Living in a metropolitan area in Germany I can attest, that this isn't an American phenomena. I think it is a human (or at least "civilized" human) phenomena.

Living in a metropolitan area in Germany I can attest, that this isn't an American phenomena. I think it is a human (or at least "civilized" human) phenomena. My SO has a very strong emetophobia and she is very, very clear to not touch any food without having washed her hands very good. Even at home. I learned a lot from her and have not been sick for ages. I also don't eat out in flu season. I just don't. I worked in gastronomy during my time at university. I know why I (at least in flu season) just don't eat out. as long as people need to earn money and don't get sick pay, people go to work when sick. At least I did during financially desparate times. So I don't blame the people doing it at all - I just don't buy food from them.