410 IAC 7-26-139 Removal of exclusions and restrictions

Sec. 139. (a) 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 under section 138(a)(1)(A) of this rule if the food employee: (i) is asymptomatic for at least twenty-four (24) hours; or (ii) provides to the person in charge written medical documentation from a 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 under section 138(a)(1)(B) of this rule: (i) restrict the food employee, who is asymptomatic for at least twenty-four (24) hours and works in a retail food establishment not serving a highly susceptible population, until the conditions for reinstatement specified under subdivision (4)(A) or (4)(B) are met; or (ii) retain the exclusion for the food employee, who is asymptomatic for at least twenty-four (24) hours and works in a retail food establishment that serves a highly susceptible population, until the conditions for reinstatement as specified under subdivision (4)(A) or (4)(B) are met; (C) if a food employee was diagnosed with an infection from Shigella spp. and excluded as specified under section 138(a)(1)(B) of this rule: (i) restrict the food employee, who is asymptomatic for at least twenty-four (24) hours and works in a retail food establishment not serving a highly susceptible population, until the conditions for reinstatement as specified under subdivision (5)(A) or (5)(B) are met; or (ii) retain the exclusion for the food employee, who is asymptomatic for at least twenty-four (24) hours and works in a retail food establishment that serves a highly susceptible population, until the conditions for reinstatement as specified under subdivision (5)(A) or (5)(B) are met; (D) if a food employee was diagnosed with an infection from STEC and excluded as specified under section 138(a)(1)(B) of this rule: (i) restrict the food employee, who is asymptomatic for at least twenty-four (24) hours and works in a retail food establishment not serving a highly susceptible population, until the conditions for reinstatement as specified under subdivision (6)(A) or (6)(B) are met; or (ii) retain the exclusion for the food employee, who is asymptomatic for at least twenty-four (24) hours and works in a retail food establishment that serves a highly susceptible population, until the conditions for reinstatement as specified under subdivision (6)(A) or (6)(B) are met; or (E) if a food employee was diagnosed with an infection from Salmonella (nontyphoidal) and excluded as specified under section 138(a)(1)(B) of this rule: (i) restrict the food employee, who is asymptomatic for at least thirty (30) days until the conditions for reinstatement as specified in subdivision (7)(A) or (7)(B) are met; or (ii) retain the exclusion for the food employee who is symptomatic, until conditions for reinstatement as specified under subdivision (7)(A) or (7)(B) are met. (2) Reinstate a food employee with a hepatitis A virus or jaundice diagnosis, who was excluded as specified under section 138(a)(2) of this rule, if the person in charge obtains approval from the regulatory authority and one (1) of the following conditions is met: (A) The food employee has been jaundiced for more than seven (7) calendar days. (B) The anicteric food employee has been symptomatic with symptoms other than jaundice for more than fourteen (14) calendar days. (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. (3) Reinstate a food employee with typhoid fever who was excluded as specified under section 138(a)(3) of this rule if: (A) the person in charge obtains approval from the regulatory authority; and (B) 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. (4) Reinstate a food employee with a norovirus diagnosis who was excluded as specified under section 138(a)(1)(B) or 138(a)(4)(A) of this rule, or restricted under section 138(a)(4)(B) of this rule, if the person in charge obtains approval from the regulatory authority and one (1) 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 norovirus infection. (B) The food employee was excluded or restricted after symptoms of vomiting or diarrhea resolved, and more than forty-eight (48) hours have passed since the food employee became asymptomatic. (C) The food employee was excluded or restricted and did not develop symptoms, and more than forty-eight (48) hours have passed since the food employee was diagnosed. (5) Reinstate a food employee with a Shigella spp. diagnosis who was excluded as specified under section 138(a)(1)(B) or 138(a)(5)(A) of this rule, or restricted under section 138 (a)(5)(B) of this rule, if the person in charge obtains approval from the regulatory authority and one (1) 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 (2) consecutive negative stool specimen cultures that are taken: (i) not earlier than forty-eight (48) hours after discontinuing antibiotics; and (ii) at least twenty-four (24) hours apart. (B) The food employee was excluded or restricted after symptoms of vomiting or diarrhea resolved, and more than seven (7) calendar days have passed since the food employee became