CDC Reports: Ill Restaurant Employees Associated with 40% of Foodborne Disease Outbreaks

New data released by the Centers for Disease Control and Prevention has found that sick restaurant workers are a significant cause of foodborne illness outbreaks. The study, published in the Morbidity and Mortality Weekly Report, looked at 800 outbreaks reported to the National Environmental Assessment Reporting System by 25 participating state and local governments between 2017 and 2019. Among those outbreaks, investigators were able to identify contributing factors in 500 of them and found that 41% were associated with sick workers. Lack of comprehensive policies, including paid sick leave, for ill and infectious employees is seen as a contributing factor to the outbreaks.

Norovirus was found to be the most common cause of illness (47% of outbreaks), followed by Salmonella (19%). The study’s authors have said that retail food establishments need to adopt more comprehensive food safety policies in order to help prevent foodborne illness outbreaks. They suggest that “comprehensive ill worker policies will likely be necessary to mitigate this public health problem.”

Further investigation was conducted into the policies of establishments where outbreaks had been reported, with the majority of managers (92%) confirming that their establishments did have policies requiring food workers to tell their manager when they were sick, and 86% had policies that restricted ill workers from working. But less than one-fifth of managers reported that their policies listed all five symptoms recommended by the Food and Drug Administration’s Food Code. This indicates that written policies are more effective in preventing illness than policies that are verbally communicated, but that managers need to implement the policies and workers need to comply with them for it to be effective.

Compliance is not always easy: many food handlers are paid hourly and therefore calling out of work means taking a pay cut, and managers often have to find a replacement quickly for a sick worker. Sick leave policy is seen as a key solution, as workers may be incentivised to work while sick if they do not get paid if they call in sick. Many cases of foodborne illness also go unreported, meaning that the true extent of the problem may be much larger than the figures suggest. The study authors suggest that restaurants and other food establishments should focus on implementing comprehensive policies for sick workers with a focus on compliance.

These policies—including potential paid sick leave—should also not be viewed as an employee perk, but as an integral part of business. “This should not be viewed as a benefit,” Detwiler said, “but as a requirement for the benefit of employees, of the company and their reputation, and of consumers.”

Although the symptoms of norovirus and other foodborne illnesses are far from subtle, viruses and bacteria can end up on your food without your knowledge in a restaurant setting. “We are talking about invisible dangers and about information regarding employees that consumers are unlikely to know,” Detwiler said.

The only way to fully protect yourself from restaurant foodborne illness is to avoid eating anything other than food prepared in your own home—but that’s unrealistic for many people. You can, however, consider a restaurant’s reputation before choosing to dine there.

“If consumers are aware of companies that have repeated violations or that are tied to outbreaks, perhaps they can be avoided,” Detwiler said.

Additionally, Moritz suggests checking inspection scores of the restaurants you commonly visit, which can be found on your local health department’s website.

And while it should go without saying, if you see someone vomit in a restaurant—whether it’s a customer or staffer—Schaffner recommends you leave immediately. “Unlike many other foodborne diseases,” Schaffner said, “We know that norovirus can also spread through vomit as well as diarrhea.”