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United States Department of AgricultureFood Safety and Inspection Service
Collaborative Efforts of Federal, State, and Local Public Health Partners in Foodborne Illness
Investigations
United States Public Health Commissioned Corps Scientific and Training Symposium
Environmental Health PAC Category DayLCDR Latasha A. Allen, MSPH
June 21, 2012
United States Department of AgricultureFood Safety and Inspection Service
Learning Objectives• Identify the mission of the U.S. Department of Agriculture Food
Safety and Inspection Service (FSIS)
• List the three Teams within the Applied Epidemiology Division (AED) and explain how this multi-disciplinary collaboration fulfills the Agency mission
• Explain how federal, state, and local agencies collaborate during a foodborne illness investigation using a listeriosis outbreak as a case study and list at least three types of information that FSIS needs during an investigation
United States Department of AgricultureFood Safety and Inspection Service
AGENDA
• Discuss the Food Safety and Inspection Service and the Applied Epidemiology Division within the Office of Public Health Science
• Discuss the Investigations Team in operational flow during outbreaks
• Case Study - Hog Head Cheese in Southern Louisiana
United States Department of AgricultureFood Safety and Inspection Service
USDA FOOD SAFETY AND INSPECTION SERVICE
Applied Epidemiology Division
United States Department of AgricultureFood Safety and Inspection Service
What is the Food Safety and Inspection Service?
“One Team, One Purpose . We are one team, with only one purpose. And that is to protect public health. FSIS employees take pride in the fact that their jobs help prevent foodborne illness.” –FSIS Strategic Plan
• FSIS is a public health and regulatory agency operating within USDA. The Agency ensures the commercial supply of meat, poultry, and processed egg products is safe, wholesome, and correctly labeled and packaged.
• There are four primary laws that provide FSIS the authority to issue regulations.
These include the:– Federal Meat Inspection Act (FMIA),– Poultry Products Inspection Act (PPIA),– Egg Products Inspection Act (EPIA), – Humane Methods of Slaughter Act (HMSA)
United States Department of AgricultureFood Safety and Inspection Service
FSIS Vision and Mission
Vision: A trusted public health
regulatory agency committed to
preventing foodborne illness
Mission: Protect consumers by ensuring that meat, poultry, and processed egg products are safe, wholesome, and correctly labeled and packaged
United States Department of AgricultureFood Safety and Inspection Service
Applied Epidemiology Division
The Applied Epidemiology Division (AED) within the Office of Public Health Science (OPHS) consists of three Teams:
– Surveillance Team: Enable FSIS to detect and respond to foodborne hazards through the application of surveillance, epidemiology, and food safety science;
– Investigations Team: Collaborate with public health partners to investigate foodborne illnesses possibly associated with FSIS-regulated products;
– Prevention and Control Team: Support the FSIS mission through the application of epidemiology to prevent and control foodborne illness.
Multi-disciplinary collaboration among veterinarians, medical doctors, epidemiologists, environmental health scientists
United States Department of AgricultureFood Safety and Inspection Service
AED Functions of Surveillance, Investigation, and Control
InvestigationsOutbreak investigation and coordination, develops risk
hypotheses and gathers novel data to determine hazard, source, and possible risks.
Prevention and Control
Tests risk hypotheses for risk identification and
uses epidemiologic data to develop future
prevention and control measures.
SurveillancePerforms systematic
monitoring for indications of growing food borne hazards or outbreaks, characterize incidence and prevalence of risks
and develops techniques to detect incidents
earlier.
