The Vomiting Chef
A 24-year-old commis chef at a 60-cover restaurant reports for the Saturday evening shift at 16:00. At 15:40 he had vomited once in the staff toilet and now feels 'a bit off' but says he can work. He has no fever, no diarrhoea, and no recent travel. He prepared raw chicken earlier that week and handles salads and garnishes for plating. The head chef is short-staffed: two other kitchen staff called in sick, and the restaurant is fully booked. The chef has not told anyone else about the vomiting. The kitchen has a handwash basin but the soap dispenser is empty and staff have been using the basin to fill jugs.
1. Advise the head chef on whether the commis should work this shift. Justify your answer by reference to fitness-to-work principles and the specific risks in this kitchen.
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He should not work with open food. Vomiting is a symptom that requires exclusion from food handling until 48 hours after symptoms have stopped. Even a single episode, with no fever or diarrhoea, meets the threshold for exclusion because viral gastroenteritis (norovirus) can be shed before and after symptoms, and the infectious dose is very low.
Why the risk is high here:
- He handles ready-to-eat salads and garnishes - no further cooking step to kill pathogens.
- The soap dispenser is empty and the basin is used for filling jugs: hand hygiene is already compromised, so any contamination will spread easily.
- Norovirus spreads by the faecal-oral route and by aerosol from vomiting; a single episode in the staff toilet can contaminate the area.
Legal/procedural basis: Food handlers must report vomiting, diarrhoea, or certain illnesses to their manager, and managers must exclude them from food handling. The decision is not a matter of staffing convenience. The head chef must find cover or reduce the menu - the legal duty to sell safe food overrides the booking.
2. Set out the actions the head chef must take: for the chef, for the toilet, and for the kitchen's handwashing arrangements.
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For the chef:
- Send him home immediately; do not let him handle food or enter the kitchen.
- Record the report, the symptoms, the date and time, and the exclusion decision in the fitness-to-work log.
- Tell him he may return 48 hours after his last episode of vomiting, and that he must report any recurrence. Give written confirmation of the return-to-work date.
For the toilet:
- Close and clean the toilet; norovirus is resistant to some disinfectants, so use a chlorine-based disinfectant at the correct concentration for the contact time stated on the label.
- Clean high-touch surfaces: flush handle, door handle, taps, light switch.
- Wash hands thoroughly after cleaning and dispose of cleaning materials safely.
For the kitchen:
- Restock the soap dispenser immediately and provide paper towels.
- Stop using the handwash basin for filling jugs - it is for handwashing only, and a separate sink must be used for other purposes.
- Brief all staff on reporting symptoms and on handwashing technique; record the briefing.
3. The head chef decides to let the commis work 'just on the grill, away from salads'. Evaluate this compromise.
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The compromise fails. The grill station is not isolated: the same person moves around the kitchen, touches fridge and cupboard handles, taps, cloths, and shared utensils, and may plate or pass food. Cross-contamination is a pathway issue, not a station issue - pathogens travel on hands, cloths, and equipment.
There is also an aerosol route: a person who has been vomiting may still be shedding virus, and the low infectious dose means even limited contact can contaminate ready-to-eat food handled by others.
The correct approach is exclusion from all food handling, not relocation. If the head chef genuinely cannot cover the shift, the safe options are to reduce the menu, close the section, or bring in agency cover - not to keep an excluded handler in the kitchen. The decision and its rationale should be recorded so it can be reviewed.