Watch Dr Ackerley on BBC1 Watchdog 8pm Thurs 5th November

On Thurs 24th September Dr Lisa Ackerley appeared on BBC1 Watchdog 8pm. The feature was on infections acquired by British tourists whilst holidaying at an All Inclusive resort in Turkey.

Dr Lisa Ackerley spoke to BBC1 on what to look out for when it comes to food hygiene in restaurants and hotels and how to deal with food poisoning at home and abroad. Anne Robinson confronted the Chief Executive of First Choice and convinced him that Dr Ackerley and her team should go out to Turkey to carry out an investigation and do their own independent testing.

 Last week, a Hygiene Audit Systems team;  Kirsten Lawton, Melissa Thompson, Clare Wildey and of course Dr. Ackerley herself  jetted off  to Turkey with BBC Watchdog to try to get to the bottom of the problem; and to see if they could offer First Choice any solutions. The team are now back and compiling the results from their inspections and testing.  Watch Dr Ackerley on BBC1 Watchdog 8pm Thurs 5^th November to see the outcome of the visit and hear their findings.

Campylobacter is still a big problem in raw chicken….

The Food Standards Agency has published the findings of a new survey testing for campylobacter and salmonella in chicken on sale in the UK.

The survey showed that campylobacter was present in 65% of the samples of chicken tested. Salmonella was in 6% of samples, 0.5% of these samples contained S. Enteritidis and S. Typhimurium.

The survey has also shown that there have been shifts in the Campylobacter spp. and Salmonella serotypes isolated since the previous 2001 survey. Whilst Campylobacter Jejuni remains the most common campylobacter, an increase in Campylobacter Coli has also been seen. With Salmonella the most common serotypes found were Salmonella Kentucky and Salmonella Bredeney.

Whilst levels of salmonella have decreased mainly due to industry control programmes, including the vaccination of chicken flocks; levels of campylobacter are still high. Campylobacter is the commonest bacterial cause of food poisoning in the UK, responsible for over 55,000 cases a year. Although it is accepted that there are a number of routes by which humans are exposed to Campylobacter; there is strong evidence that the most significant is the presence of this organism on chicken and therefore something needs to be done to reduce the levels found in raw chicken. This is a priority for the Food Standards Agency and as part of this work an international conference on campylobacter is being organised for 2010, where a range of options for tackling the bug will be discussed.

In the meantime you should assume that any raw chicken you buy is potentially contaminated with food poisoning bacteria and take steps to reduce the risk of food poisoning. If food is prepared, handled, and cooked properly bacteria will not have a chance to spread and cause harm. Preventing cross contamination is essential. The following tips can help prevent food poisoning:

 • Store raw chicken at the bottom of the refrigerator, covered and away from other foods.
• Use separate chopping boards and knives for cutting raw chicken and raw meats. Colour coded boards are best.
• Wash hands thoroughly after handling raw chicken, using hot water and antibacterial soap
• This survey found that levels of bacteria were higher on whole chickens than on portions so unless you are roasting a whole chicken it is safer to buy ready portioned chicken rather than cutting and boning a whole raw chicken yourself. This may be particularly relevant to small catering establishments where space is at a premium, and risks of cross-contamination are higher
• Clean and disinfect surfaces after preparation – remember cloths are a bug superhighway and can spread contamination around a kitchen so using disposable cloths is best
• Ensure chicken is cooked thoroughly until the juices run clear – even better probe the thickest part to check it has reached 75OC

The full survey report can be found at:

 http://www.food.gov.uk/multimedia/pdfs/fsis0409.pdf

E.coli O157 linked to a petting farm in Surrey.

I’m sure you are all aware of the recent O157 strain of the illness connected to Godstone Farm, reported by the Times to have up to 2000 people attending a day in the school holidays.

Five children remain in hospital – twins suffered acute kidney failure they are described as improving although there are mixed reports about whether one child is seriously ill.

