Epi-Ready

1. Epi-Ready Response Teams – Planning and Preparation Module 3

2. Module Objectives • By the end of this module, participants will be able to determine what is required to perform as an effective foodborne outbreak response team • Identify the members of the foodborne outbreak response team • Describe the agencies that may provide members to the team • Explain the communication and coordination strategies used by effective outbreak response teams

3. Team Elements Subject Matter Expertise Problem Solving Knowledge Skills Technical Cross-disciplinary Understanding Interpersonal Goal Oriented Common Approach Shared Purpose Attitude

4. Three Core Disciplines

5. Epidemiologic Investigator Responsibilities • Case-based surveillance • Identifies and interviews cases and controls • Develops hypotheses and strategies to test them • Collects and analyzes investigation data • Plans and conducts epidemiologic studies • Consults and coordinates with environmental and laboratory investigators Skills: • Critical thinking • Observation and interpretation • Positive communication/interview • Understands the host-pathogen relationship and associated illness

6. Environmental Investigator Responsibilities: • Investigates possible source of foodborne illness • Collects environmental and food samples • Interviews food employees and managers • Reviews records • Conducts product tracing • Consults and coordinates with epidemiologic and laboratory investigators Skills: • Critical thinking • Positive communication/interview • Observation and analytic • Characterizes pathogens from a food-production and food-preparation perspective

7. Laboratory Investigator Responsibilities: • Analyzes clinical specimens and food and environmental samples • Interprets and reports test results and suggests follow-up testing • Coordinates testing among laboratories • Advises and coordinates with other team members Skills: • Understanding of microbiological techniques as epidemiologic tools • Critical thinking as it applies to laboratory methods and quality assurance • Understands pathogens by their cellular characteristics

8. Other Important Team Members

9. Local Public Health System Authorities stem from constitutional, statutory, regulatory, judicial case law and general police powers • Surveillance and control of communicable disease, including foodborne illness • Receive and investigate complaints of illness • Regulate and inspect food service establishments • Manage public risk communication • Communicate and coordinate activities with local healthcare professionals

10. State Public Health Agencies Authorities stem from constitutional, statutory, regulatory, judicial case law and general police powers • Conduct statewide surveillance activities – some complaint-based activities • Provide advanced laboratory testing • Coordinate multi-jurisdictional or statewide investigations • May conduct food safety regulatory programs

11. State Departments of Agriculture • Pre and post-harvest food regulatory programs • Statewide responsibilities for the safety of food and dairy products offered in intrastate commerce • Monitors food and dairy safety by collecting and testing food, dairy, and environmental samples • Conducts food safety regulatory programs at the food service (retail) level in certain circumstances

12. Food and Drug Administration • Conducts post-market surveillance and compliance of food industry • Conducts and coordinates regulatory product tracing investigations • Coordinates industry-initiated recalls of food products and regulatory-initiated recalls • Coordinated Outbreak Response and Evaluation Network (CORE) • Publishes the FDA Food Code

13. Food Safety and Inspection Service • Conducts microbiological and chemical testing of meat, poultry products, Siluriformes fish, and egg products • Conducts audits to determine the equivalency of foreign food-safety programs and inspects imported products under USDA-FSIS jurisdiction • Assures state agencies operate at the “at least equal to” standard of the Federal Meat Inspection Act

14. Centers for Disease Control and Prevention • Coordinates and supports national surveillance • Laboratory-based Enteric Diseases Surveillance (LEDS) • Foodborne Diseases Active Surveillance Network (FoodNet) • PulseNet • Environmental Health Specialists Network (EHS-Net) • Provides consultation, assistance, and leadership in outbreak investigations • Facilitates coordination among jurisdictions with multijurisdictional outbreaks

15. Agencies with Jurisdictional Authorities

16. Activity • Agency where you find the following: • Epidemiologic Investigators • Environmental Health Investigators • Laboratory Investigators Other agencies involved with response activities: Agencies with jurisdictional authority: This whole-class activity will identify disciplines and agencies involved with foodborne outbreak response in the jurisdictions participating in the training. Record response in participants guide. Instructor will lead the discussion and record responses on an easel pad. This activity should take no more than 10 minutes to complete.

17. Outbreak Response Teams

18. Interdisciplinary Response Teams • Prepare for and respond to foodborne illness outbreaks and other food emergencies • Enhance intra-agency and interagency collaboration and communication • Train and exercise teams to be ready to respond to events when they occur • Establish national best practices and tools that can be shared with other states to improve their response to food emergencies

19. Response Team Communication • Clear and concise and leave little leeway for interpretation • Delivered in a consistent fashion • Communication should clarify roles and responsibilities of the team members • Lines of communication must be structured • Top-down • Bottom-up • Lateral communication • Develop a plan!

20. Team Communication Strategies Does your agency have communications plan?

21. Coordination

22. National Incident Management System

23. Incident Command System Incident Command Public Information Officer Liaison Officer Safety Officer Finance/Admin Section Planning Section Logistics Section Operations Section

24. Summary

25. Coming Up Next