Content Information
Foodborne illness infects 76 million Americans, causes 325,000 hospitalizations and 5,000 deaths annually.
Introduction
Foodborne illness infects 76 million Americans, causes 325,000 hospitalizations and 5,000 deaths annually. Anyone, regardless of race, age, gender, ethnicity, or socioeconomic status, is at risk. Fortunately, most foodborne illnesses are self-limited; however, they cost our nation millions in lost productivity, medical, and legal expenses.
Organization
The manual is organized to mirror the progression of a general foodborne outbreak investigation. However, outbreaks of foodborne illness are often unpredictable. Therefore, the specific circumstances of the individual outbreak must always dictate the course of action.
This manual addresses a foodborne outbreak investigation from the three discipline approach: epidemiology, environmental, and laboratory. There may be other health officials and organizations involved in foodborne outbreak investigations, and their information is located in Chapter 4 Roles and Responsibilities.
The purpose of the manual is to:
- Describe the methods to conduct an outbreak investigation of a foodborne illness.
- Provide an Iowa specific resource to public health and environmental agencies.
- Define the major functions of epidemiology, laboratory and environmental services.
- List the roles and responsibilities of the multiple public health practitioners in an outbreak investigation.
This manual was created by the Iowa Department of Public Health Center for Acute Disease Epidemiology (CADE) working in collaboration with multiple state department authors, and is intended to be used as a reference. Its purpose is to guide public health agencies and staff through foodborne illness and outbreak investigation and its prevention and control. It is designed as a comprehensive reference covering epidemiologic, environmental, and laboratory aspects of an investigation. It contains basic information, guidelines, recommendations and regulatory requirements. While it is targeted to local public health agencies and public health practitioners, other health professionals may also use the information to facilitate understanding of how state and local public health agencies operate, and how they themselves play a role in foodborne illness surveillance, investigation, and control. All information in this manual must be considered in light of newer information available after publication. Its three-ring binder format allows for addition of new and updated material as it becomes available.
Outbreak investigations by public health practitioners provide insight into the understanding and means of preventing foodborne illness. While prevention of foodborne illness is any investigation’s primary goal, it also provides unique opportunities and challenges to your agency. These challenges and opportunities include:
Legal Basis: In Iowa, reporting of communicable diseases is required under Iowa Code, Chapter 139A, and implemented under Iowa Administrative Code Chapter 641. This legislation includes provisions for the reporting and investigation of foodborne outbreaks which are outlined in Iowa Administrative Code 641—1.4(1) b. (135, 139A) Reporting and Investigation:
Other diseases that carry serious consequences or spread rapidly. A healthcare provider and a public, private, or hospital clinical laboratory shall immediately report any confirmed or suspected case of a common source epidemic or disease outbreak of unusual numbers by telephone to the department’s disease notification hotline at 1-800-362-2736.
Research opportunities: Each foodborne outbreak investigation teaches us more about the nature of disease. Furthermore, outbreak investigations often unexpectedly identify people at greater risk for illness, breakdowns in disease-prevention procedures, drug vaccine failures, and numerous other factors that affect the public’s health. The more that is learned in each outbreak investigation the better public health can prevent future outbreaks.
Training opportunities: Many methods used in foodborne illness outbreak investigations are fundamental to investigations of all infectious disease. By conducting “routine” foodborne illness investigations, agencies are better prepared to investigate and control more serious, more widespread outbreaks.
Legal challenges: Foodborne illness outbreaks may lead to legal action, such as fines, closures, and lawsuits. The significant costs and reputations of parties involved require an objective, scientifically sound investigation by each agency.
Public interaction opportunities: Outbreak investigations demonstrate to the public the constant need for public health actions to prevent and control diseases. Each outbreak investigation should be viewed as an opportunity to build relationships with the community to deliver the core functions of public health