Foodservice Employee Sick Policy

Proper management of a food establishment operation begins with employing healthy people and instituting a health system of identifying employees who present a risk of transmitting pathogens.

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The person in charge is responsible for ensuring all food employees and conditional employees are knowledgeable and understand their responsibility to report listed symptoms, diagnosis with an illness from a listed pathogen, or exposure to a listed pathogen to the person in charge. The person in charge is also responsible for reporting to the regulatory official if a food employee reports a diagnosis with a pathogen.

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Employee Health Policy Questions

The development and effective implementation of an employee health policy is to maintain a work environment.  Below are a few questions to help determine in your employee health policy is adequate.

Source: FDA Food Code Subpart 2-201 – Infected Food Employees and Conditional Employees, pp. 355-356

  1. Does the food service operation have an Employee Health Policy? If so, are the food employees aware of the employee health policy, and is it available in written format and readily available for food employees?
  2. Does the food service operation require conditional employees and food employees to report certain illnesses, conditions, symptoms, and exposures?
  3.  Are the reporting requirements explained to all employees?
  4. What are the reporting requirements for conditional employees, food employees, and the food establishment manager?
  5. Are conditional employees asked if they are experiencing certain symptoms or illnesses upon offer of employment? If so, which symptoms or illnesses?
  6. If a food employee reports a diagnosis, what questions are asked of the food employee? (The first question every food manager should ask a food employee who reports diagnosis with a listed pathogen is if the employee is currently having any symptoms.)
  7. Who does the food service operation notify when a food employee reports a diagnosis with one of the listed pathogens?
  8. What symptoms would require exclusion of a food employee from the food establishment?
  9. What history of exposure is a conditional employee or food employee required to report?
  10. If a food employee reports a symptom, what criteria are used to allow the employee to return to work?

Symptoms of Illnesses

  • Common symptoms of foodborne illness are diarrhea and/or vomiting, typically lasting 1 to 7 days. Other symptoms might include abdominal cramps, nausea, fever, joint/back aches, and fatigue.
  • What some people call the “stomach flu” may actually be a illness caused by a pathogen (i.e., virus, bacteria, or parasite) in contaminated food or drink.
  • The incubation period (the time between exposure to the pathogen and onset of symptoms) can range from several hours to 1 week.
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People (Groups) Vulnerable to Illness

Foodborne illness can affect anyone who eats contaminated food. However, certain populations are more susceptible to becoming ill with a greater severity of illness. These groups include:

  • Pregnant women;
  • Infants and young children;
  • Older adults;
  • People taking certain kinds of medications or with immune systems weakened from medical conditions, such as diabetes, liver disease, kidney disease, organ transplants, HIV/AIDS, or from receiving chemotherapy or radiation treatment.

Most people with a foodborne illness get better without medical treatment, but people with severe symptoms should see their doctor.


These vulnerable groups should take extra precautions and avoid the following foods:

  • Raw or rare meat and poultry;
  • Raw or undercooked fish or shellfish;
  • Raw or undercooked eggs or foods containing them ( cookie dough and homemade ice cream);
  • Fresh sprouts;
  • Unpasteurized ciders or juices;
  • Unpasteurized milk and milk products;
  • Uncooked hot dogs.

Biological Food Pathogens

The chart below includes foodborne disease-causing organisms that frequently cause illness in the United States.

OrganismOnset Time After IngestingSigns & SymptomsDurationFood Sources
Bacillus cereus10-16 hrsAbdominal cramps, watery diarrhea, nausea24-48 hoursMeats, stews, gravies, vanilla sauce
Campylobacter jejuni2-5 daysDiarrhea, cramps, fever, and vomiting; diarrhea may be bloody2-10 daysRaw and undercooked poultry, unpasteurized milk,contaminated water
12-72 hoursVomiting, diarrhea, blurred vision, double vision, difficulty in swallowing, muscle weakness. Can result in respiratory failure and deathVariableImproperly canned foods, especially home-canned vegetables, fermented fish, baked potatoes in aluminum foil
8–16 hoursIntense abdominal cramps, watery diarrheaUsually 24
Meats, poultry, gravy, dried or precooked foods, time and/or temperature-abused foods
Cryptosporidium2-10 daysDiarrhea (usually watery), stomach cramps, upset stomach, slight feverMay be remitting and relapsing over weeks to monthsUncooked food or food contaminated by an ill food handler after cooking, contaminated drinking water
1-14 days, usually at least 1 weekDiarrhea (usually watery), loss of appetite, substantial loss of weight, stomach cramps, nausea, vomiting, fatigueMay be remitting and relapsing over weeks to monthsVarious types of fresh produce (imported berries, lettuce, basil)
E. coli
(Escherichia coli)

producing toxin
1-3 daysWatery diarrhea, abdominal cramps, some vomiting3-7 or more daysWater or food contaminated with human feces
E. coli O157:H71-8 daysSevere (often bloody) diarrhea, abdominal pain and vomiting. Usually, little or no fever is present. More common in children 4 years or younger. Can lead to kidney failure.5-10 daysUndercooked beef (especially hamburger), unpasteurized milk and juice, raw fruits and vegetables (e.g. sprouts), and contaminated water
Hepatitis A28 days average (15-50 days)Diarrhea, dark urine, jaundice, and flu-like symptoms, i.e., fever, headache, nausea, and abdominal painVariable, 2 weeks-3 monthsRaw produce, contaminated drinking water, uncooked foods and cooked foods that are not reheated after contact with an infected food handler; shellfish from contaminated waters
9-48 hrs for gastro-intestinal symptoms, 2-6 weeks for invasive diseaseFever, muscle aches, and nausea or diarrhea. Pregnant women may have mild flu-like illness, and infection can lead to premature delivery or stillbirth. The elderly or immunocompromised patients may develop bacteremia or meningitis.VariableUnpasteurized milk, soft cheeses made with unpasteurized milk, ready-to-eat deli meats
Noroviruses12-48 hrsNausea, vomiting, abdominal cramping, diarrhea, fever, headache. Diarrhea is more prevalent in adults, vomiting more common in children.12-60 hrsRaw produce, contaminated drinking water, uncooked foods and cooked foods that are not reheated after contact with an infected food handler; shellfish from contaminated waters
Salmonella6-48 hoursDiarrhea, fever, abdominal cramps, vomiting4-7 daysEggs, poultry, meat, unpateurized milk or juice, cheese, contaminated raw fruits and vegetables
Shigella4-7 daysAbdominal cramps, fever, and diarrhea. Stools may contain blood and mucus.24-48 hrsRaw produce, contaminated drinking water, uncooked foods and cooked foods that are not reheated after contact with an infected food handler
Staphylococcus aureus1-6 hoursSudden onset of severe nausea and vomiting. Abdominal cramps. Diarrhea and fever may be present.24-48 hoursUnrefrigerated or improperly refrigerated meats, potato and egg salads, cream pastries
4-96 hoursWatery (occasionally bloody) diarrhea, abdominal cramps, nausea, vomiting, fever2-5 daysUndercooked or raw seafood, such as shellfish
Vibrio vulnificus1-7 daysVomiting, diarrhea, abdominal pain, bloodborne infection. Fever, bleeding within the skin, ulcers requiring surgical removal. Can be fatal to persons with liver disease or weakened immune systems.2-8 daysUndercooked or raw seafood, such as shellfish (especially oysters)


It is very important to understand what, why, and how foods can make you sick, but more importantly, the food safe principles and procedures to prevent foodborne illnesses.