CDC Finds Sick Workers at Root of Illness Outbreaks Tied to Restaurants

May 31, 2023 by Dan McCue
CDC Finds Sick Workers at Root of Illness Outbreaks Tied to Restaurants
A restaurant. (Photo by Dan McCue)

ATLANTA — If you’re sick and work in the restaurant industry, stay home.

That’s at least one underlying takeaway from a new Centers for Disease Control and Prevention report that found roughly 40% of foodborne illness outbreaks between 2017 and 2019 were at least partly associated with food contamination from a sick or infectious worker.

Each year state and local public health departments report hundreds of foodborne illness outbreaks associated with retail food establishments to the CDC through the National Outbreak Reporting System.

However, much of this reporting is broad and gaps in the data are common. The next analysis, based on environmental health data collected during outbreak investigations and reported to the National Environmental Assessment Reporting System, sought to close these gaps.

Launched in 2014, NEARS was intended to complement the National Outbreak Reporting System and enhance prevention efforts.

It enables state and local health departments to voluntarily enter data from their foodborne illness outbreak investigations of retail food establishments into a central database. 

The data include the characteristics of the outbreaks themselves, characteristics of establishments with outbreaks and food safety policies in these establishments. 

For its report, which was published Tuesday afternoon, the CDC looked at outbreaks across 25 state and local health departments during a two-year period that ended in 2019.

In that time, there were a total of 800 reported foodborne illness outbreaks associated with 875 retail food establishments.

Among outbreaks with a confirmed or suspected agent (555 of 800 or 69.4%), the most common pathogens were norovirus and Salmonella, accounting for 47.0% and 18.6% of outbreaks, respectively. 

Contributing factors were identified in 62.5% of outbreaks. 

Approximately 40% of outbreaks with identified contributing factors had at least one reported factor associated with food contamination by an ill or infectious food worker. 

As part of their research, CDC investigators interviewed a total of 725 managers at retail establishments associated with a foodborne illness outbreak.

Of these, 91.7% said their establishment had a policy requiring food workers to notify their manager when they were ill, and 66% also said these policies were written. 

However, only 23% said their policy listed all five illness symptoms workers needed to notify managers about (i.e., vomiting, diarrhea, jaundice, sore throat with fever and lesion with pus). 

Most (85.5%) said that their establishment had a policy restricting or excluding ill workers from working, and 62.4% said these policies were written. 

Only 17.8% said their policy listed all five illness symptoms that would require restriction or exclusion from work. 

Only 16.1% of establishments with outbreaks had policies addressing all four components relating to ill or infectious workers (i.e., policy requires workers to notify a manager when they are ill, policy specifies all five illness symptoms workers need to notify managers about, policy restricts or excludes ill workers from working, and policy specifies all five illness symptoms requiring restriction or exclusion from work).

Based on these findings, the report’s authors concluded that sick and infectious workers “continue to play a substantial role in retail food establishment outbreaks.”

They also felt “comprehensive ill worker policies will likely be necessary to mitigate this public health problem.”

“Retail food establishments can reduce viral foodborne illness outbreaks by protecting food from contamination through proper hand hygiene and excluding ill or infectious workers from working,” they wrote. “Development and implementation of policies that prevent contamination of food by workers are important to foodborne outbreak reduction.”

Foodborne diseases cause around 48 million illnesses and 3,000 deaths in the U.S. each year. 

Dan can be reached at [email protected] and at https://twitter.com/DanMcCue


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  • Centers for Disease Control and Prevention
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