Diarrhoea, Vomiting and Food – Are you Fit to Work?

Organisms such as bacteria and viruses can cause gastroenteritis; the symptoms of which include diarrhoea and vomiting. As the organisms multiply or are contained in the gut they can very easily be transferred to hands and surfaces (just the flushing of a toilet may cause aerosols to be transmitted). Some viruses such as norovirus can also be airborne; spread through the air from person to person. Diarrhoea, vomiting and food are not a good combination!

Even before someone becomes ill they may be infectious. In addition, after symptoms have stopped they may continue to be infectious for some time. Some organisms can live on in their host for a long time after they have appeared without them exhibiting any symptoms. ‘Typhoid Mary‘ was a cook who lived and worked in the U.S as a cook in the early part of the 20th century. During her time as a cook it is presumed that she infected 51 people with a type of salmonella commonly referred to as Typhoid. For decades she remained infectious by asymptomatic. Her case helped us understand more about how humans act as carriers of disease.

Diarrhoea, Vomiting and Food – Your Responsibilities

Most first world countries have rules relating to the fitness of personel who work drectly with food. In Europe, for example, regulations require that ‘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 [.]’. There are also requirements to report related illnesses or symptoms to a manager or supervisor in that business. In summary the duties are as follows:

1. Workers
   Staff working in food handling establishments must report certain symptoms to their manager immediately.
2. Managers
   Managers must ensure that staff exhibiting symptoms such as diarrhoea or vomiting are excluded from the working environment for an appropriate period (usually until 48 hours have passed since the last symptoms have occurred).

Food handlers will come into direct contact with food. However, it must also be recognised that anyone entering a food establishment has the potential to contaminate surfaces and equipment; which could, in turn, result in the spread of bacteria or viruses. This is why hand washing is such a priority.

In many countries screening results from blood and faecal tests are collated centrally. Any cases of serious foodborne illness are flagged up and health professionals will contact those affected to determine whether they should be excluded from work. Health care workers and food handlers are examples of people who can be stopped from working and who may be submitted to further tests to determine whether they are still carrying the organism.

Typhoid Mary was isolated by health officials for a long time as she refused to give up working as a cook. It is therefore important that workers are honest about their health so that similar events can be avoided. This can be difficult when staff are worried about a loss of pay.

Further advice on fitness to work can be found here.