Employee Illnesses: What You Need to Know

Food service employees who work when sick can easily contaminate food and food contact surfaces, resulting in a foodborne illness outbreak.
Employee Illnesses: What You Need to Know - Articles



Good personal hygiene on the part of a food worker is a key component for any type of operation that prepares, serves, and/or provides food to the public. In fact, the Food and Drug Administration (FDA) Food Code outlines specific guidelines around employee health and hygiene in a retail food service operation. These guidelines spell out the responsibilities of both the food worker and the person in charge surrounding hygienic practices designed to prevent contamination of food to prevent a foodborne illness.

Unfortunately, data reveals that about 68% of foodborne illness outbreaks are associated with food prepared in restaurants with the most common cause being sick employees handling the food in some way. Further, a Centers for Disease Control and Prevention (CDC) study indicated that one in five restaurant workers reported having worked while experiencing vomiting or diarrhea, both symptoms that can result in contamination of food and food contact surfaces.

Section 2-2, Employee Health, of the FDA Food Code outlines the specific roles and responsibilities around employee illness and reporting in retail operations. A food employee is required to report to the person in charge health information related to illnesses caused by:

  • Norovirus
  • Hepatitis A virus
  • Shigella spp.
  • Shiga toxin producing E. Coli
  • Salmonella Typhi
  • nontyphoidal Salmonella

Additionally, they must report the following symptoms:

  • vomiting
  • diarrhea
  • jaundice
  • sore throat with fever
  • lesion that is open or draining on the hand or arms if it cannot be safely covered

Once reported, it is up to the manager/person in charge to take action to exclude or restrict the employee from working with or around food and follow proper protocol for reporting specific illnesses and symptoms.

Why then is there such a high number of foodborne illness outbreaks linked to sick food workers? A study by the Environmental Health Specialist Network (EHS-Net) found a number of factors among food service workers that influence their decision to work if they have symptoms of vomiting or diarrhea. Personal traits (gender, years on the job), financial concerns (fear of job loss, no sick pay) and social concerns (worry about coworkers, no one else to do the job) are the main reasons given for working while sick. In most cases, employees do not tell the manager they are sick for fear of being sent home.

In order to resolve these issues, it is important for managers to understand and address these reasons with their employees. An important step in this process is talking with employees about these issues. As a person in charge, you have the right and responsibility to educate staff about these reportable illnesses and symptoms. In 2017, there were a number of foodborne outbreaks of Norovirus and Hepatitis A all attributed to food workers working while ill. These have occurred in both large and small retail facilities. Not only have hundreds of people become sick and some hospitalized, the facilities have suffered financially by having to close down for cleaning and training or in some cases close completely because of lack of trust by the public.

As a manager, work with your employees to create a culture of open communication. Talk with employees about why it is so critical to report these symptoms and illnesses. Use the FDA Food Code guidelines as a starting point for the discussion. Maybe ask if any of them have had a foodborne illness and what that was like and whether they would want that to happen to one of their customers. Talk about the financial implications of an outbreak as well. For example, what that could mean in terms of their job and their coworkers jobs and the continued viability of the operation.

If you are concerned about the legalities of asking an employee about their health in terms of determining whether they should be working around food, the CDC provides a fact sheet titled “Can Restaurant Managers Talk with Sick Workers? 3 Things Restaurant Managers Need to Know.”

By working together, managers and employees can prevent the spread of a foodborne illness!


  1. Radke, T. (December 2017). Discussing Symptoms with Sick Food Service Employees. Journal of Environmental Health 80 (5), 24-26.
  2. U. S. Department of Health and Human Services. (2013). Food Code, U.S. Public Health Service, FDA. U.S. Department of Commerce, Alexandria, VA.
  3. U. S. Department of Health and Human Services. (2015). Supplement to the 2013 Food Code, U.S. Public Health Service, FDA. U.S. Department of Commerce, Alexandria, VA.
  4. Food Workers Reasons for Working When Sick. (August 16, 2016). Retrieved January 18, 2018.
  5. Can Restaurant Managers Talk with Sick Workers? 3 Things Restaurant Managers Need to Know. (December 12, 2017). Retrieved January 18, 2018.