Outbreaks and Certified Managers

For Public Health

At a glance

We looked at how restaurant traits (for example, number of meals served), policies, and practices were linked to foodborne illness outbreaks and to sick food workers as the cause of outbreaks. Explore our findings on restaurants with kitchen managers certified in food safety.

Kitchen manager with staff members in front of a counter full of plated food.

Key takeaways

Our research showed that restaurants with kitchen managers certified in food safety were less likely to have outbreaks of foodborne illness. Restaurant managers can reduce their risk of outbreaks by requiring kitchen managers to pass a food safety certification exam.

More research is needed to find out how to reduce outbreaks caused by sick food workers. In the meantime, restaurants should stress the importance of managing illness of food workers.

Why this is important

Each year, the United States reports approximately 800 outbreaks of foodborne illness. We need to know the causes of foodborne illness outbreaks so we can prevent future ones. This study focused on restaurants because they are the most common place for outbreaks to occur.

What we learned

Our study found that restaurants with kitchen managers certified in food safety were less likely to have foodborne illness outbreaks.

Restaurant traits linked to outbreaks

Outbreak and nonoutbreak restaurants were similar on these traits:

  • Ownership (chain vs. independent)
  • Number of meals served
  • Food safety training
  • Language barriers
  • Sick leave pay
  • Policies to keep sick workers from working

Outbreak restaurants were less likely to have:

  • A certified kitchen manager (CKM)A on staff
  • Food safety certification training provided by a state or local agency
  • Food safety certification training provided by a restaurant corporation

Outbreak restaurants were more likely to be:

  • Sit-down restaurants
  • Classified as ethnic restaurants

Outbreak restaurants with CKMs were less likely than outbreak restaurants without CKMs to have had outbreaks:

  • Of norovirus and Clostridium perfringens
  • Caused by workers touching food with their bare hands

Within outbreak restaurants, CKMs were more likely than other managers to be familiar with the Hazard Analysis Critical Control Point (HACCP)B system. All CKMs were familiar with the HACCP food safety system recommended by the U.S. Food and Drug Administration. Twenty percent of other managers were familiar with HACCP.

Restaurant traits linked to sick food workers

Kitchen manager certification, sick leave pay, and policies to keep sick workers from working did not lower rates of sick workers as a cause of outbreaks.

CKMs are linked to restaurants with fewer outbreaks

Graph showing differences in restaurants with outbreaks
CKMs in restaurants make a difference

Twenty percent of norovirus outbreaks occurred in restaurants with a certified kitchen manager (CKM); 80% occurred in restaurants without a CKM.

No C. perfringens outbreaks occurred in restaurants with a CKM; 100% occurred in restaurants without a CKM.

Bare-hand contact with food was not a contributing factor in any outbreaks in restaurants with a CKM. It was a contributing factor in 47% of outbreaks in restaurants without a CKM.

More information

About this study

This study was conducted by the Environmental Health Specialists Network (EHS-Net). EHS-Net is a federally funded collaboration of federal, state, and local environmental health specialists and epidemiologists working to better understand the environmental causes of foodborne illness.
Content Source
National Center for Environmental Health
About This Page
Published: May 15, 2024
Updated: August 20, 2026

This page was last updated on this date. Updates may include minor edits, image changes, or other modifications to page content.

Reviewed: August 20, 2026

The information on this page was last reviewed by subject matter experts to ensure accuracy.

  1. Certified kitchen manager: Manager who passed a test to show knowledge of food safety.
  2. HACCP: A seven-step approach to identify and manage food-safety hazards.