Food Borne IllnessFood Borne Illness

Letha Quashie Letha Quashie

PHD Public Health PHD Public Health

Walden UniversityWalden University

PUBH 8165- 10PUBH 8165- 10

Instructor: Dr. Howard RubinInstructor: Dr. Howard Rubin

Spring, 2011Spring, 2011

Foodborne IllnessFoodborne Illness

PurposePurpose The purpose of this discussion is to The purpose of this discussion is to

provide information on foodborne illnesses provide information on foodborne illnesses that can affect food handlers, hence the that can affect food handlers, hence the general public. As a result I would provide general public. As a result I would provide information about prevention and safety. information about prevention and safety.

Food borne illnessFood borne illness

OBJECTIVES:OBJECTIVES: Inform & educate on foodborne illness from Inform & educate on foodborne illness from

food handlersfood handlers Help reduce or prevent incidence of foodborne Help reduce or prevent incidence of foodborne

illness as a result of eating from NYC street illness as a result of eating from NYC street vendor/ pushcart vendors.vendor/ pushcart vendors.

Provide information & resources in the event of Provide information & resources in the event of an outbreak.an outbreak.

Inform vendors of their responsibilities in Inform vendors of their responsibilities in preventing foodborne illness.preventing foodborne illness.

Major Public Health ProblemMajor Public Health Problem

DEFINITIONDEFINITION Foodborne illness is defined by WHO;Foodborne illness is defined by WHO;

Infectious or toxic diseases, caused by agents Infectious or toxic diseases, caused by agents that enter the body through ingestion of food. that enter the body through ingestion of food.

Every person is at risk for foodborne illness.Every person is at risk for foodborne illness.

Food safety and foodborne illness. WHO. Retrieved on 4/20/11 fromFood safety and foodborne illness. WHO. Retrieved on 4/20/11 fromhttp://www.who.int/mediacentre/factsheets/fs237/en/http://www.who.int/mediacentre/factsheets/fs237/en/

Major Public Health ProblemMajor Public Health Problem

StatisticsStatistics~ ~ 48 million people (1 in 6 Americans) get sick48 million people (1 in 6 Americans) get sick ~ 128,000 are hospitalized~ 128,000 are hospitalized ~ ~ 3,000 die3,000 die ~ $152 Billion annually~ $152 Billion annually

CDC Reports 1 in 6 Get Sick from Foodborne Illnesses Each Year. Retrieved on 4/ 12/11 CDC Reports 1 in 6 Get Sick from Foodborne Illnesses Each Year. Retrieved on 4/ 12/11 From From http://www.cdc.gov/media/pressrel/2010/r101215.htmlhttp://www.cdc.gov/media/pressrel/2010/r101215.html

Scharff, Robert L. (2010). Health-Related Cost from Foodborne Illness in the United Scharff, Robert L. (2010). Health-Related Cost from Foodborne Illness in the United States. Retrieve on April 29, 2011 from States. Retrieve on April 29, 2011 from http://www.producesafetyproject.org/admin/assets/files/Health-Related-Foodborne-http://www.producesafetyproject.org/admin/assets/files/Health-Related-Foodborne-Illness-Costs-Report.pdf-1.pdfIllness-Costs-Report.pdf-1.pdf

Major Public Health ProblemMajor Public Health Problem

Initiative to estimate the Global Burden of Foodborne Diseases. Retrieve on 4/11/2011 from Initiative to estimate the Global Burden of Foodborne Diseases. Retrieve on 4/11/2011 from http://www.who.int/foodsafety/foodborne_disease/ferg/en/index1.htmlhttp://www.who.int/foodsafety/foodborne_disease/ferg/en/index1.html

Public Health Problem NYCPublic Health Problem NYC

~ 5,000 people are hospitalized~ 5,000 people are hospitalized ~ 10,000 emergency departments~ 10,000 emergency departments visitvisit

Department of Health and Mental Hygiene .Board of Health .Notice of Department of Health and Mental Hygiene .Board of Health .Notice of Intent to Amend Article 81 of the New York City Health Code. Retrieve Intent to Amend Article 81 of the New York City Health Code. Retrieve on 4/3/11 fromon 4/3/11 from

http://www.nyc.gov/html/doh/downloads/pdf/notice/article-81-amend-1209.pdhttp://www.nyc.gov/html/doh/downloads/pdf/notice/article-81-amend-1209.pdff

