SECTION 310:257-3-6. Removal, adjustment, or retention of exclusions and restrictions

(a)   Managing exclusions or restrictions. The person in charge shall adhere to the following conditions when removing, adjusting, or retaining the exclusion or restriction of a food employee:

(1)   Conditions for diagnosis other than hepatitis A virus, or Salmonella. Except when a food employee is diagnosed with an infection from hepatitis A virus or Salmonella:

(A)   Removing exclusion for food employee who was symptomatic and not diagnosed. Reinstate a food employee who was excluded as specified in OAC 310:257-3-5(a)(1)(A) if the food employee:

(i)   Is asymptomatic; or

(ii)   Provides to the person in charge written medical documentation from a health practitioner that states the symptom is from a noninfectious condition.

(B)   Norovirus diagnosis. If a food employee was diagnosed with an infection from Norovirus and excluded as specified in OAC 310:257-3-5(a)(1)(B):

(i)   Adjusting exclusion for food employee who was symptomatic and is now asymptomatic. Restrict the food employee, who is asymptomatic for at least twenty-four (24) hours and works in a food service establishment not serving a highly susceptible population, until the conditions for reinstatement as specified in (a)(4)(A) or (a)(4)(B) of this Section are met; or

(ii)   Retaining exclusion for food employee who was asymptomatic and is now asymptomatic and works in food establishment serving highly susceptible population. Retain the exclusion for the food employee, who is asymptomatic for at least twenty-four (24) hours and works in a food establishment that serves a highly susceptible population, until the conditions for reinstatement as specified in (a)(4)(A) or (a)(4)(B) of this Section are met:

(C)   Shigella spp. diagnosis. If a food employee was diagnosed with an infection from Shigella spp. and excluded as specified in OAC 310:257-3-5(a)(1)(B):

(i)   Adjusting exclusion for food employee who was symptomatic and is now asymptomatic. Restrict the food employee, who is asymptomatic for at least twenty-four (24) hours and works in a food service establishment not serving a highly susceptible population, until the conditions for reinstatement as specified in (a)(5)(A) or (a)(5)(B) of this Section are met; or

(ii)   Retaining exclusion for food employee who was asymptomatic and is now asymptomatic. Retain the exclusion for the food employee who is asymptomatic for at least twenty-four (24) hours and works in a food establishment that serves a highly susceptible population, until the conditions for reinstatement as specified in (a)(5)(A) or (a)(5)(B) of this Section, or (a)(5)(A) and (a)(3)(A) of this Section are met.

(D)    STEC diagnosis. If a food employee was diagnosed with an infection from Shiga toxin-producing Escherichia coli (STEC) and excluded as specified under OAC 310:257-3-5(a)(1)(B):

(i)   Adjusting exclusion for food employee who was symptomatic and is now asymptomatic. Restrict the food employee, who is asymptomatic for at least twenty-four (24) hours and works in a food establishment not serving a highly susceptible population, until the conditions for reinstatement as specified in (a)(6)(A) or (a)(6)(B) of this Section are met; or

(ii)   Retaining exclusion for food employee who was asymptomatic and is now asymptomatic and works in food establishment serving highly susceptible population. Retain the exclusion for the food employee, who is asymptomatic for at least twenty-four (24) hours and works in a food establishment that serves a highly susceptible population, until the conditions for reinstatement as specified in (a)(6)(A) or (a)(6)(B) of this Section are met.

(2)   Hepatitis A virus or jaundice diagnosis - removing exclusions. Reinstate a food employee who was excluded as specified in OAC 310:257-3-5(a)(2) if the person in charge obtains approval from the Department and one of the following conditions are met;

(A)   Jaundiced for more than seven (7) days. The food employee has been jaundiced for more than seven (7) calendar days;

(B)   Symptoms other than jaundice. The anicteric food employee has been symptomatic with symptoms other than jaundice for more than fourteen (14) calendar days; or

(C)   Medical documentation - free of hepatitis A virus. The food employee provides to the person in charge written medical documentation from a health practitioner stating that the food employee is free of hepatitis A virus infection.

