P1-111 A State-by-State Assessment of Food Safety Regulations for Prevention of Norovirus Outbreaks

Sunday, July 26, 2015
Exhibit Hall (Oregon Convention Center)
Anita Kambhampati
Kayoko Shioda
L. Hannah Gould , Centers for Disease Control and Prevention , Atlanta , GA
Donald Sharp
Laura Brown , Centers for Disease Control and Prevention , Atlanta , GA
Umesh Parashar , Centers for Disease Control and Prevention , Atlanta , GA
Aron Hall , Centers for Disease Control and Prevention , Atlanta , GA
Introduction: Noroviruses are the leading cause of foodborne illness in the United States. Foodborne norovirus transmission is commonly associated with contamination of food during preparation by an infected food service worker. The United States Food and Drug Administration’s Food Code provides model food safety regulations to prevent transmission of foodborne illness in restaurants; however, adoption of specific provisions is at the discretion of state and local governments. 

Purpose: To describe differences in adoption of norovirus-related provisions among jurisdictional food safety regulations and the 2013 version of the Food Code.

Methods: We analyzed the food safety regulations of all 50 states, the District of Columbia, and Puerto Rico. Key areas assessed were hand-washing procedures, prohibition of bare-hand contact with Ready-to-Eat (RTE) foods, management of ill workers, presence of a contamination event response plan, and requirements for certified food protection managers (CFPM). Data were abstracted from publically accessible state legislation and compiled for descriptive analysis.

Results: Of 52 jurisdictions assessed, 47 (90%) require hand-washing and 49 (94%) prohibit bare-hand contact with RTE food. In contrast, 22 (42%) jurisdictions require a CFPM and 7 (13%) require a response plan for contamination events, such as vomiting. There was wide variation in the adoption of criteria specifying when and for how long ill food service workers should be excluded or restricted from the workplace. Nine states (17%) do not provide any specific management criteria for ill workers.

Significance: Most states have adopted some form of the recommended provisions to reduce foodborne norovirus transmission, although there is variation in the adoption of specific regulations. Focus on enactment and improved compliance with recommended provisions may decrease incidence of foodborne transmission of norovirus. Future analyses could examine implementation and compliance with state regulations, and explore potential correlations between those regulations and characteristics of reported foodborne norovirus outbreaks.