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PROTECTING
CONSUMERS FROM HEPATITIS "A"
October 8, 2002
CBC News and Current Affairs
WENDY MESLEY: Hi, I'm Wendy Mesley.
Welcome to a new season of "Marketplace". It's brand
new for me, and I'm glad you found us because we're on a new
night at a new time. Our first story. Hepatitis "A"
has been in the news across the country. Thousands of people
have had to be vaccinated. A "Marketplace"
investigation travels to Missouri to check out a new program
that seems to be working well. But as Erica Johnson finds out,
here in Canada, authorities aren't keen. UNIDENTIFIED MAN:
Ordering one caesar salad and on parmesan toast, and one poached
salmon. ERICA JOHNSON (Marketplace Reporter): The food we eat
shouldn't lead to a shot in the arm. But in recent months,
thousands of Canadians have had a scare. UNIDENTIFIED MAN: As a
consumer, the incident frightens me.
JOHNSON: People who shop for groceries, or grabbed a bit to eat have gone through anxious times. UNIDENTIFIED WOMAN: It's really, really causing a big commotion. This is like putting our lives in danger.
JOHNSON: In just the past twenty months, more than 45,000 have lined up for inoculations against Hepatitis "A", a virus that attacks the liver, feels like a severe flu, and can be deadly. Hep "A" is primarily spread through poor hygiene habits. Usually, that means someone hasn't cleaned their hands properly after using the washroom. In the food business, practically impossible to monitor. So what do to? Come with us to St. Louis, Missouri, a city with a solution. This was Bob Hastings' favourite lunch spot. BOB HASTINGS (Contracted Hepatitis "A"): In all honesty, they made the best gourmet tuna fish sandwich I've ever had.
JOHNSON: But one day he
felt strangely sick.
HASTINGS: I came down with what I thought were
flu symptoms.
JOHNSON: Hastings was perfectly healthy. But
hours later, he was rushed to emergency unconscious. Doctors
realized he'd been contaminated with Hepatitis "A".
Health inspectors headed to Bob's favourite lunch haunt, made an
unappetizing discovery with a sandwich maker.
HASTINGS: They just literally caught him red-handed. I mean he literally had excrement under his fingernails which is the way Hepatitis "A", of course, is passed.
JOHNSON: All told, 68 customers developed Hepatitis. But Bob Hastings fared the worst. In one in a thousand cases, Hep "A" can be deadly.
HASTINGS: And they basically came up and told my wife that my liver is infested with the Hepatitis "A" virus. There is nothing that can bring my liver back, and, short of a transplant, I only had about 36 hours to live.
JOHNSON: Across town, city councillors started to ask questions. What could be done to protect the public, prevent another outbreak of Hepatitis "A". They came up with an idea. Make it mandatory for all food handlers to get the Hep "A" vaccination. A simple plan, but controversial. NBC NEWS CLIP*: This is what Robert Hastings, a sales exec and avid tennis player, looks like now.
JOHNSON: While politicians debated the idea, Bob Hastings got a last minute liver transplant, called a news conference. HASTINGS NEWS CONFERENCE: I, myself, I'm going to write him a letter when I get out of here to Todd Aikin, who's my representative.
HASTINGS: I spoke out because I wanted to get these aldermen to vote for mandatory vaccinations. It is the only way that the public is going to be safe from getting Hepatitis "A".
JOHNSON: Hastings' call for mandatory vaccinations had an impact. Pat Bergauer speaks for restaurant owners in St. Louis. PAT BERGAUER (Restaurant Owners Spokesperson): But we felt, well, you know, you can't keep fighting this situation when it's in the front page of the paper every day.
JOHNSON: So it was a PR
battle?
BERGAUER: Yes, it really was.
UNIDENTIFIED WOMAN: Hi Janet.
JANET WILLIAMS (St. Louis County Health
Department): Hi Joyce, come on in.
