Twenty-four food workers were employed at the main cafeteria of the university. Except for one deli bar worker who refus

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Twenty-four food workers were employed at the main cafeteria of
the university. Except for one deli bar worker who refused to talk
with investigators, all food workers were interviewed by one of the
environmental health specialists. Translators from the local health
department were used with food workers who did not speak
English.
The environmental health specialists obtained a list of foods
served during the implicated period. Food workers are questioned
about where they usually worked, the foods they prepared or
handled, and their recent work schedule. They were also asked about
glove use, handwashing practices, and recent illnesses.
None of the food workers reported being ill with vomiting or
diarrhea during the previous 2 weeks. None had been absent from
work for health reasons.
Inspections of the main cafeteria food preparation area and
serving line were unremarkable. Refrigerators and freezers were
maintained at appropriate temperatures and were organized to
prevent cross-contamination. Food preparation surfaces were clean
and well-situated with respect to the flow of kitchen traffic.
Steam tables, meat slicers, and other equipment were clean and in
good working order. Hand sinks along with soap and paper towels
were conveniently placed in the food preparation area. All sinks
were equipped with a foot pedal for hands-free operation.
Investigators, however, noted a number of problems in the deli
bar. During mealtimes, sandwiches were made to order at the deli
bar. Each day, newly prepared meats, cheeses, and condiments were
added to partially depleted items from the day before. Containers
holding these items were cleaned on a weekly basis.
While the deli bar was open for service, sandwich ingredients
were not kept refrigerated or on ice, and the refrigerator in the
deli bar only cooled to 47F
The environmental health specialists collected samples of
leftover ham, turkey, and salami (sliced on March 8-9) and lettuce
(shredded on March 11) from the deli bar for bacterial
cultures.
Before dinner on March 11, the local health department closed
the deli bar at the main cafeteria of the university.
Question 19: Do you agree with the decision to
close the deli bar?
____Yes
____No
____Unknown
Question 20: Given the findings of the
environmental health assessment, do you think it is necessary to
proceed with the case-control study?
____Yes
____No
____Unknown
Although problems with food preparation were noted in the deli
bar at the main cafeteria of the university during the
environmental health assessment, no solid evidence existed to
implicate the deli bar as the source of the illness among the
students.
Therefore, TDH investigators proceeded with plans for the
case-control study to test the original hypothesis that the source
of the outbreak was at the main cafeteria of the university.