United States
Hong KongThe Big 6: the illnesses a food worker has to report
Norovirus, Hepatitis A, Shigella, Shiga toxin-producing E. coli, Salmonella Typhi and non-typhoidal Salmonella. A food employee diagnosed with any of them must report it to the person in charge, who reports to the regulatory authority.
Six pathogens, singled out from the hundreds that cause foodborne illness, because each one spreads readily from an infected worker to food and from food to a lot of people.
That is the whole selection criterion, and it explains the list better than memorizing it does.
| Pathogen | Typically from | Worth knowing |
|---|---|---|
| Norovirus | Infected workers, ready-to-eat food, shellfish | Extremely infectious. Survives many sanitizers, which is why the vomit clean-up procedure is its own Code provision |
| Hepatitis A | Infected workers, shellfish, produce | Causes jaundice. A vaccine exists, and the incubation period runs to weeks |
| Shigella | Infected workers, flies, ready-to-eat food | A very small dose is enough. Handwashing is the whole control |
| Shiga toxin-producing E. coli | Undercooked ground beef, produce, unpasteurized milk | The reason ground meat cooks to 68°C (155°F) rather than 63°C (145°F) |
| Salmonella Typhi | Infected workers, contaminated water | Causes typhoid fever. Rare in the US and still on the list |
| Non-typhoidal Salmonella | Poultry, eggs, produce | The one added later. A list of five is out of date |
Why ground beef is different
Whole muscle is essentially sterile inside. Sear the outside and you have addressed the surface, where the bacteria were.
Grinding takes that surface and mixes it all the way through, so there is no inside left to rely on. Hence 155°F for ground meat against 145°F for a steak - the same temperature logic the storage order uses.
What a manager actually does
- A worker diagnosed with any of the six is excluded from the establishment.
- The person in charge notifies the regulatory authority.
- Return to work involves that authority, not just a clear day.
- A worker with vomiting or diarrhoea is excluded regardless of whether anyone has diagnosed anything.
The Big 6 list is about diagnoses. The exclusion rules for vomiting, diarrhoea and jaundice apply to symptoms with no diagnosis at all. Questions mix the two deliberately, and the answer changes depending on which the scenario describes.
Norovirus and the clean-up plan
The Food Code requires a written procedure for cleaning up vomiting and diarrhoeal events. Written, meaning it exists before the event rather than being improvised during it.
The reason is norovirus. A vomiting incident aerosolizes virus particles across a wide area, the infectious dose is tiny, and ordinary quaternary ammonium sanitizer is not reliable against it. That is why the plan specifies a chlorine-based product, protective equipment, containment of the area and disposal of exposed food.
The others worth recognizing
Not reportable, but examinable: Clostridium perfringens from food cooled or held badly in large batches, Bacillus cereus from rice held at room temperature, Listeria which grows in the cold and is why date marking exists, Clostridium botulinum behind the rules on reduced-oxygen packaging, and Staphylococcus aureus from bare-hand contact.
Each of those maps onto a rule you are already learning. Learning the pathogen alongside the rule makes both stick.
Common questions
What are the Big 6 foodborne illnesses?
Norovirus, Hepatitis A, Shigella, Shiga toxin-producing E. coli, Salmonella Typhi and non-typhoidal Salmonella. They are singled out because each spreads readily from an infected food worker to a large number of people.
Why is non-typhoidal Salmonella on the list?
It was added after the original five, which is why a lot of circulating study material still says Big 5. If your source lists five, it predates the change and is worth replacing.
What must a worker do if diagnosed with one?
Report the diagnosis to the person in charge, who reports it to the regulatory authority. The worker is excluded from the establishment, and return to work involves the authority rather than simply feeling better.
Why does norovirus need a special clean-up procedure?
A vomiting event aerosolizes virus over a wide area, the infectious dose is very small, and quaternary ammonium sanitizer is unreliable against it. The Food Code requires the written procedure to exist before an event, not after.
Why does ground beef cook hotter than steak?
Grinding mixes surface bacteria through the whole product, so there is no sterile interior to rely on. Ground meat cooks to 68°C (155°F) against 63°C (145°F) for a whole cut.