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Addressing Food Safety State Perspective

Addressing Food Safety State Perspective. Timothy Jones, M.D. State Epidemiologist Tennessee Department of Health. Produce from Farm to Table. Production and harvest. Irrigation water, manure, field sanitation. Initial processing. Wash water, handling. Distribution. Ice, dirty trucks.

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Addressing Food Safety State Perspective

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  1. Addressing Food SafetyState Perspective Timothy Jones, M.D. State Epidemiologist Tennessee Department of Health

  2. Produce from Farm to Table Production and harvest Irrigation water, manure, field sanitation Initial processing Wash water, handling Distribution Ice, dirty trucks Washing, handling, cross-contamination Final processing Consumption Time and temperature

  3. State Health Department FDA WHO USDA Regional HD CDC County HD EPA

  4. Many Pieces • 3000 local health departments • 50 states • Health Departments • Departments of Agriculture • Public Health Laboratories • Environmental programs

  5. Public Health Law • State laws • Disease reporting • Disease control • Restaurant inspections

  6. State Health Department Programs • Disease surveillance • Communicable disease reporting • Case follow-up • Outbreak investigation • Foodservice inspections • Coordinate communication

  7. Infrastructure • Little state support • Highly variable • Supported by other programs • Bioterrorism • WNV • Pandemic influenza

  8. Outbreaks Vehicle Etiology

  9. Foodborne Outbreaks, TN

  10. Outbreaks Per State, 1990-2003

  11. Outbreaks Per State, 1990-2003 90% investigated locally

  12. Human Animal Food

  13. Human Infection Chemical Animal Terrorism Food

  14. Farm Human Infection Factory Restaurant Chemical Animal Out-of-state Terrorism Food Multistate

  15. All national data starts local

  16. Ill people Medical providers State Health Departments Restaurant inspections Surveillance systems Ag / veterinary programs

  17. Ill people Other states Medical providers CDC FDA State Health Departments Restaurant inspections USDA Surveillance systems Industry Ag / veterinary programs Public

  18. WHO FAO PPS APHD WHA UNEP IUFOST IUPAC WMO OECD JECFA JMPR JEMRA OIE IPCS INTOX GEMS IAEA OCHA GPHIN SALMSURV IHR CDC BPRO FoodNet NARMS HACCP FDA USDA FSIS GSFS GAO RCED DOJ FBI OCI FERRET OIG ARS OEP *The Deputy Assistant to the Assistant Deputy Administrator for District Enforcement Operations agreed with this report…

  19. Communication • Ad hoc • Difficult to coordinate • Highly variable • Barriers to sharing data

  20. Challenges Increasing • More multi-state outbreaks • Food, people move more • Better laboratory technology • Faster data reporting

  21. There Is Hope • Model programs exist • FoodNet • Council to Improve Foodborne Outbreak Response • OutbreakNet • Epi-Ready • Etc., etc. …

  22. Necessary Resources • Personnel • Communication • Authority • Data sharing systems • Training

  23. Recommendations • Align resources with threats • Recognize roles at all levels • Improve resources at all levels • Focus on prevention • Update practices • Establish performance standards • Improve education • Interagency communication

  24. Tim.f.jones@state.tn.us

  25. Core Public Health Functions • Assessment • Monitor health • Surveillance – data for decision making • Epi studies – science behind PH IOM, The Future of Public Health, 1988

  26. Core Public Health Functions • Policy development • Inform & educate • Mobilize community partnerships • Develop policies • Assurance • Assure competent public health work force • Provide patient care • Enforce laws

  27. Risk Factor Identification: What is the cause? Surveillance: What is the problem? Public Health Approach Implementation: How do you do it? Intervention Evaluation: What works? Problem Response

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