Washing Those Hands

[Blether]

Right, let's get this started...

... 4. "Transmission of pathogenic E. coli often occurs via faecal-oral transmission.[24][34][35] Common routes of transmission include: unhygienic food preparation,[34] farm contamination due to manure fertilization,[36] irrigation of crops with contaminated greywater or raw sewage,[37] feral pigs on cropland,[38] or direct consumption of sewage-contaminated water."

Jesus. gfweb is so right.

O157 is a special case. Ordinary E. Coli from someone's - even your own - asshole can make you sick. So, 4b, food service workers who don't wash their hands or realise how their toilet technique may be leaving them - inadvertently - with shit on their hands.

Yes, some people can be annoyingly over-fastidious and uninformed about foodborne illness. Nonetheless, food service health codes exist for a reason.

Whoever said auto-immune diseases don't exist in third world countries needs to look up a little-known diagnosis: AIDS. Which I believe originated in the questionable practice of human consumption of hunted simian meat.

Singapore or anywhere else, what kinds in this discussion is food hygiene after preparation - that meat & veg 'produce' is going to be washed and/or cooked. C. Botulinum safety has been covered at length here on eG, with input from a number of very-well informed contributors.

[Blether]

'kinds' => 'counts.'[/delayed proofreading]

[Karri]

I would like some hard evidence if someone could provide about the inherent e-coli strains? Yes AIDS, the only acquired auto-immune disease... Now ofcourse I am not some nut who out of principle doesn't wash their hands after going to the toilet, I am a chef-in-training so obviously I know how to keep it clean, change my chopping board after changing prep ingredients, but what I am telling you is after working for a year in a 4*-hotel restaurant, and the stuff I saw there, it turned my blood in to pancake batter. BUT no one got sick, during that one year, where I did everything by-the-book, and I mean literally I kept sanitized, I bleached my own board every night, etc. It didn't make a difference, if the produce is already contaminated, and you are going to use it for a fresh salad or whatever, there is no way for you to know. But please provide some hard evidence on our own e-coli causing illness... The only way I could think it possible is that it would be given time to feed on whatever ingredient you are talking about, and then it would have time to produce the toxins which would then hit your stomach and cause you to get ill quickly... But if those are the same toxins that are produced regardless in your own colon, could it make a difference? I realize my earlier post might have made some people angry, perharps I wrote it in a style that makes me sound naïve or juvenile. But I was merely venting out some frustration. It just can't be dumb luck, since sometimes it happens and sometimes it doesn't. Or then again maybe that's just the case. I would still like to emphasise the point that if it is possible that your own e-choli can give you food poisoning, then this place where the money is handled with the same hands, there is no cold chain? I thought everyone knows the TDZ? As I have never been to America, and I'm assuming this is where the conversation began is it really that bad? That things are left on the table or are in a display that doesn't have a cooler in it? And yes ofcourse departmental health codes and enforcement is a very important thing, but sometimes too much is too much. C-Bot is a killer, if you manage to get that on to your food somehow, or if you like to buy bloated tin cans, then you're shit out of luck...

edit: From the hygiene and safety course I did with the AH&LA I understood that what we carry in our GI-tract is quite area-specific, saying that my bacteria from Finland and Spain are completely different from an Americans, and if this change in bacterium will cause "food poisoning" then that is inevitable? But that is not what is being discussed here.

Edited February 27, 2011 by Karri (log)

[weinoo]

You get grossed out in Mom and Pop delis? Then don't go.

Everyone has eyes. If there's only one guy behind the meat slicer and cash register, then you know what's going to happen.

If I was behind that deli counter, or ran that deli counter, then hands would be washed before every customer.

Thanks for your opinion.

[Karri]

Fun fact of the day:

Salmonella in Eggs - Weighing up the risks

"In 2001 (the most current collection data available at the CDC), only 11.3 cases were found per 100,000 people. That is a percentage risk of only 0.0113%. -- Moreover, 26% of the cases were from children under the age of 5. So if you're older than 5 years of age, then your risk of getting salmonellosis is only .00836% Just for reference, the odds of getting hit by lightning are 1 in 280,000 or 0.00036% (according to NOAA). - 31 more times likely to get salmonellosis than to be struck by lightning."

