Food Employee Illness Guidelines
**These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Revision Date: 3/17/2010
Illness Symptoms Action Guidance
Conditions
Action / Return-to-Work Criteria for
Foodworkers
Other Information
Acne
Reinforce good handwashing and no bare-hand
contact with ready-to-eat foods.
Acne itself is not transmitted through food, however some of
the bacteria commonly found in areas of acne can cause
foodborne illnesses. Remind foodworkers that they must not
touch acne (or other parts of their bare skin) while working with
food. If they do so, they must wash their hands immediately.
Bed bugs
No exclusions or restrictions are required. Bed bugs are not transmitted from person-to-person. They are
not like lice and will not usually travel directly on a person’s
body. Bed bugs are spread between residences and when they
hide and are transported in luggage, furniture, or other items.
Bronchitis
Food employees experiencing persistent sneezing,
coughing, or a runny nose that causes discharge
from the eyes, nose, or mouth may not
work with
exposed food; clean equipment, utensils, or linens; or
unwrapped single-service or single-use articles.
When employee returns to work: reinforce good handwashing;
emphasize no bare-hand contact with ready-to-eat foods; and
discuss employee illness reporting procedure, and the ways ill
foodworkers can spread illness through food.
Campylobacter spp.
(Campylobacteriosis or
Campylobacter
enteritis)
Exclude food employee from food establishment.
Notify local health department or call 1-877-FOOD-ILL.
Record illness on employee illness log. Health
department clearance is required
before the
foodworker may return to work.
Campylobacteriosis is an infectious disease caused by bacteria
of the genus Campylobacter, and may be transmitted through
food. Most people who become ill with campylobacteriosis get
diarrhea, cramping, abdominal pain, and fever within two to five
days after exposure to the organism. The diarrhea may be
bloody and can be accompanied by nausea and vomiting. The
illness typically lasts one week. Foodworkers diagnosed with
campylobacteriosis must report
their illness to the person-in-
charge.
Food Employee Illness Guidelines
**These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Revision Date: 3/17/2010
Illness Symptoms Action Guidance
Conditions
Action / Return-to-Work Criteria for
Foodworkers
Other Information
Chickenpox
(varicella-zoster)
Open wounds on hands or arms must be covered
with an impermeable bandage and a single-use glove
(for hand wounds) before returning to work. Reinforce
good handwashing and emphasize no bare-hand
contact with ready-to-eat foods.
Chickenpox (also known as varicella-zoster) is a viral illness
that can be prevented by vaccination. It is highly contagious,
but not transmitted through food.
Ciguatera Fish
Poisoning
Exclude food employee from food establishment if
they have symptoms of vomiting/diarrhea. Must be
symptom free for at least 24 hours before returning to
work. Record on employee illness log. Notify local
health department or call 1-877-FOOD-ILL.
Ciguatera fish poisoning (or ciguatera) is caused by eating fish
that contain toxins. While ciguatera is a foodborne illness, it
cannot be transmitted from person-to-person. People who have
ciguatera may experience nausea, vomiting, and neurologic
symptoms such as tingling fingers or toes. Symptoms usually
go away in days or weeks but can last longer.
Barracuda, black grouper, blackfin snapper, cubera snapper,
dog snapper, greater amberjack, hogfish, horse-eye jack, king
mackerel, and yellowfin grouper have been known to carry
ciguatoxins.
Foodworkers must report
their illness to the person-in-charge.
Cold
Cough/sneeze/runny
nose
Food employees experiencing persistent sneezing,
coughing, or a runny nose that causes discharge
from the eyes, nose, or mouth may not
work with
exposed food; clean equipment, utensils, or linens; or
unwrapped single-service or single-use articles.
When employee returns to work: reinforce good handwashing;
emphasize no bare-hand contact with ready-to-eat foods; and
discuss employee illness reporting procedure, and the ways ill
foodworkers can spread illness through food.
