Research, Rumors & RealitiesPrograms extending lab data into restaurant research

Research, Rumors & RealitiesPrograms extending lab data into restaurant research

August 15, 2007National Restaurant Association

Viruses Impacting the Restaurant and Foodservice Industry

Jim Mann

Viral IssuesViral Issues

• Business / Restaurant risk

• Hand sanitizer efficacy against the hard to kill viruses

• Risk reduction without running water

• Restaurant level approaches & compliance

Assessing Your RiskAssessing Your Risk

It is a Growing Risk

It is a Growing Risk

People ServedPeople Served

Break this chain! … manage as if you have an ill employee on every shift.Break this chain! … manage as if you have an ill employee on every shift.

FecalHand

Oral

Where we are …Virus, the Model Food Code & Compliance

Where we are …Virus, the Model Food Code & Compliance

Intervention: Vaccine

Industry Compliance

20092005

Hep A

Small scale usage

Hep A

Increased usage

Model Food Code

Las Vegas: Hand Hygiene Capital of the World

The war on virus - Hep A reportLas Vegas: Hand Hygiene Capital of the World

The war on virus - Hep A report

7664

124

209

273

385

188

110

69

49

2617

7 13 7

0

50

100

150

200

250

300

350

400

450

1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Year

Cases

Structural Classification of VirusesStructural Classification of Viruses

EnvelopedNon-Enveloped

Adenovirus

Hepatitis A

Norovirus

Papillomavirus

Poliovirus

Rhinovirus

Rotavirus

Hepatitis B virus

Hepatitis C virus

Herpes Virus

HIV

Influenza viruses

Respiratory Syncitial Virus

SARS-CoV

The Non-enveloped Virus ProblemThe Non-enveloped Virus Problem

• 30.9 million cases of foodborne illnesses/year*

• 23 million from norovirus*

• Lack of new vaccines

• “The majority of viruses for which hand transmission plays a critical role are non-enveloped.” Dr. Macinga

*Mead et. al., Emerging Infectious Diseases, 1999, 5:607.

Where we are …Virus, the Model Food Code & Compliance

Where we are …Virus, the Model Food Code & Compliance

Intervention: Alcohol Hand Sanitizer

Where water is readily available

Industry Compliance

20092005

Only after handwashing

Usage by few

A light soiling alternative to handwashing

(Synergized Alcohol Formulae, min 3 log reduction)

Usage by many

Model Food Code

In vitro Virucidal EfficacyIn vitro Virucidal Efficacy

Method: Quantitative Suspension Test (30 sec)

1E.J. Fendler et. al., “Efficacy of Alcohol-Based Hand Sanitizers Against Fungi and Viruses”; Infection Control and Hospital Epidemiology, Feb. 2002, 23, 2, p. 61-622D.M. Macinga et. al., “Inactivation of Viruses Using a Synergistically Formulated Alcohol-Based Hand Sanitizer”, IAFP Annual Conference, July 2007

Non-e

nvelo

ped

Envelo

ped

Improved efficacy vs. non-enveloped

viruses

Type VirusLog10 Reduction

Current1 New2

Feline Calicivirus F-9 1.00 ≥4.75

Mouse Norovirus 1.16 ≥ 3.68

Adenovirus type 2 0.50 2.75

Hepatitis A 0.00 1.75*

Poliovirus type 1 0.00 3.50

Rhinovirus type 37 2.75 ≥ 3.25

Rotavirus WA ≥ 5.75 ≥ 4.75

Influenza A ≥ 6.25 ≥ 5.25

Influenza B ≥ 5.75 ≥ 4.25

Avian Influenza (H5N1) ≥ 3.50 ≥ 3.75

Respiratory Syncytial Virus ≥ 2.50 ≥ 1.50

In vitro Virucidal Efficacy: Fingerpad

Method: Quantitative Suspension Test (30 sec)

