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Explore the legal background, reporting procedures, and control measures in investigating food poisoning and gastrointestinal infections. Understand risk groups, notification processes, and guidance under the Public Health Act (Northern Ireland) 1967. Case studies highlight outbreak investigations and control strategies.
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Environmental Health Role in Investigation & Control of Food Poisoning & Gastrointestinal Infections Hilary Byrne Belfast City Council
Scope • Legal background and reporting procedures • Organisations involved • The investigation process • Risk groups • Control measures • Guidance
Public Health Act (Northern Ireland) 1967 • Doctors have a statutory duty to report notifiable infectious diseases • These infectious diseases include food poisoning, and other gastro infections e.g. dysentery, hepatitis A, typhoid
Food Poisoning: Notifications and Laboratory Reports 2005 – 2014
Investigation jointly by the Public Health Agency & Environmental Health
Notification made to the Public Health Agency Recorded on analysis database Referred to relevant Environmental Health Department EHO makes contact or visits case Complete questionnaire & food history Advise on enteric precautions, hygiene measures, exclusions Consider faecal / food sampling as necessary Feed back to PHA Discuss further action
Reasons for investigation • Identify the possible source of infection • To take measures to prevent further spread • To trace others who may have been infected • To offer advice on enteric precautions and food hygiene • To enable early detection of outbreaks
Investigation • Personal details • date and time of onset • Occupation • Food History • Details of foreign travel • Contact with animals • Details of any others ill • Specifics for different organisms
Control • Advise the case and contacts on food and personal hygiene • Assess the risk of further spread • Trace other contacts • Consider need for exclusion • Consider follow up to food premises
Risk Groups • Person of doubtful hygiene or poor facilities • Young children at preschool • Food handlers • Care staff
Exclusions • For certain organisms cases and contacts may need to be excluded • E coli 0157 is the organism that this occurs with most • EH source cases to be excluded • PHA carry out exclusions
Guidance • PHA – Investigation of Food Poisoning and Gastrointestinal Infections • Regional Guidance for Public Health Practitioners and Environmental Health Officers in NI (2012) • Other specific guidance on • E coli VTEC • Typhoid & Paratyphoid • Incident/Outbreak Plan
Outbreaks 2 or more unrelated case
E. coli O157 Outbreak - 2012 • 1st case Tuesday 9th October 2012 • Multi Agency Outbreak Control Team • 300 individuals affected • 141 clinically confirmed • 19 admitted to hospital
E. coli O157 Outbreak - 2012 • First 9 days worked 15 hour days • Voluntary Closure / disposal of food • Every food and garnish • Every supplier • Food, water, environmental samples • Interviewed over 300 adults / children • Wrote to 3000 businesses
E. coli O157 Outbreak - 2012 • Source – contaminated food stuff or infected staff member • Vehicle of spread – food (some evidence to implicate parsley) • Food Handler 1 – may have contributed to spread
E. coli O157 Outbreak - 2012 • Crown Court • 250 exhibits • Statements from > 100 cases • 11 offences • Fined £110,000 (largest ever in NI)
