[Federal Register Volume 63, Number 178 (Tuesday, September 15, 1998)]
[Notices]
[Pages 49359-49360]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-24660]


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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), 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 49518-9). The final list has been 
reviewed in light of new information and has been revised as set forth 
below.

EFFECTIVE DATE: September 15, 1998.

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 A-38, Atlanta, Georgia 30333, 
telephone (404) 639-2206.

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 22, 1997 (62 FR 49518), new 
information has been reviewed. Two reports on probable transmission of 
Cryptosporidium parvum by infected food workers form the basis for 
adding it to the list of infectious and communicable diseases. As is 
true for two other parasitic foodborne pathogens, Giardia lamblia and 
Taenia solium, transmission of Cryptosporidium parvum from infected 
food workers through contamination of food is believed to be uncommon; 
therefore, Cryptosporidium parvum is being added to Part II. In 
addition, Norwalk and Norwalk-like viruses, previously listed in Part 
I, are now identified as Caliciviruses.

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.


[[Page 49360]]


    Dated: September 9, 1998.
Thena M. Durham,
Acting Associate Director for Management and Operations Centers for 
Disease Control and Prevention (CDC).
[FR Doc. 98-24660 Filed 9-14-98; 8:45 am]
BILLING CODE 4163-18-P