Question

Hilary is a nurse inspector at the county health department. She visits businesses in the community that have the potential to spread infectious diseases to large and/or vulnerable populations. Today she will visit the We Love Kids daycare center and a nearby seafood restaurant.

The daycare center cares for children ages one month to six years. To enroll a child in day care, parents must show proof that the child is up-to-date on all age-appropriate immunizations or must show proof of medical or religious exemption. Nurse Hilary finds the records in the office area and confirms that all children have received the necessary immunizations. She observes the employees use gloves when changing diapers, cleaning a baby's spit-up, and tending to a scratched knee from a playground accident. Employees also wash their hands after each of these events, before and after giving a baby his bottle, and before entering the one- to six- month old room after leaving the two-to-three-year-old room. Nurse Hilary also notices a flyer posted in the employee break room that informs staff of the upcoming mandatory in-service that will be held to discuss the importance of checking bottles, especially those that contain breast milk, for the correct name before feeding a child.

The seafood restaurant is a chain restaurant that has become less popular over the past couple of years. Many customers have complained about the quality of the food. Recently, 20 cases of severe diarrhea were reported to the health department by people who had just eaten at the restaurant. Nurse Hilary observes the cooks in the kitchen. The refrigerator and the freezer are kept at appropriate temperatures for storing food. Food is stored in air-tight, plastic containers. She watches as the cook who is preparing the chicken for broiling is also in charge of prepping the plates that are going out to customers. Upon cutting into a piece of chicken that is about to go out to the dining room, Hilary notes that the meat looks pink and undercooked. Pieces of wilted lettuce are scattered on the countertops. During her two hour visit, the main chef washes his hands twice, although he leaves the kitchen four times for a smoke break.

Answer the following questions for this case study:

1) How is the daycare center providing infectious disease control?

2) Describe the outbreak of severe diarrhea in the restaurant customers. Was it an endemic? An epidemic? A pandemic? Why

3) Which of the Five Keys to Safer Food does the restaurant not follow?

Answer 1

1. Daycare center is providing infectious disease control by:

a) Checking the proper immunization record of all children.

b) Staff are using gloves while changing diapers, cleaning a baby's spit-up.

c) Employees washing their hands before giving bottles to babies and also when entering rooms of different age groups.

d) By informing staff the importance of checking bottles.

2. The outbreak of severe diarrhea in the restaurant customers is an epidemic, which is caused by improperly cooked meat.

Definition of epidemic: a widespread occurrence of an infectious disease in a community at a particular time.

While endemic is infection is constantly maintained at a baseline level in a geographic area without external inputs, and pandemic is disease that has spread across a large region.

3. Restaurant is not following the cook thoroughly Key to Safer Food.