: The Food Safety Modernization Act: Implications for State Health Departments

1. : The Food Safety Modernization Act: Implications for State Health Departments National Center for Emerging and Zoonotic Infectious Diseases Centers for Disease Control June 14, 2011 National Center for Emerging and Zoonotic Infectious Diseases Division of Foodborne, Waterborne, and Environmental Diseases Dale Morse, MD, MS

2. Food Safety Modernization Act • More focus on prevention • New safety standards • (e.g., produce) • Inspections and compliance • Import safety • Surveillance “The most significant food-safety law of the last 100 years.” Kathleen Sebelius, Secretary, Health and Human Services

3. FSMA: CDC has ITS SHARE OF work to do “The act requires CDC to strengthen the capacity of state and local health departments to respond to foodborne outbreaks and improve the coordination and integration of surveillance systems and laboratory networks.” -Thomas R. Frieden, MD, MPH, Director, CDC

4. CDC support for theFood Safety Modernization Act • International expertise in foodborne illness • Strong partnerships with federal, state, and local public health agencies • Laboratory, epidemiologic, and environmental health networks • Systems and agreements for surveillance and data exchange • Communications with the public health community, industry, and consumers “This law represents a sea change for food safety in America, bringing a new focus on prevention.” – Margaret A. Hamburg, MD Commissioner of Food and Drugs

5. CDC’s role in the FSMA CDC provides the vital link between illness in people and the food safety systems of government agencies and food producers.

6. Foodborne Illness Surveillance Systems • Foodborne Disease Active Surveillance Network (FoodNet) • National Electronic Norovirus Outbreak Network (CaliciNet) • National Molecular Subtyping Network for Foodborne Disease Surveillance (PulseNet) • National Antimicrobial Resistance Monitoring System—enteric bacteria (NARMS) • National NotifiableDiseases Surveillance System (NNDSS) • National Outbreak Reporting System (NORS) • Contributing factor surveillance (Environmental Health Specialists Network, or EHS-Net) • Public health laboratory information system (PHLIS)

7. CDC FSMA lead responsibilities • Enhancing foodborne illness surveillance systems to improve the collection, analysis, reporting, and usefulness of data • Forming a Working Group of diverse experts and stakeholders to provide the Secretary advice and recommendations on the improvement of foodborne illness surveillance • Designating 5 Integrated Food Safety Centers of Excellence to serve as resources for Federal, State, and local public health professionals • Developing guidelines to manage the risk of food allergy and anaphylaxis in schools and early childhood education programs

8. FSMA Food Safety Integrated Centers of Excellence • The Secretary, acting through [CDC] and in consultation with a working group shall designate 5 Integrated Food Safety Centers of Excellence … to serve as resources for Federal, State, and local public health professionals to respond to foodborne illness outbreaks. • Requires a public/private partnership • Entities must be a state health department • Partnered with 1 or more institutions of higher education

9. Potential additional FSMA activities for CDC to support FDA include: • Development and completion of the state and local capacity review • Development of the national strategy on food safety • Working with DHS on the integrated consortium of laboratory networks • Supporting FDA as it implements provisions of the bill on hazard analysis and preventive measures, performance standards, food safety training for state and local officials, and other activities

10. CDC FSMA Enhanced Surveillance Responsibilities • coordinating and integrating Federal, State and local foodborne illness surveillance systems • increasing participation in national networks • facilitating timely sharing of information • developing improved epidemiological tools • improving attribution of illness to specific foods

11. CDC FSMA Enhanced Surveillance Responsibilities (cont.) • identifying new causes of illness • allowing timely public access to data • publishing annual summaries • promoting scientific research by academia • forming a Working Group to improve foodborne disease surveillance

12. Reach out to state and local partners • Expand and improve national surveillance for foodborne illness with state and federal partners • Share data through new approaches for messaging (RSS feeds, Twitter) • Support and enhance PulseNet capacity at state and national levels • Increase the number OutbreakNet sentinel sites to build investigative capacity • Support the Council to Improve Foodborne Outbreak Response

13. FSMA: Implications for states and CSTE’s Role • State HDs do foodborne disease surveillance • FSMA will monitor how that surveillance is done -with or without new resources • What should CSTE’s role be? • Development of surveillance metrics • Development of a national foodborne disease surveillance plan • Development of a state prevention action plan • Other?