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CDC: Infected food service workers responsible for most norovirus outbreaks
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Approximately 20 million people get sick from norovirus each year, mostly by having close contact with other infected people or by eating contaminated food, according to a CDC Vital Signs report.
Although norovirus receives a lot of attention from causing outbreaks on cruise ships, these outbreaks only account for about 1% of all reported norovirus outbreaks each year, according to CDC Director Thomas Frieden, MD, MPH.
Thomas Frieden
“Norovirus is the leading identified cause of outbreaks from contaminated food in the United States,” Frieden said during a media briefing. “Most of the reported outbreaks occurred in food service settings, where infected food service workers continue working. More can be done to create a work environment that promotes food safety and ensures that workers adhere to food safety laws and regulations that are already in place.”
The CDC analyzed norovirus outbreak data from 2009 to 2012 that were reported to the National Outbreak Reporting System. During this time, 1,008 norovirus outbreaks related to contaminated food were reported, mostly in restaurants and catering or banquet facilities. For 520 of the outbreaks, factors contributing to the food contamination were reported and 70% of them resulted from an infected food worker. Among those, 54% involved food workers touching ready-to-eat foods with their bare hands.
In the analysis, the investigators also looked at foods that were commonly implicated. There were 324 outbreaks in which a specific food item was implicated. More than 90% were contaminated during final preparation and 75% were foods that were eaten raw. The most common food categories implicated included leafy vegetables, fruits and mollusks, such as oysters.
According to the report, one in five food service workers reported working at least once in the previous year while sick with vomiting and diarrhea. The most common reasons include fear of job loss and not wanting to leave co-workers short-staffed.
“It is vital that food service workers stay home if they are sick, otherwise they risk contaminating food that many people will eat,” Aron Hall, DVM, MSPH, of CDC’s Division of Viral Diseases, said in a press release. “Businesses can consider using measures that would encourage sick workers to stay home, such as paid sick leave and a staffing plan that includes on-call workers.”
The Vital Signs report includes recommendations to help the food service industry prevent norovirus outbreaks resulting from contaminated food. The recommendations, which are in line with the FDA Food Code, include: making sure food service workers practice proper hand washing and use utensils and single-use disposable gloves to avoid touching ready-to-eat foods with bare hands; certifying kitchen managers and training food service workers in food safety practices; and establishing policies that require food service workers to stay home when sick with vomiting and diarrhea and for at least 48 hours after symptoms stop.
Disclosure: Frieden and Hall report no relevant financial disclosures.
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