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51 Cards in this Set

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What is a reportable disease under the Health Protection and Promotion Act?
means a disease specified as a reportable disease by regulation made by the Minister
Who are the reportable diseases reportable to?
Local MOH
Give some examples of communicable diseases the the EHO will encounter.
*Botulism

*Campylobacter enteritis

*Food poisoning, all causes

*Gastroenteritis, institutional
outbreaks

*Giardiasis, except asymptomatic
cases
How would you recommend cleaning up mouse droppings?
10% sollution of bleach
Use a mask to protect from dropping dust.
What is the role of PHI officials in emergencies or disasters?
acute medical care
communicable disease control
sanitation
water supply
emergency shelter
safe food supply
You are inspecting a farmers market and see someone selling eggs from their truck. Farmer Brown selling eggs at his booth and another booth is selling cider-what, if anything might you be concerned about?

While at the farmers market, someone askes you about cider, they were told fresh cider is unsafe to drink. What is your response?
- Eggs must be graded by an egg grading station.

-Eggs must be refrigerated.

-Only grade A or B, in properly marked containers.

-Farmers can only sell ungraded eggs directly from their farm.

-Legislation PFR sec 54

-Contact CFIA

Cider
-Juices can become contaminated with bacteria - specifically E.coli 0157 H7, Salmonella, Crpytosoridium and viruses.

-Unpasteurized cider has been linked to outbreaks.

-The raw fruit can become contaminated if it has fallen to the ground and comes into contact with bacteria from animal dropping/water used during processing contains harmful bacteria/Improper food handling practices or soiled equipment.

-Also advise her on the importance of drinking either pasteurized cider or boiled unpasteurized cider especially if she is giving it to her two year elderly are mostly susceptible to pathogens.
During an inspection of a restaurant you see raw chicken breast sitting on the counter. In the refridgerator a large pot of gravy. A very large pot of cooked rice sitting on the counter. What are your concerns if any and what actions will you take?
Concern for each food is temperature abuse.

Concern for the rice is B. cereus.

Take the internal temperature of the food.

Discuss cooking and cooling procedures with the owner/cook.

Improper cooling of hazardous foods-elapsed time from prep to cooking and should be less than 2 hours.

Discuss safe temperatures, shallow pans.

Legislation
Food may require refrigeration, cooking.

Actions:
Condemn food if necessary.
Food may require refridgeration, cooking.
Fine $375
You inspect a restaurant and everthing looks fine. You turn on the tap at the handsink and there is no water. What do you do? Under what conditions would you close a restaurant?
Check to see if there is another water supply.

If water available elsewhere but not at sink then determine why.

Write up infraction and tell operator to repair water supply.

Premises must be closed if no running water under section 13 of the HPPA.
What is a hazard under the HPPA.
-Anything that affects the health of any person.
If you must order the restaurant closed what steps do you take to close the restaurant.
Advise the operator that the restaurant will be closed give written notice, placard front of restauranat with closeure sign, follow-up with Sec 13 Order under the HPPA. Information must have:`
Who is responsible
What is the reason
Where (address)
When and right to appeal
You are asked by a group of real estate agents to put on a seminar on private sewage disposal (septic systems).
Discuss what you would like to cover in this seminar with respect to septic system design requirements, life span signs of failure.
1. Ontario building code.

2. Types of systems

3. Septic systems.

4. Aerobic systems.

5. Alternatice technology

6. Choosing a location with respect to:
-H2O
-Wells (shallow-deep)
-soil tye
-rock
-slopes
-property lines
-municipal by-laws
-lifespan

7. Signs of failure
-backup
-wet, damp ground
-lush growth
-frequent pumping.
Walk through an inspection of a barbershop. What are you looking for? What are your public health concerns?
What do you discuss with the operator?
Concerned with Infection control practices because of blood borne illnesses (HIV, Hep B) which can be transmitted through a contaminated object (razor blade, sharps) common tool shared between clients, used for shaving in a barbershop or hair salon.

Need to educate barbers and hair stylists about infection control procedures:

-Using powdered astringent instead of stypic pencil to stop the flow of blood.

-Disposable safety razors.

-Wash-disinfect utensils.

-Dispose of sharps.

