Why do we need food inspections?

One of the tasks for the Henry County Health Center is to make sure the food that is served in restaurants, grocery stores, gas stations and even caterers is safe to consume.  But some might ask why do we need a food inspection program?  In the old days we didn’t have any food inspections.  When you went to a restaurant to eat it was a case of buyer beware.  If the dining area looked clean you would eat at the restaurant, but you never saw the kitchen.  You looked at the food you were served and if it had a good appearance, a pleasant aroma, and good taste you figured it was ok.  Unfortunately, many food borne illnesses have no scent or taste.  Some of the most common food borne illnesses are:

Campylobacter is a bacterial pathogen that causes fever, diarrhea, and abdominal cramps. It is the most commonly identified bacterial cause of diarrhea illness in the world. These bacteria live in the intestines of healthy birds, and most raw poultry meat has Campylobacter on it. Eating undercooked chicken or other food that has been contaminated with juices dripping from raw chicken is the most frequent source of this infection.

Salmonella is also a bacterium that is widespread in the intestines of birds, reptiles and mammals. It can spread to humans via a variety of different foods of animal origin. The illness it causes, Salmonellosis, typically includes fever, diarrhea and abdominal cramps. In persons with poor underlying health or weakened immune systems, it can invade the bloodstream and cause life-threatening infections.

E. coli 0157:H7 is a bacterial pathogen that is commonly found in the intestines of cattle and other similar animals. Human illness typically follows consumption of food or water that has been contaminated with microscopic amounts of cow feces. The illness it causes is often a severe and bloody diarrhea and painful abdominal cramps, without much fever. In 3% to 5% of cases, a complication called hemolytic uremic syndrome (HUS) can occur several weeks after the initial symptoms. This severe complication includes temporary anemia, profuse bleeding, and kidney failure.

Calicivirus or Norovirus is an extremely common cause of foodborne illness, though it is rarely diagnosed, because the laboratory test is not widely available. It causes an acute gastrointestinal illness, usually with more vomiting than diarrhea, that resolves within two days. Unlike many foodborne pathogens that have animal reservoirs, it is believed that Norovirus spread primarily from one infected person to another via the oral-fecal route. Infected kitchen workers can contaminate a salad or sandwich as they prepare it, if they have the virus on their hands. Infected fishermen have contaminated oysters as they harvested them.

In 2009, a total of 17,468 laboratory-confirmed cases of food borne illness infection were identified nationwide.  It should be emphasized this was lab confirmed cases only; most people don’t get laboratory tests (expensive) or even seek medical attention when suffering from these illnesses.  Approximately 12% of those infected required hospitalization.

What does the Health Center do to keep this number under control?  We use a three tiered approach, prevention, education and investigation.

·        Prevention:  The Henry County Health Center Environmentalist Fred Boehler performs unannounced food inspections once or twice per year (frequency depends upon type of food prepared).  During the inspection the Environmentalist checks the kitchen and dining areas to see if they are clean and meet established guidelines.  As he performs the inspection his primary goals are to ensure the food is being prepared in sanitary conditions and to educate the individual escorting him (usually a manager of assistant-manager).

·        Education:  Since 1998 the supervisor on each shift has been required to attend a food service class annually at the Health Center.  While a step in the right direction it was felt this did not adequately train the rank and file workers at a food establishment.  Many times it was found that the food establishments had not sent an adequate number of individuals to the training, resulting in some shifts having no trained individuals working.  In January 2010 the Henry County Health Center Board of Trustees voted to expand the training requirement of food service workers in Henry County.  This new requirement takes affect in August 2010 and requires all food service workers in Henry County to study and take an online test on food handling safety.  This will greatly increase the number of trained food handlers in Henry County and increase the safety of area restaurants (go to henrycountyhealth.org and look under food handler card if you would like to see the study materials and test)

·        Investigation:  If someone becomes ill from eating at a local restaurant then the Environmentalist will conduct an onsite investigation.  The primary goal of the investigation is education of the facility to prevent problems in the future.  Follow up is conducted to ensure compliance.  If the illness is wide spread (usually called an “outbreak”) then the Health Center Epidemiology Specialist, with assistance from the Missouri Department of Health and Senior Services, will conduct an investigation.  The primary reason for the investigation is to find out what caused the outbreak.  If the restaurant is found at fault the long term ramifications are loss of revenue (no one wants eat at a restaurant where there has been an outbreak) and possibly law suits for medical expenses incurred by the ill patrons.  Most outbreaks also make the TV news resulting in an entire town being identified with the outbreak.  Tourists traveling through the area may not remember the name of the restaurant but they will remember the name of the town.

So, why do we need food inspections?  We need them to make sure the food we buy tastes good and is prepared in a clean kitchen.  We need them to make sure tourists see our area in a positive light.  We need them to make sure the food we are eating won’t taste good now but make us sick later, resulting in lost wages and possible medical bills.  We need it because we have excellent restaurants in Henry County and we want to keep them that way.