Godstone Farm has been closed for over a week and its sister farm, Horton Park Children’s Farm in Epsom, is also shut because of “unsatisfactory” hygiene arrangements.

The World of Country Life in Exmouth, Devon, closed its petting farm and deer ride on Friday on the advice of the Health Protection Agency (HPA) as 3 children who visited in August were also shown to have the E.coli O157 infection. 

Four people also became infected with E.coli after visiting White Post Farm at Farnsfield, near Mansfield, Nottinghamshire, though no direct link has been made.

I recently presented papers on prevention of E.coli O157 at the RSPH and CIEH conferences and in Jamaica at the 4th International Conference on Food Safety and Security, where I discussed the wider implications of outbreaks, and actually mentioned that the next large E.coli outbreak may well be non-food in origin.

E.coli O157 has been shown to survive for weeks on farmland and even on dry kitchen surfaces, including inside fridges. We need to use this knowledge to ensure that we put in controls to prevent E.coli from causing illness.

Providing facilities and signs for hand washing on farms is all very well, but with very young children, it is almost impossible to stop them from touching surfaces on the farm after they have washed their hands – contact surfaces such as gates, tables, fencing and play equipment could all have become contaminated if there is E.coli present on the farm through direct or indirect contact. Whilst the educational stimulus for children on farms is great, and it would be a shame to ban visits, the risk of contracting such a serious illness must now be taken very seriously. The real solution to this issue must be to eliminate E.coli O157 from the animals, through regular testing and control of feed and environment.

Schools also need to take note – many have visiting petting farms at school fetes where children may be touching animals one minute and munching on home-made cake the next.

Don’t forget you can get a leaflet produced by the Scottish Executive: Shedding Light on E.Coli O157 is very informative and can be downloaded from: http://www.scotland.gov.uk/Resource/Doc/37428/0012529.pdf

Jamaica

In July I visited the beautiful island of Jamaica to present papers at the 4th International Conference on Food Safety and Security for the Food Hygiene Bureau of Jamaica, headed up by Marva Hewitt, a former student of mine at Thames Polytechnic. Over 300 delegates attended from all over the Caribbean and from the USA. This is the second time I have been to the Conference, and it was great to meet up again with colleagues from other countries such as Dr Lisa Indaries from Trinidad, and Professor Roy Costa from the USA, a very experienced Environmental Health professional who carries out work around the world to improve public health in the leisure industry. Like me, Roy carries out expert witness work, and so we had a number of discussions to exchange ideas. He works on occasion with Bill Marler, the famous personal injury and products attorney in the USA, who I met recently at dinner at the House of Lords, kindly hosted by Lord Soulsby for the Royal Society of Public Health.

Roy’s main paper focussed on the faults behind the Salmonella peanut outbreak, and how fundamental flaws in the structure of the processing plant led to contamination of product. This is interesting because we need to be reminded from time to time how important the prerequisites for hygiene are – we can get carried away with HACCP and forget the basics! This outbreak had many similarities in this respect to the Cadbury’s Salmonella outbreak in this country, where structural issues were also identified. A particularly fascinating part of Roy’s talk was about how some of the initial investigation work that he carried out was done using Google Earth!

My first paper was on the lessons to be learned from the E.coli outbreaks in food premises, not knowing that in only a few weeks time my warnings that we should consider not only food related E.coli but also environmental issues would be so poignant.

I also presented a paper and workshop on food allergies and the work that Karen Martin and I have carried out with Hazel Gowland of Allergy Action. Karen has now trained over 1000 EHOs in England, Wales, Scotland, Northern Ireland and ROI. I was asked to put together an allergy workshop which was attended by 40 delegates to introduce them to the concepts of food allergens and controls.

Dr Lisa Ackerley to appear on BBC1 Watchdog 8pm 24th September

On thurs 24th September  BBC1 Watchdog 8pm will include a feature on infections acquired by British tourists in Turkey.

Watch Dr Lisa Ackerley being interviewed by Anne Robinson and helping out with investigations.