I'm not trying to tell people not to wash their hands or stop being hygienic, far from it, especially in a professional setting it is even more important than ever. But... isn't all this hype a bit too much? In my opinion it is the shock value of the -perceived- threat that the media is just jumping on...

Recently read a news article from my home country in Finland which made it look like some parasite that moles carry is making an attack through the neighbouring countries in to Finland, and that because foxes and eagles eat the moles they become carriers and their droppings will soon infest all the berries and mushrooms in ALL the forests of Finland. So the news article questioned that should people freeze berries from the forest or should they be boiled from now on...

I mean please, all this panic, and it might not be common sense what I said about boiling the pacifiers and whatnot, but what about H1N1? Massive panic about a little fever and a headache IF you are not under, what five years of age or over 70, or immunocompomised... And they vaccinated people for it in my home country and I don't know where else, and now what happened? Th vaccine was a sham, causing epilepsy, that's great.

I think enough is enough, sound practices are sound practices, and everything above that is just being a little bit silly...

[gfweb]

Pointing out media hysteria over infectious diseases doesn't disprove the need for proper

procedure.

You might as well say who needs water treatment and sewers, we haven't had cholera in generations.

Sent from my Droid using Tapatalk

[Karri]

Hahahaha... Please read my posts properly, how many times have I pointed out that good hygiene is important? All I'm saying is that enough is enough. And your argument has a fallacy, you point at my statement and create a straw-doll by regarding to something completely different and over simplifying my argument.

[Karri]

Escherichia coli

"Many strains of E. coli are harmless and are found naturally in the gut of humans and

animals. Traditionally its presence in foods has been an indication of faecal

contamination of food or water. However, particular strains are pathogenic and

traveller’s diarrhoea and haemolytic uraemic syndrome (HUS) are caused by E. coli

strains. Although pathogenic types are rare, in the last few years there have been

several foodborne outbreaks from certain strains of E. coli both in Australia and

overseas."

This is completely new information to me, I agree and substract my ill-chosen words on this, sincere apologies:

Staphylococcus aureus

* Characteristics: Produces a heat-stable toxin.

* Habitat: Nose and throat of 30 to 50 percent of healthy population, sometimes skin and superficial wounds.

* Source: Meat and seafood salads, sandwich spreads and high salt foods.

* Symptoms: Nausea, vomiting and diarrhoea within 4 to 6 hours of infection. No fever.

* Cause: Poor personal hygiene and subsequent temperature abuse.

* Temperature sensitivity: No growth below 40°F. Can be destroyed by normal cooking but toxin is heat-stable.

Edited February 27, 2011 by Karri (log)

[Karri]

Good god I think I'm turning in to one of those people who rant alone on an empty forum... Well might aswell start blogging next.

On autoimmune:

"The hygiene hypothesis has expanded from eczema and hay fever to include exposure to several varieties of microorganisms and parasites, with which humans coexisted throughout much of our evolutionary history, as necessary for balanced and regulated immune system development.[14] In recent times, the development of hygienic practices, elimination of childhood diseases, antibiotics and effective medical care have diminished or eliminated exposure to these microorganisms and parasites during development. Examples of organisms that may be important for proper development of T regulatory cells include lactobacilli, various mycobacteria, and certain helminths."

Who didn't grow up with atleast a few of those kids who were allergic to pretty much everything from the air to the clothes they wore? I believe it is due to hypochondriac parents. More info here

To avoid embarassing myself anymore this is all I have to say about this.

[gfweb]

The hygiene hypothesis is just that, an (interesting) very unproven theory that needs experimental confirmation; which so far is lacking. Might be true, might not. It will take many years to sort this out. I don't know a scientist who doesn't wish the media would stop trolling the scientific journals and publicizing research that hasn't ripened.

There is also great difficulty in extrapolating animal studies into people. We just don't work exactly the same. Think of all the experimental drugs that are a home run in rats and strike out in humans.

But even if it is completely true in all of its possible ramifications, its hard to see low rates of hay fever (which isn't exactly an auto-immune disease) being worth the consequences of stopping vaccinations and sanitation. Asthma and allergy is a good trade off for no cholera epidemics or intestinal parasites or river blindness.

