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Instruction under § 43 IfSG

Gesundheitsamt · Infection protection in the food sector

In person or onlineBefore starting workNot an examination

One word first, because it is almost always stated incorrectly: “health certificate” does not appear in the Infection Protection Act (Infektionsschutzgesetz, IfSG). The term comes from the Federal Epidemics Act (Bundes-Seuchengesetz), which applied until the end of 2000 — and there it stood for something different, namely a medical examination including a stool sample. What the Gesundheitsamt issues today under § 43 IfSG is a certificate of instruction: you are informed of the prohibitions on working and declare that you are not aware of any grounds that would prevent you. No examination takes place, no blood is taken and no sample is given. Anyone who attends expecting a medical certificate is expecting the wrong service — and anyone who asks for a “health certificate” is asking for a document that has not existed for over twenty years.

What the instruction actually teaches is set out in § 42 IfSG — and it is precisely this content that has been missing so far. Abs. 1 prohibits the activity in the case of typhoid, paratyphoid, cholera, shigellosis, salmonellosis, other infectious gastroenteritis, and hepatitis A or E, as well as in the case of infected wounds or skin diseases through which pathogens can be transmitted, and for those who excrete Shigella, Salmonella, EHEC or cholera vibrios — even without being ill themselves. Abs. 2 lists which foods are affected: meat, milk, fish, egg products, infant and young children's food, ice cream, baked goods with a filling that has not been fully heated through, delicatessen and raw-vegetable salads, as well as sprouts and shoots. And Abs. 3 extends the prohibition to kitchens of restaurants and communal catering establishments, as well as to persons who come into contact with the crockery. That is the real message: it is not about a piece of paper, but about recognising this list if it applies to you.

Who needs the certificate thus follows by itself: you need it before you take up, on a commercial basis, any of the activities under § 42 — in the kitchen, in service involving open food, in production, in sales at a fresh-food counter, or in the communal catering of a Kita (child daycare centre), school, hospital or care home. This also applies to short-term temporary work, internships and voluntary activities, if carried out on a commercial basis — and it applies before the first day of work, not during the first week after.

And the point that raises the most questions: the certificate does not expire. It is valid indefinitely. What is time-limited is something else, namely its usability when starting the job: when taking up the activity, under § 43 Abs. 1 IfSG it must be no more than three months old. Anyone who completes the instruction in January and starts in June needs a new one — anyone who starts in January and stays for ten years does not.

Last updated28 August 2026
Legal basis§§ 42, 43 IfSG
VerificationChecked against IfSG, TrinkwV, LFGB and Regulation (EC) 852/2004
Written and reviewed byAndrés Sánchez Botta
Independent information website: we are not the Gesundheitsamt, not an authority and not a paid advice service – we do not submit applications on your behalf. All information comes from official sources and is explained here in plain language; binding information always comes from the competent body. No legal advice and not an official authority. We are neither lawyers nor tax consultants: we document official procedures and check the information against the official source – this is information, not legal or tax advice.
What it isInstructionNot a medical examination
At the start of workNo more than 3 months old§ 43 Abs. 1 IfSG
ValidityUnlimitedThe certificate does not expire
Follow-up instructionThe employerEvery two years, free of charge
Required documents

What you need

Official photo ID

Identity card, passport or residence title. The certificate is issued in your name, which is why identity must be proven — without identification, the appointment generally does not take place.

Nothing medical

No medical certificate, no vaccination record, no stool sample. This is not an oversight in this list: § 43 IfSG simply does not provide for an examination. Anyone who tells you otherwise is confusing the certificate with the old health certificate under the Federal Epidemics Act.

Consent for minors

For young people under 18 years of age, many Gesundheitsämter require the consent or presence of a person with parental responsibility. Clarify this when booking the appointment so that it does not end without a result.

Details of the planned activity

Which activity you are taking up and in which company. The instruction is tailored to the prohibitions on working under § 42, and the certificate is not limited to one employer: you can continue to use it when you change jobs.

The office's means of payment

Many Gesundheitsämter accept only EC card payments or only cash. This is the most common reason for a second trip — ask in advance rather than finding out on the spot.

Step by step

How to proceed

  1. 1

    Check whether you are affected at all

    What matters is § 42 Abs. 1 to 3 IfSG: commercial handling of the foods named there, kitchens of restaurants and communal catering, plus handling the crockery. Anyone who sells packaged goods without opening them generally does not fall under this.

  2. 2

    Book an appointment at the Gesundheitsamt — or check online

    Your local Gesundheitsamt is responsible. Many offer group appointments, some an online instruction; whether and in what form is decided by each office itself. Ask about this before planning a journey.

  3. 3

    Attend the instruction

    You are informed about the prohibitions on working under § 42 and about your obligations under § 43 Abs. 2, 4 and 5. You then declare that you are not aware of any grounds that would prevent you. That is exactly what the process consists of — no examination follows.

  4. 4

    Receive and keep the certificate safe

    You generally receive it on the same day. Photograph it immediately: under § 43 Abs. 5, the original goes to the employer, and a replacement certificate incurs fresh fees. With several employers, you need to present it more than once.

  5. 5

    Keep track of the follow-up instruction

    After taking up the activity, and every two years thereafter, your employer instructs you again and records your participation. This is not a new appointment at the office and costs you nothing — but it is mandatory, and whoever carries out inspections will want to see this documentation.