Dr Lisa Ackerley spoke to BBC1 on what to look out for when it comes to food hygiene in restaurants and hotels and how do deal with food poisoning at home and abroad. Click on the link below to view

http://www.bbc.co.uk/watchdog/consumer_advice/foodhygiene.shtml

Best Before and Use by Dates

I have just been interviewed on BBC Three Counties Radio by Jonathan Vernon-Smith on his consumer show (10th August 2009) about Best Before and Use by Dates. The thorny issue at the moment is that we are wasting too much food, throwing stuff away that is perfectly edible. The Government is concerned about it and there are discussions underway about what should be done.

Best before dates are used for foods that have a long shelf-life – frozen foods, canned foods, shelf stable items such as cereals, biscuits and crisps. With these foods, the date relates more to the quality of the food rather than the safety, and exceeding the date is neither harmful nor against the law if it is sold. In these circumstances, consumers with foods past these dates can usually be sure that the foods are not going to poison them after the expiry of the date. Eggs, on the other hand should not be consumed after the expiry of the best-before date as the composition of the egg changes, allowing growth of Salmonella (if present).

Use -by dates are another issue altogether, and should not be exceeded. It is a criminal offence to sell foods or have them on the premises for sale after the expiry of the use by date. These dates are determined by manufacturers to ensure that food is safe to consume. They are given as a result of microbiological testing regimes to show safe periods of time for foods held at the recommended temperatures. There may of course be some tolerance, but the idea that the consumer is equipped to tell whether the food is safe after the expiry date is a ludicrous proposition.

Certainly, milk’s off flavour and smell is a good enough warning not to drink it, but pate and cooked ham could look and smell perfectly OK whilst harbouring dangerous food poisoning organisms that may have been allowed to proliferate even under refrigeration. Bacteria such as Listeria monocytogenes can cause not only food poisoning but also miscarriage in pregnant women, and other serious complications. These organisms have been found in pre-washed salads, ready-meals, pates, cooked meats and soft cheeses. They do not develop any tell-tale signs of their presence in food.

The other issue here is that the consumer may not have kept the food in accordance with the manufacturer’s instructions anyway, thus increasing the risks: how did the food get home? Was it bought at lunch time, left in a hot office under the desk, taken home on the tube and then put in a fridge that was operating at a temperature of about 8oC? Further, was the packet opened and the food left for longer than the recommended time after opening – all these factors could lead to problems, and give opportunistic bacteria time to multiply.

Many cases of food poisoning are not reported or identified, and often the last thing people blame is themselves! But a “dodgy tummy,” “tummy upset,” “ bug going round” or even “food poisoning from a take away” may in fact be self-inflicted poisoning due to unsafe food storage in the home.

So in a bid to simplify things, what could be a better alternative? Maybe “best before” needs to be something like “best quality before” so that the consumer knows they will not be poisoned if they eat the food after the recommended date, and “use by” should be changed to “safe until.” Stores using “display until” and “sell by” as information for internal stock rotation may also need to think about how confusing this can be for the consumer and come up with something else.

One other issue is that people are being encouraged to buy too much food with BOGOFFS (buy one get one free) and three for the price of two deals. To take advantage of these deals but reduce wastage freezing can be an option, or use the food as an ingredient in recipe for freezing. So long as this is done carefully (i.e. freeze on day of purchase) and then defrost properly (either in the fridge overnight in a deep dish if meat or poultry or in the microwave just before cooking), then there is no problem, and less wastage. Maybe what we need is a “don’t waste food but stay safe cook book” – now there’s a job for my spare time…..

I hope that changes to date labelling will not inadvertently reduce consumer choice – a ban of best before dates, for example would give us no idea of how old foods are, and make stock rotation impossible. Even an informed consumer can’t make a risk assessment without that crucial information.

For further information on food labels go to:

http://www.eatwell.gov.uk/foodlabels/labellingterms/

More Swine Flu – the Real Experience!

