The U.S. Food and Drug Administration (FDA) has completed a research study that identifies strategies to reduce the risk of contracting norovirus from the consumption of foods prepared in foodservice establishments. The study used an FDA quantitative risk assessment model that was published in 2017 to evaluate how the implementation of and compliance with FDA Food Code recommendations impacted norovirus transmission in more than 60 scenarios. Observed Food Code recommendations included those for restaurant surface cleaning and sanitizing, hand hygiene, and employee health.

The purpose of the study was to provide a basis for considering potential changes to the 2017 FDA Food Code regarding employee health. The study involved the evaluation of the dynamics of norovirus transmission from infected food employees to ready-to-eat food and consumers, as well as the assessment of the impact of prevention strategies and compliance levels on the prevalence of contaminated food and the resulting number of infected consumers. Specifically, the study evaluated each of the 60 scenarios for the following Food Code recommendations:

• Foodservice establishment surface cleaning and sanitizing
• Hand hygiene: handwashing and glove use with ready-to-eat food
• Exclusion of ill food employees
• Restriction of ill food employees.

FDA highlighted several key findings from its study. First, full compliance with Food Code recommendations for hand hygiene and the exclusion of ill food employees from the workplace had the largest impact on consumer illnesses and led to significant norovirus reductions. However, FDA found that the restriction of ill food employees must include additional provisions—such as mandated, increased handwashing frequency or eliminating ill employees’ hand contact with any surfaces outside of the restroom—to be effective.

Furthermore, the study found that employee handwashing prior to donning gloves is critical to ensure that gloves do not facilitate norovirus contamination nor contribute to the risk of illness; improving compliance with this recommendation was demonstrated to reduce risk. Additionally, eliminating the need for employee hand contact with restroom surfaces, as well as improving the cleaning and sanitization of restroom surfaces, was also shown to help control the transmission of norovirus to food and consumers in restaurants.