Due Diligence – Norovirus:
Don’t Play Russian Roulette with Your Customer’s Health
By Jeff Nelken, MA, RD
Norovirus outbreaks usually occur in large institutional type of facilities. However, that doesn’t mean that it can’t or won’t happen in restaurants. The problem is that it may take days or even weeks to actually identify the presence of the virus through laboratory testing. In addition a typical outbreak can last from one to two weeks unless the environment causing the infection is closed. Here are a few facts about the virus and ideas to keep your restaurant safe from an outbreak.
The norovirus incubation period ranges from 12 hours up to 48 hours. The illness once contracted by a person can last anywhere from 12 hours to 60 hours. The symptoms are particularly violent and include nausea, vomiting, abdominal cramps and diarrhea. Diarrhea is by far the most common complaint for adults, while children tend to exhibit the disease through vomiting. Please note that in cases of norovirus contamination, severe dehydration has been known to be fatal.
The norovirus is transmitted through a very small dose of infection. In my experience, through laboratory testing, only 10 particles can infect an individual. The amount that could fit on the head of a pin can actually impact 100’s people at a time. It is extremely virulent. This increases the risk of cross contamination. The mode of transmittal can be through droplets of the virus, fomites, person to person contact, touching infected counters and contamination through environmental channels such as food, raw seafood, water or ice. In fact, it is reported by the CDC that in America 50% of gastroenteritis outbreaks can be attributed to the norovirus through foodborne illness.
Since the norovirus can spread quickly it is important to follow certain guidelines to prevent an outbreak. One of the biggest issues I’ve witnessed in restaurants is the lack of an illness policy for employees. Or if an illness policy does exist, it may not be enforced. If an employee exhibits the symptoms of a fever, accompanied by vomiting and diarrhea, it is imperative that they do not work in the restaurant. The cost of losing an employee for the day is far better than contending with a norovirus outbreak in your restaurant. So if a policy doesn’t exist, create one. If it does exist, then enforce it. That is your first line of defense.
The second line of defense is an enforceable guideline to employee hand washing. Employees need to be trained to wash their hands at the following intervals: upon entering the kitchen; after using the restroom; after sneezing, touching their face or blowing their nose; after handling raw food, dirty kitchen utensils or kitchenware; after cleaning, sweeping or mopping; and after taking a break, smoking, eating or drinking. The only way to maintain vigilance is through active managerial control, reminding employees regarding the policy and correcting for infractions. Another way is to have a strict policy for all employees handling food to wear gloves. Finally, consider using auto- dispensing paper towel dispensers in the restrooms and kitchens.
Additionally, increasing cleaning procedures to sanitize all areas of the kitchen to prevent norovirus outbreaks is a way to defend against it. Clean and sanitize all handles on doors and sinks throughout the restaurant, including the restrooms. Increase the frequency of cleaning these areas to be once per hour. Use of disposable cleaning cloths will also reduce the transmission of the infection. In toilet areas, use different cloths that are colored to differentiate them.
It is important to note that use of regular cleaning and sanitizing solutions will not kill or prevent the norovirus. You must ensure that the cleaning products utilized are EPA approved and certified to be effective against the norovirus. Without that, there is no guarantee that the norovirus will be killed on the surfaces cleaned. Using a virucidal agent, make sure to clean and sanitize the inside of all dishwashers, as well as all floor surfaces. Use of HEPA filter bags for vacuum cleaners is highly recommended. Before use of the HEPA filter, make sure that you clean and sanitize the vacuum bags with a virucidal agent too.
While investigating a restaurant that made a group ill; the Health Department suspected a norovirus outbreak. I noticed a few red flags. First, they did not have a crisis team in place that included a laboratory to oversee any microbiological challenges or incidents. The second being that the mop and bucket used to clean the kitchen, was also used to clean the bathroom. You must use a separate mop and bucket for the kitchen versus the bathroom. They should be color coded mops, buckets and any other cleaning tools. Third, the bus boys would stick their fingers in the glasses as they were clearing the tables and dropping them off to be cleaned. They didn’t wash their hands before they filled water glasses or bread baskets. Fourth, the stool test of the salad preparation person came back positive for the norovirus. No one knew that the virus may have been spread due to lack of washing the salads thoroughly. Lastly, the restaurant lacked a sanitization schedule so it was performed without monitoring and happened sporadically.
Now had it not been for the new technology that exists, it would have taken me two to three times to sanitize the entire restaurant/BOH and FOH. As it stood, without the steam vapor machine I would not have had the ability to steam clean the front and back of the house. This would have caused the restaurant to be closed for even longer.
In the end, food health safety is paramount to running a successful operation. It requires a proactive approach to prevent the spread and outbreak of the norovirus. Specific policies need to be instituted before tragedy hits. Following the policies outline above will go a long way to help your catering business.
Jeff Nelken is a Food Safety Expert Witness, Speaker, Auditor and Servsafe instructor. He provides advice to the legal community, food distributors, provides safety training to restaurants and is a restaurant consultant. He helps coordinate cleaning and training programs to help get restaurants reopened. Feel free to contact him at (818) 703-7147 or email him at email@example.com.