Tips to Prevent Norovirus: The Leading Cause of Foodborne Illness

By Francine L. Shaw  |  Published May 2016

Norovirus is the leading cause of foodborne illnesses and it spreads rapidly. Anyone can get infected with Norovirus and it’s possible to get it more than once. The average person will get Norovirus approximately five times during their lifetime. Peak season for Norovirus is during cooler months: November to April.

The Centers for Disease Control (CDC) estimates that each year, Norovirus causes:

• 19 - 21 million illnesses

• 56,000 - 71,000 hospitalizations

• 570 - 800 deaths

When Norovirus enters food service establishments, the results can be serious and widespread. In December 2015, a Boston-area Chipotle had a Norovirus outbreak that sickened over a hundred customers. Then, in March, Chipotle shuttered a different Massachusetts restaurant amid Norovirus concerns.   

When Chipotle learned that four employees at this location were ill, they decided to close the store for a full sanitation. At the time, it wasn’t known for certain if the employees had Norovirus, so this closure and full sanitation was done as a precaution. This closure cost them a day’s sales, the cost of the sanitation, and more negative press (that they didn’t deserve). Erring on the side of caution was wise, as at least one employee was ultimately confirmed to have the virus. As a result of Chipotle’s actions, no customers were infected. They prevented an outbreak.

Chipotle has received considerable bad press since for months, as the quick service chain suffered one foodborne illness outbreak after another, including Salmonella, E. coli, and Norovirus. These events hit multiple locations, sickened hundreds, caused Chipotle’s stocks to plummet, sparked lawsuits, and even resulted in a criminal investigation by the Department of Justice.

When they suspected Norovirus in early March, they did exactly what they should’ve done – closed and sanitized this restaurant. Unfortunately, their actions to prevent yet another foodborne illness outbreak were not reported in the most positive light.

Norovirus is extremely common. When employees come to work with diarrhea and vomiting, most facilities don’t close for sanitation. In fact, these employees are often permitted to work with these very contagious symptoms that can infect others – and even cause a foodborne illness outbreak.

Norovirus can easily contaminate food because it’s very tiny and infective. It only takes a very small amount of virus particles (as few as 18) to make someone sick. Food can get contaminated with Norovirus when:

• Infected people who have feces or vomit on their hands touch the food.

• Food is placed on counters or surfaces that have infectious feces or vomit on them.

• Tiny drops of vomit from an infected person spray through the air and land on the food.

Foods can also be contaminated at their source:

• Oysters that are harvested from contaminated water

• Fruit and vegetables that are contaminated during the growing process

At Food Safety Training Solutions, Inc., we offer food service professionals these tips to avoid Norovirus-related issues:

• Do not work or allow your employees to work when ill.

• Avoid preparing food for others while you’re sick and for at least 48 hours after symptoms 

  stop. Get a note from your physician before returning to work.

• Wash your hands carefully and often with soap and water (at least 100°F). The hand 

  washing process should take at least 20 seconds.

• Rinse fruits and vegetables carefully.

• Cook shellfish thoroughly.

• Clean and sanitize kitchen utensils, counters, and surfaces routinely.

• Wash table linens, napkins, and other laundry thoroughly and often.

• Have (and implement) a policy for “Clean-up and Disinfection of Norovirus” as stated in the 

  2013 Food Code.

Let’s give credit where credit is due. Kudos to Chipotle for doing the right thing, regardless of what it cost the business. On the day they closed one location to prevent yet another a foodborne illness outbreak, their stocks dropped again, and the media headlines were negative. Chipotle is going to continue to be under the microscope for a long time. They’ve made many mistakes over the past months, but they appear to be making positive changes in their foodborne illness protocols, and that should be applauded.

Accommodating Food Allergies: Good for Business and Good for Your Customers!

By Francine L. Shaw CP-FS, CFSM, FSP, FMP   |   fsts.net
An EXCLUSIVE for Convenience Store News  |  Published January 2016

Individuals with food allergies must be properly accommodated across all spectrums of the food service industry. Approximately 230,000 hospitalizations and 200 deaths occur annually because food-allergic individuals accidentally ingested or inhaled their allergens. Make one tiny mistake with “just a trace” of an allergen, and someone could die, literally.

