The Listeriosis outbreak in South Africa has been the biggest in the world with the highest number of cases and deaths. Cases were also reported in Australia and Namibia some time ago. At the time of writing this article, 1000 cases were reported with almost 200 deaths and it appears that cases have been occurring over quite some years, although the disease was not a notifiable disease until recently and therefore the scope of the outbreak was not recognised. This in itself indicates a shortcoming in South Africa’s ability to identify and deal with serious outbreaks of less common communicable diseases.
The Minister of Health, Dr Aaron Motsoaledi, has indicated that the Enterprise factories in Polokwane and Germiston and the RCL Foods Rainbow facility near Sasolburg have been identified as the source of the recent contamination. Since then, several retailers have removed cold meats from their stores. Furthermore, restaurant groups such as Famous Brands recalled ready-to-eat meat products from their menus. It appears also that a dairy farm near Ladysmith in KZN was affected with the disease. In the meantime, law firms have initiated class action law-suits against the food manufacturing companies.
Whilst the figures quoted in the media show that the incidence of Listeriosis in terms of the general population is very low and therefore not every workplace will encounter the problem, certain sections of the population are more at risk and therefore an evaluation of the risk in every organisation should be carried out and appropriate action taken, as outlined in this article. In addition, the Listeriosis outbreak is a timely reminder of the importance of food safety and hygiene in general, and organisations should review their practices to ensure suitable prevention and mitigation of the risks.
There is a difference between Listeria, the bacterium, and Listeriosis, the disease, as shown below:
The bacterium, listeria, is a naturally occurring bacterium which at low levels of concentration is not a problem. Under certain circumstances, it becomes concentrated and infects water, vegetation and animals, thus eventually creating a disease in humans.
Since the announcement about the source of Listeriosis on 4 March 2018 by the Minister of Health there has been wide-spread speculation about who will take responsibility for the crisis. The outbreak raises several questions that need to be answered:
Although the media criticised the Tiger Brands CEO, Lawrence MacDougall, for an inadequate response to the outbreak after it has been traced back to his Enterprise factories in Polokwane and Germiston, it is clear that the debate about food safety has only started. However, it is evident that a lack of responsibility and accountability has been a feature of the responses so far. The Tiger Brands response is as follows:
“We acknowledge that we are dealing with an extremely serious issue that pertains to people’s personal health and wellbeing and want to provide assurance to all South Africans that we are dealing with this matter with the utmost urgency.”
Lawrence MacDougall, CEO: Tiger Brands
The trade union federation Cosatu responded as follows:
Other possible implications of listeriosis in the workplace to be considered are as follows:
To address the workplace implications of listeriosis as discussed above, we are providing you with practical approaches and guidelines for HR Managers to deal with Listeriosis:
First and foremost, create an awareness campaign about listeriosis and food safety in the workplace. While food manufacturing companies may be more severely affected than other companies, food is consumed in all workplaces, therefore all workplaces are affected. Because some misinformation may be distributed in the media (including social media), ensure that you distribute information from credible sources such as the Department of Health or the National Institute of Communicable Diseases. Use brochures, social media, websites and intranets, notice boards and all other communication channels to reach all your employees and even visitors to your organisation. Furthermore, it is important to ensure consistency in communication and to be cautious when possible inconsistencies in messages are created, e.g. discouraging staff to wash their hands in water saving campaign will most certainly create unsafe conditions in the food safety campaign.
Staff training should include food safety at home, e.g. encouraging staff to disinfect their fridges and surfaces, and transferring this knowledge to their family members and domestic workers.
The 5 keys to safer food as prescribed by the Department of Health are essential for all staff in organisations, not only at work, but also at home and other places they visit:
Key 1: Keep hands, utensils and surfaces clean
Key 2: Separate raw and cooked food
Key 3: Cook food thoroughly
Key 4: Keep food at safe temperatures
Key 5: Use safe water and raw materials
While general awareness and training is essential for all staff, certain groups of staff are more exposed to viruses and bacteria, for example, staff working in cafeterias or kitchens, or those receiving food from catering suppliers, and indeed cleaners. These high risk staff members should receive intensive training on food safety and the prevention of diseases. Thus, ensuring that relevant professionals such as occupational nurses, health and safety officers, environmental health practitioners, and employee wellness practitioners are well trained to deal proactively with listeriosis prevention and treatment will be key in ensuring effective training and development of staff.
