NAME CountyRevenge of the Lunch Lady

Table Top ExerciseDate

Welcome!

NAME COUNTY

Revenge of the Lunch Lady

Table Top Exercise

Date

Purpose Statement

The purpose of today’s exercise is to improve communication and coordination between government agencies at multiple levels as well as improve understanding of the roles and responsibilities of each agency as it relates to a food safety and public health.

This exercise will be based on a food poising outbreak within a school system.

The exercise will focus on evaluation of Communications and Emergency Public Information and Warning, with particular regard to the response phase.

Exercise Ground Rules

• Turn off all cell phones and pagers

• Only one person speaking at a time

• Be respectful of other opinions

• Be respectful as you express your thoughts

• Limit side-bar conversations

• Contribute to the discussion

• Create a mindset that allows for learning

• Enjoy the exercise

Controller/Facilitator

• Moderates the discussion

• Focuses players on issues relating to objectives

• Clarifies issues relating to the scenario

• Injects events, messages, and other information to stimulate discussion

• Moderates Hot Wash

Players

• Follow Facilitator/Controller Directions

• Use Policy & Procedure, Administrative Rules, or any other documents that prescribe and aid in making decisions

• Keep track of any issues

Evaluator’s Role

• Discretely observe players

• Impartially judge whether objectives are discussed and to what degree the objectives have been met

• Make recommendations based upon the improvement plan

• Participate in evaluator debriefing

Background

Each day millions of Americans head to their local grocery store to purchase food, relying upon government to ensure that the food they are purchasing is safe for them to eat. However, over the past few years we have seen an unprecedented number of cases in which the food we purchase is not safe for consumption. There has been salmonella in peanut butter, botulism in carrot juice, melamine in candy, and listeria in cheese.

Background – Continued

Each year approximately 76 million people in the United States are sickened by contaminated food, hundreds of thousands are hospitalized, and about 5,000 die, public health experts estimate.

Background – Continued

While growers and producers have primary responsibility for maintaining the safety of our food system, local and state government agencies must be prepared to respond to a breach in this system, with the goal of controlling the incident before it becomes catastrophic.

Phase 1

Tuesday, November 10, 2009, 8:00 am, Silver Eagle School System, Vista County

The Silver Eagle School System accommodates children in grades Pre-K through 12th grade. There are seven schools, with more than 1,600 students in total. On this particular morning approximately 25% of the student body is absent due to illness, primarily children ages four through seven.

Phase 1 – Continued

Tuesday, November 10, 2009, 1:00 pm

Silver Eagle School System, Vista County

Throughout the morning and lunch period there has been a steady number of students going home because they are sick. The symptoms expressed by the students include nausea, vomiting, diarrhea, headache, fever, and fatigue.

Phase 1 – Continued

Tuesday, November 10, 2009, 3:00 pm, Silver Eagle School System, Vista County

The School District Superintendent has become aware of the situation through conversation with the area principals, and has contacted the local health department. The schools are now collecting contact information for each of the absent students to supply to the Health Department. The Health Department suspets the students have become sick from salmonella poisoning which they will confirm through stool cultures and epidemiological histories. The Health Department has put a hold on all of the food within the school cafeterias and has sent samples of food to the Bureau of Laboratory Services for testing.

Phase 1 - Questions

• Who from the Health Department oversees the collection of stool samples and epidemiological histories?

• Is the State Department of Health Services actively involved in the process? If so, who contacts them and what role do they play?

• Is DATCP contacted? Who contacts DATCP? Who within DATCP is contacted?

• What actions does DATCP take once notified?

• Are DATCP and Public Health working together? If so, how?

Phase 1 – Questions - Continued

• Is County Emergency Management contacted? If not, at what point are they contacted, and by whom?

• What does County Emergency Management do once they are notified of the situation?

• Is a PIO appointed? Are multiple PIOs appointed? If so, which agencies will appoint a PIO?

• How will the PIO(s) coordinate consistency among their messages?

• How will the PIO(s) address rumor control and public panic?

• Who else is notified and by whom?

• What information is relayed in the notification process?

Phase 2Wednesday, November 11, 2009, 8:00 am Silver Eagle School System, Vista County

Attendance within the School System is extremely low, with only about 20% of students showing up for classes today. The area high school has the highest rate of attendance (50%) and the grade schools have the lowest (10%). Additionally, a few of the teachers and staff have called in sick with similar symptoms of illness. These findings are compatible with the Health Department’s initial diagnosis of a food poisoning outbreak within the school cafeteria.

Phase 2 - Continued

Thursday, November 12, 2009, 7:00 pm, Vista County Sheriff’s Department

The Vista County Sheriff’s Department has contacted the local health department. Yesterday evening a significant number of inmates began exhibiting flu-like symptoms. By the next morning even more inmates were exhibiting similar symptoms. And, this evening, by dinner time, more than half of the inmates have come down with the same illness. The Health Department is investigating the situation to see what sort of link, if any, may exist between the outbreak at the prison and the local school system.

