Food Supply Defense Plan: Lessons from Oregon Public Health

1. Food Supply Defense Plan:Lessons from Oregon Public Health James C. Mack, M.P.A., R.S. Foodborne Disease Outbreak InvestigatorEHS-Net Site Coordinator State of Oregon

2. Public Health Food Defense Emergency Response Plan Presentation outline: • Describe the complex nature of Public Health Food Defense Emergency Response. • Review the overview of the State of Oregon Public Health Food Defense Emergency Response Plan. • List the diverse roles, responsibilities, and methods of communication of local, state, federal, industry, and private entities in food defense. • Identify resources to aid in the improvement or development of Public Health Food Defense Emergency Response Plans.

3. Feedback Poll My jurisdiction has a public health food defense emergency response plan. • Yes • B. No

4. Public Health Food Defense Emergency Response Plan Complex nature of food defense • Federal • State • Local • Industry

5. Complex Nature of Food Defense Federal • The Centers for Disease Control & Prevention (CDC) • Food and Drug Administration (FDA) • Food Emergency Response Network (FERN) • Federal Bureau of Investigation (FBI) • United States Department of Agriculture (USDA) • Department of Homeland Security: Science and Technology (S&T) Directorate • Department of Homeland Security: Information • Analysis and Infrastructure Protection (IAIP) Directorate • Environmental Protection Agency (EPA)

6. Complex Nature of Food Defense State • Oregon Public Health Division • Foodborne Illness Prevention Program • Acute and Communicable Disease Program • Office of Family Health • Public Health Emergency Preparedness Program • Oregon State Public Health Laboratory • Oregon Department of Agriculture

7. Complex Nature of Food Defense Local • Health departments • Hospitals and health care systems • Emergency medical services

8. Feedback Poll The ongoing relationship between food industry representatives and public health within my jurisdiction is: A. Positive B. Uncertain C. Negative D. None of the above

9. Complex Nature of Food Defense Industry • Retail food establishments • Associations that support restaurants

10. Writing a Food Defense Emergency Response Plan • Step 1: • Follow the food flow from farm to table. • Partnerships are important. • All players must be engaged.

11. Writing a Food Defense Emergency Response Plan Step 2: Focus on your part of food defense. LOCAL STATE FEDERAL INDUSTRY

12. Writing a State Food Defense Emergency Response Plan Step 3: Identify state public health programs with food defense responsibilities. State of Oregon Public Health, Offices of: • Public Health Preparedness (Preparedness) • Multicultural Health (Multicultural) • Public Health Laboratories (Labs) • Family Health (Family) • Community Health & Health Planning (Community) • Environmental Public Health (Environmental) • Disease Prevention & Epidemiology (Epi)

13. Writing a Food Defense Emergency Response Plan Step 4: Organize a working group.

14. Writing a Food Defense Emergency Response Plan Step 5: Write a draft public health food defense plan.

15. Public Health Roles and Responsibilities at the Federal Level • Coordinate national and international surveillance, monitor health impacts, and provide laboratory support. • Lead public health communications among states and other public health agencies. • Provide legal advice and policy guidance on food response activities.

16. Operational Priorities • Mitigate the health effects in retail food establishments. • Provide information regarding the scope and health effects of the contamination. • Coordinate with Oregon Department of Agriculture (ODA) and other appropriate state agencies on threat assessment and resource needs. • Assist LHDs in field assessments and investigations involving retail food establishments.

17. Public Health Roles and Responsibilities at the State Level Public Health Director, State Health Officer, Susan Allan, M.D., J.D., M.P.H. Authorized the Public Health Food Defense Response Plan

18. State Office of Multicultural Health • Identifies credible voices in: • Special populations • Diverse communities • Helps to develop appropriate messages that are: • Linguistically and culturally oriented • In communication formats specific to food defense incident and the affected populations

19. State Office of Public Health Preparedness • Provide information on: • Food process being used to confirm or rule out contamination of the food supply • When/where the presumed incident took place • When additional information will be available • Precautions taken to prevent additional contamination

20. State Office of Public Health Laboratories • Participates in the systematic sampling of enteric isolates sent to CDC for antimicrobial susceptibility testing. • Screen meat and poultry samples that are collected monthly for selected pathogens and indicator bacteria. • Subtype Escherichia (E. coli) O157,Salmonella, and Shigella isolates by Pulse Field Gel Electrophoresis.

21. State Office of Family Health • Provides LHDs with emergency checklists. • Assists Foodborne Illness Prevention Program and Acute Communicable Disease Program in outbreak interviews and surveillance. • Assists OEPH and LHDs in monitoring members of the public in their preparation and serving of preserved food.

22. Feedback Poll In my opinion, coordination between state and local public health regarding public health food defense in my area is: A. Excellent B. Okay C. Weak D. Non-existent

23. State Office of Community Health and Health Planning • As a liaison to other counties: • Develop communication link with LHDs. • Assist in surge capacity for ICS.

24. State Office of Environmental Public Health Foodborne Illness Prevention Program • Conduct situation (disaster) assessment of retail food establishments. • Provide technical advice to LHDs. • Support field assessments and outbreak investigation of retail food establishments. • Provide scientifically-based guidance concerning disposition of food.

25. State Office of Environmental Public Health Environmental and Occupational Epidemiology (EOE) • Liaison between the public and health care workers. • Provides clinical expertise in the area of medical toxicology including chemical, toxin, and food poisoning. • Interfaces with the public, other state agencies and the public regarding media communications.

26. State Office of Disease Prevention and Epidemiology Acuteand Communicable Disease Prevention Program • Assists LHDs in investigating of outbreaks. • Collaborates with the ODA and the FDA. • Leads in food contamination epidemiology investigations. • Is one of eleven Foodborne Diseases Active Surveillance Network (FoodNet) sites in the United States.

27. Training Regional food defense emergency training of first receivers, responders, and local health departments will be completed on a yearly basis.

28. Exercise Design Exercise Design Committee will design and deliver: • Exercise orientations • Tabletop exercises • Functional exercises • Full-scale exercises • Homeland Security Exercise Evaluation Program (HSEEP)

29. Feedback Poll Which of the following exercise related activities has the most practical value in my jurisdiction? A. Tabletop exercises B. Functional exercises C. Full-scale exercises D. Other

30. Special Populations The young and the elderly should be given the highest priority for evaluation due to the following: • Higher risk of rapid dehydration due to vomiting or diarrhea. • Higher risk of shock or death from blood loss resulting from foodborne illness. • Children and the elderly need special considerations for medical treatment.

31. Plan Maintenance • Revised annually. • Revised from previous year exercises or emergencies. • Food Program will conduct this review.

32. Public Food Defense Emergency Response Plan