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###### Department of Health and Human Services

###### Centers for Disease Control and Prevention 

# 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. 

# 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), September 27, 2002 (67 FR 61109) and November 6, 2003 (68 FR 62809). No new information that would warrant additional changes has been received; therefore the list, as set forth in the last update and below, remains unchanged. 

# EFFECTIVE DATE:

October 4, 2004. 

# 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 November 6, 2003 (68 FR 62809), CDC has received no information to indicate that additional unlisted diseases are transmitted through handling the food supply. Therefore, the list set forth below is unchanged from                           ( print page 59238)                        the list published in the                     **Federal Register**                     on November 6, 2003.                 

## 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:

Noroviruses 

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*

*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: September 24, 2004. 

James D. Seligman, 

Associate Director for Program Services, Centers for Disease Control and Prevention (CDC). 

# Footnotes

*.                             Kauffmann-White scheme for designation of Salmonella serotypes                    
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[FR Doc. 04-22260 Filed 10-1-04; 8:45 am] 

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