Food Employee Illness Guidelines
**These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Revision Date: 3/17/2010
Illness Symptoms Action Guidance
Conditions
Action / Return-to-Work Criteria for
Foodworkers
Other Information
Cut, wound, or
burn
Open wounds on hands or arms must be covered
with an impermeable bandage and a single-use glove
(for hand wounds) before returning to work. Reinforce
good handwashing and emphasize no bare-hand
contact with ready-to-eat foods.
Reinforce good handwashing. Emphasize no bare-hand
contact with ready-to-eat foods. Discuss employee illness
reporting procedure. Discuss the ways ill foodworkers can
spread illness through food.
**Cryptosporidium
parvum
(Cryptosporidiosis)
Exclude food employee from food establishment.
Notify local health department or call 1-877-FOOD-ILL.
Record illness on employee illness log. Health
department clearance is required
before the
foodworker may return to work.
Cryptosporidium can be transmitted from an infected
foodworker to customers through food.
Foodworkers diagnosed with cryptosporidiosis must report
their
illness to the person-in-charge.
Diarrhea
Exclude food employee from food establishment.
Employee must be symptom free for at least 24 hours
before returning to work. Record on employee illness
log.
Foodworkers with diarrhea are a SEVERE FOOD SAFETY
RISK. Diarrheal illnesses are often highly contagious and can
be easily transmitted from an infected foodworker to
customers.
Foodworkers with diarrhea must report
their symptoms to the
person-in-charge.
Food Employee Illness Guidelines
**These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Revision Date: 3/17/2010
Illness Symptoms Action Guidance
Conditions
Action / Return-to-Work Criteria for
Foodworkers
Other Information
**E. coli O157:H7
Exclude food employee from food establishment.
Notify local health department or call 1-877-FOOD-ILL.
Record illness on employee illness log. Health
department clearance is required
before the
foodworker may return to work.
E. coli is a SEVERE FOOD SAFETY RISK. E. coli is a highly
contagious foodborne illness and can be easily transmitted
from an infected foodworker to customers.
Foodworkers diagnosed with E. coli must report
their illness to
the person-in-charge.
There are many different types of E. coli infection. E. coli
O157:H7 is the most widely recognized. Infection with E. coli
O157:H7 can result in serious complications (such as
Hemolytic Uremic Syndrome, or HUS), especially in young
children and people with compromised immune systems.
Infection with E. coli may also be referred to as
enterohemorrhagic colitis, STEC, EHEC, or Shiga toxin-
producing E. coli. Health department evaluation of all
diagnosed E. coli infections in foodworkers is mandatory before
they may return to work.
Food Employee Illness Guidelines
**These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Revision Date: 3/17/2010
Illness Symptoms Action Guidance
Conditions
Action / Return-to-Work Criteria for
Foodworkers
Other Information
Fever
If symptoms include diarrhea or vomiting, exclude
food employee from food establishment, Must be
symptom free for at least 24 hours before returning to
work. Record on employee illness log.
If fever is not accompanied by diarrhea or vomiting,
employee may be allowed to work. Reinforce good
handwashing; emphasize no bare-hand contact with
ready-to-eat foods; and discuss employee illness
reporting procedure and the way ill foodworkers can
spread illness through food.
If fever is accompanied by sore throat or cough, see
“Influenza”.
Fevers may be caused by a number of conditions. A
foodworker experiencing a fever may not be a food safety risk,
but should be closely monitored for vomiting, diarrhea, or
influenza.
If foodworker experiences these symptoms, they must report
their symptoms to the person-in-charge and be immediately
excluded from work.
**Giardia spp.
(Giardiasis)
Exclude food employee from food establishment.
Notify local health department or call 1-877-FOOD-ILL.
Record illness on employee illness log. Health
department clearance is required
before the
foodworker may return to work.
Giardia can be transmitted from an infected foodworker to
customers through food.
Foodworkers diagnosed with giardiasis must report
their illness
to the person-in-charge.