Phase 2 - Questions

• How do the roles of the local and state health departments change as the scope of the situation grows?

• How does DATCPs role change as the scope of the situation changes?

• How does the role of the County Emergency Management Department change as the situation grows?

• Is a County EOC established? If not, at what point would one be established? Who makes this decision? How is the EOC activated? What role does the EOC play?

Phase 2 – Questions - Continued

• Who else is notified and by whom?

• What will Public Health and DATCP be expecting from these other agencies?

• What role do these other agencies see themselves assuming during the response phase?

• Are new/additional PIO(s) appointed?

• How will the PIO(s) work together to address rumor control, public panic, and coordinate consistent messages?

Phase 3Friday, November 13, 2009 10:30 am, Vista County Health Department, Laboratory Services

Milk is the suspected culprit. Although the foods served within the schools and prison systems are different, milk is offered at schools and prisons with each snack or meal each day. Happy Cows Dairy is the distributor of the single serving white and chocolate milk drinks offered in each institution.

Happy Cows Dairy is a large dairy cooperative with more than 2,000 dairy farmer members in a five-state region. Annually they produce nearly 4 billion pounds of milk with annual sales near $1.5 billion. Additionally, Happy Cows Dairy is inspected by both the State and the USDA.

Phase 3 - Continued

Friday, November 13, 2009 2:00 pm, Department of Agriculture, Trade & Consumer Protection

Field staff from the Food Safety Division of DATCP have met with management of the Happy Cows Diary. They have determined that the students and inmates consumed milk from a batch which was pasteurized and bottled at the local facility during the week of November 2nd. Additionally, they have also identified other institutions which may have received milk from the same batch – including a local nursing home, a neighboring school system, and a senior citizens activity center.

Phase 3 - Questions

• How do the roles of the local and state health departments change as the scope of the situation continues to grow and the source of the contamination has been identified?

• How does the role of DATCP change as the scope of the situation continues to grow and the source of the contamination is identified?

• Is the USDA contacted? Who contacts them? What role will the USDA play in the investigation process?

• How does the role of the County Emergency Management Department change as the scope of the situation continues to grow and the contaminant is identified?

• At what point will the State EOC be activated? Who makes this decision? How is the SEOC activated? What role does the SEOC play?

Phase 3 – Questions - Continued

• Who else is notified and by whom?

• What will Public Health and DATCP be expecting from these other agencies?

• What role do these other agencies see themselves assuming during the response phase?

• How does the role of the PIO(s) change as the situation changes?

• Are new/additional PIOs appointed?

• How will PIOs ensure consistency in messages?

Phase 4Friday, November 13, 2009, 2:30 pm, Happy Cows DairyDATCP Food Safety officers have been deployed to the dairy to collect milk samples, perform environmental swabbing, and inspect packaging operations. The milk samples will be hand delivered to the Bureau of Laboratory Services (BLS) where it will be tested for salmonella.

Saturday, November 14, 2009, 10:30 am, Bureau of Laboratory ServicesStool samples have been collected and cultured; preliminary test results are now available. The Health Department announces that they have a presumptive positive for Salmonella. More tests will be run to identify the bacteria strain and type. It may take more than two weeks before both the strain and type are identified.

Phase 4 - Continued

Sunday, November 14, 2009, 4:00 pm, Bureau of Laboratory Services

Initial tests on the milk samples have been completed and the results are a presumptive positive for Salmonella.

Thursday, November 19, 2009, 11:15 am, Bureau of Laboratory Services

The BLS reports that the test results from the Happy Cows Dairy milk samples have resulted in a confirmed positive for Salmonella. The laboratory will send the milk samples to the State Hygiene Lab for continued testing of the samples to determine the type and strain of Salmonella present in the milk products.

Phase 4 - Questions

• What happens to the dairy during this process?

• Who has the authority to temporarily close the Happy Cows Dairy? If no agency has this authority, how might the Diary be encouraged to close, even if it is resistant to the idea?

• What happens to the milk usually shipped to the diary during this process?

• At what point would a recall be placed on milk products from the Dairy? Who has the authority to implement a recall? How is a recall implemented?

• What is the department of health doing as the investigation continues?

• What is the USDA doing as the investigation continues?

Phase 4 – Questions - Continued

• What is DATCP doing as the investigation continues?

• Would DATCPs role in the investigation be different if the Dairy had not been a USDA inspected facility? If so, then how?

• What is the County EOC doing during the investigation process? How long with the County EOC remain in operation?

• What is the State EOC doing during the investigation process? How long with the State EOC remain in operation?

• How does the role of the PIO(s) change as the situation changes?

End of Exercise

• What worked well?

• In what way did you find this exercise valuable?

• What needs improvement?

• Suggestions on how to make these improvements, specifically?

Hot Wash