HAR §11-50-21. Employee health

(a) Responsibility owner or operator, person in charge, and conditional of employees. ( 1) The owner or operator shall require food employees and conditional employees to report to the person in charge information about their health and activities as they relate to diseases that are transmissible through food. A food employee or conditional employee shall report the information in a manner that allows the person in charge to reduce the risk of foodborne disease transmission, including providing necessary additional information, such as the date of onset of symptoms and an illness, or of a diagnosis without symptoms, if the food employee or conditional employee: (A) Has any of the following symptoms: (i) Vomiting; (B) (C) (ii) Diarrhea; (iii) Jaundice; (iv) Sore throat with fever; or (v) A lesion containing pus such as a boil or infected wound that is open or draining and is on the hands or wrists, unless an impermeable cover such as a finger cot or stall protects the lesion and a single-use glove is worn over the impermeable cover or on exposed portions of the arms, unless the lesion is protected by an impermeable cover, or on the other parts of the body, unless the lesion is covered by a dry, durable, tight- fitting bandage; Has an illness diagnosed by a health practitioner due to: (i) Norovirus; (ii) Hepatitis A virus; (iii) Shigella spp.; (iv) Shiga toxin-producing Escherichia (v) Coli; Typhoid fever (caused by Salmonella Typhi) or (vi) Salmonella (nontyphoidal); Had typhoid fever, diagnosed by a health practitioner, within the past three months, 50-49 §11-50-21 without having received antibiotic therapy, as determined by a health practitioner; (D) Has been exposed to, or is the suspected source of, a confirmed disease outbreak, because the food employee or conditional employee consumed or prepared food implicated in the outbreak, or consumed food at an event prepared by a person who is infected or ill with: (i) Norovirus within the past forty-eight hours of the last exposure; (ii) Shiga toxin-producing Escherichia Coli or Shigella spp. within the past three days of the last exposure; (iii) Typhoid fever (caused by Salmonella Typhi) within the past fourteen days of the last exposure; or (iv) Hepatitis A virus within the past thirty days of the last exposure; or (E) Has been exposed by attending or working in a setting where there is a confirmed disease outbreak, or living in the same household as, and has knowledge about, an individual who works or attends a setting where there is a confirmed disease outbreak, or living in the same household as, and has knowledge about, an individual diagnosed with an illness caused by: (i) Norovirus within the past forty-eight hours of the last exposure; (ii) Shiga toxin-producing Escherichia Coli or Shigella spp. within the past three days of the last exposure; (iii) Typhoid fever (caused by Salmonella Typhi) within the past fourteen days of the last exposure; or (iv) Hepatitis A virus within the past thirty days of the last exposure; (2) The person in charge shall notify the regulatory authority when a food employee is: (A) Jaundiced; or (B) Diagnosed with an illness due to a pathogen as specified in subsection (a) (1) (B) (i) to (vi). (3) The person in charge shall ensure that a conditional employee: 50-50 §11-50-21 (A) Who exhibits or reports a symptom, or who reports a diagnosed illness as specified in subsection (a) (1) (A) to (C), is prohibited from becoming a food employee until the conditional employee meets the criteria for the specific symptoms or diagnosed illness as specified in subsection (c); and (B) Who will work as a food employee in a food establishment that serves as a highly susceptible population and reports a history of exposure as specified in subsection (a) (1) (D) to (E), is prohibited from becoming a food employee until the conditional employee meets the criteria as specified in subsection (c) (10); (4) The person in charge shall ensure that a food employee who exhibits or reports a symptom, or who reports a diagnosed illness or a history of exposure as specified in subsection (a) (1) (A) to (E) is: (A) Excluded as specified in subsection (b) (1) to (3), (4) (A), (5) (A), (6) (A), or (8) (A) and in compliance with the provisions specified in subsection (c) (1) to (8); (B) Restricted as specified in subsection (b) (4) (B), (5) (B), (6) (B), (7), (8) (B) or (9) or (10) and in compliance with the provisions specified in subsection ( c) ( 4) to (10); (5) A food employee or conditional employee shall report to the person in charge the information as specified in paragraph (1); (6) A food employee shall: (A) Comply with an exclusion as specified in subsection (b) (1) to (3), and (4) (A), (5) (A), (6) (A), (7) or (8) (A} and with the provisions specified in subsection ( c) ( 1) to (8); or (B) Comply with a restriction as specified in