Hangover
If symptoms include diarrhea or vomiting, exclude
food employee from food establishment. Must be
symptom free for at least 24 hours before returning to
work. Record on employee illness log.
Food Employee Illness Guidelines
**These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Revision Date: 3/17/2010
Illness Symptoms Action Guidance
Conditions
Action / Return-to-Work Criteria for
Foodworkers
Other Information
Headache
If symptoms include vomiting or diarrhea, exclude
food employee from food establishment. Must be
symptom free for at least 24 hours before returning to
work. Record on employee illness log.
If headache is not accompanied by vomiting or
diarrhea, employee may be allowed to work.
Reinforce good handwashing; emphasize no bare-
hand contact with ready-to-eat foods; and discuss
employee illness reporting procedure, and the ways ill
foodworkers can spread illness through food.
Headaches may be caused by a number of conditions. A
foodworker experiencing a headache may not be a food safety
risk, but should be closely monitored for vomiting or diarrhea.
If foodworker experiences these symptoms, they must report
their symptoms to the person-in-charge and be immediately
excluded from work.
HIV/AIDS
No exclusions or restrictions are required. HIV/AIDS attacks the immune system. The HIV/AIDS virus is
transmitted through contact with the blood and body fluids of
someone who is infected.
HIV/AIDS is not considered to be a foodborne pathogen.
Practice routine blood-borne pathogen precautions.
H1N1 Novel
Influenza
(Swine flu)
See “Influenza.”
Food Employee Illness Guidelines
**These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Revision Date: 3/17/2010
Illness Symptoms Action Guidance
Conditions
Action / Return-to-Work Criteria for
Foodworkers
Other Information
**Hepatitis A
Exclude food employee from food establishment.
Notify local health department or call 1-877-FOOD-ILL.
Record illness on employee illness log. Health
department clearance is required
before the
foodworker may return to work.
Hepatitis A is a SEVERE FOOD SAFETY RISK. Hepatitis A is
a highly contagious foodborne illness and can be easily
transmitted from an infected foodworker to customers.
Yellowing of skin and eyes are common symptoms of hepatitis
A.
Foodworkers diagnosed with hepatitis A must report
their
illness to the person-in-charge.
Hepatitis B
No exclusions or restrictions are required. Hepatitis B is a serious liver infection. The hepatitis B virus is
transmitted through contact with blood and body fluids of
someone who is infected. Hepatitis B is not a considered to be
a foodborne pathogen. Practice routine blood-borne pathogen
precautions.
Hepatitis C
No exclusions or restrictions are required. Hepatitis C is a serious liver infection. The hepatitis C virus is
transmitted through contact with blood and body fluids of
someone who is infected. Hepatitis C is not considered to be a
foodborne pathogen. Practice routine blood-borne pathogen
precautions.
Impetigo
Open wounds on hands or arms must be covered
with an impermeable bandage and a single-use glove
(for hand wounds) before returning to work. Reinforce
good handwashing and no bare-hand contact with
ready-to-eat foods.
Impetigo is not a foodborne illness, but a contagious skin
infection occurring on the nose, arms, and legs, or around the
mouth. Impetigo is spread person-to-person by contact with
fluid from around the sores.
Food Employee Illness Guidelines
**These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Revision Date: 3/17/2010
Illness Symptoms Action Guidance
Conditions
Action / Return-to-Work Criteria for
Foodworkers
Other Information
Infected wound or
pustular boil
Open wounds on hands or arms must be covered
with an impermeable bandage and a single-use glove
(for hand wounds) before returning to work. Reinforce
good handwashing and emphasize no bare-hand
contact with ready-to-eat foods.
Influenza
(Seasonal or H1N1
novel flu)
Exclude food employee from food establishment if
symptoms included diarrhea or vomiting, foodworker
must be symptom free for at least 24 hours before
returning to work. Record on employee illness log.
