Added: (Thu Nov 29 2018)
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In the spring of 1997, I spent a wonderful day with Dr Omar Amin in Phoenix, Arizona. Dr Amin is one of the most respected and sought-after parasitologists in the world and runs the Parasitology Center Inc in Scottsdale, Arizona.
He gave me a copy of his paper 'Understanding Parasites' in which there was a sentence that has always stuck in my mind: "A recent inspection of an expensive restaurant in Los Angeles showed that 100% of all employees (not just servers) had fecal matter under their nails".
Fecal matter and disease (particularly parasites) generally go together. With our cities offering cuisine from increasingly exotic regions of the world, this carries a higher incidence of parasite-borne diseases, especially if these regional foods are undercooked or even raw: Dutch herring, steak tartar, ceviche, sashimi, sushi for example. Tapeworm is high on the list of 'residents' in these foods as is the Anisakid Worm.
A food-handler with poor personal hygiene will more than likely increase the exposure and risk of pathogenic organisms spreading. Years ago kitchen staff wore gloves and hairnets when handling food. They don't seem to do this any longer although regular hand-washing habits may be mandatory nowadays.
University of Gondar, Ethiopia
In 2003, 127 food-handlers working in the cafeterias of the University of Gondar and the Teachers Training College there were fingernail-tested. These café's were selected because the mass-provision of foods is a likely source of transmitting infections. Fingernail contents of both the hands and stool specimens were collected from all 127 food-handlers. In addition to fecal matter under the fingernails, the following was found:
- Coagulase-negative staphylococci (41.7%) by Staphylococcus aureus (16.5%), Klebisella species (5.5%), Escherichia coli (3.1%), Serratia species (1.58%), Citrobacter species (0.8%), and Enterobacter species (0.8%).
- Shigella species were isolated from stool samples of four food-handlers (3.1%). None of the food-handlers was positive for Salmonella species and Shigella species in respect of their fingernail contents.
Thankfully no intestinal parasites were detected from fingernail contents, but intestinal parasites were detected in their stools:
- Ascarislumbricoides (18.11%), Strongyloidesstercoralis (5.5%) Entamoebahistolytica/dispar (1.6%), Trichuristrichiura (1.6%), hookworm species (0.8%), Gardialamblia (0.8%), and Schistosomamansoni(0.8%); 1.6% of the study subjects were positive for each of A. lumbricoides, T. trichiura, hookworm, and Giardia lamblia.
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