FSIS Consumer Complaints
(CCMS)
Non-CCMS Surveillance
United States Department of AgricultureFood Safety and Inspection Service
THE INVESTIGATIONS TEAM
United States Department of AgricultureFood Safety and Inspection Service
Investigations Team
The Team supports FSIS to:
– Trace foods implicated in foodborne illness back to their producing establishments
– Facilitate collection and sampling of foods implicated in foodborne illness to identify pathogens that may be causing human illness
– Assist FSIS recall activity and health hazard evaluations– Serve as a liaison to state and local public health agencies on
foodborne disease investigations and food safety issues
United States Department of AgricultureFood Safety and Inspection Service
Collaboration with Partners during Foodborne Illness Investigations
Centers for Disease Control and Prevention (CDC) – Consistent communication and information sharing during outbreak
investigations to receive epidemiologic information from states
Food and Drug Administration (FDA)– Collaboration of foodborne illness investigations involving both FSIS- and
FDA-regulated products
State and Local Departments of Health and Agriculture– Provide epidemiological data through interviews of case-patients– Collaborate traceback activities – FSIS laboratories verify product testing conducted by state laboratories to
determine if FSIS can accept non-FSIS laboratory results
United States Department of AgricultureFood Safety and Inspection Service
Data Operational Flow during an Outbreak
United States Department of AgricultureFood Safety and Inspection Service
Data Needs during a Foodborne Illness Investigation
Clinical information
Laboratory Information
Exposure Information
Illness onset date and incubation period
Isolate information
Food history
Symptoms Pulsed-Field Gel Electrophoresis (PFGE)
Food preparation review
Number of suspected and confirmed cases
Other tests of clinical and food specimens
Other possible sources of exposure
United States Department of AgricultureFood Safety and Inspection Service
Data Needs during a Foodborne Illness Investigation
Who? What? When? Where?
FSIS establishment number
Product name and type
Production date code or lot number
Point of purchase
Copy of label Product weight and units per case
Sell by/use by date
Complete name and address of store
Amount of product purchased
Purchase date
United States Department of AgricultureFood Safety and Inspection Service
CASE STUDYListeriosis in Southern Louisiana
United States Department of AgricultureFood Safety and Inspection Service
Case Study: Listeriosis in Southern Louisiana
January 2010, an investigation of a cluster of eight listeriosis cases in Southern Louisiana resulted in a recall of hog head cheese
United States Department of AgricultureFood Safety and Inspection Service
What is Hog Head Cheese???
United States Department of AgricultureFood Safety and Inspection Service
Collaboration
Intra-agency Collaboration•Microbiology Division (MD)- Microbiological Investigations Branch (MIB)
• Office of Field Operations (OFO)• Office of Public Affairs and Consumer Education (OPACE)
Inter-agency Collaboration• Louisiana Office of Public Health (OPH)• Louisiana Department of Agriculture and Forestry (LDAF)• CDC
United States Department of AgricultureFood Safety and Inspection Service
Timeline of Investigation, Louisiana, 2010
MMWR/April 8,2011/Vol.60/No. 13
United States Department of AgricultureFood Safety and Inspection Service
For Further information• MMWR Publication - Outbreak of Invasive Listeriosis Associated with the
Consumption of Hog Head Cheese --- Louisiana, 2010 Weekly April 8, 2011 / 60(13);401-405http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6013a2.htm
• USDA FSIS – http://www.fsis.usda.gov/ • CDC – Outbreak Response Team - http://www.cdc.gov/outbreaknet/outbreaks.html • U. S. Food and Drug Administration - http://www.fda.gov/ • FoodSafety.gov – www.foodsafety.gov • http://www.fsis.usda.gov/Food_Safety_Education/Ask_Karen/index.asp • Ask Karen- (mobile) m.askkaren.gov • USDA FSIS Twitter- twitter.com/usdafoodsafety• FSIS Multi-Media Site:
http://www.fsis.usda.gov/News_&_Events/multimedia/index.asp
United States Department of AgricultureFood Safety and Inspection Service
Acknowledgements• USDA FSIS
– Office of Public Health Science• Applied Epidemiology Division• Microbiology Division• Outbreaks Section of Eastern Laboratories
– Office of Field Operations– Office of Public Affairs and Consumer Education
• Centers for Disease Control and Prevention
• Louisiana Office of Public Health
• Louisiana Department of Agriculture and Forestry
United States Department of AgricultureFood Safety and Inspection Service