I was asked recently to give some tips for mothers about what to do if their children got swine flu, and this was particularly pertinent as a few weeks ago my 14 year old son caught it. He went down with a high temperature very quickly, and had a very sore throat. We knew he was really unwell as he said he couldn’t pour himself a drink from a bottle of fizzy drink. They say that the difference between a cold and flu is the £50 note test – if you have a cold, then you would bend down to pick it up, if you have flu you leave it on the floor. I didn’t try it though…

The doctor diagnosed the flu over the phone and organised for us to collect Tamiflu from the chemist – she sent a voucher by fax. It occurred to me later that there was no advice from the doctor or the chemist about preventing the spread of flu within the family. I know they are busy, but a little information at this point could go a long way.

Luckily, as I’m a Dettol spokesperson, and my husband is also an Environmental Health Practitioner, we were armed with lots of product and some knowledge, we were prepared and informed. Whilst government advice is to use any cleaning product, we weren’t taking any chances, and I know that many Dettol products have been tested to kill H1N1, including the anti-bacterial spray and wipes. By the way, I don’t get many freebies, but because I have trusted the product for years, I am prepared to pay the full price!

We have two other children so were keen to protect them from being ill, and of course, we wanted to avoid illness ourselves, so that we could still look after the kids!

Key tips are:

•  Keep the sick child in one room if possible – if they share a room, remove the other children.
• Keep other children out of the room.
• Every time you go out of the sick room, wash your hands (we used anti-bacterial hand wash for good measure)
• Wipe any surfaces you may have touched after being in the sick room (such as door knobs and taps) with anti-bacterial spray on a paper towel or anti-bacterial wipe. Once you have removed a tray from the room, clean the crockery in a dishwasher or using hot water in the sink (rinse using hot water from the kettle)
• Use a high temperature wash for any laundry
• Line a bin in the child’s room with a plastic bag and get them to put their tissues in the bin, so you can dispose of them quickly and easily
• Wash your hands all the time and don’t rub your eyes, bite your nails, suck your thumb etc – try to make sure everyone in the household does as well. Use anti-bacterial hand gel.
• If you are lucky enough to have more than one bathroom, get the person who is sick to use one bathroom exclusively if possible, and other members of the household can use another one

I can appreciate how hard it will be for parents of very small sick children to keep themselves well, but hopefully some of the tips above will be helpful.

We found the most potentially dangerous time was when our son felt better and started wandering round the house – constant handwashing and surface cleaning is even more important then!

•  Remote controls
• Telephones
• Computer key boards
• Tables
• Door handles
• Fridge door handles
• Taps
• Kettle

Some training on using tissues and coughing into tissues and disposing of them quickly and safely is also essential once they start to be mobile.

If you suspect you or your children have Flu

There will shortly be a National Flu Pandemic web site and help line, but in the meantime, call NHS direct, 0845 4647 and if you have a child under 12 months, ring the GP as soon as possible.

According to the NHS and Government sites, people who are at higher risk are:

• people with chronic lung, kidney or heart disease,
• under fives, particularly under one year old
• over 65s and
• pregnant women (that’s a whole story in itself – check the web-sites)

If you suspect that your children have flu, and they are over 5 years old, use the NHS symptom checker: http://www.nhsdirect.nhs.uk/Sat/MiniSAT/Topics/ColdsAndFlu/BeforeWeBegin.aspx 

A useful site is:

http://www.direct.gov.uk/en/Swineflu/DG_177831

The BBC web site is also a good source of summary information,

Shopping List

• Dettol wipes or equivalent, anti-bacterial spray, anti-bacterial room and surface spray -have these all over the house so they can be used easily and anti-bacterial handwash (at all sinks)
• Paper towels
• Anti-bacterial hand gel or foam
• Squash or whatever drinks your children like (dehydration can happen)
• Sports bottle type drinks or straws (if they can’t lift their arms easily)
• Favourite foods (they may loose their appetites)
• Tissues
• Pain killers
• Thermometer (one that goes in the ear is very useful)

If you are a single parent, make sure you have organised support in case you are ill, and get prepared in advance with the shopping list above, plus foods for yourself and the rest of the family. On-line shopping may come into its own here as you may not be able to leave the house if you are nursing sick children alone.

