United States Department of Agriculture Food Safety and Inspection Service Collaborative Efforts of Federal, State, and Local Public Health Partners in

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


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


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


USDA FOOD SAFETY AND INSPECTION SERVICE

Applied Epidemiology Division


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)


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


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


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


THE INVESTIGATIONS TEAM


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


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


Data Operational Flow during an Outbreak


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


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


CASE STUDYListeriosis in Southern Louisiana


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


What is Hog Head Cheese???

http://en.wikipedia.org/wiki/File:Head_cheese.jpg

http://chadzilla.typepad.com/.shared/image.html?/photos/uncategorized/chaine_prep_018.jpg


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

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I could not find Agency Logos to include so I just took them all out.


Timeline of Investigation, Louisiana, 2010

MMWR/April 8,2011/Vol.60/No. 13


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

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6013a2.htm

http://www.fsis.usda.gov/

http://www.cdc.gov/outbreaknet/outbreaks.html

http://www.fda.gov/

http://www.foodsafety.gov/

http://www.fsis.usda.gov/Food_Safety_Education/Ask_Karen/index.asp

http://m.askkaren.gov/

http://twitter.com/usdafoodsafety

http://www.fsis.usda.gov/News_&_Events/multimedia/index.asp


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


Documents

United States Department of Agriculture Food Safety and Inspection Service Collaborative Efforts of Federal, State, and Local Public Health Partners in