Food safety: review and implications for dietitians and dietetic technicians.

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.