[Federal Register Volume 68, Number 215 (Thursday, November 6, 2003)]
[Notices]
[Pages 62809-62810]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-27923]


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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), 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, 
Pub. L. 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); September 
22, 1997 (62 FR 49518-9); September 15, 1998 (63 FR 49359), September 
21, 1999 (64 FR 51127); September 27, 2000 (65 FR 58088), September 10, 
2001 (66 FR 47030), and September 27, 2002 (67 FR 61109). The final 
list has been reviewed in light of new information and has been revised 
as set forth below.

EFFECTIVE DATE: November 6, 2003.

FOR FURTHER INFORMATION CONTACT: Dr. Art 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. 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 27, 2002 (67 FR 
61109), new information has been reviewed and added. Norwalk and 
Norwalk-like viruses, previously listed in Part l, are now identified 
as Noroviruses so as to conform with current scientific nomenclature.

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

[[Page 62810]]

in the spread of these pathogens. Pathogens that can cause diseases 
after an infected person handles food are the following:

Noroviruses
Hepatitis A virus
Salmonella Typhi*
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    * 1. Kauffmann-White scheme for designation of Salmonella 
serotypes
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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
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: October 31, 2003.
Joseph R. Carter,
Deputy Chief Operating Officer, Centers for Disease Control and 
Prevention (CDC).
[FR Doc. 03-27923 Filed 11-5-03; 8:45 am]
BILLING CODE 4163-18-P