Most Common Foodborne PathogenMost Common Foodborne PathogenCampylobacter Campylobacter SalmonellaSalmonellaE. coli O157:H7E. coli O157:H7

Norwalk & Norwalk-like virusesNorwalk & Norwalk-like virusesFoodborne Illness. Retrieve on 4/20/11 from Foodborne Illness. Retrieve on 4/20/11 from

http://www.cdc.gov/ncidod/dbmd/diseaseinfo/foodborneinfections_g.htm#mostcommohttp://www.cdc.gov/ncidod/dbmd/diseaseinfo/foodborneinfections_g.htm#mostcommonn

Some Other Common PathogenSome Other Common Pathogen

ShigellaShigella Hepatis A- VirusHepatis A- Virus

ParasitesParasites Giardia lambiaGiardia lambia CryptosporidaCryptosporida

Foodborne Illness. Retrieve on 4/20/11 from Foodborne Illness. Retrieve on 4/20/11 from http://www.cdc.gov/ncidod/dbmd/diseaseinfo/foodborneinfections_g.htm#mostcommohttp://www.cdc.gov/ncidod/dbmd/diseaseinfo/foodborneinfections_g.htm#mostcommonn

Food HandlersFood Handlers

Who can be exposedWho can be exposed CooksCooks Waiter / Waitress Waiter / Waitress Cafeteria & Deli ; workersCafeteria & Deli ; workers Pushcart vendorsPushcart vendors

Focus Focus Pushcart vendors in NYCPushcart vendors in NYC

Pushcart vendors in NYCPushcart vendors in NYC

Vendors in NYCVendors in NYC ~4100 food carts in ~4100 food carts in

the citythe city Like many other Like many other

sector, the food sector, the food vendors fight the city vendors fight the city for their rights.for their rights.

Policies & Regulation: NYCPolicies & Regulation: NYC Permits- required Permits- required Inspection- randomInspection- random License - MandatoryLicense - Mandatory

Food Protection Course for Mobile Vendors Food Protection Course for Mobile Vendors 8 Hr class8 Hr class

No Medical ClearanceNo Medical Clearance

New York City Department of Health & Mental Hygiene: Checklist for New York City Department of Health & Mental Hygiene: Checklist for Mobile Food Vendor License. Retrieve 4/1011 from Mobile Food Vendor License. Retrieve 4/1011 from www.www.nycnyc.gov/html/doh/downloads/.../.gov/html/doh/downloads/.../permitpermit/mfv_/mfv_licenselicense_appl.pdf_appl.pdf

Public Health MenacePublic Health Menace

Typhoid Mary House cook Typhoid Mary House cook Notorious Public Health MenaceNotorious Public Health MenaceGave Typhoid to 47 people, 3 diedGave Typhoid to 47 people, 3 died

The Most Dangerous Woman in America. Retrieve on 4/12/2011 from The Most Dangerous Woman in America. Retrieve on 4/12/2011 from http://http://www.pbs.org/wgbh/nova/typhoid/about.htmlwww.pbs.org/wgbh/nova/typhoid/about.html

Public Health MenacePublic Health Menace

In 1915 outbreak of typhoid fever at Sloane In 1915 outbreak of typhoid fever at Sloane Maternity Hospital trace to facility cook, a Mrs. Maternity Hospital trace to facility cook, a Mrs. Brown.Brown.

She turned out to be Typhoid MaryShe turned out to be Typhoid Mary

The Most Dangerous Woman in America. Retrieve on 4/12/2011 from The Most Dangerous Woman in America. Retrieve on 4/12/2011 from http://http://www.pbs.org/wgbh/nova/typhoid/about.htmlwww.pbs.org/wgbh/nova/typhoid/about.html

Hepatitis A virus (HAV) Classified with the enterovirus group of the Classified with the enterovirus group of the

PicornaviridaePicornaviridae family: family: HAV single molecule of RNA; small protein HAV single molecule of RNA; small protein

capsidcapsid Infectious dose is presumably is 10-100 virus Infectious dose is presumably is 10-100 virus

particles.particles.