0

1

2

3

4

5

6

7

FelineCalicivirus

MouseNorovirus

Adenovirus Hepatitis A Poliovirus Rhinovirus Rotavirus

Log

10 Reduction From Baseline

Current New

**

**

* Complete inactivation below detection limit

*

More Viral Efficacy DataMore Viral Efficacy Data

• Research is on the rise

• Hand sanitizer efficacy and viral detection are hot spots

• In-vivo data presented and in press

• Stay tuned…

Where we are …Virus, the Model Food Code & Compliance

Where we are …Virus, the Model Food Code & Compliance

Intervention: Alcohol Hand Sanitizer-

SaniTwice ProcessWhere water is not readily available

Industry Compliance

20092005

Usage in special situations (military)

A light soiling alternative to handwashing

A moderate soiling alternative to handwashing when used with a nailbrush

(Synergized Alcohol Formulae, min 3 log reduction)

Usage by many

Model Food Code

Where we are …Virus, the Model Food Code & Compliance

Where we are …Virus, the Model Food Code & Compliance

Step 1 – Apply alcohol hand-sanitizer generously.

Step 2 – “Wash” vigorously for 20 seconds.

Step 3 – Wipe off / dry with a disposable paper towel.

Step 4 – Re-apply alcohol hand-sanitizer according to label instructions.

Introducing SaniTwiceTM

For light to moderate soiling, when water is not readily available.

SaniTwice Study - NEHASaniTwice Study - NEHA

Participants: 44 FDA, USDA, CDC, Operators & Academia

Test Method:

1. Contaminate hands with UV tracer.

2. Use SaniTwice method.

3. Measure residues using UV light.

Results:

“Surprised with the level of cleaning.”

Break this chain! … manage as if you have an ill employee on every shift.Break this chain! … manage as if you have an ill employee on every shift.

FecalHand

Oral

“Not reasonably safe”“Not reasonably safe”

Jaundice (Yellowing of the Eyes &

Skin)

Health Monitoring, Ill employee exclusionHealth Monitoring, Ill employee exclusion

Where we are …Virus, the Model Food Code & Compliance

Where we are …Virus, the Model Food Code & Compliance

Intervention: Handwashing

Industry Compliance

“Handwashing compliance is no longer about training or the Food Code, it’s about filling

the voids in operational standards and management information systems.”

Jim Mann

20092005

Almost everything covered

Poor

Almost everything covered

(See Issue Incubator)

Measurement, documentation,QA/audited systems

Model Food Code

Management Information Initiative Maricopa County, RTE…variance programManagement Information Initiative Maricopa County, RTE…variance program

Participating Operators: 210 Independent & chain restaurants:

Taco Bell, Burger King, Arby’s, Jack-in-the-Box, Sonic, Kona Grill, KFC, Cold Stone Creamery & more

“Operators are rewarded for taking control of their handwashing, making it a system which they monitor and document.”

David Ludwig, Maricopa County

Hand Hygiene: A Game of Chance … or a managed system

Hand Hygiene: A Game of Chance … or a managed system

ProGrade™:Each employee periodically demonstrates their handwashing proficiency.

Handwashing …establishing your Safe Level for quality

Handwashing …establishing your Safe Level for quality

Handwashing FrequencyMyQ™ - Safe Level WorksheetHandwashing FrequencyMyQ™ - Safe Level Worksheet

Event Prep Server/Drive-Thru Busser

Arrival

Pre/Post Break

Restroom Use

Task Change

Pre/Post Gloving

Nose/Facial Touch/Sneeze

Customer Contact

Departure

Totals

W= Wash S= Sanitize

Shift Standard

Documented Success

“ What getsmeasured gets done.”

Documented Success

“ What getsmeasured gets done.”

5. Monitor

Contact us:Contact us:

Jim MannExecutive DirectorThe Handwashing For Life® Institute

1216 Flamingo ParkwayLibertyville, IL 60048

jmann@handwashingforlife.com1.800.446.3628