[Mjx]

. . . .

On autoimmune:

"The hygiene hypothesis has expanded from eczema and hay fever to include exposure to several varieties of microorganisms and parasites, with which humans coexisted throughout much of our evolutionary history, as necessary for balanced and regulated immune system development.[14] In recent times, the development of hygienic practices, elimination of childhood diseases, antibiotics and effective medical care have diminished or eliminated exposure to these microorganisms and parasites during development. Examples of organisms that may be important for proper development of T regulatory cells include lactobacilli, various mycobacteria, and certain helminths."

Who didn't grow up with atleast a few of those kids who were allergic to pretty much everything from the air to the clothes they wore? I believe it is due to hypochondriac parents. More info here

. . . .

Well, I'm supposed to be working, but reading about pathogens is my idea of a fun 10-minute break.

Mycobacteria include the causative organism for tuberculosis and leprosy, as well as forms that cause less serious infections, or do nothing noticeable. None of these things is known for bringing much in the way of health benefits.

Lactobacilli are fine, we still enjoy them.

Helminths are intestinal parasites, and include hook worms, pin worms, and filaria. Some are actually being used to treat automimmune and allergic conditions, but you don't want to get them because your deli guy has poor hygiene.

The allergic-to-everything people I've known haven't had parents who were any more hypochondriacal than any others, nor are they themselves particularly uptight about it: the bring along a roll of paper towel, and do whatever the normally do.

The presence of parasites and pathogens is more likely to have contributed to the much shorter life-spans people used to have, than to have created strapping heroes. By the early 1900s, people probably did have what might be described as elite immune systems (no way to know for sure), simply because of millenia of the weaker being culled out before they had a chance to reproduce, but the cost was high: parents assumed than at least one child would die before making it to adulthood. And immunity in one place might mean nothing if you moved to another location, with a fresh array of pathogens to which your forefathers had never been exposed.

This is by the way, and... because it's past 1.00 a.m. here, and I'm geeking out.

But it comes down to this: Thanks to science, we know that plenty of things that are just fine in our noses or lower GI tracts play merry hell elsewhere, such as in the upper GI tract.

A great way to control what gets into your upper GI tract (unless you think 'all that science stuff' is a sort of fairy story) is to observe basic sanitary practices.

We also know that hand-washing is a simple, cheap, and effective sanitary practice for avoiding the trasmission of food-borne disease.

There have been a few who have suggeted that if you don't like the idea of feces or other contaminants in your food, you should bugger off. My view (and I run my own business, so I've thought about customer service a lot) is that if you run a shop, you should deliver service that doesn't risk compromising customer health.

I think a brief note to a shop keeper who's being sort of gross might not be a bad idea.

[Karri]

Please read the whole wiki entry, everything you just said is a gross generalization of facts and studies performed by doctors.

[Blether]

... Well, I'm supposed to be working, but reading about pathogens is my idea of a fun 10-minute break...

Thanks for a well-rounded summary, and for taking the time, Mjx.

gfweb pointed out that AIDS isn't even an auto-immune disease - it's a virus attacking t-lymphocytes.

Of course, there are those in the world who seem under the impression that disease statistics are reliably collected by the extensive, bureaucratised health services prevalent in the third world. Apparently the ministry of health of Mbongoland does report a high incidence of "possession by evil spirits" (DSMX).

"There are no auto-immune diseases in the third world". Nice piece of politicised pseudo-science, right there. If you're going to denigrate mass media 'science', Karri, you'd be better to find alternative sources for your own. There's a political dimension to the teacher-student relationship, too. And you're talking like you want to study by yourself. Hobbesian enough for you ?

Edited February 28, 2011 by Blether (log)

[Mjx]

Please read the whole wiki entry, everything you just said is a gross generalization of facts and studies performed by doctors.

Thanks, but... no. Wikipedia just isn't reliable enough to trust on its own.

As far as I can see (if I've overlooked something, please point it out, and my apologies) you haven't cited any specific facts or studies to generalize; a hypothesis is no more than an educated guess that is formulated with the idea of testing it.

