Diseases Transmitted Through the Food Supply

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

Diseases Transmitted Through the Food Supply

AGENCY: Centers for Disease Control and Prevention (CDC), Public Health

Service, HHS.

ACTION: Notice of annual update of list of infectious and communicable

diseases that are transmitted through handling the food supply and the

methods by which such diseases are transmitted.

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SUMMARY: Section 103(d) of the Americans with Disabilities Act of 1990

requires the Secretary to publish a list of infectious and communicable

diseases that are transmitted through handling the food supply and to

review and update the list annually. The Centers for Disease Control

and Prevention (CDC) published a final list on August 16, 1991, (56 FR

40897) and an update on September 8, 1992, (57 FR 40917). No new

information that would warrant additional changes has been received;

therefore the list, as set forth in the first update and below, remains

unchanged.

EFFECTIVE DATE: January 13, 1994.

FOR FURTHER INFORMATION CONTACT: Dr. Morris E. Potter, National Center

for Infectious Diseases, Centers for Disease Control and Prevention

(CDC), 1600 Clifton Road, NE., Mailstop C-09, Atlanta, Georgia 30333,

telephone (404) 639-2237.

SUPPLEMENTARY INFORMATION: Section 103(d) of the Americans with

Disabilities Act of 1990, 42 U.S.C. 12113(d), requires the Secretary of

Health and Human Services to:

1. Review all infectious and communicable diseases which may be

transmitted through handling the food supply;

2. Publish a list of infectious and communicable diseases which are

transmitted through handling the food supply;

3. Publish the methods by which such diseases are transmitted; and,

4. Widely disseminate such information regarding the list of

diseases and their modes of transmissibility to the general public.

Additionally, the list is to be updated annually.

Since the publication of the revised list on September 8, 1992, no

information has been received on additional diseases that are

transmitted through handling the food supply. Therefore, the list set

forth below is unchanged from the list published in the Federal

Register on September 8, 1992:

I. Pathogens Often Transmitted by Food Contaminated by Infected Persons

Who Handle Food, and the Modes of Transmission of Such Pathogens

The contamination of raw ingredients from infected food-producing

animals and contamination during processing are more important causes

of foodborne disease than is contamination of foods by persons with

infectious or contagious diseases. However, some pathogens are

frequently transmitted by food contaminated by infected persons. The

presence of any one of the following signs or symptoms in persons who

handle food may indicate infection by one of these pathogens: Diarrhea,

vomiting, open skin sores, boils, fever, dark urine, or jaundice. The

failure of food employees to wash hands (in situations such as after

using the toilet, handling raw meat, cleaning spills, or carrying

garbage, for example), wear clean gloves, or use clean utensils is

responsible for the foodborne transmission of these pathogens. Non-

foodborne routes of transmission, such as from one person to another,

are also important in the spread of these pathogens. Pathogens that can

cause diseases after an infected person handles food are the following:

Hepatitis A virus

Norwalk and Norwalk-like viruses

Salmonella typhi

Shigella species

Staphylococcus aureus

Streptococcus pyogenes

II. Pathogens Occasionally Transmitted by Food Contaminated by Infected

Persons Who Handle Food, But Usually Transmitted by Contamination at

the Source or in Food Processing or by Non-foodborne Routes

Other pathogens are occasionally transmitted by infected persons

who handle food, but usually cause disease when food is intrinsically

contaminated or cross-contaminated during processing or preparation.

Bacterial pathogens in this category often require a period of

temperature abuse to permit their multiplication to an infectious dose

before they will cause disease in consumers. Preventing food contact by

persons who have an acute diarrheal illness will decrease the risk of

transmitting the following pathogens:

Campylobacter jejuni

Entamoeba histolytica

Enterohemorrhagic Escherichia coli

Enterotoxigenic Escherichia coli

Giardia lamblia

Nontyphoidal Salmonella

Rotavirus

Taenia solium

Vibrio cholerae 01

Yersinia enterocolitica

References

1. World Health Organization. Health surveillance and management

procedures for food-handling personnel: report of a WHO

consultation. World Health Organization technical report series;

785. Geneva: World Health Organization, 1989.

2. Frank JF, Barnhart HM. Food and dairy sanitation. In: Last

JM, ed. Maxcy-Rosenau public health and preventive medicine, 12th

edition. New York Appleton-Century-Crofts, 1986:765-806.

3. Bennett JV, Holmberg SD, Rogers MF, Solomon SL. Infectious

and parasitic diseases. In: Amler RW, Dull HB, eds. Closing the gap:

the burden of unnecessary illness. New York: Oxford University

Press, 1987:102-114.

4. Centers for Disease Control. Locally acquired

neurocysticercosis--North Carolina, Massachusetts, and South

Carolina, 1989-1991. MMWR 1992; 41:1-4.

Dated: January 7, 1994.

Walter R. Dowdle,

Deputy Director, Centers for Disease Control and Prevention (CDC).

[FR Doc. 94-848 Filed 1-12-94; 8:45 am]

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