National Shellfish Sanitation Program
Guide for the Control of Molluscan Shellfish
2007

Section IV. Guidance Documents
Chapter III. Harvesting, Handling, Processing, Distribution

Guide Contents

.07 Guidance for Reinstating a Previously Infected Employee

The dealer and/or supervisor may reinstate an excluded employee under one or more of the following conditions: [K]

1. The employee is recovered from Norovirus illness and more than 24 hours have passed since the employee became completely asymptomatic, or the employee provides the dealer or supervisor with written medical documentation from a health practitioner stating that the employee is free of a Norovirus infection with one of the following:
   1. Test results show two consecutive negative stool samples taken at least 24 hours apart; or
   2. Otherwise determined by the health practitioner to be free of a Norovirus infection.
2. The employee diagnosed with an infection from Norovirus is now completely asymptomatic, and the employee provides written medical documentation from a health practitioner stating that the employee is free from Norovirus infection with one of the following:
   1. Test results show two consecutive negative stool samples taken at least 24 hours apart; or
   2. Otherwise determined by the health practitioner to be free of a Norovirus infection.
3. The employee diagnosed with an infection from Norovirus is completely asymptomatic and without medical documentation, and more than 24 hours have passed since the employee became completely asymptomatic, or the employee never developed symptoms and more than 24 hours have passed since the employee was diagnosed.
4. Except when diagnosed with an infection from Norovirus, hepatitis A virus, Salmonella typhi, Shigella spp., or Enterohemorrhagic or Shiga Toxin-producing Escherichia coli, and when the employee was excluded because of symptoms of vomiting and/or diarrhea, the employee is asymptomatic for at least 24 hours or provides the dealer and/or supervisor with written medical documentation stating the symptom is from a noninfectious condition.
5. When the employee is symptomatic with jaundice or is diagnosed with an infection from hepatitis A virus, one of the following conditions is met:
   1. The employee has been jaundiced for more than 7 calendar days;
   2. Documentation of test results from a medical practitioner is provided that show falling liver enzymes in at least two consecutive blood tests; or
   3. Documentation is provided from a health practitioner otherwise determining the employee to be free of a hepatitis A virus infection.
6. When excluded because of a diagnosis or a previous reported infection of Salmonella typhi, the employee provides written medical documentation from a health practitioner stating that the employee is free from S. typhi infection;
7. When diagnosed with an infection from Shigella spp. and completely asymptomatic, and one of the following conditions is met:
   1. The employee provides to the dealer or supervisor written medical documentation from a health practitioner stating that the employee is free of a Shigella spp. infection based on test results from 2 consecutive stool specimens taken at least 48 hours after discontinuance of antibiotics and taken at least 24 hours apart report negative findings for Shigella spp.; or
   2. Without medical documentation if all symptoms of vomiting and/or diarrhea have resolved and more than 7 calendar days have passed since the employee became completely asymptomatic, or if the employee never developed symptoms and more than 7 calendar days have passed since the diagnosis.
8. The employee of the dealer that was excluded because of a diagnosis of infection from Enterohemorrhagic or Shiga Toxin-producing Escherichia coli, the employee is completely asymptomatic and one of the following conditions is met:
   1. The employee provides written medical documentation from a health practitioner stating that the employee is free of an infection from Enterohemorrhagic or Shiga Toxin-producing Escherichia coli based on test results showing 2 consecutive negative results for Enterohemorrhagic or Shiga Toxin-producing Escherichia coli, from stool specimens occurring at least 24 hours apart, and not earlier than 48 hours after discontinuance of antibiotics; or
   2. Without medical documentation if the asymptomatic employee was excluded or restricted after symptoms of vomiting or diarrhea have resolved, and more than 7 calendar days have passed since the employee became asymptomatic, or the asymptomatic employee was excluded or restricted without ever developing symptoms, and more than 7 calendar days have passed since the employee was diagnosed.
9. For an employee of the dealer that was excluded because an illness exhibiting acute sore throat with fever symptoms, the employee provides written medical documentation from a health practitioner stating that the employee meets one of the following conditions:
   1. Employee has received antibiotic therapy for Streptococcus pyogenes infection, as determined by a health practitioner, for more than 24 hours;
   2. Employee has at least one negative throat specimen culture to Streptococcus pyogenes infection; or
   3. Employee is otherwise determined by a health practitioner to be free of a Streptococcus pyogenes infection;
10. For an employee of the dealer that was excluded because of an unprotected infected wound, cut, or pustular boil, restriction may be removed when the infected wound, cut, or pustular boil is properly covered with one of the following:
    1. A dry, durable, tight-fitting, impermeable bandage and a single-use glove is worn over the impermeable cover on the hand, finger or wrist;
    2. A dry, durable, tight-fitting, impermeable bandage is worn over the wound on the arm; or
    3. A dry, durable, tight-fitting, impermeable bandage, is worn over the wound on other parts of the body.
11. For an employee of the dealer that was excluded because of exposure to a known foodborne pathogen, restriction may be removed as follows:
    1. If exposed to Norovirus, one of the following conditions is met:
       1. More than 24 hours have passed since the last day the employee was potentially exposed, or
       2. More than 24 hours have passed since the employee's household contact became asymptomatic.
    2. If exposed to Shigella spp., or Enterohemorrhagic or Shiga Toxin-producing Escherichia coli, one of the following conditions are met:
       1. More than 3 calendar days have passed since the last day the employee was potentially exposed, or
       2. More than 3 calendar days have passed since the employee's household contact became asymptomatic;
    3. If exposed to S. typhi, one of the following conditions are met:
       1. More than 14 calendar days have passed since the last day the employee was potentially exposed, or
       2. More than 14 calendar days have passed since the employee's household contact became asymptomatic;
    4. If exposed to hepatitis A virus, one of the following conditions are met:
       1. More than 30 calendar days have passed since the last day the employee was potentially exposed, or
       2. More than 30 calendar days have passed since the employee's household contact became jaundiced.