The Wikipedia article does have some good sources, including the WHO site (I'm sure that by now, you've read the handwashing document I linked to; they have plenty of other information, too), and some that are distictly iffy, for example, the study of the pregnant Ugandan women treated with albendazole, whose infants displayed an increased incidence of eczema (which doesn't seem to seriously address the possibilty of the eczema being a direct response to the drug itself, rather than the absence of worms; one way to control for that that would be to look into the incidence of eczema among Ugandan infants whose mothers did not have worms to begin with).

I'm not entirely clear on your stance, but the gist of what you've written seems to be that people worry too much, oversanitize, that parasites, bacteria, and viruses are not exclusively harmful, that autoimmune diseases and allergies are the outcome of excessive health measures.

My position is that what you say is not entirely inaccurate, but neither is it complete. And (to keep this on-topic) I certainly do believe that everyone has the right to decide for him or herself the extent of the pathogen/parasite load to which he or she wishes to be exposed: The decision should not rest with a deli guy who doesn't wash his hands.

Again: People who handle food should wash their hands before so doing, and the research and debate surrounding pathogen ubiquity and overmedication/sanitation in no way conflict with this.

[Karri]

Blether: Nice piece of spindoctoring and misquoting on your part: "since autoimmune diseases are pretty much nonexistent in 3rd world countries" that is what I said. Which incidentally were words that came out of a South African doctors mouth when we were discussing prevailing diseases when I was seeking a consult for my MDI...

(edit: Lived in Cape Town for 2½ years)

And yes, I am still formulating my ideas, but it's quite hard to formulate on your own without anything to bounce your ideas off of. But this topic is one of those where we could spend days on days arguing, you know you're right, but how do you know? You insult me, question my logic, but then again none of you have provided any hard evidence, except for the handwashing which I agree with 100%. That is what I mean about media hysteria, people can quote out of memory lines that aren't actually linked to anything, just that they sound very effective and that "e-choli is going to kill you if you don't wash your hands". (<<< hyperbole... getit?)

Please provide facts.

Edited February 28, 2011 by Karri (log)

[weinoo]

I don't really need any hard evidence. I don't need any hypothetical bullshit. I don't need to be told I won't get sick. I don't need any arguments.

I saw the guy handle the money from the customer before me, touch his hair, perhaps cough so...

All I really want and need is for my deli guy to wash his hands or put on a new, clean pair of disposable gloves before he slices and handles every single piece of my Fra' Mani salami, Comte cheese, Luques olives and artichoke hearts packed in olive oil.

Just like I would do if I was behind the counter.

[anzu]

Speaking as someone who has two autoimmune diseases, who has lived in two third-world countries (India and China), and who has visited doctors and hospitals in both countries for my condition

AND

being married to a person from a third-world country (India) who has an autoimmune disease, and who has had to regularly visit doctors and hospitals there for his condition,

then just on the base of personal experience I can assure you that your claim of there being no autoimmune disases in third world countries is nonsensical. Unless you wish to claim that all the other people seeing doctors in those countries were just pretending to be ill...

Just because the person making some outlandish claim is a doctor doesn't make it true. Like people in other professions, doctors can be good or bad, ignorant or well-informed. And they can also be astoundingly ignorant even about medical matters if the issue is outside of their own area.

Edited to add:

On the actual topic. Yes, PLEASE wash your hands. Pretty much no-one does in Germany. Drives me nuts.

Edited February 28, 2011 by anzu (log)

[Mjx]

Blether: Nice piece of spindoctoring and misquoting on your part: "since autoimmune diseases are pretty much nonexistent in 3rd world countries" that is what I said. Which incidentally were words that came out of a South African doctors mouth when we were discussing prevailing diseases when I was seeking a consult for my MDI...

(edit: Lived in Cape Town for 2½ years)

Data on HIV/AIDS (an autoimmune disease) is available on the WHO site; the problem is a serious one in third world countries, as you can see.

And yes, I am still formulating my ideas, but it's quite hard to formulate on your own without anything to bounce your ideas off of. But this topic is one of those where we could spend days on days arguing, you know you're right, but how do you know? You insult me, question my logic, but then again none of you have provided any hard evidence, except for the handwashing which I agree with 100%. That is what I mean about media hysteria, people can quote out of memory lines that aren't actually linked to anything, just that they sound very effective and that "e-choli is going to kill you if you don't wash your hands". (<<< hyperbole... getit?)