Recently, I was teaching food safety classes for a convenience store chain after they had rolled out barista-style coffee. At one point during class, we were discussing the new products and I discovered they offered a beverage containing soy milk. Later in the day, as we talked about food allergies, I used the soy milk as an example. I remember saying, “It’s great that you have signs with warnings that state: Soy products are served here; therefore, there could be potential contamination.” Everyone in the class looked at me like I was speaking a language they’d never heard. I then said, “You do have a warning statement, don’t you?” Slowly, everyone began to shake their heads no.

Having no signage about food allergens and possible contamination was the first of a series of problems, showing me that these employees were not properly trained to accommodate food-allergic customers. We discussed cleaning procedures for the mixers that were used for multiple beverages, including products with common allergens like peanut butter, dairy and soy, and the employees told me they were just being “spun” in water with sanitizer, not thoroughly cleaned with hot water and soap before being sanitized. Additionally, there was not an assigned mixer for allergen-free products only. This brand had big problems.

During the next break, I called the corporate office to inform them of these oversights. A few hours later, after class, I stopped into another one of their units on the way home. In the short time since I’d reported the problem to corporate, the stores had already posted temporary allergen warning signs. I also noticed that they had labeled the mixers for allergen and allergen-free products. This showed – without a doubt – how valuable an external set of eyes and ears can be. I was delighted to see that the convenience store chain was able to quickly fix their errors and start improving their food allergy protocols. The leadership team was ecstatic that these issues were caught (and resolved) prior to a tragedy.

I’ve had numerous conversations with individuals who (erroneously) believe that cooking oil gets hot enough to “kill the protein” that causes an allergic reaction. This is simply not true. Speaking of cooking oil, don’t use the same fryer or oil for French fries that you use for breaded products, fish or foods containing nuts, as doing so will cause cross-contact for people with gluten, fish or nut allergies. Allergen-free foods must be cooked in clean oil, using separate (clean) prep stations and equipment (cutting boards, knives, pans, etc.)

All food service establishments – including convenience stores – must have procedures in place to ensure safe experiences for food-allergic customers, and must train all employees to always follow these procedures. Here are a few tips to make your stores allergy-friendly:

• Create a separate workspace in your prep areas to prepare allergen-free products. Make certain you clean and sanitize all work surfaces and equipment.
• Utilize color coded allergy tools in your kitchens to reduce the risk of cross-contact. Purple is the universal color for allergen-free kitchen utensils. Keep these tools clean and covered.
• Identify allergen-free products with colored stickers (purple is the color of choice) so they can be easily identified.
• Make certain all dishware is properly washed, rinsed, and sanitized prior to reuse.
• Ensure that all employees know the ingredients in every component of every food they serve, including sauces, marinades, sandwich breads, etc. Train them to read and understand ingredient labels.
• Ensure that your employees know the “aliases” for common allergens – e.g., casein and whey are dairy, semolina is grain, etc.
• Communicate with your team, and train them on food allergy protocols. There are numerous webinars, videos, and live classes that can assist you with this endeavor. 

It’s critical that everyone on your staff understands the difference between cross-contact and cross-contamination:

• Cross-contact occurs when an allergen is inadvertently transferred from a food containing an allergen to a food that does not contain the allergen – such as chopping peanuts on a board and then chopping grilled chicken on that same board. The grilled chicken has come into contact with the peanuts, which could trigger an allergic reaction in a guest with peanut allergies. Cooking does not reduce or eliminate the risk of cross-contact.
• Cross-contamination is a common factor in the cause of foodborne illness. If you place raw chicken on a board, and then chop vegetables on that same board, you risk cross-contamination, spreading bacteria from the raw poultry onto the vegetables. Proper cooking of the contaminated food in most cases will reduce or eliminate the chances of a foodborne illness. 

The main difference between cross-contact and cross-contamination is that anyone can become ill from cross-contamination if they eat foods that have touched raw meats or poultry. Cross-contact is dangerous only for food-allergic guests, who may inadvertently ingest their allergens if proper care wasn’t taken during food prep.

