Bacteria, viruses, and parasites are attributed with causing about 48 million foodborne illnesses in the United States each year. According to the CDC, the top 5 biological organisms that cause the most foodborne illnesses in the United States are Norovirus, non-typhoidal Salmonella, Clostridium perfringens, Campylobacter and Staphylococcus aureus (often referred to as Staph). However, the “Big Six” foodborne illnesses required to be reported to the health authority by the persons in charge of food service establishments if found among food workers are Norovirus, Escherichia coli, Hepatitis A, Shigella, Salmonella typhi, and nontyphoidal Salmonella. You may wonder why these two lists differ. Although both lists are important, our food service regulations require the “Big Six” to be reported to the health authority due to the fact that it only takes a few organisms or viral particles to cause illness. For instance, it takes 10 or fewer Hepatitis A viral particles to cause illness, yet a sick food worker may shed about 100 million of those viral particles in one gram of feces upon a trip to the restroom. Hence, ensuring effective handwashing is of utmost importance in all cases.