Download 2016 07 16 Foodborne Illness Outbreak IDMT Training

Headquarters U.S. Air Force
Integrity - Service - Excellence
Foodborne Illness Outbreak
IDMT Training
Objectives
 Training
Objectives

Define key aspects/steps of a Foodborne Illness
(FBI) Outbreak.

Understand Public Health responsibilities during a
Foodborne Illness Outbreak.
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Overview
 Define

Foodborne Illness Outbreak
Epidemiologic Steps of an Outbreak
Investigation
 Public
Health Roles and Responsibilities
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Definition

Foodborne Illness – disease carried or transmitted to
people by food.

Two main types of Foodborne Illness



Infection
Intoxication
Outbreak – an epidemic limited to localized increase in
the incidence of disease
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Epidemiologic Steps of an
Outbreak Investigation

Prepare for field work

Establish the existence of an outbreak

Verify the diagnosis

Construct a working case definition

Find cases systematically and record information

Perform descriptive epidemiology

Develop hypotheses

Evaluate hypotheses epidemiologically
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Epidemiologic Steps of an
Outbreak Investigation

As necessary, reconsider, refine, and re-evaluate
hypotheses

Compare and reconcile with laboratory and/or
environmental studies

Implement control and prevention measures

Initiate or maintain surveillance

Communicate findings
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Prepare for Field Work

Before a confirmation in increased cases or after the
confirmation?

Be prepared







Required Forms *(AF Form 431, 432, and CDC 52.13)
Tools to take samples (notify lab)
Place to keep samples cold
Gloves
Camera
Notebook/pen
Plan of action
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Establish the Existence of an
Outbreak

More cases of disease than historically indicated

Common cause or related to each other

No changes in local procedures
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Verify the Diagnosis

Properly identify

Rule out laboratory error


Foodborne Illness testing
Take a history


Interview patient with AF Form 431
Document time distribution of those affected
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Verifying the Diagnosis

AF Form 431, Food
Poisoning Outbreak –
Individual Case
History (72 hours)
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Verify the Diagnosis

AF Form 432,
Time
Distribution of
Persons
Affected
(Onset data)
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Construct a Working Case
Definition

Clinical Criteria*



Fever
Abdominal cramps
Diarrhea
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Find Cases Systematically and
Record Information

Healthcare practitioners

Medical facilities

Alerting the public*
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Perform Descriptive
Epidemiology

Summarizing data

Time (epidemic curve)
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Perform Descriptive
Epidemiology

Summarizing data


Place
Person
 Susceptibility
 Age
 Race
 Sex
 Medical status
 Opportunities for exposure
 Occupation
 Leisure activities
 Medications, tobacco, drugs
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Develop Hypotheses

The hypotheses should address:


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Source of the agent
Mode of transmission
Exposures that caused the disease
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Evaluate Hypotheses
Epidemiologically
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Plausibility


Laboratory testing of patient for foodborne illness
Laboratory testing of suspect food
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As Necessary, Reconsider, Refine,
& Re-Evaluate Hypotheses

Hypotheses




Necessity
Reconsider
Refine
Re-evaluate
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Compare & Reconcile with Lab
and/or Environmental Studies

Provide the proof


Laboratory results (human & food)
Inspection findings
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Implement Control and
Prevention Measures

Control & Prevention
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Educate the population/food facility
Treat the ill
Dispose of contaminated food
Learn from the outbreak investigation
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Initiate or Maintain Surveillance
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Continue to monitor the situation
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Is it getting better or worse?
Are the control methods even working?
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Communicate Findings

Briefing for the local authorities/base/medical
group/public health

Written report/documentation for historic
value/training

Report of foodborne illness outbreak
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Communicate Findings

CDC 52.13, Investigation
of a Foodborne Outbreak


Send to MAJCOM/SGP
In the 50 states also send to
the state health department
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Public Health Roles and
Responsibilities

Conduct annual in-service training on foodborne
illness

Investigate and report all foodborne illness outbreaks
to MAJCOM/SGP and the state health department

Report each confirmed case in accordance with
current AF reportable event guidelines.
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Public Health Roles and
Responsibilities

Ultimate goal

Preventing them from happening in the first place.
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Summary
 Define

Foodborne Illness Outbreak
Epidemiologic Steps of an Outbreak
Investigation
 Public
Health Roles and Responsibilities
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QUESTIONS?
QUESTIONS?
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Tool Kit

References:

AFI 48-116, Food Safety Program

Principles of Epidemiology in Public Health Practice, Third
Edition, Updated May 2012 from the Centers for Disease Control
and Prevention (CDC)

US Department of Health and Human Services, Food and Drug
Administration (FDA) Food Code
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Tool Kit

Websites:

Approved Source
 http://phc.amedd.army.mil/topics/foodwater/ca/Pages/DoDApp
rovedFoodSources.aspx

CDC Food Safety Homepage
 http://www.cdc.gov/foodsafety/investigations.html

USAFSAM/PHR Website
 https://gumbo2.wpafb.af.mil/epi-consult/index.cfm
 Food Protection
 https://gumbo2.wpafb.af.mil/epi-consult/foodprotection/
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Tool Kit

Websites:

Armed Forces Reportable Medical Events Guidelines & Definitions
 https://gumbo2.wpafb.af.mil/epiconsult/reportableevents/documents/TriService%20Reportable%20Events,%20Guidelines%20and%20Ca
se%20Definitions%20(2012).pdf

Air Force Disease Reporting System internet (AFDRSi)
 Go to the following link: https://gumbo2.wpafb.af.mil/epiconsult/reportableevents/
 This page will give you information and training on AFDRSi
 https://data.nmcphc.med.navy.mil/afdrsi/Login.aspx (AFDRSi
Website)
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USAFSAM Contact Information

USAFSAM Public Health Education Division
 Mr. James Gage, Chief, Education and Training Branch
 DSN: 798-4130
 Commercial: (937) 938-4130
 Email: [email protected]
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