For additional information about our food inspection program, please contact Fred Boehler at 660-885-8193 or boehlf@lpha.mopublic.org.

Shigella, What is it, how do I get it and how do I fight it

Recently the Henry County Health Center has had several laboratory confirmed cases of Shigella identified in the Windsor area.  State wide Shigella infections are 550% higher than the five year average for this month.  Now that we know it is here, what is Shigella?

Shigella is a bacterial infection spread from one person to another by direct or indirect contact with an infected individual or by ingesting contaminated food or water.  After using the restroom and having a bowel movement, the infected individual fails to properly wash their hands and can then spread the bacteria to things they touch, food, or directly to other people.  Humans are the only significant source of the organism.  It takes only 10 – 100 Shigella organisms to produce illness, making this a highly contagious disease.  One infected food handler, who does not use proper hand washing techniques, could infect a large number of restaurant patrons.  The elderly and young children are most susceptible to the disease and may have more severe illness.  Most common symptoms of Shigella are diarrhea, fever, nausea, vomiting and stomach cramps.  How do you tell the difference between Shigella and the “Stomach Flu”?  You can’t, unless laboratory tests are conducted.

Cases and symptomatic contacts of Shigella patients should be excluded from food service, daycare, the care of children or patients, and other occupations that pose a significant risk of transmission until diarrhea ceases and two negative stool cultures are obtained.  Commercial food handlers must provide documentation of two consecutive stool specimens before returning to work.

How do we fight Shigella?

• Frequent and thorough hand washing with soap and running water is one of the best ways to keep the illness from spreading to others.  Younger children may need to be educated in the proper technique of hand washing and to be supervised during hand washing.
• Soiled diapers from infected children should be disposed of properly and the diapered areas should be disinfected immediately afterwards.  The caregiver and the child both need to wash their hands or have them washed.
• Children and adults with diarrhea should stay out of public and private swimming pools. Saunas, spas or any other recreational water activity for two weeks following the end of diarrhea.

Our number one weapon in the fight against Shigella is HAND WASHING.  The infection will not be spread to others if proper hand washing techniques are used.  What is the right way to wash you hands?

Step One

Using warm or lukewarm running water lather your hands with soap. Cold water is not as effective and hot water should be avoided because it is drying to the skin. The soap does not need to be antibacterial to be effective.

Step Two

Rub your hands together to make a lather. If you have dirt under your nails, use this opportunity to clean under them. Rub your palms together and intertwine your fingers to make sure you get between them. Don't forget the back of your hands!

Step Three

Keep rubbing your hands together! For a proper hand washing this step should take no less than 20 seconds. Not sure when you're done? Try singing your ABC's twice, and you should be fine.

Step Four

Rinse your hands well. Ideally, start by rinsing your wrists and letting the water run off of your finger tips. Then rinse the rest of your hands as necessary.

Step Five

Dry your hands well, using a clean paper towel or allowing your hands to air dry. Nurses and doctors are trained to turn the faucet off with a paper towel. Why? Because you turned it on with dirty hands, so you may not want to touch it with your freshly cleaned hands.

If you have any questions about Shigella or any other communicable disease, please contact Gary French at 660-885-8193 or frencg@lpha.mopublic.org.

Effective June 15th, 2009 the following fees will be charged:

Immunizations:  There will be a $15 administration fee for one vaccination.  There will be a $20 vaccination fee for more than one vaccination (total). 

Hep A, B or TwinRix (All Ages):  $15

Shots (Person brings in own RX):  $10

TB Skin Test:  $15

Pregnancy Test:  $10

Lipid Profile (this includes a blood sugar test):  $25

Fasting Blood Sugar:  $10

Strep Test:  $15

Lead Testing:  $15

STD/HIV Testing:  $20

Meningitis Vaccination:  $15

HPV Vaccination (Must pay for first)

• Under 18 AND has Medicaid:  FREE
• Under 18 AND has NO insurance:  $15
• Under 18 AND HAS insurance:  Cost + $15
• 19 or older, with insurance, no insurance, or Medicaid:  Cost + $15

Pneumonia Shot:  Cost + $20

Zostavax Vaccination (60 or older, must pay first):  Cost + $20

Water Tests

• Bacteria or Chemical:  $15
• Quantity Tray:  $20

CPR Classes:

BLS CPR Classes:  $50 per person

Heart Saver/AED CPR Classes:  $40 per person

Heart Saver CPR Classes:  $35 per person

Out of County Heart Saver:  $40 per person

Friends and Family CPR Classes:  $15 per person

Set-up Fee for Off-Site Classes:  $50 per class

Septic Classes:  FREE

If they DO NOT install in Henry County:  $10

Food Classes:  $10

Special Septic Classes:  $100

Special Food Classes:  $100 plus $10 for each person