Key Takeaways
- Report vomiting, diarrhea, jaundice, sore throat with fever, and infected wounds
- Big Six pathogens require exclusion: Norovirus, Hepatitis A, Salmonella Typhi, Nontyphoidal Salmonella, Shigella, STEC
- Exclusion means cannot work at all; restriction means cannot work with exposed food
- Cover wounds with waterproof bandage and glove
- Stay home when sick - one worker can infect hundreds of customers
1.2 Illness Reporting and Work Restrictions
Sick food handlers are a major cause of foodborne illness outbreaks. Knowing when to stay home and what symptoms to report is critical for protecting customers.
Symptoms That Must Be Reported
Food handlers MUST report the following symptoms to their manager:
| Symptom | Action Required |
|---|---|
| Vomiting | Exclude from work |
| Diarrhea | Exclude from work |
| Jaundice (yellowing of skin/eyes) | Exclude from work |
| Sore throat with fever | Restrict from working with exposed food |
| Open or infected wounds | Cover with bandage and glove, or restrict |
The Big Six Pathogens
If a food handler is diagnosed with any of these six illnesses, they must be excluded from the operation:
- Norovirus - Most common cause of foodborne illness outbreaks
- Hepatitis A - Viral infection affecting the liver
- Salmonella Typhi - Causes typhoid fever
- Nontyphoidal Salmonella - Common in poultry and eggs
- Shigella spp. - Spread through fecal contamination
- Shiga toxin-producing E. coli (STEC) - Can cause kidney failure
For the Exam: The "Big Six" are the most highly contagious pathogens. Workers diagnosed with these MUST be excluded, not just restricted.
Exclusion vs. Restriction
| Term | Definition | Example |
|---|---|---|
| Exclusion | Cannot work in any capacity | Employee with active vomiting or Big Six diagnosis |
| Restriction | Can work but not with exposed food | Sore throat with fever, covered wound on hand |
When Can Excluded Workers Return?
| Condition | Return Requirement |
|---|---|
| Vomiting/diarrhea (no diagnosis) | Symptom-free for 24 hours |
| Norovirus | Symptom-free for 48 hours |
| Salmonella Typhi | Medical clearance required |
| Hepatitis A | Medical clearance required |
| Shigella/STEC | Medical clearance required |
Covering Wounds and Injuries
If a food handler has cuts, burns, or wounds:
- Clean the wound thoroughly
- Cover with a waterproof bandage
- Wear gloves over the bandage if on hands/arms
- If the wound is infected (pus, redness, swelling), the worker should be restricted or excluded
Food Handler Responsibilities
Every food handler should:
- Report symptoms honestly to management
- Stay home when experiencing vomiting or diarrhea
- Inform management of any Big Six diagnosis
- Cover wounds properly
- Never prepare food while sick
Remember: It's always better to miss work than to cause an outbreak. One sick worker can infect hundreds of customers.
Which symptom requires a food handler to be EXCLUDED from work?
What are the "Big Six" pathogens that require food handler exclusion?
A food handler has a cut on their finger. What should they do?
How long must a food handler be symptom-free after vomiting (without a Big Six diagnosis) before returning to work?