(3)   Salmonella diagnosis - removing exclusions. Reinstate a food employee who was excluded as specified in OAC 310:257-3-5(a)(3) if:

(A)   Approval from Department. The person in charge obtains approval from the Department; and

(B)   Medical documentation - free from Salmonella. The food employee provides to the person in charge written medical documentation from a health practitioner that states the food employee is free from Salmonella infection.

(4)   Norovirus diagnosis - removing exclusion or restriction. Reinstate a food employee who was excluded as specified in OAC 310:257-3-5(a)(1)(B) or OAC 310:257-3-5(a)(4)(A) who was restricted under OAC 310:257-3-5(a)(4)(B) if the person in charge obtains approval from the Department and one of the following conditions are met:

(A)   Written medical documentation - free of Norovirus. The excluded or restricted food employee provides to the person in charge written medical documentation from a health practitioner or public health official stating that the food employee is free of a Norovirus infection;

(B)   Symptoms resolved and more than seventy-two (72) hours. The food employee was excluded or restricted after symptoms of vomiting or diarrhea resolved, and more than seventy-two (72) hours have passed since the food employee became asymptomatic; or

(C)   Excluded or restricted food employee did not develop symptoms and more than seventy-two (72) hours have passed since diagnosis. The food employee was excluded or restricted and did not develop symptoms and more than seventy-two (72) hours have passed since the food employee was diagnosed.

(5)   Shigella spp. diagnosis - removing exclusion or restriction. Reinstate a food employee who was excluded as specified in OAC 310:257-3-5(a)(1)(B) or OAC 310:257-3-5(a)(5)(A) or who was restricted in OAC 310:257-3-5(a)(5)(B) if the person in charge obtains approval from the Department and one of the following conditions is met:

(A)   Written medical documentation - free of Shigella spp. The excluded or restricted food employee provides to the person in charge written medical documentation from a health practitioner or public health official stating that the food employee is free of a Shigella spp. infection based on test results showing two (2) consecutive negative stool specimen cultures that are taken:

(i)   Not earlier than forty-eight (48) hours after discontinuance of antibiotics, and

(ii)   At least twenty-four (24) hours apart;

(B)   Symptoms resolved - more than four (4) days passed. The food employee was excluded or restricted after symptoms of vomiting or diarrhea resolved, and more than four (4) calendar days have passed since the food employee became asymptomatic; or

(C)   Excluded or restricted food employee did not develop symptoms and more than four (4) days passed since diagnosis. The food employee was excluded or restricted and did not develop symptoms and more than four (4) calendar days have passed since the food employee was diagnosed.

(6)    STEC diagnosis - removing exclusion or restriction. Reinstate a food employee who was excluded or restricted as specified in OAC 310:257-3-5(a)(1)(B) or OAC 310:257-3-5(a)(6)(A) or who was restricted in OAC 310:257-3-5(a)(6)(B) if the person in charge obtains approval from the Department and one of the following conditions is met:

(A)   Written medical documentation - free of infection. The excluded or restricted food employee provides to the person in charge written medical documentation from a health practitioner or public health official stating that the food employee is free of an infection from Shiga toxin-producing Escherichia coli (STEC) based on test results that show 2 consecutive negative stool specimen cultures that are taken:

(i)   Not earlier than forty-eight (48) hours after discontinuance of antibiotics; and

(ii)   At least twenty-four (24) hours apart;

(B)   Symptoms resolved - more than ten (10) days passed. The food employee was excluded or restricted after symptoms of vomiting or diarrhea resolved and more than ten (10) calendar days have passed since the food employee became asymptomatic; or

(C)   Excluded or restricted employee did not develop symptoms and more than ten (10) days passed since diagnosis. The food employee was excluded or restricted and did not develop symptoms and more than ten (10) days have passed since the food employee was diagnosed.