As with all other diseases, listeriosis poses a significant disruptive risk to an organisation in terms of losing staff, law suits, costs, absenteeism, reputational risk and should therefore, like HIV/AIDS, be treated as an external risk entering your business. The focus should therefore be on prevention so that it does not affect your business, but once staff or customers are infected it must be treated and further spread minimised. Risk mitigation becomes a key strategy in dealing with listeriosis. Using the guidelines proposed in the SABPP HR Risk Management Standard, as well as the Employee Wellness Standard could be a useful point of departure in dealing with the threat of listeriosis.
Companies operating in the food manufacturing, food distribution, health and safety, tourism, entertainment, hotels and restaurants are directly affected, but it is also reported that the country faces a critical shortage of food technologists and health and safety inspectors. Municipalities are responsible for food health and safety inspections and apparently many municipalities are severely dysfunctional in this service delivery.
Skills development practitioners and learning providers should ensure that there is an adequate supply of staff with the requisite skills in in the food sector. In particular, the listeriosis outbreak highlights the need for an increased focus on food safety and quality control specifically. The problem is exacerbated by the national shortage of 3 300 health inspectors. The appropriate Sector Education and Training Authorities should take up this issue.
In the event of staff being infected by Listerioris, ensure that over and above the normal sick leave and medical aid benefits being activated, the necessary emotional and counselling support via the employee assistance programme and wellness interventions is provided.
Most health and safety programmes focus more on the physical safety of the workplace in terms of safety equipment and behaviour. Listeriosis certainly puts the spotlight on the impact of communicable diseases, and it is therefore essential to ensure that occupational health and safety policies and regulations are expanded to include food safety and hygiene in the workplace. Also, apart from the risk of being infected with listeriosis, the debate surrounding the bacteria has expanded to the broader issue of unhealthy eating and lifestyles, a problematic area for most South Africans. Eating unhealthily, and in particular the excessive intake of large quantities of meat and processed food, is a health risk and has contributed to one of the highest obesity and high blood pressure rates in the world.
What complicates the Listeriosis epidemic is that the symptoms are very similar to flu and other typical outbreaks typically experienced during the winter months. This may cause unnecessary panic among staff members on the one hand, but also pose additional infection rates for staff with weaker immune systems. It is recommended that HR Managers invite medical practitioners to the workplace to orientate and support staff during periods of flu outbreaks to prevent the spread of flu and listeriosis.
The problem in some companies is that compliance is sometimes seen as a “necessary evil” at best and “unnecessary evil” at worst. In other words, compliance is seen as a problem and not the solution. The reality is that compliance regimes are instituted to address problems in organisations and society such as fraud, corruption, collusion, price fixing, inequality, poor safety and exploitation of employees, customers, suppliers and other stakeholders. As one of the professions with the strongest compliance systems, HR is uniquely positioned to become facilitators of compliance in the workplace. This means that HR should support and enable a culture of compliance. In addition to laws – rules, codes and standards, good practice guidelines should be followed. As indicated by Rose some companies have a poor track record of non-compliance and making excuses without apologies is described as “lukewarm about owning up to the truth.” Human rights lawyer, Richard Spoor when discussing the Tiger Brands situation is quoted by Barronas follows:
“We are lagging a long, long way behind in terms of standards, compliance and accountability.”
Richard Spoor, Human Rights Lawyer
There is no better way of establishing a culture of compliance in food safety than by embedding food safety standards, such as the Food Safety System Certification Standard (22 000) of the International Standards Organizationand the National Standard for processed meat products (SANS885). Furthermore, it is important that consumers must be protected against harm caused by a product or service in accordance with the Consumer Protection Act.
Whilst we do not recommend incorporating specifics about Listeriosis into company disciplinary codes, we do recommend a review of the code of conduct, or workplace rules, whatever approach you take to communicating with employees on what is acceptable behaviour and what is likely to lead to disciplinary action.