JOHNSON: Janet Williams agrees. The near death of
Bob Hastings was too serious to ignore. Williams works for the
St. Louis County Health Department.
WILLIAMS: As a public health agency, we're always looking at a way to prevent illness rather than continue to respond to an outbreak, and this was a way for us to be proactive and not reactive. UNIDENTIFIED WOMAN: I sure wouldn't want to get Hepatitis at my age.
JOHNSON: So who gets vaccinated? Anyone from deli workers at the grocery store to chefs and waiters. Who pays? The employer or the employee. Regardless, the customer is reassured. UNIDENTIFIED WOMAN: It's definitely peace of mind for us. UNIDENTIFIED WOMAN: I think it's an excellent idea. UNIDENTIFIED MAN: I can't eat comfortably knowing that the people who serve the food have been immunized.
JOHNSON: Here is how it's tracked. Once someone is vaccinated, they get a card like this. It's registered on a central computer so there's a record if food handlers switch jobs. People who won't get the shot are fired. The only exception, pregnant women, people with medical issues or religious objections. Since the program started, there have been no reports of food handlers passing on Hep "A", and these restaurant stickers remind customers that employees have been vaccinated. St. Louis has now had mandatory Hep "A" vaccinations for food handlers for over two years. Los Vegas has a similar program. So do the Chicago suburbs. But in Canada, despite recent Hep "A" scares, the very idea is getting the brush off. DR. PATRICIA DALY (Vancouver Health Department): I don't think the risk is high enough to warrant a mandatory vaccination program.
JOHNSON: In Vancouver, Dr. Patricia Daly tracks communicable diseases for the city's Health Department. She says, food handlers are just a small part of Canada's Hep "A" problem.
DALY: I think if we look back over the last five or ten years, the number of instances have been small. The number of people who have acquired Hepatitis "A" from a food handler in a restaurant is very small in Canada.
JOHNSON: True, we only know of ten people who've developed Hep "A" after recent incidents involving food handlers. One case confirmed just yesterday in Toronto. And the cost of vaccinating every food handler across the country would be tens of millions of dollars.
DALY: Given the very small chance of a food handler developing Hepatitis "A" and passing it on to customers, we don't think that cause is warranted.
JOHNSON: Unless you're the
person who gets Hep "A".
DALY: If you're the person who gets Hep
"A" you may feel differently.
JOHNSON: Instead, Vancouver has introduced a
voluntary program for restaurant owners who want their employees
vaccinated. CHARLENE KOC-SPADARO (Restaurant Owner): I tried to
say you have to have it done, but I can't force people to have
it done. It would be nice if everybody would have to have it
done. It would be easier. UNIDENTIFIED WOMAN: Yeah, I'm ready
for you.
JOHNSON: And that's the problem. Of fifty thousand restaurant workers in Vancouver, fewer than 600 think they need the needle. UNIDENTIFIED WOMAN: I'm excited.
JOHNSON: No. In Canada, people in the food business prefer to stick with the old reminder, wash your hands. Just ask Joyce Reynolds of the Canadian Restaurant Association. JOYCE REYNOLDS (Canadian Restaurant Association): Simple, old fashioned practices like thorough handwashing certainly minimizes the chances of a spread of any communicable disease, and that's why they're emphasized.
JOHNSON: But as we found out, simple handwashing done properly is actually kind of complicated. GEORGE SUYDEKO (George Brown College): Good morning.
JOHNSON: At Toronto's
George Brown College, Lloyd Suydeko dispenses the art of
handwashing to future food handlers.
SUYDEKO: So what I want you to do is take your
choice of crayon or marker and pass one down.
JOHNSON: Before class, Suydeko treated the
crayons.
SUYDEKO: And I want you to draw and trace around
your hands.
JOHNSON: As the students draw, an invisible gel
contaminates their hands. Next, Suydeko demonstrates the six
steps of proper handwashing.
