Reviewing IFH and 2002
2002 has been an extremely busy and productive time for IFH, in this, its sixth year of operation. The first 3 months of the year were largely taken up by the organisation of our second international conference “Preventing infectious disease in developing countries: a responsibility for all”, which took place in New Delhi, India in April 2002. The conference was attended by 170 delegates from India, S.E. Asia and elsewhere. During the conference we took the opportunity to release the second set of IFH guidelines, entitled: “Guidelines for the prevention of infection and cross infection in the domestic setting – with a focus on developing country situations”.

More details of the conference are available in the IFH newsletter (2002, issue 2), which was published and distributed to our “home hygiene community” (for a copy please contact the IFH Secretariat).

During the year the IFH also produced two major scientific review papers covering the evidence base for the IFH “Guidelines” and “Recommendations” documents. These peer-reviewed papers are entitled: “The infection potential in the domestic setting and the role of hygiene practice in reducing infection” and “Hygiene procedures in the home and their effectiveness: a review of the evidence base” . In addition to this we have regularly updated our home hygiene library with summaries of new publications on home hygiene.

During the latter half of the year IFH worked with the UK Infection Control Nurses Association to produce a home hygiene teaching resource for “home carers” and their trainers. The resource presents the IFH “targeted approach to home hygiene” in a simple and practical manner. This resource will be available in spring 2003. We are also working with Dr Ros Stanwell Smith to finalise a review of the “hygiene hypothesis” and its implications for home hygiene.

For IFH it has thus been an excellent year. We have now established a “community” of around 1,400 scientists in some 80 countries, all of whom have been involved in developing and promoting good home hygiene practice based on sound scientific principles. In January 2003, our Scientific Advisory Board will meet to agree our plans for 2003. We hope that it will be an equally stimulating and productive year.

Campylobacter risk in outdoor chickens
According to the University of Bristol, almost all free-range and organic chickens are likely to be contaminated with Campylobacter. The research, carried out for the UK Food Standards Agency (FSA), showed such flocks are “twice as likely” as conventional intensive reared flocks to carry Campylobacter, now the leading cause of bacterial food poisoning in the UK and in many other European countries. The researchers, led by Professor Tom Humphrey, said environmental contamination could be responsible. These findings parallel similar results from a survey in Denmark earlier this year.
Source: BBC newsonline 19/11/02

Rise in severe food poisoning in UK
According to the surveillance data from the BgVV-FAO/WHO collaborating centre, understanding the risks associated with handling of food in the home – and how to prevent them – is important since most foodborne Infectious Intestinal Disease (IID) in greater Europe occurs in the home. Official reported cases of food poisoning in England and Wales stand at approximately 100,000 each year. In 1999, a community study estimated that there were
10 million cases of IID. Our current understanding is that 4.5 million cases of IID are due to food poisoning. In a new paper, the Public Health Laboratory Service has presented revised estimates on indigenous foodborne disease (IFD) in England and Wales during 1992–2000. At first sight the good news from this is that although cases of IID still stand at around 10 million, the estimated number of food poisoning cases has dropped. However, on further analysis it appears that this may be because some circumstances and organisms were excluded from the latest calculations. In 1992, there were nearly 3 million cases of foodborne infection, with more than 21,000 hospital admissions (and almost 1,000 deaths). However, in 2000, despite the total reported cases falling to 1.3 million, the proportion of cases classified as severe (i.e. required hospitalisation) had risen. The number of cases caused by Norwalk-like viruses and Campylobacter also increased by 125% and 45%, respectively.
Ref: Adak et al. Trends in indigenous foodborne disease and deaths, England and Wakes. Gut 2002;51:832-842.

Alert over hygiene in food industry
A survey by the UK Food Standards Agency found more than a third of staff working in the catering industry do not wash their hands after going to the toilet, and half do not wash their hands before preparing food. More than 1,000 workers and managers in small independent catering businesses were questioned. Only half of catering managers said food hygiene was a key factor in the success of their business. As we know, many food poisoning incidents can be prevented through washing hands properly and at the right time, but only two thirds understood that everyone should wash their hands. The FSA is now targeting small, independent catering businesses to persuade them that they should take more care over hygiene. It has sent food safety information and a training video to more than 300,000 UK businesses. For all of us, either directly or indirectly involved in hygiene and wherever we work, much of our knowledge of hygiene and hygiene practice comes from what we originally learnt at home. IFH believes that better understanding of home hygiene could be the key to improved hygiene in hospitals, food processing, catering and other settings.
Source: BBC newsonline 31/10/02

Outbreaks of ‘winter vomiting disease’
There has been a much higher than average number of outbreaks of ‘winter vomiting disease’ (caused by Norwalk-live virus) in UK hospitals and in US and European cruise ships this year. The statistics increasingly suggest that the disease is just as, or even more prevalent in the general and home community. What has surprised the experts is that the “explosion” of outbreaks which started last winter has continued on through the summer months. Hospitals in the UK are adjusting their infection control policies in order to deal with this situation. However, the IFH believes that it would be useful to know what proportion of the sequential outbreaks is the result of index cases bringing the virus into the hospitals rather than spread within the hospital. It may be that preventing the spread of this disease in the home could be one of the keys to reducing the incidence of hospital outbreaks. The causative virus is highly infectious and spreads very quickly and widely via aerosol particles produced by vomiting. This is the reason, once it starts, for rapid spread in a confined setting, such as a hospital ward or a ship. It seems that the virus is also spread via hands and surfaces. It has been found that if an infected ship is not thoroughly cleaned between cruises, the spread of infection starts up again as soon as a new group of passengers come aboard. Thus, it can be deduced that hygiene is a very important way to prevent this disease spreading in the home.
Source: The Sunday Times 17/11/02