Please provide facts.

Facts on what? If you want data on parasitic/bacterial/viral morbidity/mortality, go to the WHO site, and take a look. No one said "e-choli is going to kill you if you don't wash your hands", [sic] but that failing to wash one's hands before handling food risks contaminating the food with an array of pathogens, which customers' immune systems may or may not fend off unassisted, but which they are certainly justified in wishing to avoid.

The original post was about washing hands. It was about professionalism, and courtesy, about leaving the decision to take on pathogens to the individual, should they so choose.

No one denies the misuse and misapplication of modern medical technology, or the intricacies of the relationships between humans and the life forms they may host; we take that as read. But when disagreement with your position is taken as an insult, impartial debate is an impossibility. At the risk of further offending, the discussion is becoming circular, and I don't see any point in pursuing the matter any further.

Edited February 28, 2011 by Mjx (log)

[Darcie B]

I know others have already responded well and at length but I can't stay silent on this.

Yes ready-to-eat items that are prepared on-site are risky, -but- the fact of the matter really is that unless the person handling his/her hair, the money, the ingredients, does not carry any bacteria that are harmful, there really is no danger... This whole "food-poisoning" mania that has been going on for so long is truly irksome.

What's irksome is spending two days in the hospital with food poisoning. It's only mania if it hasn't happened to you?

P.S. I have eaten at some really shady places, I ate riverclams off a streetvendor in South Africa, they had been standing in the sun for an hour, but they smelled really delicious. Oh and they were raw... Never had a stomachbug.

Lucky you. I grew up on a farm where we casually picked the sh*t off the eggs before cracking them, ran around with the barnyard animals, etc. I'm certainly not an oversanitized person and probably aquired lot of antibodies by playing in the dirt. Yet I still got food poisoning (at least twice) due to someone else's bad food handling practices. No, I probably won't get E.coli from someone not washing their hands, but I might get something else that I'd rather not have. Sure, it won't kill me, but why should I have to get sick at all from someone else's lack of sanitation? You like to post a lot of "facts" but in essence your argument is "*I* never get sick so why all the fuss?"

[angevin]

I'm with Karri on this one. Nothing in life is risk free. If you don't want an STD, NEVER have sex. If you don't want E. Coli poisoning, NEVER eat rare beef. If you don't want Hep A, NEVER eat raw oysters. If you don't want food poisoning from lysteria, NEVER eat cheese made from raw milk.

Of course fastidious hygene will minimize the risk, but there's also a camp (me included) that believes getting sick every now and then is the best protection. For instance, there is now fairly strong evidence that suggests carrying oral Herpes protects against the aquisition of the genital variety. You can't build a strong immune system without getting sick.

[ShaneH]

I think back to my work, in a hospital, and how signs in the room state something to the effect, "Have you asked the one taking care of you if they washed their hands?" ...it goes on to say that the patient can request the healthcare worker to wash their hands right there in front of them.

If it's important there I think it's just as important when I'm eating out of the hands of a stranger...

[angevin]

Well, ok. If you're in the hospital, chances are you're sick and your immune sytem is in a weakened state. So that's probably not a good time to catch something.

[gfweb]

When would be a good time to catch something?

[angevin]

When you're strong enough to get over it and build that immune system.

When I was in high school, I remember being sick a lot. The flu, colds, stomach viruses. Having weathered those few years, I've been healthy as a horse ever since. I still get the occasional cold and all, but it rarely causes me to miss work or anything.

My daughter had a liver transplant when she was six. Her transplant team noted that it was a good thing she attended day care beforehand, as she already had a lot of stuff that would have been serious with her compromised immune system.

[ScoopKW]

How about the argument that it's simple common courtesy to wash hands before offering a guest food with said hands?

Regardless whether we can find the definitive web-based health report on hand washing -- if someone coughs into their hands, handles money, handles a telephone, or anything else for that matter; they should damned-well wash their paws before handing me food. Not doing so is rude. It says to me, "Your health isn't worth me spending 30 seconds to properly wash my hands."

Anyone trying to pull this either gets corrected or doesn't get my business.