asymptomatic. (C) The food employee was excluded or restricted and did not develop symptoms, and more than seven (7) calendar days have passed since the food employee was diagnosed. (6) Reinstate a food employee with a STEC diagnosis who was excluded or restricted as specified under section 138(a)(1)(B) or 138(a)(6)(A) of this rule, or restricted under section 138(a)(6)(B) of this rule, if the person in charge obtains approval from the regulatory authority and one (1) 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 STEC based on test results showing two (2) consecutive negative stool specimen cultures that are taken: (i) not earlier than forty-eight (48) hours after discontinuing antibiotics; and (ii) at least twenty-four (24) hours apart. (B) The food employee was excluded or restricted after symptoms of vomiting or diarrhea resolved, and more than seven (7) calendar days have passed since the food employee became asymptomatic. (C) The food employee was excluded or restricted and did not develop symptoms, and more than seven (7) days have passed since the food employee was diagnosed. (7) Reinstate a food employee diagnosed with Salmonella (nontyphoidal) who was excluded as specified under section 138(a)(1)(B) of this rule, or restricted as specified in section 138(a)(7) of this rule, if the person in charge obtains approval from the regulatory authority and one (1) 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 Salmonella (nontyphoidal) infection based on test results showing two (2) consecutive negative stool specimen cultures that are taken: (i) not earlier than forty-eight (48) hours after discontinuing antibiotics; and (ii) at least twenty-four (24) hours apart. (B) The food employee was restricted after symptoms of vomiting or diarrhea resolved, and more than thirty (30) days have passed since the food employee became asymptomatic. (C) The food employee was excluded or restricted and did not develop symptoms, and more than thirty (30) days have passed since the food employee was diagnosed. (8) Reinstate a food employee with a sore throat with fever who was excluded or restricted as specified under section 138(a)(8)(A) or 138(a)(8)(B) of this rule if the food employee provides to the person in charge written medical documentation from a health practitioner stating that the food employee meets one (1) of the following conditions: (A) Has received antibiotic therapy for Streptococcus pyogenes infection for more than twenty-four (24) hours. (B) Has at least one (1) negative throat specimen culture for Streptococcus pyogenes infection. (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 under section 138(a)(9) of this rule if the skin, infected wound, cut, or pustular boil is properly covered with one (1) 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. (C) A dry, durable, tight fitting bandage if the infected wound or pustular boil is on another part of the body. (10) An employee who works in a retail food establishment serving a highly susceptible population that was restricted due to the condition specified under section 138(a)(10) of this rule may be reinstated when: (A) After the food employee was exposed to norovirus: (i) more than forty-eight (48) hours have passed since the last day the food employee was potentially exposed; or (ii) more than forty-eight (48) hours have passed since the food employee's household contact became asymptomatic. (B) After the food employee was exposed to Shigella spp. or STEC: (i) more than three (3) calendar days have passed since the last day the food employee was potentially exposed; or (ii) more than three (3) calendar days have passed since the food employee's household contact became asymptomatic. (C) After the food employee was exposed to typhoid fever (caused by Salmonella Typhi): (i) more than fourteen (14) calendar days have passed since the last day the food employee was potentially exposed; or (ii) more than fourteen (14) calendar days have passed since the food employee's household contact became asymptomatic. (D) After the food employee was exposed to hepatitis A virus: (i) the food employee is immune to hepatitis A virus infection because of a previous 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 immunoglobulin G (IgG) administration; (iv) more than thirty (30) calendar days have passed since the last day the food employee was potentially exposed; (v) more than thirty (30) calendar days have passed since the food employee's household contact became jaundiced; or (vi) the food employee does not use an alternative procedure that allows bare hand contact with ready-to-eat food until at least thirty (30) days after the potential exposure, as specified in items (iv) and (v), and the food employee receives additional training about: (AA) hepatitis A symptoms and preventing the transmission of infection; (BB) proper handwashing procedures; and (CC) protecting ready-to-eat food from contamination introduced by bare hand contact. (b) For purposes of this section, a violation of subsection (a) is a P item.