Download 401.003, Management of Apparent Foodborne Outbreaks (Eff 07

MICHAEL D. CREWS
SECRETARY
PROCEDURE NUMBER: 401.003
PROCEDURE TITLE:
MANAGEMENT OF APPARENT FOODBORNE
OUTBREAKS
RESPONSIBLE AUTHORITY: OFFICE OF HEALTH SERVICES
EFFECTIVE DATE:
JULY 21, 2014
INITIAL ISSUE DATE:
APRIL 14, 2000
SUPERSEDES:
HEALTH SERVICES ADMINISTRATIVE
MEMORANDUM NO. 97-1
RELEVANT DC FORMS:
DC4-539A, DC4-543, DC4-544C, AND DC4-672
OTHER RELEVANT FORMS: DH 1847
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ACA/CAC STANDARDS: 4-4354
STATE/FEDERAL STATUTES: SECTIONS 381.006 AND 381.0072(2), F.S.
FLORIDA ADMINISTRATIVE CODE: CHAPTER 64E-11, F.A.C.
Procedure 401.003
PURPOSE: To provide administrative and operational guidelines to manage foodborne outbreaks.
DEFINITIONS:
(1) Comprehensive Health Care Contractor (CHCC) refers to contracted staff that has been
designated by the Department to provide medical, dental, and mental health services at
designated institutions within a particular region.
(2) Clinical Contract Monitor-Public Health refers to the employee located in the Office of
Health Services in the central office who oversees all Department infection control issues.
(3) Foodborne Illness refers to a disease acquired by consumption of contaminated food. The
contaminants can be bacteria, viruses, parasites, toxins produced by microorganisms, other
toxins or chemicals.
(4) Foodborne Outbreak refers to an incident in which two (2) or more persons experience a
similar illness after ingestion of a common food, and epidemiologic analysis implicates the
food as the source of the illness. The only exceptions are a single case of botulism or a single
illness caused by a chemical might be said to constitute an outbreak.
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SPECIFIC PROCEDURES:
These standards and responsibilities apply to both Department staff and Comprehensive Health
Care Contractor (CHCC) staff.
(1) The institution Infection Control Nurse or designee will initiate the “Checklist for
Management of Possible Foodborne Outbreaks,” DC4-672, when an outbreak is suspected.
The DC4-672s will be kept on file by the institution’s Infection Control Nurse for three (3)
years. The DC4-672s will not be filed as a part of the medical record or with any committee
minutes.
(2) During regular day hours, the Chief Health Officer/Insitutional Medical Director or designee
will notify the appropriate staff below:
(a) the Warden, the facility Environmental Health and Safety Officer, Food Service Director,
and all institutional personnel with a need to know;
(b) the Assistant Secretary of Institutions (Contract Manager);
(c) the Regional Director of Institutions;
(d) the local Department of Health office (if there is no response, the Department of Health,
Bureau of Environmental Epidemiology Administrator in Tallahassee will be called at
[850] 245-4401; if there is no answer, medical staff will call the Administrator’s pager or
the other telephone numbers provided for this purpose);
(e) the Regional Medical Director;
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Procedure 401.003
(f) the central office Clinical Contract Monitor-Public Health or designee ; and
(g) The CHCC Regional Infection Control Coordinator will notify the regional Epidemiologist
for foodborne illness at (850) 653-2111 extension 108 or 109 Monday through Friday 8
a.m. to 5 p.m. After hours, holidays, or emergencies at (850) 653-5980 or (850) 370-0803.
(3) During off duty hours, the Regional Medical Director will notify the Department of Health at
the number listed in section (2)(d) of this procedure.
(4) Health services staff will refer to “Movement Restrictions During Communicable Disease
Outbreaks,” Procedure 401.001, for the additional staff to be notified.
(5) The institution’s Infection Control Nurse will arrange with food service staff to:
(a) keep all leftover foods clearly marked and refrigerated (the food service staff will keep the
leftover food preserved until the Department of Health Investigator determines if there is a
need to culture),
(b) acquire a list of all menus for the previous three (3) days (the institution’s Infection
Control Nurse and the Department of Health Investigators will use these menus to help
determine what food is the suspected cause of the illness), and
(c) acquire food temperature logs for the previous three (3) days.
(6) If contraband food is involved, the institution’s Infection Control Nurse will obtain assistance
from security staff to determine if any contraband food is still available. Staff will place this
food in a clearly marked package and refrigerate it for possible investigation by the Department
of Health.
(7) Health services staff will:
(a) collect stool culture(s) for enteric pathogens and viral organisms (viral stool cultures may
be collected in a sterile urine cup without any preservatives if the proper specimen
containers cannot be obtained from the Department of Health immediately, and follow the
example of Department of Health “Laboratory Form,” DH 1847) on the first ten (10) to
twelve (12) inmates who are ill with gastrointestinal symptoms, including fever, nausea,
vomiting, diarrhea, etc.; and
(b) consult with the local Department of Health staff for lab recommendations regarding
delivering the specimens.
(8) The institution’s Infection Control Nurse will:
(a) start the “Infectious Disease Outbreak Worksheet,” DC4-544C, and
(b) collect the following information from anyone who seems ill (inmates and staff):
1. signs and symptoms of illness,
2. onset date and time (as accurate as possible),
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Procedure 401.003
3.
4.
current housing location, and
work assignments.
(9) Health services staff will collect a food history, including beverages and ice. The food history
will include answers to the following questions:
(a) “What did they eat or drink?”
(b) “Where did they eat or drink?”
(c) “When did they eat or drink?”
(10) The food history should cover the seventy-two (72) hours prior to the onset of the illness. The
Department of Health may assist in collecting food histories.
(11) The Chief Health Officer/Insitutional Medical Director will determine if any food handlers
have been ill from the week before the first case until the present.
(12) Health services staff will submit a DC4-544C daily to the CHCC Regional Infection Control
Coordinator or designee who will forward it to the Central Office Clinical Contract MonitorPublic Health. This form should be submitted to Central Office by 10 a.m. every morning.
Inmate information on this form is required to compile the Movement Restriction list needed
by the Population Management Section within the Bureau of Classification Management.
(13) The institution’s nursing supervisor or Infection Control Nurse will submit the “Summary of
Infection Control Investigation – Table V,” DC4-539A, to the CHCC Regional Infection
Control Coordinator or designee upon the conclusion of the outbreak within one(1) week and
the CHCC Regional Infection Control Coordinator will forward the form to the central office
Clinical Contract Monitor Public Health. Private facilities will submit this form directly to the
central office Clinical Contract Monior-Public Health.
(14) CHCC and private facilities are to submit a daily “Daily Infectious Disease Outbreak Report,”
DC4-543, to Department of Health Epidemiologist, excluding weekends and holidays.
__/S/_________________________
Secretary
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