Understanding Reportable Symptoms in Food Service
In the food service industry, maintaining the health and safety of both employees and customers is paramount. One of the most critical aspects of food safety management is ensuring that employees who are experiencing certain symptoms of illness report those symptoms to their manager before beginning work. The failure to report and properly manage ill employees can result in foodborne illness outbreaks that affect dozens or even hundreds of people. In this comprehensive guide, we will explore which symptoms must be reported to a manager, the illnesses they may indicate, the regulatory framework that governs these requirements, and the responsibilities of both employees and managers in maintaining food safety.
The Big Five Foodborne Illnesses
The FDA Food Code identifies five major pathogens that are highly infectious and can be easily transmitted through food. These are commonly known as the Big Five, and they include Salmonella Typhi, Norovirus, Hepatitis A, Shigella, and Shiga toxin-producing Escherichia coli, also known as E. coli O157:H7 and similar strains. These pathogens are particularly dangerous because they are highly contagious, can cause severe illness, and are easily spread through food handling.
Understanding the Big Five is important because the symptoms that must be reported to a manager are largely associated with these pathogens. When an employee reports specific symptoms, the manager must determine whether the employee may have a condition caused by one of these organisms and take appropriate action to prevent potential contamination of food.
Symptoms That Must Be Reported
The FDA Food Code specifies several symptoms that food service employees are required to report to their person in charge, typically their manager or supervisor. These symptoms include vomiting, diarrhea, jaundice, sore throat with fever, and exposed or infected wounds or lesions containing pus on the hands or wrists that are not properly covered.
Vomiting is a critical symptom that must be reported immediately. Vomiting can be caused by several of the Big Five pathogens, particularly Norovirus, which is the leading cause of foodborne illness in the United States. Norovirus particles can become airborne during vomiting episodes and can contaminate surfaces and food in the vicinity. An employee who is vomiting should not be allowed to work in any capacity that involves food handling, preparation, or service.
Diarrhea is another symptom that requires immediate reporting. Like vomiting, diarrhea can be caused by multiple Big Five pathogens including Norovirus, Shigella, Salmonella Typhi, and E. coli. An employee experiencing diarrhea poses a significant risk of contaminating food and food contact surfaces, particularly if hand hygiene is not maintained to the highest standards. Employees with diarrhea should be excluded from food handling duties until the symptoms have resolved.
Jaundice, a yellowing of the skin and eyes, is an important symptom that may indicate Hepatitis A infection. Hepatitis A is a viral liver infection that can be transmitted through food handled by an infected person. Jaundice typically appears several weeks after the initial infection, but the person may be contagious before symptoms appear. If an employee develops jaundice, they must be excluded from the food establishment and may need medical clearance before returning to work.
A sore throat accompanied by fever is a reportable symptom because it can indicate an infection with a pathogen that could be transmitted through food handling. While a sore throat alone is not necessarily a food safety concern, the combination of a sore throat and fever suggests a more serious infection that could pose a risk to food safety. Employees with these combined symptoms should be restricted from working with exposed food, clean equipment, clean utensils, and clean linens.
Exposed or infected wounds and lesions on the hands, wrists, or exposed portions of the arms that contain pus are also reportable. These wounds can harbor Staphylococcus aureus bacteria, which produce toxins that cause food poisoning. If an employee has such a wound, it must be properly bandaged and covered with a waterproof barrier, such as a finger cot or glove, to prevent contamination. If the wound cannot be adequately covered, the employee should be restricted from food handling duties.
Diagnosed Illnesses That Must Be Reported
In addition to symptoms, food service employees are required to report any diagnosis of illness caused by one of the Big Five pathogens. If an employee is diagnosed with Salmonella Typhi, Norovirus, Hepatitis A, Shigella, or E. coli, they must inform their manager immediately, even if they are not currently experiencing symptoms. Some of these pathogens can be shed by infected individuals for weeks or months after symptoms resolve, meaning that a person can still contaminate food even after they feel better.
Employees must also report if they have been exposed to someone diagnosed with one of these illnesses, particularly in a household setting. Close contact with an infected person increases the risk that the employee may also become infected and could potentially transmit the pathogen through food handling.
Manager Responsibilities When Symptoms Are Reported
When an employee reports any of the above symptoms or conditions, the manager has specific responsibilities under the Food Code. The manager must determine the appropriate course of action, which may include restricting the employee from certain duties or excluding them from the establishment entirely.
Restriction means that the employee can continue to work at the establishment but is prohibited from working with exposed food, clean equipment, clean utensils, unwrapped single-service articles, and clean linens. The employee might be assigned to tasks like cashiering, busing tables, or cleaning areas that do not involve food contact surfaces.
Exclusion means that the employee cannot work at the food establishment in any capacity until they have met specific criteria for return. Exclusion is typically required for employees who are vomiting, who have diarrhea caused by certain pathogens, who have jaundice, or who have been diagnosed with one of the Big Five illnesses. The criteria for returning to work after exclusion vary depending on the specific pathogen and may require medical clearance or a negative laboratory test.
Creating a Culture of Reporting
One of the biggest challenges in food service is creating an environment where employees feel comfortable reporting their symptoms without fear of negative consequences. Many food service workers are hourly employees who cannot afford to miss work, and they may be reluctant to report symptoms if they believe it will result in lost shifts and reduced income.
Managers can address this challenge by establishing clear policies and procedures for illness reporting, training all employees on the importance of reporting symptoms, and creating a supportive environment that prioritizes food safety over short-term staffing concerns. Some progressive food service operators offer paid sick leave or other benefits that reduce the financial impact on employees who need to stay home due to illness.
Regular training and reinforcement of food safety policies are essential. All new employees should receive training on reportable symptoms as part of their onboarding process, and existing employees should receive periodic refresher training. Posting clear guidelines in employee areas and making reporting procedures simple and accessible can also help encourage compliance.
The Consequences of Not Reporting
The consequences of failing to report symptoms can be severe for both the employee, the establishment, and the public. Foodborne illness outbreaks linked to a food service establishment can result in regulatory action, fines, temporary or permanent closure, lawsuits, and devastating reputational damage. For the individuals affected by the illness, the consequences can include hospitalization, long-term health complications, and in rare cases, death.
By taking symptom reporting seriously and following established protocols, food service employees and managers work together to protect public health and maintain the trust that customers place in the food they consume.
