Learning Objectives

1. Collaborative Efforts of Federal, State, and Local Public Health Partners in Foodborne Illness InvestigationsUnited States Public Health Commissioned Corps Scientific and Training Symposium Environmental Health PAC Category DayLCDR Latasha A. Allen, MSPHJune 21, 2012

2. 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

3. 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

4. Applied Epidemiology Division Usda Food Safety and Inspection Service

5. 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)

6. 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

7. 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

8. AED Functions of Surveillance, Investigation, and Control FSIS Consumer Complaints (CCMS) Non-CCMS Surveillance

9. The Investigations Team

10. 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

11. 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

12. Data Operational Flow during an Outbreak

13. Data Needs during a Foodborne Illness Investigation

14. Data Needs during a Foodborne Illness Investigation

15. Listeriosis in Southern Louisiana Case study

16. 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

17. What is Hog Head Cheese???

18. 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

19. Timeline of Investigation, Louisiana, 2010 MMWR/April 8,2011/Vol.60/No. 13

20. 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

21. 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