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), Department of

Health and Human Services (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,

Public Law 101-336, 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 updates on September 8, 1992

(57 FR 40917); January 13, 1994 (59 FR 1949); August 15, 1996 (61 FR

42426); and September 22, 1997 (62 FR 49518); and September 15, 1998

(63 FR 49359). No new information that would warrant additional changes

has been received; therefore the list, as set forth in the last update

and below, remains unchanged.

EFFECTIVE DATE: September 21, 1999.

FOR FURTHER INFORMATION CONTACT: Dr. Arthur P. Liang, National Center

for Infectious Diseases, Centers for Disease Control and Prevention

(CDC), 1600 Clifton Road, NE., Mailstop G-24, Atlanta, Georgia 30333,

telephone (404) 639-2213.

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

Disabilities Act of 1990, 42 U.S.C. Sec. 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 last publication of the list on September 15, 1998 (63 FR

49359), CDC has received no information to indicate that additional

unlisted diseases 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 15, 1998.

I. Pathogens Often Transmitted by Food Contaminated by Infected

Persons Who Handle Food, and Modes of Transmission of Such

Pathogens

The contamination of raw ingredients from infected food-producing

animals and cross-contamination during processing are more prevalent

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 a pathogen that could be

transmitted to others through handling the food supply: diarrhea,

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

failure of food-handlers 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 major contributors in the spread of these pathogens. Pathogens

that can cause diseases after an infected person handles food are the

following:

Caliciviruses (Norwalk and Norwalk-like viruses)

Hepatitis A virus

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

Cryptosporidium parvum

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 and Prevention. Locally acquired

neurocysticercosis--North Carolina, Massachusetts, and South

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

5. Centers for Disease Control and Prevention. Foodborne

Outbreak of Cryptosporidiosis-Spokane, Washington, 1997. MMWR 1998;

47:27.

Dated: September 15, 1999.

Joseph R. Carter,

Associate Director for Management and Operations, Centers for Disease

Control and Prevention (CDC).

[FR Doc. 99-24530 Filed 9-20-99; 8:45 am]

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