Approximately 40 percent of foodborne illness outbreaks associated with retail food establishments during 2017–2019 were caused by an infectious employee, according to the U.S. Centers for Disease Control and Prevention (CDC).

A recent entry in CDC’s Morbidity and Mortality Weekly Report summarized environmental health data that was collected during retail foodborne outbreak investigations and was submitted to the National Environmental Assessment Reporting System (NEARS). NEARS was launched in 2014 to compliment National Outbreak Reporting System (NORS) surveillance. State and local health departments voluntarily enter data from their foodborne illness outbreak investigations of retail food establishments into NEARS.

During 2017–2019, a total of 800 foodborne illness outbreaks linked to 875 retail food establishments were reported to NEARS by 25 state and local health departments. Of the 800 outbreaks, 555 had a confirmed or suspected agent. Norovirus and Salmonella accounted for 47 and 18.6 percent of the outbreaks, respectively.

CDC also found that approximately 40 percent of outbreaks with identified contributing factors had at least one reported factor associated with food contamination by an ill or infectious food worker.

In interviews, the vast majority (91.7 percent) of retail food managers reported that their establishment had a policy requiring food workers to notify their manager when they were ill. Additionally, 66 percent of the 725 managers interviewed stated that their sick employee policy was written, and only 23 percent said their policy included a complete list of illness symptoms about which workers were required to notify managers. Although 85.5 percent of interviewees said that their establishment had a policy restricting or excluding ill workers from working, only 16.1 percent of establishments linked to outbreaks had policies addressing all four components relating to ill or infectious workers, which are:

1. Policy requires workers to notify a manager when they are ill
2. Policy specifies all five illness symptoms about which workers need to notify managers (vomiting, diarrhea, jaundice, sore throat with fever, and lesion with pus)
3. Policy restricts or excludes ill workers from working
4. Policy specifies all five illness symptoms requiring restriction or exclusion from work.

Based on its report, CDC suggests that the content and enforcement of existing sick policies might need to be reexamined and refined. Future analyses of data may help guide the development of effective contamination prevention strategies by describing how establishments’ characteristics and food safety policies and practices relate to foodborne illness outbreaks.