subsection (b) (4) (B), (5) (B), (6) (B), (7), (8) (B), or (8), (9), or (10) and comply with the provisions specified in subsection (c) (4) to (10); (b) The person in charge shall exclude or restrict a food employee from a food establishment in accordance with the following: 50-51 §11-50-21 (1) Except when the symptom is from a noninfectious condition, exclude a food employee if the food employee is: (A) Symptomatic with vomiting or diarrhea; or (B) Symptomatic with vomiting or diarrhea and diagnosed with an infection from Norovirus, Shigella spp., Salmonella (nontyphoidal), or Shiga toxin-producing E. Coli; (2) Exclude a food employee who is: (A) Jaundiced and the onset of jaundice occurred within the last seven calendar days, unless the food employee provides to the person in charge written medical documentation from a health practitioner specifying that the jaundice is not caused by hepatitis A virus or other fecal-orally transmitted infection; (B) Diagnosed with an infection from hepatitis A virus within fourteen calendar days from the onset of any illness symptoms, or within seven calendar days of the onset of jaundice; or (C) Diagnosed with an infection from hepatitis A virus without developing symptoms; (3) Exclude a food employee who is diagnosed with Typhoid fever, or reports having had Typhoid fever within the past three months as specified in subsection (a) (1) (C); (4) If a food employee is diagnosed with an infection from Norovirus and is asymptomatic: (A) Exclude the food employee who works in a food establishment serving a highly susceptible population; or (B) Restrict the food employee who works in a food establishment not serving a highly susceptible population; (5) If a food employee is diagnosed with an infection from Shigella spp. and is asymptomatic: (A) Exclude the food employee who works in a food establishment serving a highly susceptible population; or (B) Restrict the food employee who works in a food establishment not serving a highly susceptible population; 50-52 §11-50-21 (6) If a food employee is diagnosed with an infection from Shiga toxin-producing E. Coli, and is asymptomatic: (A) Exclude the food employee who works in a food establishment serving a highly susceptible population; or (B) Restrict the food employee who works in a food establishment not serving a highly susceptible population; (7) If a food employee is diagnosed with an infection from Salmonella (nontyphoidal) and is asymptomatic, restrict the food employee who works in a food establishment serving a highly susceptible population or in a food establishment not serving a highly susceptible population; (8) If a food employee is ill with symptoms of acute onset of sore throat with fever: (A) Exclude the food employee who works in a food establishment serving a highly susceptible population; or (B) Restrict the food employee who works in a food establishment not serving a highly susceptible population; (9) If a food employee is infected with a skin lesion containing pus such as a boil or infected wound that is open or draining and not properly covered as specified in subsection (a) (1) (A) (v), restrict the food employee; (10) If a food employee is exposed to a foodborne pathogen as specified in subsection (a) (1) (D) and (E), restrict the food employee who works in a food establishment serving a highly susceptible population. (c) The person in charge shall adhere to the following conditions when removing, adjusting, or retaining the exclusion or restriction of a food employee: (1) Except when a food employee is diagnosed with Typhoid fever or an infection from hepatitis A virus: (A) Reinstate a food employee who was excluded as specified in subsection (b) (1) (A) if the food employee: (i) Is asymptomatic for at least twenty- four hours; or (ii) Provides to the person in charge written medical documentation from a 50-53 §11-50-21 health practitioner that states the symptom is from a noninfectious condition; (B) If a food employee was diagnosed with an infection from Norovirus and excluded as specified in subsection (b) (1) (B): (i) Restrict the food employee, who is asymptomatic for at least twenty-four hours and works in a food establishment not serving a highly susceptible population, until the conditions for reinstatement as specified in subsection (b) (4) (A) or (B) are met; or (ii) Retain the exclusion for the food employee, who is asymptomatic for at least twenty-four hours and works in a food establishment that serves a highly susceptible population, until the conditions for reinstatement as specified in subsection (b) ( 4) (A) or (B) are met; (C) If a food employee was diagnosed with an infection from Shigella spp. and excluded as specified in subsection (b) (1) (B): (i) Restrict the food employee, who is asymptomatic for at least twenty-four hours and works in a food establishment not serving a highly susceptible population, until