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Author: Joann Lindenmayer, DVM,MPH

1. Introduction

ESSENTIAL PUBLIC HEALTH SERVICE #2: Diagnose and investigate health problems and health hazards in the community.

This includes epidemiologic identification of emerging health threats; public health laboratory capability using modern technology to conduct rapid screening and high volume testing; active infectious disease epidemiology programs; and technical capacity for epidemiologic investigation of disease outbreaks and patterns of chronic disease and injury

ACVPM MODEL CURRICULUM AREAS:

Food Safety: Food Safety in the Processing Plant (Sanitary requirements in food processing facilities, Regulatory requirements for food processing facilities), Biologic agents of foodborne disease (E. coli, salmonella spp., Staphylococcus spp., listeria, campylobacter), Food science/chemistry (critical factors in controlling food pathogens), Application of HAACP principles to food safety (agencies involved in regulation of food products, sanitary requirements), Foodborne disease surveillance and outbreak investigation

Zoonoses: Campylobacteriosis, E. coli 0157:H7 infection, Listeriosis, Salmonellosis

Environmental health: Location and use of human resources, agencies and laboratory services

Epidemiology and Biostatistics: Outbreak investigation (steps in investigating an outbreak, sample outbreak problem)

PRIMARY EXAMPLE: E. coli 0157:H7

SECONDARY EXAMPLES: Salmonellosis, Listeriosis, Campylobacteriosis (may revise this)

2. Learning Objectives

At the end of class, students should be able to:

  • List the steps to an outbreak investigation

  • Describe the elements of a Hazard Analysis and Control Points Plan (HAACP)

  • Name two surveillance systems involved in foodborne disease outbreaks and threats

  • Identify state and federal agencies, departments and programs involved in foodborne disease outbreaks

  • Know where to go for federal regulations pertaining to in-plant processing of food of animal origin (beef)

  • List three foodborne diseases of public health importance and discuss the role of veterinarians in preventing and controlling those disease

  • Apply epidemiologic and biostatistical skills and veterinary knowledge learned in first and second year courses to the resolution of an outbreak

  • Apply understanding of the organization of the public health system to make appropriate professional connections to resources and individuals involved in food safety

  • Discuss the importance of surveillance to the detection, implementation and evaluation of an outbreak

  • Identify which agencies should be involved in a multistate investigation of a foodborne outbreak and the responsibilities of each one

3. Required Reading

CDC. Multistate Outbreak of Salmonella Typhimurium Infections Associated with Eating Ground Beef --- United States, 2004. MMWR 2006; 55:180-182.

CDC. Principles of Epidemiology in Public Health Practice: An Introduction to Applied Epidemiology and Biostatistics (Third edition). Chapter 6: Investigating an Outbreak, pages 410-468 (or 6-1 to 6-58

Commonwealth of Massachusetts Government, Executive Office of Health and Human Services, Massachusetts Department of Health, Communicable Disease Control, Division of Epidemiology and Immunization, Epidemiology Program, Foodborne Illness. Foodborne Illness Investigation and Control Reference Manual

Chapter 1. History and Trends, pp. 1-12;

Chapter 2. Disease Characterization, pp. 1-17;

Chapter 4. Foodborne Illness Surveillance, pp. 1-21.

Report of the Blue Ribbon Task Force. The Future of FSIS Veterinarians: Public Health Professionals for the 21st Century. USDA, 2000

Executive Summary, pages i-iv;

Purpose and Scope, page 1;

The Task Force, page 2;

Background, pages 2-5;

What Veterinarians Bring to the Food Safety Table, pages 5-7;

Chapter I. Defining the Role of the FSIS Veterinarian, pages 8-16;

Chapter III. Partnerships, pages 23-26;

Chapter IV. Information Management Systems and Animal Identification, pages 26-30

Code of Federal Regulations. Title 9 – Animals and Animal Products, Chapter III – Food Safety and Inspection Service, Department of Agriculture, Part 417: Hazard Analysis and Critical Control Points Regulations, Subsection 17.2. Hazard Analysis and HAACP Plan

Healthy People 2010. Chapter 10: Food Safety , pages 1-19.

4. Required Websites

Centers for Disease Control and Prevention, Coordinating Center for Infectious Diseases, National Center for Infectious Diseases, Division of Bacterial and Mycotic Diseases, Foodborne and Diarrheal Diseases Branch

Food Net Program

Pulse Net Program

Outbreak Response and Surveillance Team