Bad Bug Book: Foodborne Pathogenic Microorganisms and Natural Toxins Bad Bug Book: Foodborne Pathogenic Microorganisms and Natural Toxins Handbook. Hepatitis A Virus Retrieve on 4/1/2011fromHandbook. Hepatitis A Virus Retrieve on 4/1/2011from

http://www.fda.gov/Food/FoodSafety/FoodborneIllness/FoodborneIllnessFoodbornePhttp://www.fda.gov/Food/FoodSafety/FoodborneIllness/FoodborneIllnessFoodbornePathogensNaturalToxins/BadBugBook/ucm071294.htmathogensNaturalToxins/BadBugBook/ucm071294.htm

Hepatitis A

Incubation period 10 to 50 days Incubation period 10 to 50 days Danger of spreading, middle of incubation period,Danger of spreading, middle of incubation period, Before presentation of symptoms Before presentation of symptoms Usually a mild illness;Usually a mild illness;

Bad Bug Book: Foodborne Pathogenic Microorganisms and Natural Toxins Bad Bug Book: Foodborne Pathogenic Microorganisms and Natural Toxins Handbook. Hepatitis A Virus Retrieve on April /1/2011fromHandbook. Hepatitis A Virus Retrieve on April /1/2011from

http://www.fda.gov/Food/FoodSafety/FoodborneIllness/FoodborneIllnessFoodhttp://www.fda.gov/Food/FoodSafety/FoodborneIllness/FoodborneIllnessFoodbornePathogensNaturalToxins/BadBugBook/ucm071294.htmbornePathogensNaturalToxins/BadBugBook/ucm071294.htm

How it’s TransmittedHow it’s Transmitted

Fecal-oral route:Fecal-oral route:

Person-to-person contact; consuming Person-to-person contact; consuming contaminated food or watercontaminated food or water

Foods commonly implicated in outbreaksFoods commonly implicated in outbreaks Cold cuts, sandwiches, fruits, fruit juices, milk Cold cuts, sandwiches, fruits, fruit juices, milk

products, milk, vegetables, salads, shellfish iced products, milk, vegetables, salads, shellfish iced drinks.drinks.

Bad Bug Book: Foodborne Pathogenic Microorganisms and Natural Toxins Bad Bug Book: Foodborne Pathogenic Microorganisms and Natural Toxins Handbook. Hepatitis A Virus Retrieve on 4/1/2011fromHandbook. Hepatitis A Virus Retrieve on 4/1/2011from

http://www.fda.gov/Food/FoodSafety/FoodborneIllness/FoodborneIllnessFoodhttp://www.fda.gov/Food/FoodSafety/FoodborneIllness/FoodborneIllnessFoodbornePathogensNaturalToxins/BadBugBook/ucm071294.htmbornePathogensNaturalToxins/BadBugBook/ucm071294.htm

Hepatitis A

New York CityNew York City2006 ~ 122 cases 2006 ~ 122 cases 1.5 (Rate per 100,000 people)1.5 (Rate per 100,000 people)2007 ~ 158 cases2007 ~ 158 cases 1.9 (Rate per 100,000 people)1.9 (Rate per 100,000 people)

Hepatitis A, B, and C Surveillance Report, New York City, 2006 and 2007. Hepatitis A, B, and C Surveillance Report, New York City, 2006 and 2007. New York City Department of Health and Mental Hygiene Division of New York City Department of Health and Mental Hygiene Division of Disease Control Bureau of Communicable Diseases. Retrieve on April /2/11 Disease Control Bureau of Communicable Diseases. Retrieve on April /2/11 from from

www.nyc.gov/html/doh/.../pdf/.../cd-hepabc-surveillance-report-06-07.pdfwww.nyc.gov/html/doh/.../pdf/.../cd-hepabc-surveillance-report-06-07.pdf

Hepatitis A Fiore Anthony E. 2004. Hepatitis A Transmitted by Food. FOOD SAFETY • CID 2004:38Fiore Anthony E. 2004. Hepatitis A Transmitted by Food. FOOD SAFETY • CID 2004:38

