Food Code Adoption

At a glance

This study described state-level adoption of provisions in the Food Code related to preventing foodborne norovirus outbreaks. We examined state and District of Columbia food codes to determine which states had adopted these provisions. We also used data from CDC's National Outbreak Reporting System to see how many foodborne norovirus outbreaks occurred from 2009 through 2014. Learn about key provisions from the Food Code that may contribute to lower rates of foodborne norovirus outbreaks.

Restaurant server handing guests their meals.

Key takeaways

States that adopted key provisions from the Food Code had lower rates of foodborne norovirus outbreaks. These provisions require restaurants, delis, caterers, and others to:

  • Exclude sick staff for at least 24 hours after symptoms have gone away
  • Have a certified food protection manager (manager who has passed a test to show knowledge of food safety)
  • Prohibit food workers from touching ready-to-eat food with bare hands (bare-hand contact). Ready-to-eat food can be served without washing, cooking, or other preparation

Why this is important

Norovirus is the leading cause of foodborne disease outbreaks in the United States. The Food Code is designed to help prevent outbreaks of pathogens like norovirus, but state and local governments must decide if they will adopt any of the provisions.

We did this study to find out which states adopted key provisions of the Food Code and whether states that adopted those provisions had lower rates of outbreaks.

The Food Code‎

The Food Code is published by the Food and Drug Administration (FDA). It contains science-based guidance to improve food safety in restaurants, delis, caterers, and others. States, tribes, localities, and territories can use it as a model for their own food safety rules for these establishments.

What we learned

States that adopted three specific provisions of the Food Code had lower rates of foodborne norovirus outbreaks per million person-years than states without these provisions.

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Chart showing adoption of Food Code provision
States that adopted key provisions from the Food Code had lower rates of foodborne norovirus outbreaks

States that adopted the Food Code provision to exclude sick staff had lower rates of foodborne norovirus outbreaks per million person-years (0.44) than states without the provision (0.73). States that adopted the Food Code provision to require a certified food protection manager had lower rates of foodborne norovirus outbreaks per million person-years (0.38) than states without the provision (0.75). States that adopted the Food Code provision to prohibit bare-hand contact had lower rates of foodborne norovirus outbreaks per million person-years (0.45) than states without the provision (0.74).

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More information

Journal article this plain language summary is based on

More practice summaries and investigation summaries in plain language

CDC National Outbreak Reporting System

CDC Norovirus

FDA Food Code

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Content Source:
National Center for Environmental Health