Food handlers are required to report six specific diagnosed illnesses to their manager, along with four key symptoms, whether those symptoms appear at work or at home. These rules come from the FDA Food Code, which most state and local health departments adopt. Understanding what triggers a report can prevent a foodborne illness outbreak and keep you in compliance with food safety regulations.
The Six Diagnosed Illnesses You Must Report
The FDA Food Code identifies six pathogens that are highly contagious and easily spread through food. If a food handler is diagnosed with any of these, they must immediately tell their manager (referred to in the Food Code as the “person in charge”):
- Salmonella Typhi (the cause of typhoid fever)
- Nontyphoidal Salmonella
- Shigella
- Shiga toxin-producing E. coli (STEC), sometimes called enterohemorrhagic E. coli
- Hepatitis A
- Norovirus
These six are singled out because they spread easily from person to person through contaminated food, they can cause serious illness in customers, and infected people can shed the pathogen even before or after their symptoms stop. A diagnosis of any one of them triggers not just a report to your manager but also, in most jurisdictions, a report from the manager to the local health department.
Symptoms That Require Reporting
You don’t need a formal diagnosis to be required to speak up. Four symptoms on their own must be reported to your manager as soon as they appear, regardless of the cause:
- Diarrhea
- Vomiting
- Jaundice (yellowing of the skin or eyes)
- Sore throat with fever
This applies whether the symptom starts during a shift or on your day off. You’re expected to report the date of onset. The reason is straightforward: these symptoms often accompany the six reportable illnesses listed above, and a manager needs to act before a diagnosis is confirmed rather than after.
Jaundice carries an especially strict response. Because it’s a hallmark of hepatitis A, food handlers who develop jaundice must be reported to the local regulatory authority. If the jaundice appeared within the past seven days, the food handler must be excluded from the operation entirely. Returning to work after jaundice requires both a written release from a doctor and approval from the health department.
What Happens After You Report
Your manager’s response depends on what you reported and whether you work with food directly. In general, the person in charge will either restrict you or exclude you. Restriction means you can still work but cannot handle exposed food, clean equipment, or touch surfaces that contact food. Exclusion means you cannot work in the food establishment at all until you’re cleared.
For the six diagnosed illnesses, exclusion is the typical response when the food handler has symptoms like vomiting or diarrhea. Even without symptoms, a confirmed diagnosis of hepatitis A or typhoid fever still results in exclusion because those pathogens are so easily transmitted. For the other four (nontyphoidal Salmonella, Shigella, STEC, and norovirus), a diagnosis without symptoms usually results in restriction rather than full exclusion, though this varies by state.
Managers are required to notify the local health department immediately when a food handler is diagnosed with one of the six illnesses. In many states, the manager must also log the illness on an employee illness record. Health department clearance is typically required before the food handler can return to work.
Exposure Without Symptoms
Reporting isn’t limited to your own illness. If someone in your household has been diagnosed with one of the six reportable illnesses, or if you’ve been identified as a suspected source of a disease outbreak within the past 30 days, you must tell your manager even if you feel perfectly fine. The concern is that you could be carrying the pathogen without knowing it yet, and the incubation period for some of these illnesses can last days or even weeks.
Your manager will then decide whether to restrict or exclude you based on the specific exposure, whether you develop symptoms, and whether your workplace serves a high-risk population.
Stricter Rules for High-Risk Settings
If you work in a facility that serves what the Food Code calls “highly susceptible populations,” the rules tighten considerably. These settings include hospitals, nursing homes, assisted living facilities, child daycare centers, and adult daycare centers. The people eating the food in these locations are more vulnerable to severe illness from foodborne pathogens due to age, immune status, or existing health conditions.
In high-risk settings, a diagnosed food handler is more likely to be excluded rather than simply restricted, even without active symptoms. For example, a food handler diagnosed with norovirus but not currently symptomatic would typically be restricted in a standard restaurant but excluded from a nursing home kitchen. Hepatitis A and typhoid fever result in exclusion regardless of symptoms in any setting, but especially in these facilities, managers and health departments treat every case with maximum caution.
Why Reporting Matters
These reporting requirements exist because a single infected food handler can contaminate hundreds of meals in a shift. Norovirus, for instance, can spread through tiny droplets that land on surfaces or food, and an infected person sheds billions of virus particles. Hepatitis A can be transmitted for weeks before the infected person even feels sick. The six reportable pathogens were chosen specifically because of how efficiently they move through a food service environment.
Failing to report carries real consequences. Food handlers who conceal symptoms or diagnoses put customers at risk of serious illness and put their employer at risk of being shut down by the health department. Most food safety certification programs, including ServSafe, require food handlers to sign a reporting agreement when they’re hired, acknowledging their obligation to disclose symptoms and diagnoses. That agreement isn’t just a formality. It’s the first line of defense in preventing an outbreak.