Role of Public HealthRole of Public Health during an outbreakduring an outbreak

Hepatitis A as a Foodborne DiseaseHepatitis A as a Foodborne Disease In the event of an outbreakIn the event of an outbreak Reporting Reporting SurveillanceSurveillance ContainmentContainment

PreventionPrevention

TreatmentTreatment

Role of vendors during an outbreakRole of vendors during an outbreak

Seek medical attentionSeek medical attentionPostpone food from the same food Postpone food from the same food

sourcesourceEnsure proper sanitation at all timesEnsure proper sanitation at all times

Role of the General PublicRole of the General Public

Be vigilanteBe vigilanteSay something if proper sanitation is not Say something if proper sanitation is not

practiced.practiced.Pay attention to personal hygienePay attention to personal hygiene

Prevention of Hepatitis APrevention of Hepatitis A

Personal hygiene not successful in Personal hygiene not successful in interrupting Hep A outbreaks interrupting Hep A outbreaks

identifying exact source is difficultidentifying exact source is difficultvaccination most effective vaccination most effective Disinfection 1:100 dilution of household Disinfection 1:100 dilution of household

bleach in water inactivate HAVbleach in water inactivate HAVReduce bare hand contact with foods not Reduce bare hand contact with foods not

subsequently cookedsubsequently cooked

Center for Disease Control and Prevention. Hepatitis A. retrieved on April Center for Disease Control and Prevention. Hepatitis A. retrieved on April /13/11 from /13/11 from http://www.cdc.gov/std/treatment/2006/hepatitis-a.htmhttp://www.cdc.gov/std/treatment/2006/hepatitis-a.htm

Hepatitis A as a Foodborne DiseaseHepatitis A as a Foodborne Disease

However vaccination is not mandatory However vaccination is not mandatory Best alternative screen food handlersBest alternative screen food handlers

requesting, mandatory medical clearance prior to, requesting, mandatory medical clearance prior to, getting a permit or license and periodically.getting a permit or license and periodically.

Center for Disease Control and Prevention. Hepatitis A. retrieved on 4/13/11 from Center for Disease Control and Prevention. Hepatitis A. retrieved on 4/13/11 from http://www.cdc.gov/std/treatment/2006/hepatitis-a.htmhttp://www.cdc.gov/std/treatment/2006/hepatitis-a.htm

Screen Food HandlersScreen Food Handlers

Benefits to Public Health Benefits to Public Health Reduce possibility of disease individual in food Reduce possibility of disease individual in food

industry industry Interventions can be done earlyInterventions can be done early

CONCLUSIONCONCLUSIONhttp://www.fda.gov/Food/FoodSafety/RetailFoodProtection/http://www.fda.gov/Food/FoodSafety/RetailFoodProtection/FoodborneIllnessandRiskFactorReduction/ucm106234.htmFoodborneIllnessandRiskFactorReduction/ucm106234.htm

ReferenceReference

Bad Bug Book: Foodborne Pathogenic Microorganisms and Natural Toxins Handbook. Bad Bug Book: Foodborne Pathogenic Microorganisms and Natural Toxins Handbook. Hepatitis A Virus Retrieved on April /11/2011fromHepatitis A Virus Retrieved on April /11/2011from

http://www.fda.gov/Food/FoodSafety/FoodborneIllness/FoodborneIllnessFoodbornePathhttp://www.fda.gov/Food/FoodSafety/FoodborneIllness/FoodborneIllnessFoodbornePathogensNaturalToxins/BadBugBook/ucm071294.htmogensNaturalToxins/BadBugBook/ucm071294.htm

CDC Reports 1 in 6 Get Sick from Foodborne Illnesses Each Year. Retrieved on April/ 12/11 CDC Reports 1 in 6 Get Sick from Foodborne Illnesses Each Year. Retrieved on April/ 12/11 From From http://www.cdc.gov/media/pressrel/2010/r101215.htmlhttp://www.cdc.gov/media/pressrel/2010/r101215.html

Center for Disease Control and Prevention. Hepatitis A. retrieved on April/13/11 from Center for Disease Control and Prevention. Hepatitis A. retrieved on April/13/11 from http://www.cdc.gov/std/treatment/2006/hepatitis-a.htmhttp://www.cdc.gov/std/treatment/2006/hepatitis-a.htm

