According to the Danish food agency, there is still uncertainty among chefs and kitchen workers about the management of norovirus.

A Danish Veterinary and Food Administration (Fødevarestyrelsen) control and guidance campaign targeted restaurants, kitchens, and shops that supply ready-to-eat (RTE) food. Work involved 829 visits from June to November 2023.

The agency asked kitchen managers what steps they should take to prevent outbreaks. Some said they were unsure how far they could go concerning an employee’s illness and health.

Scale of issue
Norovirus is the most common cause of foodborne outbreaks in Denmark. The campaign focused on companies’ training of employees regarding personal hygiene, guidance on staff notification, and employer obligations to avoid contamination with foodborne viruses.

Danish officials said that if outbreaks are to be prevented and reduced, kitchen staff and company managers need to have the necessary knowledge to operate in a hygienically correct manner and in a way that minimizes the risk of food contamination with norovirus, as well as enabling them to act responsibly if an incident occurs, by informing management.

“Several kitchen managers have replied that they have not yet introduced procedures for handling norovirus and have not instructed employees in what to do if they are affected by norovirus,” said Lene Mølsted Jensen from the Danish Veterinary and Food Administration.

“Because a sick employee can be a danger to food safety, the kitchen manager can inquire about the symptoms if the employee reports being sick with an upset stomach, just as the employee also must inform the boss about an upset stomach.”

Results showed that all visited companies had sufficient procedures around personal hygiene, including the behavior of employees in connection with symptoms of norovirus, so no sanctions were applied.

However, the fact that there were 20 outbreaks with 790 cases in 2021 and 2022 points to a difference between these findings and the companies’ actions in daily operations. The Danish Veterinary and Food Administration said detecting issues with a single pre-announced inspection can be difficult.

Main control findings
On two occasions, inspectors found sites did not have the necessary facilities for employees to maintain a high level of personal hygiene. In both cases, there was a lack of handwashing facilities.

Over half of the questionnaire respondents were unaware that General Data Protection Regulation (GDPR) rules do not prevent them from asking about an employee’s possible symptoms.

Less than half of the participants knew about a guide from the Danish Veterinary and Food Administration with advice on avoiding infecting consumers with norovirus.

More than 60 percent of companies use the Danish Veterinary and Food Administration as their primary source of information when looking for advice in the event of a suspected incident. Other sources include industry organizations and consultants.

In 2019, 2020, and 2021, outbreaks resulting from infection with norovirus represented 37 percent, 17 percent, and 22 percent, respectively, of all registered foodborne outbreaks. The number of confirmed norovirus outbreaks increased to 14 in 2021 from six in 2020.

The Danish Veterinary and Food Administration repeated bits of a control campaign from 2020/2021. The initiative is part of efforts against foodborne viruses from January 2019 to December 2023, alongside the agency’s strategy and goal of fewer people getting sick from food.

Similar work in 2022 revealed kitchen staff and food companies lacked knowledge about how foodborne viruses such as norovirus are transmitted and how to avoid passing the infection on to customers and colleagues.

Norovirus can spread through sick people, contaminated surfaces, or contaminated food and water. A person usually develops symptoms 12 to 48 hours after being exposed. Most people with norovirus illness get better within 1 to 3 days, but they can still spread the virus for another few days. Kitchen workers should stay away from work for at least 48 hours after symptoms have passed.