002, 23, 2, p. 61-622D.M. Macinga et. al., “Inactivation of Viruses Using a Synergistically Formulated Alcohol-Based Hand Sanitizer”, IAFP Annual Conference, July 2007
Non-e
nvelo
ped
Envelo
ped
Improved efficacy vs. non-enveloped
viruses
Type VirusLog10 Reduction
Current1 New2
Feline Calicivirus F-9 1.00 ≥4.75
Mouse Norovirus 1.16 ≥ 3.68
Adenovirus type 2 0.50 2.75
Hepatitis A 0.00 1.75*
Poliovirus type 1 0.00 3.50
Rhinovirus type 37 2.75 ≥ 3.25
Rotavirus WA ≥ 5.75 ≥ 4.75
Influenza A ≥ 6.25 ≥ 5.25
Influenza B ≥ 5.75 ≥ 4.25
Avian Influenza (H5N1) ≥ 3.50 ≥ 3.75
Respiratory Syncytial Virus ≥ 2.50 ≥ 1.50
In vitro Virucidal Efficacy: Fingerpad
Method: Quantitative Suspension Test (30 sec)
0
1
2
3
4
5
6
7
FelineCalicivirus
MouseNorovirus
Adenovirus Hepatitis A Poliovirus Rhinovirus Rotavirus
Log
10 Reduction From Baseline
Current New
**
**
* Complete inactivation below detection limit
*
More Viral Efficacy DataMore Viral Efficacy Data
• Research is on the rise
• Hand sanitizer efficacy and viral detection are hot spots
• In-vivo data presented and in press
• Stay tuned…
Where we are …Virus, the Model Food Code & Compliance
Where we are …Virus, the Model Food Code & Compliance
Intervention: Alcohol Hand Sanitizer-
SaniTwice ProcessWhere water is not readily available
Industry Compliance
20092005
Usage in special situations (military)
A light soiling alternative to handwashing
A moderate soiling alternative to handwashing when used with a nailbrush
(Synergized Alcohol Formulae, min 3 log reduction)
Usage by many
Model Food Code
Where we are …Virus, the Model Food Code & Compliance
Where we are …Virus, the Model Food Code & Compliance
Step 1 – Apply alcohol hand-sanitizer generously.
Step 2 – “Wash” vigorously for 20 seconds.
Step 3 – Wipe off / dry with a disposable paper towel.
Step 4 – Re-apply alcohol hand-sanitizer according to label instructions.
Introducing SaniTwiceTM
For light to moderate soiling, when water is not readily available.
SaniTwice Study - NEHASaniTwice Study - NEHA
Participants: 44 FDA, USDA, CDC, Operators & Academia
Test Method:
1. Contaminate hands with UV tracer.
2. Use SaniTwice method.
3. Measure residues using UV light.
Results:
“Surprised with the level of cleaning.”
Break this chain! … manage as if you have an ill employee on every shift.Break this chain! … manage as if you have an ill employee on every shift.
FecalHand
Oral
“Not reasonably safe”“Not reasonably safe”
Jaundice (Yellowing of the Eyes &
Skin)
Health Monitoring, Ill employee exclusionHealth Monitoring, Ill employee exclusion
Where we are …Virus, the Model Food Code & Compliance
Where we are …Virus, the Model Food Code & Compliance
Intervention: Handwashing
Industry Compliance
“Handwashing compliance is no longer about training or the Food Code, it’s about filling
the voids in operational standards and management information systems.”
Jim Mann
20092005
Almost everything covered
Poor
Almost everything covered
(See Issue Incubator)
Measurement, documentation,QA/audited systems
Model Food Code
Management Information Initiative Maricopa County, RTE…variance programManagement Information Initiative Maricopa County, RTE…variance program
Participating Operators: 210 Independent & chain restaurants:
Taco Bell, Burger King, Arby’s, Jack-in-the-Box, Sonic, Kona Grill, KFC, Cold Stone Creamery & more
“Operators are rewarded for taking control of their handwashing, making it a system which they monitor and document.”
David Ludwig, Maricopa County
Hand Hygiene: A Game of Chance … or a managed system
Hand Hygiene: A Game of Chance … or a managed system
ProGrade™:Each employee periodically demonstrates their handwashing proficiency.
Handwashing …establishing your Safe Level for quality
Handwashing …establishing your Safe Level for quality
Handwashing FrequencyMyQ™ - Safe Level WorksheetHandwashing FrequencyMyQ™ - Safe Level Worksheet
Event Prep Server/Drive-Thru Busser
Arrival
Pre/Post Break
Restroom Use
Task Change
Pre/Post Gloving
Nose/Facial Touch/Sneeze
Customer Contact
Departure
Totals
W= Wash S= Sanitize
Shift Standard
Documented Success
“ What getsmeasured gets done.”
Documented Success
“ What getsmeasured gets done.”
5. Monitor
Contact us:Contact us:
Jim MannExecutive DirectorThe Handwashing For Life® Institute
1216 Flamingo ParkwayLibertyville, IL 60048