Influenza (seasonal and H1N1 novel) is a respiratory illness
caused by a virus. Symptoms include fever (above 100
o
F),
cough, sore throat, stuffy nose, and in some cases diarrhea
and vomiting.
Up-to-date information on all types of influenza is available at
www.state.health.mn.us
or www.cdc.gov.
Jaundice
Exclude food employee from food establishment.
Notify local health department or call 1-877-FOOD-ILL.
Record illness on employee illness log. Health
department clearance is required
before the
foodworker may return to work.
Jaundice, yellowing of the eyes or skin, is a common symptom
in people infected with hepatitis A.
Jaundiced foodworkers may be a SEVERE FOOD SAFETY
RISK and must report
their symptoms to the person-in-charge.
Food Employee Illness Guidelines
**These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Revision Date: 3/17/2010
Illness Symptoms Action Guidance
Conditions
Action / Return-to-Work Criteria for
Foodworkers
Other Information
Lice
No exclusions or restrictions are required. Although head lice do not present a food safety risk, it is still
important to take appropriate precautions to ensure that they
do not spread among workers. Common headsets used for
drive-through windows should not be used by foodworkers with
head lice. Combs and other hair accessories should not be
shared. Clothing should not be shared. Clothing should be
stored in an organized fashion on separate hooks or in lockers
to prevent spread of lice.
Listeria
monocytogenes
(Listeriosis)
Exclude food employee from food establishment.
Must be symptom free for at least 24 hours before
returning to work. Record on employee illness log.
Notify local health department or call 1-877-FOOD-ILL.
Listeriosis is a serious infection caused by eating food
contaminated with the bacterium Listeria monocytogenes
.
While listeriosis is a foodborne illness, it cannot be transmitted
from person-to-person.
The disease mostly affects older
persons, pregnant women, newborns, and adults with
weakened immune systems.
A person with listeriosis may have fever, muscle aches, and
sometimes nausea or diarrhea.
Foodworkers diagnosed with listeriosis must report
their illness
to the person-in-charge.
Meningitis,
Bacterial
Exclude food employee from food establishment.
If symptoms include diarrhea or vomiting, foodworker
must be symptom free for at least 24 hours before
returning to work. Record on employee illness log.
Some forms of bacterial meningitis are contagious. Symptoms
include high fever, headache, stiff neck, nausea, vomiting,
confusion, and sleepiness.
Up-to-date information is available at www.cdc.gov
.
Food Employee Illness Guidelines
**These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Revision Date: 3/17/2010
Illness Symptoms Action Guidance
Conditions
Action / Return-to-Work Criteria for
Foodworkers
Other Information
Mononucleosis
(mono)
No exclusions or restrictions are required. Reinforce good handwashing. Emphasize no bare-hand
contact with ready-to-eat foods. Discuss employee illness
reporting procedure and the ways ill foodworkers can spread
illness through food.
**Nausea
Exclude food employee from food establishment if
symptoms include diarrhea or vomiting. Must be
symptom free for at least 24 hours before returning to
work. Record on employee illness log.
If nausea is not accompanied by diarrhea or vomiting,
allow employee to work. Reinforce good
handwashing; emphasize no bare-hand contact with
ready-to-eat foods; and discuss employee illness
reporting procedure, and the ways ill foodworkers can
spread illness through food.
Nausea may be caused by a number of conditions. A
foodworker experiencing nausea may not be a food safety risk,
but should be closely monitored for vomiting or diarrhea.
If foodworker experiences these symptoms, they must report
their symptoms to the person-in-charge and be immediately
excluded from work.
**Norovirus
Exclude food employee from food establishment.
Notify local health department or call 1-877-FOOD-ILL.
Record illness on employee illness log. Health
department clearance is required
before the
foodworker may return to work.
Norovirus is a SEVERE FOOD SAFETY RISK. Norovirus is a
highly contagious illness and can be easily transmitted from an
infected foodworker to customers.
Foodworkers diagnosed with norovirus must report
their illness
to the person-in-charge.
