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. —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.
“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 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 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. —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.
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. —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.
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. —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.
“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.” —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.
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. —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.
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. —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.
“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.” —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.
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. —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.
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 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 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. —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.
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. —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.
“Hand washing and the wearing of gloves is the only way to control it,” Moe said. —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.
Yet, as others noted, neither of those remedies is fail-safe. —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.
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. —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.
“If I’m an employee with poopy fingers and I do everything I’m supposed to—I wash my hands like no one ever has before—I reduce the number by two logs,” scientific shorthand for knocking two zeroes off an exponential number. With 100,000 particles left, and 10 percent of fecal residue transferred on average to food, 10,000 norovirus would be channeled through the kitchen, or enough to make 1,000 people ill, he noted. —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.
That’s only if the employees washed their hands. The CDC’s Selman cited research indications that restaurant employees wash their hands in only 27 percent of the occasions where the precaution is warranted. Part of the problem, she said, is the number of times that it’s advisable: 8.6 times per hour per employee, on average. —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.
“I tried it myself,” she said, by setting out to wash her hands eight times an hour one day at her office. But the chapping was so severe that she had to stop. —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.
Gloves were not disparaged as a barrier if they’re worn as directed. But they offer no defense if an employee infected with norovirus should vomit in the restaurant, or a child in the dining room should get sick. Up to 30 million particles of the virus can be atomized by a single vomiting episode, possibly contaminating surfaces elsewhere. —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.
Karen Gulley, an environmental-health specialist for the health department of Georgia’s Cobb and Douglas counties, related the experiences of a hotel in her area. An employee infected with the pathogen was overcome by nausea, and ran to a nearby sink to vomit. The sink was normally used to prep produce. The facility cleaned and sanitized the basin in accordance with the health code, and used it the next day to clean potatoes for potato salad. The dish was served at a wedding where 47 guests got sick, or more than half the people who sampled it. —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.
A far better defense against norovirus, several speakers said, is keeping an infectious employee out of the restaurant. —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.
“If we could manage that,” Tart said, “we could really break it down.” —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.
But if employees can be infectious for 35 days, as Moe found, how can a restaurateur keep them out of the kitchen—and off the payroll—for that long of a stretch? —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.
“I don’t see a way of getting around having someone with the virus come back into the kitchen,” Moe said. —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.
No wonder, said the CDC’s Selman, 5 percent of food workers come to work when they’re still beset by vomiting or diarrhea. —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.
“Five percent admit they were ill—perhaps I should say that,” she added. —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.
Although no participant or speaker recommended a shift by the industry to paid sick leave, several noted that it would alleviate the situation. —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.
“If you pay them, that’s easier,” Harris said. —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.
Moe also observed that foodservice employees could be “an important target group” for a norovirus vaccine, which, she said, is in the early stages of development. —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.
Harris suggested that the industry cut its vulnerability to viruses in general by pushing for universal inoculation against Hepatitis A. —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.
“Press your local health authorities for mandatory, universal inoculation and take that off the table,” he said. —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.
Hal King, manager of food and product safety for the Chick-fil-A quick-service chicken chain in Atlanta, said his company tries to manage the problem by fostering communication between managers and employees who say they’re ill. —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.
“We tell them: ‘Don’t just stay home sick. Call your manager and talk to them,’” King said. —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 manager will then make an assessment, based on the employee’s input, such as whether or not the staffer is vomiting or afflicted with diarrhea. Deciding whether they’re asymptomatic and still shedding is likely beyond the scope of that crude assessment, he acknowledged. —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.
“I don’t have any solutions other than training,” King said. —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.
In fighting norovirus on that and other fronts, “there is no easy solution,” Harris told the audience of food-safety specialists. “You won’t be bored, and you’ll probably be more ulcer-prone than you already are.” —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.
New ammunition in the war against viruses The industry’s first conference devoted to combating viral infections touched on several new ways of resisting the spread of pathogens. —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. Chick-fil-A has outfitted the dining areas of 10 test stores with hand-wipe dispensers for customers, said Hal King, manager of food and product safety for the Atlanta-based quick-service chicken chain. The program dovetails with the company’s effort to promote the washing of children’s hands after they exit in-store playgrounds, where surfaces could be contaminated with norovirus. —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 U.S. Food & Drug Administration is preparing an advisory on cleaning up vomit in public places, said Alan Tart, regional food specialist for the regulatory agency. Because norovirus particles can spread through the air and contaminate surfaces, the vomit of an infected guest or employee poses a significant risk. —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. Work has begun on a vaccine against norovirus. Christine Moe, a noted researcher in the field, identified foodservice workers as ideal subjects for inoculation. —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 U.S. Centers for Disease Control and Prevention is conducting research on why sick employees come to work, said Carol Selman, a senior environmental officer for the CDC. Because employees can be a “reservoir” for norovirus, keeping them out of a restaurant when they suffer from diarrhea or vomiting is crucial to halting a pathogen’s spread, she and other speakers stressed. —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 CDC also is developing a database called Calicinet—after calicivirus, the category of virus that includes norovirus—to detect outbreaks more quickly. Five states are participating in the pilot program, in which initial results are likely to be aired by the end of August, said Jan Vinje, head of the agency’s National Calicivirus Laboratory. —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. Arelatively simple and fast test for norovirus infections has been developed and adapted widely throughout Europe, though it has yet to be approved for use in the United States, Vinje said. He noted that five states still do not have the capability to test for norovirus even in the time-consuming, conventional manner. —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. Scientists have succeeded in cultivating a norovirus-like pathogen in the laboratory, a crucial step for further research and the development of a vaccine. —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.