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It's Enough To Make You Sick

A restaurant's inspection doesn't make it healthy

FRIDAY, May 4 (HealthScout) -- Even if your favorite restaurant carries a Board of Health seal of approval, that doesn't mean you won't pick up a nasty little bug, a new study says.

In a survey of dining establishments in Miami-Dade county, researchers found that health inspections were pretty much useless when it came to predicting outbreaks of food-borne illness.

"We were expecting to find a stronger association," says lead author and epidemiologist Miguel Cruz, who did the study while he was with the Miami-Dade Health Department's Office of Epidemiology and Disease Control.

But the study instead found that results of restaurant inspections did not forecast an outbreak of food-borne illness, which is defined as at least two people reporting a similar illness after eating.

The data, compiled from l995, compared 51 restaurants with reports of outbreaks against 76 randomly selected restaurants with a clean slate. Only one critical violation, the evidence of vermin, say researchers, was associated with the outbreaks. Cruz wouldn't name any of the restaurants involved.

During l995, the Miami-Dade Country Health Department confirmed 60 of the 187 reports of food-borne illnesses. A cause was identified for 32 percent of the outbreaks and the way it was spread for 47 percent. The last inspection report before the outbreak was available for 85 percent of the restaurants.

Restaurants with cases of illness were only "somewhat less likely to receive the most favorable overall rating," researchers say.

Cruz admits, however, it's extremely hard to pinpoint the cause of any food-borne illness, which is most frequently reported to the health department.

"By the time the inspectors go back to the establishment, the food has been disposed of, the people are feeling better and have no interest, and we're past the time when we can recover the organism," he says.

Lynn Joens, professor in the department of veterinary science and microbiology at the University of Arizona agrees. "It's impossible to detect food that's tainted already. You can detect bad methods like not cleaning adequately, people not washing hands, but…by the time people become sick, the food is gone."

"What are we doing to make sure that consumers are getting food that is safer? We should look at food inspection and evaluate and see if they are doing what they are supposed to do," says Cruz.

He hope his study, only the second one to look at inspections as a predictor of illness, will prompt other cities, towns, counties and states to take a careful look at food inspection.

"If we work with inspectors, the food community, the owners of restaurants, restaurant chains, the consumer, government and regulators," says Cruz, "we can find better ways to make sure our food is safe."

Joens feels the responsibility lies squarely in the hands of the restaurants, who she says must be sure they deal with reputable wholesalers, keep their facilities spotless, and store food properly.

Cruz is now with the Emergency Preparedness and Response Branch at the Centers for Disease Control and Prevention. The study is in the current issue of the American Journal of Public Health.

What To Do

Most health departments publish a list of restaurants that have been cited for violations or shut down for health reasons. Joens recommends you get a look at the lists and find out which places have had problems -- and stay away.

Get the facts on food-borne infections from the Centers for Disease Control and Prevention.

The causes of food-borne illness could be lurking in your own kitchen. Learn how to prevent sickness from the FDA.

For more HealthScout stories on food-borne illness, click here.

SOURCES: Interviews with Miguel A. Cruz, M.Ph., former epidemiologist, Office of Epidemiology and Disease Control, Miami-Dade County Health Department, now with the Emergency Preparedness and Response Branch, Centers for Disease Control and Prevention, Atlanta, Ga.; Lynn Joens, Ph.D, professor, department of veterinary science and microbiology, University of Arizona
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