Food Employee Illness Guidelines
**These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Revision Date: 3/17/2010
Illness Symptoms Action Guidance
Conditions
Action / Return-to-Work Criteria for
Foodworkers
Other Information
Pink eye
No exclusions or restrictions are required. Pink eye is an infection or inflammation of the eye. It is highly
contagious, but is not transmitted through food. Foodworkers with pink
eye must take extra precautions not to touch their eyes or face, and to
wash their hands thoroughly to prevent the spread of pink eye to others.
Pneumonia
Food employees experiencing persistent sneezing,
coughing, or a runny nose that causes discharge
from the eyes, nose, or mouth may not work with
exposed food; clean equipment, utensils, or linens; or
unwrapped single-service or single-use articles.
When employee returns to work: reinforce good handwashing;
emphasize no bare-hand contact with ready-to-eat foods;
discuss employee illness reporting procedure, and the ways ill
foodworkers can spread illness through food.
Pregnancy
If vomiting, exclude from food establishment. Vomiting and nausea are common symptoms of morning
sickness, a side effect of pregnancy. While morning sickness
itself is not a communicable illness, care must be taken to
prevent the contamination of food. Pregnant foodworkers
experiencing ongoing nausea may work in a food
establishment, but must be closely monitored for symptoms
that would indicate a communicable illness.
If foodworker experiences these symptoms, they must report
their illness to the person-in-charge and be immediately
excluded from work.
Food Employee Illness Guidelines
**These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Revision Date: 3/17/2010
Illness Symptoms Action Guidance
Conditions
Action / Return-to-Work Criteria for
Foodworkers
Other Information
Ringworm
Open wounds on hands or arms must be covered
with an impermeable bandage and a single-use glove
(for hand wounds) before returning to work. Reinforce
good handwashing and emphasize no bare-hand
contact with ready-to-eat foods.
Ringworm is a fungal infection of the body, scalp or feet.
Ringworm is transmitted by touching lesions of an infected
person or animal.
**Salmonella
(Salmonellosis)
Exclude food employee from food establishment.
Notify local health department or call 1-877-FOOD-ILL.
Record illness on employee illness log. Health
department clearance is required
before the
foodworker may return to work.
Salmonella is a SEVERE FOOD SAFETY RISK. Salmonellosis
is a highly contagious foodborne illness and can be easily
transmitted from an infected foodworker to customers.
Foodworkers diagnosed with salmonellosis must report
their
illness to the person-in-charge.
Scabies
Open wounds on hands or arms must be covered
with an impermeable bandage and a single-use glove
(for hand wounds) before returning to work. Reinforce
good handwashing and emphasize no bare-hand
contact with ready-to-eat foods.
Scabies is an infestation caused by tiny mites that burrow and
lay eggs under the skin. Scabies is transmitted by prolonged,
direct skin contact with an infected person.
Food Employee Illness Guidelines
**These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Revision Date: 3/17/2010
Illness Symptoms Action Guidance
Conditions
Action / Return-to-Work Criteria for
Foodworkers
Other Information
Scombroid Fish
Poisoning
(Histamine Poisoning)
Exclude food employee from food establishment if
they have symptoms of vomiting/diarrhea. Must be
symptom free for at least 24 hours before returning to
work. Record on employee illness log. Notify local
health department or call 1-877-FOOD-ILL.
Scombroid fish poisoning, or histamine fish poisoning, is a
syndrome resembling an allergic reaction that occurs after
eating fish contaminated with high levels of histamine. While
scombroid poisoning is a foodborne illness, it cannot be
transmitted from person-to-person.
Symptoms begin within 2 minutes to several hours after eating
the fish. The most common symptoms are tingling and burning
sensations around the mouth, facial flushing, sweating,
nausea, vomiting, headache, palpitations, dizziness, and rash.
Foodworkers must report
their illness to the person-in-charge.
**Shigella spp.
(Shigellosis)
Exclude food employee from food establishment.
