In the aftermath of a party, 70% (25 of 36) of attendees had gastroenteritis. The objectives of this study were to identify a risk factor associated with the food during the banquet and to identify measures of control for avoiding this kind of outbreak in the future.
A retrospective cohort study was used. We tried to reach by telephone all guests who had attended this banquet. A standardized questionnaire was used to provide information about identification of a risk factor, especially in relation to food.
The cohort study has shown that potato salad served at the party was significantly associated with the disease. The mayonnaise used to prepare the salad was analyzed and Bacillus cereus was isolated (10(3) bacteria per gram).
Bacillus microorganisms are usually found in decaying organic matter, dust, soil, vegetables and water. The bacteria has a remarkable ability to survive strong environmental stresses. There are strains of B. cereus that can cause food poisoning episodes with infective doses as low as 10(3) to 10(4) bacteria per gram. B. cereus is an infrequently reported cause of foodborne illnesses in Quebec and in North America but this may be due to underreporting of episodes. In this outbreak, bacterial multiplication was facilitated at several points in the interval between the preparation of the meal and the consumption of the banquet by the guests. Because the spores are ubiquitous and resistant to inactivation with most food grade disinfectants, temperature control should be the main focus of B. cereus outbreak prevention.
The meal was prepared by a restaurateur who was inexperienced in catering services and temperature control in particular when food is served outside the restaurant. This outbreak underscores the importance of maintaining meticulous hygienic procedures in food processing. Restaurateurs who offer catering services should be familiar with the constraints that are specific to this sector of the food industry.
Eat Smart! Ontario's Healthy Restaurant Program is a standard provincial health promotion program. Public health units grant an award of excellence to restaurants that meet designated standards in nutrition, food safety, and non-smoking seating. The purpose of this study was to assess whether program objectives for participating restaurant operators were achieved during the first year of program implementation, and to obtain operators' recommendations for improving the program. Dillman's tailored design method was used to design a mail survey and implement it among participating operators (n = 434). The design method, which consisted of four mail-outs, yielded a 74% response rate. Fifty percent of respondents operated family-style or quick-service restaurants, and 82% of respondents learned about the program from public health inspectors. Almost all respondents (98%) participated in the program mainly to have their establishments known as clean and healthy restaurants, 65% received and used either point-of-purchase table stands or postcards to promote the program, and 98% planned to continue participating. The respondents' suggestions for improving the program were related to the award ceremony and program materials, media promotion, communication, education, and program standards. Program staff can use the findings to enhance the program.
Eat Smart! Ontario's Healthy Restaurant Program is a standard provincial health promotion program. Public health units give an award of excellence to restaurants that meet nutrition, food safety, and non-smoking seating standards. The purpose of this study was to determine why some restaurant operators have not applied to participate in the program, and how to get them to apply. Four focus group interviews were conducted with 35 operators who didn't apply to participate. The analysis of responses yielded various themes. The participants' perceived barriers to participation were misunderstandings about how to qualify for the program, lack of time, concern about different non-smoking bylaw requirements, and potential loss of revenue. Their perceived facilitators to participation were convenience of applying to participate, franchise executives' approval to participate, a 100% non-smoking bylaw, flexibility in the assessment of restaurants, the opportunity for positive advertising, alternative payment for food handler training, and customer demand. Program staff can use the findings to develop and use strategies to encourage participation.
The effectiveness of restaurant inspections and food handler education are not known. Consequently, the optimal frequency of neither has been determined. Thirty randomly selected restaurants from seven health units in three provinces were inspected by one of three senior inspectors. A questionnaire was used to collect the data. The violation score worsened when the time since last inspection was greater than 12 months, but did not worsen when the interval was shorter. Those restaurants in which supervisors and food handlers had completed food handler education courses had better inspection scores than those without. Restaurants whose food handlers had food service education had better scores only for time and temperature violations. These outcomes were all significant in a multiple regression model. The duration of most education courses was under five days. The time since the last food service education course was not significant. Routine inspections should be done yearly. Food service education should be offered to both supervisors and food handlers.
To evaluate the efficacy and applicability of a HACCP-based program for use in restaurants.
A randomly selected sample of 16 intervention and 42 control full service, "stand-alone" restaurants with a minimum of 3 full-time food handling staff on duty per shift.
Six communities in Central West Ontario.
The Critical Approach, a HACCP-based program for use in restaurants, was designed in consultation with health inspectors and restaurant operators. It focusses on generic risk factors (Critical Control Points, CCPs) for food handlers rather than assessing specific menu items or foods; offers appropriate training of both management and staff; and encourages self-monitoring of CCPs by operators without extensive record keeping or retention.
Outcome indicators measured changes in three areas: the environment, knowledge, and behaviour.
Results suggest that among a subpopulation of restaurants, the program is acceptable to operators and capable of producing tangible results. Principles and methods of the program (i.e., an initial assessment of the site, working with the operator to identify and suggest improvements, and return visits to monitor compliance) may be transferable to other types of food service operations.
To determine restaurant inspection and food handler education practices in Canada, a survey of 141 jurisdictions was conducted. The response rate was 100%. All jurisdictions inspected restaurants, but the frequency of routine inspection varied from none to six or more times per year. The frequency of violations found on routine inspection was associated with foodborne illness. However, the frequency of inspection was not correlated with disease or with violations. Food handler education courses were mandatory in 32% of jurisdictions. Most courses were one to two days. No correlation was found between the numbers of individuals trained in the past year and violations or reported foodborne disease. This lack of reduction in reported foodborne illness may be due to the ecological nature of the survey or to the lack of effectiveness of food handler education or of routine restaurant inspections in reducing violations.
To examine the relationship between density of fast food restaurants and measures of social and material deprivation at the community level in Nova Scotia, Canada.
Census information on population and key variables required for the calculation of deprivation indices were obtained for 266 communities in Nova Scotia. The density of fast food restaurants per 1000 individuals for each community was calculated and communities were divided into quintiles of material and psychosocial deprivation. One-way analysis of variance was used to investigate associations between fast food outlet densities and deprivation scores at the community level.
A statistically significant inverse association was found between community-level material deprivation and the mean number of fast food restaurants per 1000 people for Nova Scotia (p
The inspection certificate program consists of food establishments voluntarily posting a certificate to inform patrons that inspection reports can be accessed from operators or the public health department. A three-month pilot program was evaluated for program improvement purposes. Only 65% of the selected operators were willing to participate, which suggests a challenge to fully implementing the program. Thirty-nine randomly selected restaurant operators participated. Most operators posted the certificate at the front entrance, and patrons indicated that reports were clear. Operators were supportive of the program. Some operators reported that the program was good for business and offered suggestions to improve it. A total of 583 requests for reports were made which suggests that the program empowered patrons to request reports, mostly from operators. Most patron evaluation forms came from a few operators that had no deficiencies, which limits generalizability.