Ollinger-Snyder P, Matthews M E
Department of Food Science, University of Wisconsin, Madison 53706-1565, USA.
J Am Diet Assoc. 1996 Feb;96(2):163-8, 171; quiz 169-70. doi: 10.1016/S0002-8223(96)00046-6.
Section 103 (d) of the Americans with Disabilities Act directs the secretary of health and human services to identify, publish, and annually review a list of pathogens transmitted via food contaminated by infected food handlers. The secretary is also directed to publish means by which diseases on the list are transmitted. The intent of the list is to protect disabled food handlers when they become ill and to provide managers with information for determining when to remove or reassign disabled food handlers who have infectious or communicable diseases to jobs that do not involve handling food. Pathogens often transmitted via food contaminated by infected food handlers are Salmonella typhi, Shigella species, Staphylococcus aureus, Streptococcus pyogenes, hepatitis A virus, and the Norwalk and Norwalk-like viruses. This article discusses section 103 (d) and for each of the six pathogens describes characteristics and growth requirements, types of foods involved in outbreaks, factors that contribute to foodborne outbreaks, and prevention and control measures. Human beings are the only reservoir of Sal typhi. The source of Shigella species is the intestinal tract of human beings and other primates. Human beings are the common reservoir of Staph aureus and Strep pyogenes. Staph aureus is frequently found in the nose and on the skin of healthy people, whereas Strep pyogenes is carried in the throat of infected or asymptomatic carriers. Foodborne viruses of public health concern originate in the human intestine. Foods that favor the multiplication of Sal typhi are often foods that require no cooking. Many outbreaks of foodborne disease attributed to Shigella species and viruses have been associated with salads. Moist, high-protein, and salty foods that have been cooked are most often involved in outbreaks of staphylococcal foodborne illness. Foods usually implicated in Strep pyogenes outbreaks are predominately composed of milk, eggs, or meat. Dietitians and dietetic technicians can use three approaches to reduce the incidence of foodborne disease attributed to food handlers: conducting training and education programs, implementing a Hazard Analysis and Critical Control Points system, and supporting certification of foodservice managers.
《美国残疾人法案》第103(d)条指示卫生与公众服务部部长确定、公布并每年审查一份由受感染食品处理人员污染的食物传播的病原体清单。部长还被要求公布清单上疾病的传播方式。该清单的目的是在残疾食品处理人员生病时保护他们，并为管理人员提供信息，以确定何时将患有传染病或可传播疾病的残疾食品处理人员调离或重新分配到不涉及处理食物的工作岗位。通常通过受感染食品处理人员污染的食物传播的病原体有伤寒沙门氏菌、志贺氏菌属、金黄色葡萄球菌、化脓性链球菌、甲型肝炎病毒以及诺如病毒和诺如样病毒。本文讨论第103(d)条，并针对六种病原体中的每一种描述其特征和生长要求、涉及疫情爆发的食物类型、导致食源性疾病爆发的因素以及预防和控制措施。人类是伤寒沙门氏菌的唯一宿主。志贺氏菌属的来源是人类和其他灵长类动物的肠道。人类是金黄色葡萄球菌和化脓性链球菌的常见宿主。金黄色葡萄球菌常见于健康人的鼻腔和皮肤上，而化脓性链球菌则存在于受感染或无症状携带者的喉咙中。引起公共卫生关注的食源性病毒起源于人类肠道。有利于伤寒沙门氏菌繁殖的食物通常是无需烹饪的食物。许多由志贺氏菌属和病毒引起的食源性疾病疫情都与沙拉有关。已煮熟的潮湿、高蛋白和咸味食物最常涉及葡萄球菌性食源性疾病的爆发。通常与化脓性链球菌疫情有关的食物主要由牛奶、鸡蛋或肉类组成。营养师和营养技师可以采用三种方法来降低由食品处理人员导致的食源性疾病的发病率：开展培训和教育项目、实施危害分析与关键控制点系统以及支持食品服务经理的认证。
