In the wake of the Norovirus outbreak in Billings that caused a restaurant to close in April, I thought it would be timely to write about restaurant inspections. So, last week, I accompanied one of the Lewis and Clark City-County Health Department's registered sanitarians on an inspection of a full-service restaurant.

Once we arrived, the first thing we did was wash our hands. Besides getting our hands clean, the purpose of turning on the water in the hand-washing sink is to check the temperature of the water. Warm water is necessary for proper handwashing.

The sanitarian, Laura Hendley, then proceeded to check the temperatures of various items, such as butter, hamburgers on the grill, eggs, gravy and sausage. She explained that food temperatures are the number one cause of food-borne illnesses, followed by the lack of frequent hand washing.

Although dirty walls and floors support bacterial growth, they don't usually cause food-borne illnesses, Hendley explained. Nevertheless, dirty kitchens are sometimes a reflection of the food-handling practices at a restaurant.

Problems arise when hand and food contact surfaces are dirty, Hendley said. For example, if a food slicer isn't properly cleaned every four hours or between uses, food contamination can occur.

After checking food temperatures, we went into the walk-in refrigerator to see how food was being stored. To my untrained eye, I didn't notice much. But I quickly learned that raw meat and eggs must be separated from other foods to avoid cross contamination. For example, raw meat and eggs cannot be stored above vegetables.

"You don't want raw meat juices to drip on anything else," Hendley told me. "This is a great way to share bacteria from one kind of food to another."

Hendley noticed that some potatoes were cooling in a bucket on the floor. She said that improper cooling can cause food-borne illness. In order to cool food safely, it must cool rapidly, something that can't happen in a large container. Even at home, this can be a problem. Soups and other hot foods should be cooled in an ice bath in the sink to prevent bacteria from growing while they're cooling.

Our next stop was dry-goods storage. Here, we were again looking at how things were stored. Mostly, Hendley wanted to make sure chemicals weren't being stored on a shelf above food, and that there weren't signs of insects or rodents.

Then we looked in the restaurant's refrigerators, where listeria can grow. The listeria bacterium has been found in a variety of processed foods that become contaminated after processing, such as soft cheeses and cold cuts at the deli counter. We also looked in the ice machine, where mold can grow if not cleaned regularly.

Since this particular restaurant was in the city limits, we didn't review its water and sewage systems; but if a restaurant is in the county, that task is part of the sanitarian's job.

After Hendley inspected the kitchen, making notes on her form, she sat down with the manager and explained the problem areas and how to improve them.

The city-county health department's sanitarians inspect all restaurants in Lewis and Clark County at least once a year, and return to the ones that have critical problems. Inspections are risk-based, meaning that the sanitarians look at risk factors for the most common causes of food-borne illness. Risk factors include cooking, holding, cooling and reheating temperatures, cross contamination from one food to another, and personal hygiene issues such as handwashing and working while ill.

Sanitarians consider prevention of food-borne illnesses so important that they educate a restaurant's personnel, conduct monthly food safety classes for foodhandlers, and teach a manager's certification class a couple times a year.

Knowledge of food safety can prevent illness and potential tragedy, Hendley said, and restaurant inspections are an important part of public health.

For more information, call the city-county health department at 443-2584 and ask to speak with a food sanitarian.