Foodborne Illness. Retrieved on Aprl/20/11 from Foodborne Illness. Retrieved on Aprl/20/11 from http://www.cdc.gov/ncidod/dbmd/diseaseinfo/foodborneinfections_g.htm#mostcommonhttp://www.cdc.gov/ncidod/dbmd/diseaseinfo/foodborneinfections_g.htm#mostcommon

Fiore Anthony E. 2004. Hepatitis A Transmitted by Food. FOOD SAFETY • CID 2004:38Fiore Anthony E. 2004. Hepatitis A Transmitted by Food. FOOD SAFETY • CID 2004:38

Hepatitis A Information for Health professionals. Retrieve on April 13/ 2011 fromHepatitis A Information for Health professionals. Retrieve on April 13/ 2011 fromhttp://www.cdc.gov/hepatitis/HAV/index.htmhttp://www.cdc.gov/hepatitis/HAV/index.htm

ReferencesReferences

Food safety and foodborne illness. WHO. Retrieved on April /20/11 fromFood safety and foodborne illness. WHO. Retrieved on April /20/11 fromhttp://www.who.int/mediacentre/factsheets/fs237/en/http://www.who.int/mediacentre/factsheets/fs237/en/

Hepatitis A Information for Health professionals. Retrieve on April 13/ 2011 fromHepatitis A Information for Health professionals. Retrieve on April 13/ 2011 fromhttp://www.cdc.gov/hepatitis/HAV/index.htmhttp://www.cdc.gov/hepatitis/HAV/index.htm

Hepatitis A, B, and C Surveillance Report, New York City, 2006 and 2007. New York City Hepatitis A, B, and C Surveillance Report, New York City, 2006 and 2007. New York City Department of Health and Mental Hygiene Division of Disease Control Bureau of Department of Health and Mental Hygiene Division of Disease Control Bureau of Communicable Diseases. Retrieved on April /2/11 from Communicable Diseases. Retrieved on April /2/11 from

www.nyc.gov/html/doh/.../pdf/.../cd-hepabc-surveillance-report-06-07.pdfwww.nyc.gov/html/doh/.../pdf/.../cd-hepabc-surveillance-report-06-07.pdf

Initiative to estimate the Global Burden of Foodborne Diseases. Retrieved on April/11/2011 Initiative to estimate the Global Burden of Foodborne Diseases. Retrieved on April/11/2011 from from http://www.who.int/foodsafety/foodborne_disease/ferg/en/index1.htmlhttp://www.who.int/foodsafety/foodborne_disease/ferg/en/index1.html

New York City Department of Health & Mental Hygiene: Checklist for Mobile Food Vendor New York City Department of Health & Mental Hygiene: Checklist for Mobile Food Vendor License. Retrieved April/10/11 from License. Retrieved April/10/11 from www.www.nycnyc.gov/html/doh/downloads.gov/html/doh/downloads/...//.../permitpermit//mfv_mfv_licenselicense_appl.pdf_appl.pdf

The Most Dangerous Woman in America. Retrieved on 4April12/2011 from The Most Dangerous Woman in America. Retrieved on 4April12/2011 from http://www.pbs.org/wgbh/nova/typhoid/about.htmlhttp://www.pbs.org/wgbh/nova/typhoid/about.html

More information to reduce foodborne More information to reduce foodborne illness.illness.

Food Safety Net Food Safety Net http://foodsafety.suencs.com/4060http://foodsafety.suencs.com/4060

United States Department of Agriculture. Food United States Department of Agriculture. Food Safety and Inspection ServiceSafety and Inspection Service

http://www.fsis.usda.gov/Home/index.asphttp://www.fsis.usda.gov/Home/index.asp U.S. Food and Drug Administration. U.S. Food and Drug Administration.

http://www.fda.gov/Food/FoodSafety/http://www.fda.gov/Food/FoodSafety/RetailFoodProtection/RetailFoodProtection/FoodborneIllnessandRiskFactorReduction/FoodborneIllnessandRiskFactorReduction/ucm106234.htmucm106234.htm