CDC on norovirus outbreaks: Has your waiter washed his hands?

Sanitation in dining situations is key to the prevention of food-borne norovirus, the U.S. Centers for Disease Control and Prevention emphasizes. (Ed Murray/The Star-Ledger )

The next time you assume you have a case of food poisoning, don't blame the food - blame the waiter who served it.

That's the message from the U.S. Centers for Disease Control and Prevention, which reported today that the highly contagious norovirus is now the most common type of food-borne illness, surpassing salmonella.

The norovirus sickens about 20 million Americans a year, with nearly two-thirds of those cases spread person-to-person.

The CDC reported that from 2009 to 2012, there were 4,318 outbreaks of norovirus sickening 161,253 people. Of them, 2,512 ended up hospitalized, while 304 died from the illness. Typical symptoms include vomiting and diarrhea.

There were 18 reported outbreaks in New Jersey in that period - a rate that puts the state in about the middle of the pack nationally. State-to-state differences probably reflect how hard a state is looking for the information, as opposed to any vast difference in the number of outbreaks, said Aron Hall of the CDC's Division of Viral Diseases.

But a significant number stem from food, with restaurants and banquet halls accounting for four in five of food-borne illnesses. (Outbreaks on cruise ships, which typically receive a lot of attention, account for just 1 percent of cases, the CDC said in its report.)

Much of that transmission occurs in the final moments of food preparation, after a menu item has been cooked and is being served. Wait staff handling raw fruit, vegetables, salads, baked goods and sandwiches with their bare hands are the most likely source of contamination.

Prevention tips include rigorous hand washing, the use of utensils or single-use gloves in serving uncooked items.

Two of the main reasons waiters and waitresses come to work when they're sick is because they need the money, and because they don't want to leave their co-workers short-staffed, the CDC report found.

To prevent that, the CDC urged restaurants to look at paid sick days and institute a back-up staffing plan in the event of illness.

"We know how to stop it," said Hall. "We just need to do it.”