the conditions for reinstatement as specified in paragraph (5) (A) or (B) are met; or (ii) Retain the exclusion for the food employee, who is asymptomatic for at least twenty-four hours and works in a food establishment that serves a highly susceptible population, until the conditions for reinstatement as specified in subsections (b) (5) (A) or (B), or (5) (A) and (c) (1) (C) (i) are met; (D) If a food employee was diagnosed with an infection from Shiga toxin-producing Escherichia Coli and excluded as specified in subsection (b) (1) (B): 50-54 §11-50-21 (i) Restrict the food employee, who is asymptomatic for at least twenty-four hours and works in a food establishment not serving a highly susceptible population, until the conditions for reinstatement as specified in subsection (b) (6) (A) or (B) are met; or (ii) Retain the exclusion for the food employee, who is asymptomatic for at least twenty-four hours and works in a food establishment that serves a highly susceptible population, until the conditions for reinstatement as specified in subsection (b) ( 6) (A) or (B) are met; (E) If a food employee was diagnosed with an infection from Salmonella (nontyphoidal) and excluded as specified in subsection (b) (1) (B): (i) Restrict the food employee, who is asymptomatic for at least thirty days until conditions for reinstatement as specified in subsection ( c) ( 7) (A) or (B) are met; or (ii) Retain the exclusion for the food employee who is symptomatic, until conditions for reinstatement as specified in subsection (c) (7) (A) or (B) are met; (2) Reinstate a food employee who was excluded as specified in subsection (b) (2) if the person in charge obtains approval from the department and one of the following conditions is met: (A) The food employee has been jaundiced for more than seven calendar days; (B) The anicteric food employee has been symptomatic with symptoms other than jaundice for more than fourteen calendar days; or (C) The food employee provides to the person in charge written medical documentation from a health practitioner stating that the food employee is free of a hepatitis A virus infection; 50-55 §11-50-21 (3) ( 4) (5) Reinstate a food employee who was excluded as specified in subsection (b) ( 3) if: (A) The person in charge obtains approval from (B) the department; and The food employee provides to the person in charge written medical documentation from a health practitioner that states the food employee is free from Typhoid fever; Reinstate a food employee who was excluded as specified in subsection (b) (1) (B) or (4) (A) who was restricted in subsection (b) (4) (B) if the person in charge obtains approval from the department and one of the following conditions is met: (A) (B) (C) The excluded or restricted food employee provides to the person in charge written medical documentation from a health practitioner stating that the food employee is free of a Norovirus infection; The food employee was excluded or restricted after symptoms of vomiting or diarrhea resolved, and more than forty- eight hours have passed since the food employee became asymptomatic; or The food employee was excluded or restricted and did not develop symptoms and more than forty-eight hours have passed since the food employee was diagnosed; Reinstate a food employee who was excluded as specified in subsection (b) (1) (B) or (5) (A) or who was restricted in subsection (b) (5) (B) if the person in charge obtains approval from the department and one of the following conditions is met: (A) The excluded or restricted food employee provides to the person in charge written medical documentation from a health practitioner stating that the food employee is free of a Shigella spp. infection based on test results showing two consecutive negative stool specimen cultures that are taken: (i) Not earlier than forty-eight hours after discontinuance of antibiotics; and (ii) At least twenty-four hours apart; 50-56 (6) (7) §11-50-21 (B) The food employee was excluded or restricted after symptoms of vomiting or diarrhea resolved, and more than seven calendar days have passed since the food employee became asymptomatic; or (C) The food employee was excluded or restricted and did not develop symptoms and more than seven calendar days have passed since the food employee was diagnosed; Reinstate a food employee who was excluded or restricted as specified in subsection (b) (1) (B) or (6) (A) or who was restricted in subsection (b) (6) (B) if the person in charge obtains approval from the department and one of the following conditions is met: (A) The excluded or restricted food employee provides to the person in charge written medical documentation from a health practitioner stating that the food employee is free of an infection from Shiga toxin- producing Escherichia Coli based on test results that show two consecutive negative stool specimen cultures that are taken: (B) (C) (i) Not earlier than forty-eight hours after discontinuance of antibiotics; (ii) At least twenty-four hours apart; The food employee was excluded or restricted after symptoms of vomiting or diarrhea resolved and more than seven calendar days have passed since the food employee became asymptomatic; or The food employee was excluded or restricted and did not develop symptoms and more than seven days have passed since the food employee was diagnosed; Reinstate a food employee who was excluded as specified in subsection (b) (1) (B) or who was restricted as specified in subsection (b) (7) if the person in charge obtains approval from the department and one of the following conditions is met: (A) The excluded or restricted food employee provides to the person in charge written medical documentation from a health practitioner stating that the food employee is free of Salmonella (nontyphoidal) 50-57 §11-50-21 infection based on test results showing two consecutive negative stool specimen cultures that are taken; (i) Not earlier than forty-eight hours after discontinuance of antibiotics, and (ii) At least twenty-four hours apart; (B) The food employee was restricted after symptoms of vomiting or diarrhea resolved, and more than thirty days have passed since the food employee became asymptomatic; or (C) The food employee was excluded or restricted and did not develop symptoms and more than thirty days have passed since the food employee was diagnosed. (8) Reinstate a food employee who was excluded or restricted as specified in subsection (b) (8) (A) or (B) if the food employee provides to the person in charge written medical documentation from a health practitioner stating that the food employee meets one of the following conditions: (A) Has received antibiotic therapy for Streptococcus pyogenes infection for more than twenty-four hours; (B) Has at least one negative throat specimen culture for Streptococcus pyogenes infection; or (C) Is otherwise determined by a health practitioner to be free of a Streptococcus pyogenes infection; (9) Reinstate a food employee who was restricted as specified in subsection (b) (9) if the skin, infected wound, cut, or pustular boil is properly covered with one of the following: (A) An impermeable cover such as a finger cot or stall and a single-use glove over the impermeable cover if the infected wound or pustular boil is on the hand, finger, or wrist; (B) An impermeable cover on the arm if the infected wound or pustular boil is on the arm; or (C) A dry, durable, tight-fitting bandage if the infected wound or pustular boil is on another part of the body; 50-58 §11-50-21 (10) Reinstate a food employee who was restricted as specified in subsection (b) (10) and was exposed to one of the following pathogens as specified in subsection (a) ( 1) (D) or (E) : (A) Norovirus and one of the following conditions is met: (i) More than forty-eight hours have passed since the last day the food employee was potentially exposed; or (ii) More than forty-eight hours have passed since the food employee's household contact became asymptomatic; (B) Shigella spp. or Shiga toxin-producing Escherichia Coli and one of the following conditions is met: (i) More than three calendar days have passed since the last day the food employee was potentially exposed; or (ii) More than three calendar days have passed since the food employee's household contact became asymptomatic; (C) Typhoid fever (caused by Salmonella Typhi) and one of the following conditions is met: (i) More than fourteen calendar days have passed since the last day the food employee was potentially exposed; or (ii) More than fourteen calendar days have passed since the food employee's household contact became asymptomatic. (D) Hepatitis A virus and one of the following conditions is met: (i) The food employee is immune to hepatitis A virus infection because of a prior illness from hepatitis A; (ii) The food employee is immune to hepatitis A virus infection because of vaccination against hepatitis A; (iii) The food employee is immune to hepatitis A virus infection because of IgG administration; (iv) More than thirty calendar days have passed since the last day the food employee was potentially exposed; (v) More than thirty calendar days have passed since the food employee's household contact became jaundiced; or 50-59 §11-50-21 (vi) The food employee does not use an alternative procedure that allows bare hand contact with ready-to-eat food until at least thirty calendar days after the potential exposure, as specified in subsection (c) (10) (D) (iv) and (v), and the food employee receives additional training about hepatitis A symptoms and preventing the transmission of infection, proper handwashing procedures, and protecting ready-to-eat food from contamination introduced by bare hand contact. [Eff 2/24/2014; am and comp 9.d ] (Auth: HRS §321-11) (Imt4GtlRS 2~~1-11)