SUYDEKO: We like to sing the song "Happy Birthday, Happy Birthday to you, Happy Birthday to you, Happy Birthday to you" twice. Go to the sink, turn on the water. The water should be warm, tepid. Hand soap, one, two. Fingertips, in your palms, and then get this hard disk in the thumb area. Water still running, take some paper towel, dry your hands. Paper towel on hands, turn off the taps.
JOHNSON: Boy, good
handwashing takes a long time.
SUYDEKO: Discard.
JOHNSON: Now it's the students turn. How well did
they do the job? An ultraviolet light picks up all the invisible
gel that wasn't washed away.
SUYDEKO: You even have nicely demonstrated around the ring bands where the germs are collecting. And we can see where Roy rolled up his sleeves to do his handwashing and how easy it was to cross contaminate.
JOHNSON: These students also work in restaurants. They dish the dirt on handwashing. UNIDENTIFIED MAN: I believe that most places do not have handwashing signs in their bathroom. UNIDENTIFIED WOMAN: I work with all these guys and I don't think any of them wash their hands. UNIDENTIFIED WOMAN: You can tell if somebody has or if they haven't by how fast they come out of the washroom. UNIDENTIFIED WOMAN: Okay, here's your mission.
JOHNSON: To find out if restaurants practice proper hygiene, we gave students from George Brown College an informal survey. UNIDENTIFIED WOMAN: Off we go.
JOHNSON: They head out.
UNIDENTIFIED MAN: Is there proper signage for
handwashing procedures? UNIDENTIFIED MAN: Yes there is, at every
bathroom and in behind the bar there's also signs that say wash
your hands after any, touching any food, anything like that,
dirty glasses and stuff. UNIDENTIFIED WOMAN: Where exactly do
you have your handwashing sign? UNIDENTIFIED WOMAN: I believe
they're right above the sink? Right by the soap. UNIDENTIFIED
WOMAN: Yes, I believe there is in the kitchen. UNIDENTIFIED
WOMAN: Do you mind if I just saw those signs? UNIDENTIFIED
WOMAN: And that's the sign that I thought...
JOHNSON: Clean around the dishwasher? That's not the right sign. UNIDENTIFIED MAN: Actually, I don't have one here posted, but we do have them. UNIDENTIFIED WOMAN: Yeah. And you're saying that you do have some. Would you be able to show us? UNIDENTIFIED MAN: You know, that's, I don't have them right here. UNIDENTIFIED WOMAN: Is the handwashing station stocked with soap, paper towel and tepid water? UNIDENTIFIED WOMAN: What's tepid water? UNIDENTIFIED WOMAN: So where are your handwashing procedures located? UNIDENTIFIED WOMAN: It's right in front of it. UNIDENTIFIED WOMAN: Could I see them? UNIDENTIFIED WOMAN: I think so.
JOHNSON: This time there's
no sign at all.
UNIDENTIFIED WOMAN: I guess we're going to have
to get one.
JOHNSON: It seems like handwashing policy has
gone down the drain. In fact, in St. Louis, Bob Hastings
favourite deli had a handwashing policy in place, but it didn't
matter.
HASTINGS: By law, these restaurants have to put signs up in the restrooms saying all employees must wash their hands before going back to work. But it's the honour system. There's nobody standing in there watching them to make sure they wash their hands.
JOHNSON: Surprisingly, Bob and his wife still eat out. They feel safer knowing everyone has been vaccinated, and think Canadian food handlers should also have to get a Hep "A" shot.
HASTINGS: To not take advantage of it and use it, I just think, is wrong. It's just wrong. When you can protect people from getting it.
JOHNSON: And these people who lined up in London, Ontario, just two weeks ago, agree. UNIDENTIFIED MAN: Definitely. I feel it should be part of their health precautions. UNIDENTIFIED WOMAN: For people who work with food and stuff, that would be really good. It would probably save a lot of problems in the future.
JOHNSON: For now, unless something changes, the fate of your food literally rests in the hands that handle it.