Remind high risk groups that negligence in the event of the spread of listeriosis and other diseases can be used for the purpose of disciplinary action. Likewise, if health and safety policies are strengthened as suggested earlier, non-conformance to policy is also a ground for disciplinary action. While we are most certainly not proposing the creating of a culture a fear in the workplace, responsible behaviour based on sound principles of prevention, safety and disease control can be used to promote a culture of conformance, prevention, cleanliness, safety and discipline.
All cases of Listeriosis must be reported to the Department of Health or National Institute of Communicable Diseases within 24 hours of diagnosis. Health practitioners will do this immediately, thus employers with clinics or health centres should also ensure that this happens so that the provincial and national listeriosis statistics can be updated on a regular basis.
The responses to the current outbreak from private food companies and in certain cases government departments has been criticised and this once again shows that top and senior management teams are often not ready to deal with crisis response in a professional manner. Take this opportunity to ensure that your skills development and other human resource development programmes include appropriate training in crisis management, in particular on how to respond to the media. Inadequate responses will do more damage than the short-term loss in sales or class-action law suits, in particular when the reputation of the company is adversely affected and trust is eroded. Additional costs could include medical bills and large fines from the Department of Health.
The outbreak of Listeriosis has put the spotlight on the need for an increased focus on food hygiene and safety in the workplace, homes, shops, and other places where food is consumed. Already the listeriosis outbreak has caused more deaths than the Marikana massacre and the Life Esidimeni tragedy combined. While we attempted to share the current known implications about the bacteria with readers, it is not clear how it will spread and evolve in future. Whether we will be able to cope with the full extent of the Listeriosis epidemic remains to be seen. Clearly, more research and development work is needed in dealing with Listeriosis. However, given the fact that the outbreak is now the most severe in the world, the short-term priority should be to curb the current spread of Listeriosis and to prevent future cases.
HR practitioners have played a vital role in controlling and minimising the impact of HIV/AIDS in the workplace, so much so that infection rates have decreased in recent years. SABPP would like to commend HR practitioners for their role in dealing with the HIV/AIDS crisis in such a professional and focused way in ensuring that the disease is now under control. However, we need to remind ourselves that as the AIDS crisis in South Africa was the worst in the world and it is the same with Listeriosis. But with AIDS we managed to develop the best national AIDS programme in the world, and similar work is needed to deal with Listeriosis and other possible future communicable disease outbreaks. Increased accountability systems need to be established.
SABPP proposes a similar intensive and proactive campaign focusing not only on the Listeriosis crisis, but on food safety, hygiene and cleanliness in general. All workplaces where food is consumed are at risk, and higher levels of awareness and capacity-building is needed in creating clean, safe and healthy work and food environments. Moreover, while the short-term crisis forces us to focus on Listeriosis as one disease, it is possible that other similar or worse diseases may emerge in future. Therefore, we will need to balance short-term reactive approaches in dealing with the crisis at hand, while simultaneously developing robust and proactive approaches and systems of dealing with the outbreak of any new diseases.
Marius Meyer is CEO of SABPP Dr Penny Abbott, Research and Policy Adviser to the SABPP. This article is an extract from the April 2018 SABPP Fact Sheet on Listeriosis (google SABPP Fact Sheet on Listeriosis) or download from Twitter @SABPP1
Gama, M. 2018. Listeria and gourmet burgers be damned. Finance Week,15 March, p. 20.
Donnelly, L. 2018. Jobs shed as cooked meat sales dip. Mail & Guardian,March 16-22, p. 2
Mohlomi, S. 2018. No Kota Spared. Financial Mail,March 15-21, p .28
Rose, R. 2018. The Problem with Tiger. Financial Mail,March 15 – 21, p .5
Barron, C. 2018. Spoor on the hunt for Tiger settlement. Business Times,18 March, p. 7
Gedye, L. 2018. Tiger Brands counts the costs. Finance Week, 15 March, p. 17
Donnelly, L. 2018. Jobs shed as cooked meat sales dip. Mail & Guardian, p. 2
Gedye, L. 2018. Tiger Brands counts the costs. Finance Week,18 March, p. 16-17