Excluding Ill Workers

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Target Objectives

Questions to consider:
Is the etiologic agent suspect/confirmed? What is the incubation period?
Is the outbreak ongoing?
Is the food handler currently symptomatic?
Was the food handler out ill or symptomatic in the weeks prior to the outbreak?
Did the food handler submit a stool sample? Results?
Review the employee's job duties (Do they prepare/handle food? Cooked or ready-to-eat foods?)
Check the recommendations of the state and/or local jurisdiction
Evaluate and discuss the implications of excluding the food handler
Determine how long you expect the food handler will be excluded from work
Determine basic set of criteria needed for the food handler to return to work
Obtain laboratory or epidemiologic evidence to make the exclusion

Document the criteria for the food handler to return to work
Connect ill food worker with a (public health) infectious disease physician (if needed)
Discuss with the manager for the possibility of changing the food handler's duties so they can return to work (i.e. cash register, table busing, etc.)
Follow-up with the ill food handler to check their disease status, include symptoms and testing results

For highly infectious pathogens where cases may be asymptomatic (i.e. Norovirus, Hepatitis A), it may be necessary to require a negative stool or multiple tests before returning to work
With many pathogens, ill cases can continue shedding the organism in their stool for days to weeks even after they stop experiencing symptoms
Consult epidemiology and/or healthcare providers on when food workers can return to work

Exclusion Guidelines for Food Employees (PDF)
(click on the document below to download it)

Food Worker Exclusion Flowchart (PDF)
(click on the document below to download it)

Implementing Control Measures