Approximately 15 million Americans have food allergies, including 1 in 13 children. Food allergies among children increased approximately 50% between 1997 and 2011 and no one understands why. Recognized that 25% of people’s first allergic reactions happen outside the home. This issue isn’t going to go away any time soon. Train your staff to recognize the signs of an allergic reaction, and have plan in place in case one occurs at your store. A “small” mistake - such as standing someone up in the midst of an anaphylactic reaction - could be fatal. 

Everyone on your team should know how to handle an order for someone with food allergies. Consumers are seeking out establishments where they can eat worry free. These establishments will earn brand loyalty and, therefore, increase profitability. Wouldn’t it be nice to be recognized as the C-store that consumers with food allergies can eat with confidence?

Foodborne Illness: It CAN Happen to You.

This year, there have been numerous, widespread, serious foodborne illness outbreaks. Many in the food service industry think it won’t happen to them. But it could happen to anyone—and it could ruin a reputation.

Chipotle prides itself on “food with integrity,” but the restaurant chain had multiple reports of foodborne illness outbreaks this year; Norovirus and Salmonella several months ago, and now E.coli in restaurants across nine states. Tainted celery caused an E.coli outbreak at retail chain Costco. Hardee’s had a Hepatitis A outbreak that exposed thousands. Just over a year ago, exclusive Mohonk Mountain House Resort had a Norovirus outbreak that made hundreds of visitors ill. These incidents potentially cost companies millions of dollars in litigation, settlements, plummeting stocks, and lost sales. Not to mention, it takes significant time, money, and energy to re-build the brand after the negative fallout. Some organizations—like ChiChis—never recover from a foodborne illness outbreak. All of the abovementioned companies have implemented corporate policies and procedures to protect against foodborne illness, yet something still went wrong. The risk is real for every company serving food. Here is how to avoid it from happening:

Get your team formally trained in a Certified Food Manager course. This reiterates the importance of the critical rules and regulations that you learned when you began in the food service business. Sometimes, a busy day or being short-staffed distracts employees from following the basic rules. A “refresher” course is a helpful reminder of the fundamentals.

Train your employees using a Food Handlers program. Provide your team with basic, but critical, food safety knowledge. The more educated your team, the safer and more profitable your organization.

If you have refrigerators in guestrooms, monitor the temperatures daily. Keep temperature logs. Guests expect the units to be working appropriately—so ensure they do.

Wash your fresh fruit and wrap it in plastic. If you offer whole fruit in bowls at your front desk or buffet, this protects the produce from guests’ potentially dirty hands as they select their fruit.

Take extra precautions at buffets. Assign team members to monitor these areas constantly for food safety (e.g., correct temps, no cross contamination) and food defense (e.g., customers potentially tainting items).

Conduct self-inspections. This enables you to catch small issues before they become big problems. For example, if you receive a delivery that wasn’t stored properly, you can take corrective action to avoid spoilage issues, cross-contamination, or cross-contact.

Use temperature logs. This helps you spot temperature issues before they become a cost factor or liability issue. By utilizing temperature logs, you can take corrective action prior to having to waste product, therefore decreasing food cost and increasing profit margins. This allows you to find temperature issues prior to the health inspector writing them up as code violations but, most importantly, it’s a proactive means to keeping your patrons healthy.

Hire an agency to conduct third-party audits. Often, bringing in an objective third party will boost your profits and increase your health inspection scores. Another set of eyes from the “outside” will see things from a different perspective, which can be invaluable. They can review key elements that the health inspector will assess, and point out possible infractions. Hire someone reputable, who knows the business and genuinely cares about your outcome.

Utilize single-use gloves properly. Single-use gloves are a protective barrier between your hands and the food you serve. If your gloves become contaminated, they’re useless. Prior to putting on the gloves, wash your hands properly with warm water 100⁰F and soap, then dry them thoroughly on a single-use towel. Never blow into the gloves or roll them to make them easier to put on—these practices cause contamination. Change gloves when they become dirty or torn, when changing tasks, and after interruptions, such as taking a phone call.