Notify local health department or call 1-877-FOOD-ILL.
Record illness on employee illness log. Health
department clearance is required
before the
foodworker may return to work.
The foodworker must be excluded from working in the retail
food establishment and the law requires the manager to notify
the local health department immediately.
Foodworkers diagnosed with shigellosis must report
their
illness to the person-in-charge.
Shingles
(varicella-zoster)
Open wounds on hands or arms must be covered
with an impermeable bandage and a single-use glove
(for hand wounds) before returning to work. Reinforce
good handwashing and emphasize no bare-hand
contact with ready-to-eat foods.
Shingles is caused by the chickenpox virus and can cause
extreme pain, itching and numbness. Shingles may cause
clusters of blisters that can spread chickenpox to persons who
have not yet had the virus.
Food Employee Illness Guidelines
**These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Revision Date: 3/17/2010
Illness Symptoms Action Guidance
Conditions
Action / Return-to-Work Criteria for
Foodworkers
Other Information
Sore Throat
Reinforce good handwashing. Emphasize no bare-
hand contact with ready-to-eat foods. Discuss
employee illness reporting procedure and the ways ill
foodworkers can spread illness through food.
If sore throat is accompanied by a cough or fever, see
“Influenza”.
Also see “Influenza”.
Staphylococcus skin
infection
(Staph or
MRSA)
Open wounds on hands or arms must be covered
with an impermeable bandage and a single-use
glove. Open or draining wounds on other parts of the
body must be covered by a dry, durable, tight-fitting
bandage. Situations in which an open or draining
wound cannot be properly and effectively covered
should be addressed with the health department.
Staphylococcus bacteria can cause serious skin infections
which can be transmitted through food and cause serious
foodborne illness. Contamination of food can occur if a person
with draining lesions on the hands or forearms handles foods
or food contact surfaces.
Streptococcal
Infection
(Strep throat/scarlet
fever)
Reinforce good handwashing, emphasize no bare-
hand contact with ready-to-eat foods; and discuss
employee illness reporting procedure, and the ways ill
foodworkers can spread illness through food.
Staphylococcus aureus bacteria can cause serious skin
infections. The term MRSA refers to a Staphylococcus skin
infection that is resistant to certain antibiotics. Staph skin
infections are not foodborne; however, contamination of food
products with the bacteria can occur and result in food
poisoning.
Tuberculosis
(TB)
Food employees experiencing persistent sneezing,
coughing, or a runny nose that causes discharge
from the eyes, nose, or mouth may not work with
exposed food; clean equipment, utensils, or linens; or
unwrapped single-service or single-use articles.
Tuberculosis is not transmitted to patrons through food;
however, like any other work place, infectious food handlers
may transmit their disease to fellow workers. A worker with
active tuberculosis can spread the disease by sneezing or
coughing, which are tuberculosis’ most common symptoms.
Food Employee Illness Guidelines
**These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Revision Date: 3/17/2010
Illness Symptoms Action Guidance
Conditions
Action / Return-to-Work Criteria for
Foodworkers
Other Information
Vomiting
Exclude food employee from food establishment.
Must be symptom free for at least 24 hours before
returning to work. Record on employee illness log.
Foodworkers with vomiting are a SEVERE FOOD SAFETY
RISK. Illnesses that cause vomiting are often highly contagious
and can be easily transmitted from an infected foodworker to
customers.
Foodworkers with vomiting must report
their symptoms to the
person-in-charge.
Warts
No exclusions or restrictions are required. Warts are passed person to person, not through food. Small
numbers of warts are not concerning for foodworkers; however
large numbers of warts on the hands or wrists make these
areas difficult to clean adequately with routine handwashing. If
a food employee has a severe infestation of warts on the
hands or wrists, these areas should be covered with an
impermeable cover, and a single-use disposable glove should
be worn while working with food.
Foodborne Illness Hotline: 1-877-FOOD-ILL (1-877-366-3455)
