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The law requires that in all food businesses other than those engaged in primary production (e.g. farmers and growers) and associated operations:

“No person suffering from, or being a carrier of a disease likely to be transmitted through food or afflicted, for example, with infected wounds, skin infections, sores or diarrhoea is to be permitted to handle food or enter any food-handling area in any capacity if there is any likelihood of direct or indirect contamination.”

“Any person so affected and employed in a food business and who is likely to come into contact with food is to report immediately the illness or symptoms, and if possible their causes, to their manager or supervisor.” The people referred to in these requirements are commonly referred to as food handlers.

A person can be a carrier of a disease and pass it on through food or directly to other people. When bacteria infect an individual and cause gastrointestinal illness (food poisoning), they live and multiply in the gut and are excreted in faeces or in vomit. The risk of bacteria spreading is highest when the infected person has diarrhoea and vomiting because there are lots of bacteria and a loose or liquid stool is more likely to contaminate hands and other things. Some types of bacteria that cause food poisoning can also infect damaged skin and
can be carried in the nose and throat.

Food may be contaminated with harmful bacteria, either directly by an infected food handler, or indirectly through contact with a food contact surface that has been contaminated by an infected food handler. Foods which will not be cooked before being eaten are at greater risk because cooking is a process that would kill many of the bacteria present.

People can also have infections without showing any symptoms. This can be because they are long-term carriers of infectious bacteria; because they just have very mild infections; or because they are only in the early stages of illness and symptoms are not yet apparent. This is one reason why it is important for food handlers to always follow the hand-washing guidance in this document

Some viruses can be transmitted through food and spread in much the same way as bacteria, with similar effects. The main differences are that viruses cannot multiply on food but can survive on food for long periods. Viruses can spread via contaminated hands and some can also spread through the air, especially when an infected person vomits. This characteristic is often what causes large-scale outbreaks of viral infection in enclosed environments. Viruses are also generally quite easy to destroy by cooking food.

Some types of parasitic worms can infect the human intestines. They spread by laying tiny eggs inside the infected person, which are shed in faeces. Protozoa, such as amoeba, are single-celled organisms that can infect the human intestines and body and can cause serious illness such as dysentery. They can also spread through faeces. Infections caused by these organisms are not common in the UK.

Managers must exclude any person from food handling duties and food handling areas if they have an infection of the stomach or gut or if they have an area of infected skin that cannot be covered. The length of the exclusion is usually 48 hours from when their symptoms stop. If you are in doubt about whether to exclude someone, it is advisable to take into account the nature of the likely consequences of something going wrong should you make the wrong decision.

Factors to consider include the nature of their duties, processes that will be applied to the food and whether vulnerable people will be consuming the food, e.g. young children or people who are already ill.

Food handling duties would include directly handling open food or touching surfaces that will come into direct contact with food, such as food packaging areas and food equipment.

The affected member of staff could be given work elsewhere on the premises, such as warehouse operations where only packaged food is handled, although they should practice good personal hygiene.

It is the responsibility of the food business operator to ensure that people who are not directly employed by them, for example, maintenance staff, contractors and other visitors to food handling areas, do not pose a risk to food safety as they may know very little about food safety.

In most cases of infection, bacteria and viruses can still be found in someone’s faeces after symptoms stop. It is therefore important that managers continue to exclude food handlers for a period of 48 hours. This time is counted from the time that symptoms (mainly diarrhoea) stop of their own accord or from the end of any treatment of the symptoms with medicine.

It is reasonable to presume that a single bout (e.g. one loose stool) or incidence of vomiting is not infectious if 24 hours have elapsed without any further symptoms and this is not accompanied by fever. In this case, as long as there is no other evidence to suggest an infectious cause, the person would only pose a very low risk of being infected and could resume work before the 48-hour limit.

Infections are not the only cause of diarrhoea and vomiting and exclusion is not required where there is good evidence of a non-infective cause. Examples of this are:

  • Morning sickness during pregnancy
  • Some medicines and medical treatments
  • Inflammation of the bowel including diverticulitis, ulcerative colitis, and Crohn's disease
  • Irritable bowel syndrome
  • Cancer of the bowel
  • Coeliac disease
  • Dietary indiscretions like consuming too much alcohol or spicy food.

If in doubt, it is best to assume that the cause is an infection and to exclude the person until there evidence to show it is safe for them to return to work.