Module 1 – Building a Partnership: Who and Why?

Industry-Foodborne Illness Investigation Training & Recall Response

Elizabeth Landeen, NEHA Cindy Rice, RS, MSPH, CPFS Ken Pearson, Ed.D, CPFS

Thank You to our Host: 1

Industry-Foodborne Illness Investigation Training & Recall Response

Module 1 Building a Partnership: Who and Why?

Instructor: Ken Pearson, Ed.D, CPFS 2

Industry-Foodborne Illness Investigation Training & Recall Response

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Module 1 – Building a Partnership: Who and Why?

Module 1 - Learning Objectives  Discuss the benefits of partnership between industry and public health agencies

 Identify the roles of public health and who may be involved in an investigation

 Identify industry’s role in foodborne disease detection and communication

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Foodborne Outbreak Participants  Consumers  Industry • Retail Grocery Stores & Restaurants  Local & State Health Departments • Environmental Health, Food Regulatory, Epidemiology, Laboratory

 Federal Agencies • CDC, FDA, USDA/FSIS 4

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Module 1 – Building a Partnership: Who and Why?

Module Objective #1

Benefits of partnership between industry and public health agencies

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Estimated Annual Foodborne Illness in the United States, 2010

 48 million illness in the US 1 in 6 people will suffer from a food related illness

 128,000 hospitalizations  3,000 deaths

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Industry-Foodborne Illness Investigation Training & Recall Response

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Module 1 – Building a Partnership: Who and Why?

Estimated Annual Costs of 5 Major Foodborne Pathogens Campylobacter, Salmonella, E. coli 0157:H7, E.coli, non STEC, Listeria monocytogenes Total # Cases Hospitalizations Deaths

3,401,194 31,209 1,229

Total Annual costs .....$6.9 Billion of foodborne illnesses

Source: USDA’s Economic Research Service, August 2000/2010 7

Sample Outbreaks Source Restaurant (1993)

Processor (2007)

Pathogen

Food

Affected

Cost

E. Coli

Ground Beef

73 stores 500 cases ill 4 people died

$160 million

Salmonella

Peanut Butter

 43 states 500+ cases ill 7 people died

(lost within 18 months following outbreak)

$60 million (underestimated)

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Industry-Foodborne Illness Investigation Training & Recall Response

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Module 1 – Building a Partnership: Who and Why?

We Are All On The Same Page

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Module Objective #2 Identify the roles of public health agencies in an investigation

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Module 1 – Building a Partnership: Who and Why?

Public Health Personnel Roles Provide expertise in • Environmental health • Epidemiology • Laboratory “3 legs of the stool” Environmental health

Laboratory

Epidemiology 11

Public Health Agency Response in a Suspected Outbreak Three parts to an investigation:

 Environmental Assessment Evaluate food establishment conditions and practices, identify how the food may have become contaminated

 Epidemiologic Investigation State and local agenciesdisease surveillance & investigation, link disease cases to a common food

 Laboratory Test clinical, food, environmental samples to identify agent and links to disease 12

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Module 1 – Building a Partnership: Who and Why?

Local and State Health Dept Roles

• Responsibility to investigate all outbreaks and public health issues

• Work directly with food establishments during outbreak or recall

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Food and Drug Administration (FDA)

 Regulates all food except meat, poultry, and pasteurized egg products

 Publishes the Food Code  Supports state and local health departments

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Module 1 – Building a Partnership: Who and Why?

United States Department of Agriculture (USDA)  Inspects and regulates meat, poultry and pasteurized egg products

 Supports state and local health departments

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Centers for Disease Control and Prevention (CDC)  National surveillance for illnesses  Public Health Laboratory Information Systems (PHLIS), Foodnet, PulseNet, and electronic National Outbreak Reporting System (NORS)

 Investigates foodborne disease outbreaks  Clinical, epidemiological, and lab expertise in pathogens

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Module 1 – Building a Partnership: Who and Why?

Module Objective #3 Identify industry’s role in foodborne disease detection “the 4th leg”

Industry

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“Life Cycle” of Foodborne Disease Control and Prevention

Disease detection Prevention Measures

Epidemiologic Investigation Determine cause 18

Industry-Foodborne Illness Investigation Training & Recall Response

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Module 1 – Building a Partnership: Who and Why?

Disease Detection Pyramid Reported to health dept / state / CDC Disease confirmed Lab tests for organism Specimen obtained Person seeks care Person becomes ill

Population exposure Source: Centers for Disease Control and Prevention 19

Sources of Disease Detection Public Health Partners

Community Partners

 Epidemiologist  Environmental health  Health agents  Laboratory,

 FOOD INDUSTRY  Medical facilities  Fire / police

nursing, educators

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Module 1 – Building a Partnership: Who and Why?

Disease Detection Most common sources

 Information provided to the health agency • Consumer complaints • Industry initiated  Required reporting by physicians and laboratories

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Infectious Disease Reporting • Physicians and labs report certain infectious diseases to public health authorities

• States report nationally notifiable diseases to CDC

• Industry required to report 5 diagnoses (FDA Food Code: Hepatitis A. Salmonella. E. coli, Norovirus, Shigella)

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Module 1 – Building a Partnership: Who and Why?

Industry Chain of Command WHO do you contact to report potential outbreak/recall info -within your company -at the local or state food regulatory agency HOW do you communicate (phone, email) WHY is early contact important if an issue is suspected?

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Contact Information Worksheet Food Establishment Contact Person: Job Title: Phone Number: Email: When to contact: Food Regulatory Agency Contact Person: Health Department name: Job Title: Phone Number: Email: When to contact:

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Module 1 – Building a Partnership: Who and Why?

Module 1 - Review QUESTIONS?

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