Foodservice directors across the country are stocking up on sanitizers and preaching the necessity of proper hand washing techniques to nervous employees and customers to help prevent the spread of MRSA and to reassure patrons. With all the recent media coverage of the so-called "superbug," it’s no wonder the disease is gaining notoriety and making people think twice before grabbing a tray and going through the lunch line.
MRSA, or Methicillin-resistant Staphylococcus Aureus, is a staph infection resistant to certain antibiotics, including penicillin. The bacteria has long been found in hospitals in those patients with weakened immune systems, but recent cases are popping up in schools nationwide in seemingly healthy individuals. This community-associated strain is usually manifested as skin infections, such as abscesses, boils or other pus-filled lesions.
"Staph is the most common skin infection in the United States," says Christine Pearson spokesperson for the Centers for Disease Control and Prevention in Atlanta. According to the CDC, 25% to 30% of people are colonized with staph—meaning the bacteria is present, but there is no infection—but only 1% are colonized with MRSA. "With some common precautions like hand washing, [people] can go a long way to protecting themselves from MRSA," Pearson says. Although she doesn’t have specific figures on the number of students who have been infected with the bacteria, she says there is a greater awareness of the disease and "the vast majority of MRSA cases in the U.S. are mild." Even so, there have been several MRSA-related deaths among students this year.
Hand sanitizers: Some schools are taking a proactive approach to help curb the spread of bacteria. Even though there are currently no cases of MRSA in the Bluffton-Harrison (Ind.) School District, Foodservice Director Robin McCorkle isn’t taking any chances. She has installed hand-sanitizing pumps at the entrance to each service line and another where the students drop off their trays. In addition, after each of the three lunch periods everything is cleaned, including the food tray slides on the serving lines. Although McCorkle says these are small steps and safety precautions, she also admits, "Anything is [a step] in the right direction."
But McCorkle notes the students don’t always follow proper hand washing techniques or use the provided hand sanitizer before going through the lunch lines. She says educating the students by going to homerooms could help. "I think once they know and understand why, they will be more inclined to use the dispensers," McCorkle says. She is also looking into offering single servings of fresh fruit in prepackaged containers so students wouldn’t have to touch tongs that have been handled by dozens of other hands. But that will increase waste and cost, which she says could prevent her from implementing the effort.
At the University of Texas in Austin, Scott Meyer, associate director of foodservice, says, "As we have always cleaned extremely well, we have not changed the procedures but we have increased the training, awareness and management follow-up." The foodservice staff at the university has received educational outreach about the bacteria during meetings and employees are encouraged to stay home when they are sick, to prevent the spreading of germs. The university’s foodservice customers are urged through posted signs and verbal reminders to use the hand sanitizers provided when entering or leaving the dining facilities. Meyer also emphasized the importance of proper glove use, which, depending on a person’s job, could involve changing gloves after each customer.
Special hardware: Other schools are taking more aggressive steps and installing products designed to stop bacteria growth. Component Hardware Group, a New Jersey-based company that manufactures plumbing and hardware products, has created the SaniGuard line of door handles, grab bars, flush handles and faucets, which are coated with antimicrobial silver, to prevent bacteria from living on surfaces. Tom Carr, president of Component Hardware Group, says the products are safe for foodservice environments and do not cost more than similar products without the SaniGuard protection.
St. Peter’s School in Point Pleasant Beach, N.J., recently installed a SaniGuard-treated Encore plumbing system in its cafeteria after a parent brought the products to the attention of school administrators. School nurse Lynn Faugno admits the new plumbing system was partly in response to increased media coverage of MRSA in schools. "When the outbreak first started to occur, in the community there was a kind of panic," she says. "We just felt that this was another step to prevent communicable diseases, like MRSA, in our school setting."
St. Peter’s School is not the only one attempting to get ahead of the problem using SaniGuard products. "Over the past 12 months, we’ve seen an increase of 400% to 500% in these products," Carr says.
Gloves and hygiene: But schools and universities aren’t alone in trying to get ahead of MRSA. Foodservice directors at hospitals, which have long battled the bacteria, are also stepping up sanitation efforts. And recent studies suggest the increase is well warranted: According to the "Journal of the American Medical Association," almost 19,000 people died during hospital stays in 2005 because of invasive MRSA infections.
At Plainview Hospital in New York, Jackie Smith, director of food and nutrition services, asked the hospital’s infection control nurse to speak to the department about the proper use of gloves when handling food trays or entering isolation rooms. “They are to put on gloves before entering the patient’s room and to remove the gloves and wash their hands before they leave the room,” she says. To make sure these procedures are being followed correctly, a foodservice supervisor does random audits and sends the results to the infection control nurse for review. Gloves are also to be worn while scraping dishes in the main kitchen, Smith says. Lastly, the dishwasher has two final rinse cycles, which ensures that all non-disposable tray service items are rinsed at 180°F, or higher, twice.
John Cruse, director of culinary and nutrition services at Mason General Hospital in Shelton, Wash., says proper hygiene and wound care are essential. Keeping wounds clean and covered and changing dressings regularly are key, he adds. Other important points include keeping nails trimmed and not picking at scabs.
"A lot of this is common sense and just keeping yourself clean," Cruse says. "Hand washing is key [to prevent] spreading a plethora of viruses and bacteria." The hospital supplies pocket bottles of gel disinfectant to employees working in areas without sinks.
Spick and span?: While most foodservice directors are emphasizing proper hand washing and general cleaning of common areas, those extra sanitation efforts can be costly. After a senior at a Bedford County, Va., public school died from complications after being infected with MRSA, six schools in the district were closed and professional cleaned—to the tune of nearly $217,000. Ryan Edwards, public relations and policy coordinator for the district, says the cleaning was only partly due to the death of the student. "There were a couple of hundred students protesting, saying they were not going to go back into the schools until something was done," he says. "We were the first school division the national media descended upon with regard to MRSA. This was before there was a lot of education about the virus,” he adds. “To anyone who says that’s too much money to spend on cleaning, I say, 'To save the lives of our children, I don’t think we can put a price on that'."