All food handlers of the AUB community are expected to abide by the following policies:

General

• Complete physical exam on admission as others.
• Particular attention when sick with diarrhea, Upper Respiratory Infection, skin lesion.
• Chest X-ray every two year.
• No need for routine medical examination of food handlers since it was concluded that it is ineffective and unnecessary. However medical examination is appropriate in case of reporting sick or in the investigation of outbreaks of food borne diseases.
• Although annual Tuberculin test is done yearly as part of infection control scheme, there is no evidence that Mycobacterium Tuberculosis is transmitted through food even with sputum production.
• Biannual stool microscopy & culture in February and August. These tests should be intensified in case of outbreak.
• Although food handlers are at increased risk of acquiring Hepatitis A, their position in preparing food can make them sources of outbreaks.
• Hepatitis A vaccine is a possible measure to be implemented, if it proves to be cost effective measure in an area when Hepatitis A is endemic.

Follow up training programs

Food handling staff should receive instructions for food safety and personal hygiene and should be required to undergo a test of their knowledge of the subject. To do this effectively, the following points should be stressed:

1. Periodic training programs ensuring that all employees understand the basic principles of food safety and their own responsibility in that respect.
2. Staff should be made aware of the need to report illness immediately especially whenever they have diarrhea, Sore throat, Cold, jaundice, or open skin lesions
3. lf isolation is necessary, staff should be aware that this measure will not result in loss of employment and wages.
4. Personal hygiene should be stressed with an emphasis on hand washing and the most appropriate and official technique of doing it.
5. Health interviews which involves the completion of a questionnaire by the employee in the presence of a designated occupational nurse or supervisor. The interview should take place before employment and in special circumstance e.g. following illness; general assessment, suitability for work, appearance and cleanliness should be the main target of the questionnaires.

Essential Information for Food Handling Personnel

• Proper cooling methods for previously cooked liquid foods( soups, sauces and gravies).
• Proper cooling methods for other foods (such as meats, dressing, beans, rice, stews).
• Pre-chilling of potentially hazardous ingredients for preparation of salads (such as macaroni and potato salad).
• Proper hot holding temperatures.
• Proper re-heating temperature for potentially hazardous foods.
• Proper cooking temperature for meat and poultry.
• Use of a thermometer to determine the temperature of food during cooling refrigerated storage or re-heating.
• Assume the potential hazards of foods in advance.
• Avoidance of storage of potentially hazardous food at room temperature
• Proper use of Ice for cold storage.
• Avoid cross contamination.
• The need to wash hands after defecation or handling raw meat or poultry
• Proper storage and labeling of chemicals.
• Protection of food from contamination.
• Use of proper utensils to eliminate unnecessary hand contact.
• Proper sanitizing of utensils, work surface, cutting boards and tableware
• Proper use of wiping cloths.

Treatment

Organism	Treatment
Giardia- E. Histolytica	Flagyl Tablets 2 tablets 3 times/day after meals for 6 days
Taenia	Vermox 100 mg. 2 tablets day (3 days), 1 in am. 1 in PM.
Ascaris	Vermox 100 mg 2 tablets /day (3 days), 1 in A.M., 1 in PM.
E. Coli E. Nana	If recurrent twice, give Flagyl
Salmonella groups A, B, C	No treatment Discontinue handling food for 10 days Repeat stool tests afterwards