I second that.
Marshall
I'd like the BRC to bathe me in milk every morning, but that ain't going to happen anytime soon. In the meantime, this might help...
Recommended Control Measures for Food Handlers
Causative Agent / Illness
Incubation Period
Main Clinical Features
Food Handler Case: Exclusion
Microbiological Clearance
If Food Handler is a Household Contact of a Case
Aeromonas sp
Vomiting, diarrhoea
48 hours after first normal stool
No
Reinforce hygiene advice
Amoebic Dysentery
Variable, commonly 2-4 weeks
Fever, chills, bloody/or mucoid diarrhoea
48 hours after first normal stool
No (but late follow-up to detect chronic carriage advisable)
Screen to detect cyst excreters
Camplyobacter
1-10 days (usually 2-5 days)
Abdominal pain, profuse diarrhoea, headache, fever (vomiting uncommon)
48 hours after first normal stool
No
Reinforce hygiene advice
Cholera
Hrs – 5 days (usually 2-3 days)
Sudden onset profuse, painless watery stools, nausea and vomiting
48 hours after first normal stool
No
Reinforce hygiene advice
Clostridium perfringens
8-22 hrs (usually 12-18 hrs)
Diarrhoea and abdominal pain
48 hours after first normal stool
No
No action necessary
Cryptosporidium sp
2-5 days
Watery or mucoid diarrhoea
48 hours after first normal stool
No
Reinforce hygiene advice
Escherichia coli (other than VTEC)
12-72 hrs
Diarrhoea
48 hours after first normal stool
No
Reinforce hygiene advice
Escherichia coli (VTEC)
1-10 days (usually 3 days)
Abdominal pain, diarrhoea, haemorrhagic coltis (bloody diarrhoea), HUS
Until microbiological clearance obtained
Yes (2 negative stool samples not less than 48 hours apart)
Exclude until microbiological clearance obtained
Giardia lamblia
5-25 days
Diarrhoea, abdominal cramps
48 hours after first normal stool
No
Screening may identify those who need treatment
Hepatitis A
2-6 weeks
Fever, nausea, loss of appetite, abdominal pain, jaundice
7 days from onset of jaundice and or symptoms
No
Consider for prophylaxis (HNIG or HAV vaccine)
Salmonella sp
6-72 hours (usually 12-36 hrs
Headache, abdominal pain, fever, diarrhoea, nausea +/- vomiting
48 hours after first normal stool
No
Reinforce hygiene advice
Salmonella typhi / paratyphi
1-3 weeks
Fever, rigors, rash, variable gastro-intestinal symptoms
Until microbiological clearance gained
Yes (6 consecutive negative stool samples taken at 2 weekly intervals, starting 2 weeks after completion of antibiotic treatment)
Exclude until 3 consecutive negative stool samples taken at weekly intervals starting 3 weeks after last contact with untreated case (consider also for contact with household carrier)
Shigella
1-7 days (usually 1-3 days)
Diarrhoea, fever, abdominal pain, S.sonnei generally mild
48 hours after first normal stool
S.dysenteriae only (2 negative stool samples not less than 48 hours)
Reinforce hygiene advice
Staph Aureus
1-7 hours (usually 2-4 hrs
Vomiting, abdominal cramps, ofter with diarrhoea
Nasal carriers – no unless implicated as outbreak source
Skin – exclude if infected skin lesion on exposed part that cannot adequately covered until healed.
No
-
Streptococcal Disease
1-3 days
Variety of diseases:
e.g. sore throat – with fever, exudative tonsillitis/pharyngitis and lymphadenopathy
e.g. skin – impetigo / pyoderma
Exclude those with strep sore throat until treated
Skin – as for S.aureus above
No
-
Vibrios (non-cholera)
2-48 hrs (usually 12-18 hrs)
Diarrhoea, fever
48 hours after first normal stool
No
Reinforce hygiene advice
Viral gastroenteritis (rotavirus)
24-72 hrs
Diarrhoea, vomiting
48 hours after first normal stool
No
Reinforce hygiene advice
Virel gastroenteritis (NLV/SRSV)
12-48 hrs
Nausea, vomiting (often projectile), abdominal cramps, diarrhoea, fever, chills
48 -72 hours after first normal stool
No
Reinforce hygiene advice
Versinia sp
3-7 days
Watery diarrhoea, abdominal pain
48 hours after first normal stool
No
Reinforce hygiene advice
