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U.S. Department of Health and Human Services


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Prevention is Key to Avoiding Foodborne Illness Outbreaks

May 2007

Food Service Employee Health and Hygiene Matters


The Federal Centers for Disease Control and Prevention (CDC) estimate that more than 76 million cases, 325,000 hospitalizations and 5,000 deaths occurA 2002–03 study of foodborne illness outbreaks in restaurants found that food handling by an infected employee was a contributing factor in two-thirds of the outbreaks annually from foodborne illness. Infected restaurant employees were identified as a contributing factor in more than 65% of U.S. foodborne illness outbreaks in restaurants in a 2002–03 study. The pathogens that cause foodborne illness can be transmitted directly from an infected food employee through food to the consumer. Clearly, employee health and personal hygiene is critical in protecting your customers and your business.

Food service establishments can help prevent foodborne illness associated with infected employees. Train employees to:

  • Understand what causes foodborne illness
  • Not work or handle food when infected
  • Practice good handwashing techniques, and,
  • Not touch ready-to-eat food with bare hands.

Managers and employees share the responsibility to understand the causes of foodborne illness and use effective hygienic practices to prevent the transmission of bacteria and viruses to food.

Food safety experts have identified five foodborne pathogens, the "Big 5," that are easily transmitted through food and can cause severe illness: Norovirus, Salmonella Shigella, Enterohemorrhagic or Shiga-toxin producing E. coli and Hepatitis A virus

The greatest risk to consumers occurs when food service employees have specific symptoms (vomiting, diarrhea, jaundice, sore throat with fever and infected cuts or burns with pus) and they continue to work with food. There is also a risk of transmission if employees have been recently exposed or diagnosed with certain foodborne illnesses and either recovered from or never developed symptoms. The risk of transmitting disease through food is also increased by:

  • Employees exposed to specific pathogens by eating or working at a facility or event where an outbreak occurred
  • Employees living with someone who is diagnosed with certain foodborne illnesses

Foodborne bacteria multiply in potentially hazardous food when the appropriate conditions and nutrients are present. Viruses and parasites only multiply in human beings or animals, so any contaminated food can transmit them to the consumer. Viruses can survive on hard surfaces for days or weeks, then contaminate anything that touches those surfaces, e.g., door handles, light switches, refrigerator door handles, etc. In the case of viruses, any type of food or surface can be the vehicle to transmit the organism.

Washing hands effectively prevents the transmission of bacteria and viruses from hands to foods. The use of hand sanitizers is no substitute for proper handwashing which requires the use of soap and warm (at least 100°F), running water, brisk rubbing for 10-15 seconds, followed by rinsing and drying with a sanitary disposable towel or hand drying device.

Keys to prevention:

  • Identify employees who present a risk of transmitting foodborne pathogens to food or other employees, so they can be excluded or restricted from working with food.
  • Move restricted food employees to jobs where they do not come in contact with exposed food, utensils, food equipment, single service items or linens.
  • Frequent and effective handwashing