Fee information

Costs and payment

Costs and responsibilityYour Gesundheitsamt sets the fee
Initial instructionAccording to the office's fee ordinance
Follow-up instructionBy the employer, free of charge
Replacement certificateSubject to a fee again
ReductionOften possible, on application
Medical examinationNot provided for
ValidityUnlimited

There are no uniform nationwide amounts — the fee is set out in the fee ordinance of the federal state or local authority. Reductions for pupils, trainees, volunteers and benefit recipients are common, but must be applied for.

Good to know

Important notes

The certificate is not a closed matter, but the start of two ongoing obligations. § 43 Abs. 2 IfSG requires you to notify the employer without delay if, after taking up the activity, one of the grounds for prevention under § 42 arises — this is the part that almost nobody knows and that counts in a real case. And Abs. 4 requires the employer to provide instruction again after taking up the activity and thereafter every two years, and to document participation. The business itself carries out this follow-up instruction — it is not a second appointment at the Gesundheitsamt and costs you nothing. Under Abs. 5, the employer keeps the certificate and the most recent documentation.

One misunderstanding persists stubbornly and costs people money: the certificate from the Gesundheitsamt does not have to be renewed every two years. The two-year time limit in § 43 Abs. 4 applies to the follow-up instruction given by the employer — an in-house briefing that costs nothing. Anyone who goes back to the office every two years and pays is paying for something the law does not require.

The certificate is not tied to one employer. It belongs to you and remains valid through every job change — which is why it is worth keeping a copy, even though the original is kept by the business under § 43 Abs. 5.

An entirely different provision, which has nothing to do with food, also applies to communal facilities: § 34 IfSG governs which illnesses mean that a Kita or school must not be entered — including by staff. Anyone working in a Kita kitchen falls under both provisions at the same time.

The maximum regulatory fines under the Infection Protection Act are set out in § 73 Abs. 2 IfSG, and there are two of them. The general maximum extends to €25,000. For a specifically named group of infringements, however — numbers 7a to 7d of Abs. 1a, that is precisely the proof obligations surrounding measles vaccination under § 20 — the lower maximum of €2,500 applies. Higher amounts that are in circulation come from food law and thus from a different statute and a different authority.

Avoid these mistakes

Common mistakes

Asking for a “health certificate”. The document of that name comes from the Federal Epidemics Act and has not existed for over twenty years. What is required is the certificate under § 43 IfSG.

Going to the office only after the first day of work. The certificate must be in place before taking up the activity — obtaining it afterwards does not cure the infringement.

Completing the instruction months in advance. At the start of the activity it must be no more than three months old; otherwise the appointment has lapsed.

Paying the Gesundheitsamt again every two years. The follow-up instruction is carried out by the employer, not the office, and it costs nothing.

Concealing a newly arising illness. § 43 Abs. 2 requires grounds for prevention to be notified to the employer without delay — even long after the instruction.

Frequently asked questions

Questions and answers

Is the instruction under § 43 IfSG the same thing as a health certificate?

No, and the difference is fundamental. The health certificate comes from the Federal Epidemics Act, which applied until the end of 2000, and required a medical examination including a stool sample. Today's certificate under § 43 IfSG merely confirms that you have been instructed about the prohibitions on working under § 42 and have declared that you are not aware of any grounds that would prevent you. No examination takes place.

Must I repeat the instruction every two years?

Not at the Gesundheitsamt. The certificate under § 43 Abs. 1 is valid indefinitely. What must be repeated every two years is the follow-up instruction given by the employer under § 43 Abs. 4 — an in-house briefing that must be documented and is free of charge for you. Anyone who pays the office again every two years is paying without a legal basis.

What exactly does § 42 IfSG prohibit?

The activity of commercially handling certain foods in the case of typhoid, paratyphoid, cholera, shigellosis, salmonellosis, other infectious gastroenteritis and hepatitis A or E, as well as in the case of infected wounds and skin diseases through which pathogens can be transmitted, and for carriers excreting Shigella, Salmonella, EHEC or cholera vibrios. Abs. 2 names the foods affected, and Abs. 3 extends the prohibition to kitchens of restaurants and communal catering.

Do I need the certificate for an internship or a voluntary role too?

If the activity is carried out on a commercial basis, yes — the duration and whether you are paid make no difference. As regards the fee, however, many Gesundheitsämter offer reductions for pupils, trainees and volunteers. You must apply for these, though; they are generally not granted automatically.

What happens if I become ill later?

§ 43 Abs. 2 IfSG requires you to notify the employer of this without delay as soon as, after taking up the activity, a ground for prevention under § 42 Abs. 1 arises. This obligation does not end with the instruction but accompanies the entire employment — it is the real core of the provision.

Does the certificate also apply with a new employer?

Yes. It is not tied to one business and remains valid when you change jobs. Because the original is kept by the employer under § 43 Abs. 5, it is worth making a copy or a photograph of it straight after the appointment.

Related official procedures

Hygiene monitoring
Who really carries out inspections — and who does not
Without registration
Infection notification
Three catalogues, two recipients, two deadlines
24 hours
Drinking water testing
Action value, not a limit value
Three years or annually

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