To explain germs to children, in the hope of making them more aware of handwashing there is a really good book by Babette Cole called Dr Dog. It’s actually very funny.

Food safety is my business and if I can help I will!

Rhodri Morgan, Welsh first minister is quoted to have said EHPs need “a sixth sense of what is potentially catastrophic” to ensure safe food. Mr Morgan was responding to the Prof Pennington’s report on the 2005 South Wales E.coli 0157 outbreak, which led to the death of five-year old Mason Jones. Outlining progress on the report’s 24 recommendations, Mr Morgan said the training of inspectors and managers was being examined. Other responses to Pennington include the need for independent food hygiene audits of companies providing high risk foods to the public sector and that enforcement officers will need to ensure effective cleaning procedures and adherence to HACCP.

Fortunately, Hygiene Audit Systems is in a position to help with all of the above! Our proven supplier chain management system has assisted clients for years, in providing peace of mind and assurance that not only is the food with which they are supplied prepared, stored and transported safely, but also that they would have a robust due diligence defence in the unfortunateevent of things going wrong. I fully endorse third party audits of those supplying high risk foods to the public sector (some might say ‘of course she would’!) and again, have been providing such services for over 20 years. We are currently working with the RSPH on developing a workshop for EHP’s, which will provide them with the practical skills of HACCP auditing. I have a lot of sympathy for EHPs and feel a fair amount of unfair criticism has been levelled at them. Finally, we can supply the tools for checking if effective cleaning has taken place. Pro-cleanswabs give an instant result if they detect protein or ATP on a surface. These give an indication of inadequate cleaning and disinfection and could therefore identify surfaces that an enforcement officer might choose to use a microbiological swab on. Some of our clients use these swabs as part of their weekly checks. For more details see the clip below:

http://www.youtube.com/watch?v=GDiuc0Ajd0M

Swine Flu

A client recently asked when their employee who had swine flu should be allowed to return to work. A simple enough question, but wow quite a difficult one to get information on! The closest I got to an answer was the NHS Document: Pandemic Flu, Guidance for Businesses. This document provided the following information:

“The incubation period (time between contact with the virus and the onset of symptoms)

The range is from one to four days, though for most people it will be two to three days.

The infectious period (how long you are infectious to others)

People are most infectious soon after they develop symptoms. They can continue to spread the virus, for example in coughs and sneezes, for up to five days (seven days in children). People become less infectious as their symptoms subside, and once symptoms are gone, they are considered no longer infectious to others. “

So the advice is not really clear cut – you can’t say stay off for so many days – it’s a mater of really staying off work until the symptoms have gone. We all know that coughs can linger on for sometime, so this could be longer than 7 days. Interestingly today it was revealed that the government is considering extending the statutory sick pay provision to 14 days without confirmation from a doctor.

To download the full document, go to:

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_097137

In the meantime, make sure that you encourage all staff to wash their hands thoroughly when they arrive at work – they could have picked up the virus on their hands during the journey if they use public transport. I know I keep saying this, but hand-washing is the single most effective thing we can do to prevent all kinds of infectious diseases!

‘Professor’ Ackerley represents the UK on E.coli and food allergy

‘Professor’ Ackerley represents the UK on E.coli and food allergy

“I am really honoured to announce that I have been appointed visiting Professor of Environmental Health at Salford University, and am hopeful that this will be the start of collaboration between us in research and teaching projects.

I am shortly due to visit Jamaica where I will present two papers to the International Food Safety Conference, one on E.coli O157 and another on Food Allergy Issues in the UK. The conference organiser, Marva Hewitt-Heaven was once a student of mine at Thames Polytechnic, and has set up the only Food Safety Consultancy in Jamaica and Barbados. Delegates at the conference will include Jamaican EHOs and food safety managers from the Caribbean and US.”