(7)   Sore throat with fever - removing exclusion or restriction. Reinstate a food employee who was excluded or restricted as specified in OAC 310:257-3-5(a)(7)(A) or OAC 310:257-3-5(a)(7)(B) if the food employee provides to the person in charge written medical documentation from a health practitioner stating that the food employee meets one of the following conditions:

(A)   Has received antibiotic therapy for Streptococcus infection for more than twenty-four (24) hours;

(B)   Has at least one (1) negative throat specimen culture for Streptococcus infection; or

(C)   Is otherwise determined by a health practitioner to be free of a Streptococcus infection.

(8)   Uncovered infected wound or pustular boil - removing restriction. Reinstate a food employee who was restricted as specified in OAC 310:257-3-5(a)(8) if the skin, infected wound, cut, or pustular boil is properly covered with one of the following:

(A)   Impermeable cover - hand, finger, or wrist. An impermeable cover such as a finger cot or stall and a single-use glove over the impermeable cover if the infected wound or pustular boil is on the hand, finger, or wrist;

(B)   Impermeable cover - arm. An impermeable cover on the arm if the infected wound or pustular boil is on the arm; or

(C)   Impermeable cover - other parts of body. A dry, durable, tight-fitting bandage if the infected wound or pustular boil is on another part of the body.

(9)   Exposure to foodborne pathogen and works in food establishment serving highly susceptible population - removing restriction. Reinstate a food employee who was restricted as specified in OAC 310:257-3-5(a)(9) and was exposed to one of the following pathogens as specified in OAC 310:257-3-4(a)(4) or OAC 310:257-3-4(a)(5):

(A)   Norovirus. Norovirus and one of the following conditions is met:

(i)   More than seventy-two (72) hours have passed since the last day the employee was potentially exposed; or

(ii)   More than seventy-two (72) hours have passed since the food employee's household contact became asymptomatic or was deemed no longer communicable by a public health official.

(B)   Shigella spp., STEC. Shigella spp. or Shiga toxin-producing Escherichia coli (STEC) and one of the following conditions is met:

(i)   More than four (4) calendar days for Shigella, or more than ten (10) calendar days for STEC, have passed since the last day the food employee was potentially exposed; or

(ii)   More than four (4) calendar days for Shigella, or more than ten (10) calendar days for STEC, have passed since the food employee's household contact became asymptomatic.

(C)   Salmonella spp. Salmonella spp., with the exception of Salmonella Typhi, and one (1) of the following conditions is met:

(i)   More than three (3) calendar days have passed since the last day the food employee was potentially exposed; or

(ii)   More than three (3) calendar days have passed since the food employee's household contact was deemed no longer communicable by the Department.

(D)   Hepatitis A virus. Hepatitis A virus and one of the following conditions is met:

(i)   The food employee is immune to the hepatitis A virus infection because of a prior illness from hepatitis A;

(ii)   The food employee is immune to hepatitis A virus infection because of vaccination against hepatitis A;

(iii)   The food employee is immune to hepatitis A virus infection because of receipt of anti-hepatitis A immunoglobulin or hepatitis A vaccine within fourteen (14) days of exposure;

(iv)   More than fifty (50) calendar days have passed since the last day the food employee was potentially exposed;

(v)   More than fifty (50) calendar days have passed since the food employee's household contact became jaundiced or is deemed no longer communicable by a public health official; or

(vi)   The food employee does not use an alternative procedure that allows bare hand contact with ready-to-eat food until at least fifty (50) days after the potential exposure, as specified in (a)(9)(D)(iv) and (a)(9)(D)(v) of this Section, and the food employee receives additional training about:

(I)   Hepatitis A symptoms and preventing the transmission of infection,

(II)   Proper handwashing procedures, and

(III)   Protecting ready-to-eat food from contamination introduced by bare hand contact.

(b)   Availability of educational materials. The Department shall make available educational materials, forms, and decision trees or algorithms to assist license holders, persons in charge, employees and health care practitioners in determining when a food employee exclusion or restriction should be removed, adjusted, or retained.

[Source: Added at 23 Ok Reg 2358, eff 6-25-06; Amended at 28 Ok Reg 2289, eff 11-1-11; Amended at 33 Ok Reg 1520, eff 9-11-16]