-Cut on hands.
What is pH?
The pH scale measures how acidic or basic a substance is. It ranges from 0 to 14. A pH of 7 is neutral. A pH less than 7 is acidic, and a pH greater than 7 is basic. Each whole pH value below 7 is ten times more acidic than the next higher value. For example, a pH of 4 is ten times more acidic than a pH of 5 and 100 times (10 times 10) more acidic than a pH of 6.
What is the optimal range of pH in a pool?
7.2-7.8
What is the effect of pH on a pool?
The pH level effects the ability of chlorine (or alternative) to sanitize pool water. The higher the pH, the lower the amount of hypochloric acid available to sanitize and oxidize the unwanted materials in the pool water. The pH level also has similar effect on bromine.
What is the effect of temperature on a pool balance?
As water temperature increases, the water balance tends to become more basic and scale-forming. Alternatively, as the temperature decreases, water becomes more corrosive. Although temperature is a factor due to its effect on the properties of water, it is included here. However, relatively speaking, temperature is the least significant factor affecting water balance.
What is meant by a balanced pool?
Balanced water can be defined as being neither corrosive nor scaling
You recieve a call from a mother who is concerned that her 15 year old son is buying cigarettes from a local corner store. What do you tell her?
Find out were the son is purchasing cigs.
Conduct a test shop to see if vendor sells tobaco to a minor.
If observed that no ID was requested and tobacco was sold, charge the vendor and/or operator for sale of tabacco to a minor.
What is the legislation that gives you authority to take action to take cigs?
Tobacco control act
Are Ontario Health Cards acceptable forms of ID. What are acceptable forms of ID?
No health cards.
Can accept:
Canadian passport
Canadian citizenship card.
Ontario drivers license.
LLBO card.
Canadian Armed forces card.
A pricipal phones and informs you that students are smoking on school property. What is your course of action?
It is prohibited to smoke on school property.
Able to charge under the Act.
Educational sessions informing students and staff members of the Act, health effects of tobacco smoke
You walk into a premise and see a vending machine that sells cigarettes. What is your course of action?
Under the Tobacco Control Act, it is illegal to sell tobacco from a vending machine due to easy access to minors.
Ask operator to open the machine.
If tobacco inside , able to seize tobacco and money from the machine under the Act.
Tobacco goes to the ministry of health.
Money goes to the minister of finance.
Charge operator.
What is a reportable disease under the communicable disease reg's
Reportable diseases are those diseases which have been specified as being reportable to the
local medical officer of health by Ontario regulation 599/91 under the Health Protection and Promotion
Act, 1983 (RDIS Guidelines and Procedures Manual, 1992). There are currently 57 reportable diseases.
To who are reportable diseases reported?
local medical officer of health
What are the major reservoirs of Hep A?
humans
What are the modes of transmission for Hep A?
Hepatitis A is acquired primarily by the fecal-oral route by either direct person-to-person contact or by ingestion of contaminated food or water. HAV is found in feces of infected persons and only transiently in serum. Common-source outbreaks have been related to contaminated water; food or ice contaminated by infected food handlers, including sandwiches and salads that are not cooked or are handled after cooking; raw or undercooked shellfish (oysters, clams, mussels) harvested from contaminated waters; and contaminated produce such as lettuce, cabbage, and strawberries. HAV has been transmitted by transfusion of blood and clotting factor concentrates obtained from donors, between IV drug users, and from mother to newborn child.
You are contacted by a physician who has diagnosed a confirmed case of Hep A. The individual affected is a foodhandler who worked at a banquet on the previous weekend. What do you do?
If hepatitis A occurs in a food handler, IG should be given to other food handlers in the establishment as soon as possible and within 2 weeks of exposure. The communicable disease control nurse or the environmental specialist at the health department should request a complete list of all food handlers who have worked at the establishment during the exposure period even if they are no longer employed there. In the investigation that follows, all persons on that list should be interviewed and offered IG. The food handlers should be interviewed regarding specific tasks, food handling practices and the presence of symptoms suggestive of HAV infection. (See attached Hepatitis A Worksheet).
a) Those who are currently symptomatic must be sero-tested and must be excluded from food handling until the diagnosis of hepatitis A has been excluded or, if HAV infection is confirmed, until viral shedding in stool is presumed to have ceased. Symptomatic persons who do not receive the IG should not be permitted to return to work until 30 days past last case reported among the food handlers, unless they can demonstrate serologic evidence of immunity.
You recieve a call from a man who is concerned about finding extensive mouse droppings in his summer cabin. What recommendations do you give for clean up?
-Always use rubber gloves
-Avoid dry sweeping or vacuuming
-Open windows/doors for a half hour before and after cleaning to air out the area.
-Using a spray type bottle, mix one (1) part household bleach to nine (9) parts water. i.e., 100 ml. of bleach in a 1 litre bottle. Spray the area well. Floors should be wet mopped with household bleach and water. (One part bleach - 9 parts water)
Give some examples of corrective actions that may be administered at a food premises.
determining whether the food in question should be disposed of, correct or eliminate the cause of the problem and maintain records of corrective actions taken for continuous improvement.
What is the reason for the 10 day quarantine when bitten by a suspected animals with rabies.
The reason for the 10 day quarantine is that if the animal was shedding the virus when he/she bit the person, he/she will be dead from rabies within 10 days. If the animal appears normal after 10 days, then he/she was not shedding the virus at the time of the bite. It does not, however, mean the animal is free from rabies. The virus may not have reached the brain yet. (If this is the case, the animal was still not contagious when he/she bit the person).
Which has been linked to outbreaks of food poisoning caused by E. coli O157:H7?
a. apple juice
b. ground beef
c. lettuce
d. all of the above
d. all of the above
Purpose of a ground fault circuit breaker?
So that people don't get shocked.
What are the 3 forms of botulism?
foodborne, wound, and infant
or intestinal botulism.
What are the foods associated with botulism?
low acid (pH greater than 4.6) and may include home-canned foods, sausages, meat
products, canned vegetables and seafood products
When does wound botulism occur?
When an anaerobic wound is contaminated with C.
botulinum, usually from the soil
When does infant botulism occur?
Infant botulism is seen only in children less than a year
of age. In this form, C. botulinum spores germinate in the intestinal tract and produce toxin
What food is has commonly been implicated in infant bot?
Honey
How is Botulism disinfected or inactivated?
Exposed to sunlight are inactivated within 1 to 3
hours. Botulinum can also be inactivated by 0.1% sodium
hypochlorite, 0.1 N NaOH, heating to 80°C for 30 minutes
or 100°C for 10 minutes. Chlorine and other disinfectants
can destroy the toxins in water.
The vegetative cells of Clostridium botulinum are
susceptible to many disinfectants, including 1% sodium
hypochlorite and 70% ethanol. The spores are resistant to
environmental conditions but can be destroyed by moist heat
(120°C for at least 15 min).
Describe water treatments
Activated Carbon (AC) Water Filters:

Activated Carbon Filtration is an established technology that works through absorption of the problematic compounds, primarily to remove taste and odour but systems will also remove some harmful contaminents. AC is a highly porous material with a very large surface area. Chemical pollutants are attracted to and held by the AC's surface. These water filters are best suited for the removal of organic compounds.

Ultraviolet (UV) Water Filters
UV Filters are able to kill the majority of bacteria and viruses in the water which passes through them. However, they won't remove chemical pollutants from the water. Also you should note that the treatment is ineffective outside of the treatment area, so water should be used immediately after it is treated.

Water Distillation (Water Distillers)
Water Distillation involves heating the water to boiling point and condensing the steam. Pollutants with a boiling boint near that of water are hard to remove, but generally the distilled water is of a very high quality.

The major drawback to this method is that it requires a large amount of energy. Some people will also complain that the distilled water tastes flat (this is due to less dissolved oxygen).

Reverse Osmosis
In water filter terms, reverse osmosis (or hyper-filtration) is the process of filtering water under pressure through a semi-permeable membrane, allowing water to pass through but rejecting other particles such as bacteria, toxins, salts, and anything bigger than around 150 Daltons.
How is Hep A passed from person to person?
In the stool of infected persons.
How is Hep A prevented?
1) hepatitis A vaccine for long-term protection,

2) good personal hygiene and sanitation, and

3) immune globulin for short-term prevention
What is the public health concern regarding cockroaches?
Cockroaches move freely from filth to food, they can transfer microorganisms that cause food poisoning. People are allergic to their cast off skin
What part of day are cockroaches more active?
night
What cockroach is the most common?
The German cockroach (Blatella germanica) and the American cockroach (Periplaneta americana)
Where are cockroaches found mostly?
In the kitchen.
What is the difference b/w oriental and german cockroach?
Oriental cockroach (Blatta orientalis) is attracted to light, rather than fleeing from it.
How do you prevent cockroach multiplication?
Crumbs,spills, grease should be cleaned up. Pet food should be put away. Food should be stored off the floor. Moisture leaks should be repaired and floor drains routinely sanitized.
A live bat is found on the floor in the baby's room. It looked like that it had been there overnight while the baby was sleeping. What do you tell him?
Do you have the bat?
Baby should be taken to the hospital or doctors office for profilaxis.
What is pH?
pH is a measure of hydrogen ion (H+) concentration in water. It indicates the relative acidity or basicity of pool water. pH is measured on a scale of 0 (strong acid) to 14 (strong base) with 7 being the neutral pH.
What is meant by balanced pool?
provides bather comfort and does not damage equipment or components.
What is the importance of alkalinity?
This acid neutralizing (buffering) capacity of water is desirable because it helps prevent wide variations in pH whenever small amounts of acid or alkali are added to the pool. Total alkalinity is a measure of water's resistance to change in pH.