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

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

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.

Public Health Food Defense Emergency Response Plan

My jurisdiction has a public health food defense emergency response plan.

Feedback Poll

A. Yes

B. No

Public Health Food Defense Emergency Response Plan

Complex nature of food defense

Federal

State

Local

Industry

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)

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

Complex Nature of Food Defense

Local

Health departments

Hospitals and health care systems

Emergency medical services

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

Complex Nature of Food Defense

Industry

Retail food establishments

Associations that support restaurants

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.

Writing a Food Defense Emergency Response Plan

Step 2:

Focus on your part of food defense.

STATE

LOCAL

FEDERAL INDUSTRY

Step 3: Identify state public health programs with food defense responsibilities.State of Oregon Public Health, Offices of:

1. Public Health Preparedness (Preparedness)

2. Multicultural Health (Multicultural)

3. Public Health Laboratories (Labs)

4. Family Health (Family)

5. Community Health & Health Planning (Community)

6. Environmental Public Health (Environmental)

7. Disease Prevention & Epidemiology (Epi)

Writing a State Food Defense Emergency Response Plan

Step 4:

Organize a working group.

Writing a Food Defense Emergency Response Plan

Step 5:

Write a draft public health food defense plan.

Writing a Food Defense Emergency Response Plan

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.

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.

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

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

State Office of Public Health Preparedness

• Provide information on:o Food process being used to

confirm or rule out contamination of the food supply

o When/where the presumed incident took place

o When additional information will be available

o Precautions taken to prevent additional contamination

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.

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.

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

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.

• 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.

State Office of Environmental Public Health

Foodborne Illness Prevention Program

• 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.

State Office of Environmental Public Health

Environmental and Occupational Epidemiology (EOE)

• 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.

State Office of Disease Prevention and Epidemiology

Acute and Communicable Disease Prevention Program

Training

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

Exercise Design

• Exercise orientations

• Tabletop exercises

• Functional exercises

• Full-scale exercises

• Homeland Security Exercise Evaluation Program (HSEEP)

Exercise Design Committee will design and deliver:

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

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.

Plan Maintenance

• Revised annually.

• Revised from previous year exercises or emergencies.

• Food Program will conduct this review.

Public Food Defense Emergency Response Plan