NTF Annual Conference February 16, 2012 Dr. Regina Tan Director, Applied Epidemiology Division...
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Transcript of NTF Annual Conference February 16, 2012 Dr. Regina Tan Director, Applied Epidemiology Division...
NTF Annual ConferenceFebruary 16, 2012
Dr. Regina TanDirector, Applied Epidemiology Division
Office of Public Health ScienceFood Safety and Inspection Service
Potential Changes in Information Sharing
• Special-emphasis Salmonella• As you can imagine, our members will also be
especially interested in Salmonella, but you wouldn’t have to talk policy – Dan E. is speaking the next day so I can make sure those type of questions are directed towards him.
• If you are available, I’m happy to send over a formal invite. The meeting runs from 1-5pm and we can work around your schedule as to which specific time would be best. This slide contains quotes from the original presentation request. It’s
purpose is only to ensure the presentation is written to meet the needs of the audience. The slide will be deleted prior to presentation delivery.
Proposed Agenda• Bottom Line Up Front• Foodborne Illness Investigations
– Directive 8080.3– Anatomy of an investigation– Information-sharing opportunities– Example traceback
• Consumer Complaints– Directive 5610.1– Anatomy of a complaint investigation– Information-sharing opportunities
Bottom Line Up Front
• Partners in prevention• Shared importance in safety of food• Shared importance in consumer trust• Always opportunities to improve• Welcome conversations to do so
ILLNESS INVESTIGATIONS
Directive 8080.3
Key Points :• Factors determining whether to submit a
product sample• Collecting, preparing, and shipping
product samples• Field activities during a foodborne illness
investigation (Environmental assessment)• Procedures for analyzing data• Agency responses to the findings of a
foodborne illness investigation
FSIS Homepage search “8080.3”
Anatomy of an InvestigationNotification
• Local/State Territorial DOH
• CDC or FDA• Internal
Surveillance• Media
reports• Other parts
of FSIS
Evaluation
• Is it FSIS-regulated product?
• Is there a link to illness?
• Are methods scientifically valid?
• Are lab/epi/ environmental findings consistent?
Was the sample intact?Did it suffer temperature abuse?Was it properly stored to avoid
cross-contamination?Are the product labels available
for product identification?
*Initiate Investigation
Anatomy of an Investigation
OPEER: Traceback & Traceforward
• In commerce• Product sampling• Product info• Locate/detain
product• Product
tampering
OFO: Traceback & Traceforward
• Under est. control
• Product sampling• Supplier info• Same- or like-
coded product
OPHS: Analysis and Assessment
• Population-descriptive information
• Common source• Geographic and
temporal distribution w.r.t. product distribution
• Alternative hypotheses
• Biological plausability
Did exposure precede illness?Was illness consistent with known clinical
characteristics?Do Traceback/Forward suggest common
source?Are findings consistent with Agency
experience?Was disease confirmed by laboratory
analysis?
Concurrent activities require constant communication
Example Traceback
Points of Communication
• Directive 8080.3– CDC leads public health coordination– OPHS AED leads internal FSIS coordination– OFO leads coordination with establishment
• Discussion: Potential opportunities for communication
CONSUMER COMPLAINTS
Directive 5610.1: Origins• March 2001 OIG Investigation
Report
• CCMS established in November 2001– Provide centralized mean
of managing consumer complaints.
Directive 5610.1
• FSIS Directive 5610.1 – Procedures to Implement the Consumer Complaint Monitoring System
CCMS The System
• The CCMS System: Electronic database – Records Consumer Complaints for documentation– Triages Complaints for evaluation– Tracks and coordinates investigation
• Purpose: Facilitate detection of potential public health threats in the nation’s food supply and enable rapid response to mitigate such threats.
FNS, ODIFP, OPPD and other USDA Program Areas
Consumer
State/local DOHFDA
Meat & PoultryHotlineOFO or OPEER
CCMS FSIS-OPHS-AED-ZFHSB
FNS,ODIFP,* OPPED/LCPS*
and other USDA Program Areas
* Program Area with employees having direct access to CCMS, but generally use the system for review and not input of complaints.
Anatomy of a Complaint
Investigation
CCMS System
CCMS Team
FSIS OPHS AED
Investigation Information Consumer Contact Information Complaint
Type: Foreign object, Allergy, Illness, Other Description (symptoms, symptom onset time, known
allergies, etc) Food history, medical history, etc.
Product Information Brand Establishment number Lot codes/sell by dates, package size and type
Point of Purchase Information Name & location Purchase date
Issues Not Entered in CCMS
• Whistle-blower• Industry complaints initiated by a competitor• Retail-prepared product• Product tampering• Criminal violations of the FMIA, PPIA or EPIA• National School Lunch Program complaints NOT involving
an FSIS product • Quality issues involving meat cuts and grades• General concerns or comments
CCMS Issues• Initiated by a consumer or
on the consumer’s behalf • Directly related to an FSIS-
inspected product• Imported products re-
inspected by FSIS at the port of entry
• Complaint types:– Illness– Foreign Object– Injury– Allergic Reaction– Improper Labeling– Poor Quality– Economic Adulteration Pictures from the USDA Kitchen Companion
BACK-UP SLIDES
Multiple Locus VNTR Analysis Protocol
http://www.pulsenetinternational.org/SiteCollectionDocuments/mlva/MLVA_overview.pdf
Current State of MLVA
http://www.aphl.org/conferences/proceedings/Documents/2007_11th_Annual_PulseNet_Update_Meeting/MLVA_Protocol%20Update.pdf
Limitations of MLVA Use
To date, several schemes for MLVA subtyping of S. enteritidis have been published. However, the use of:
• Different loci in each protocol (or different promers for the same loci)• Different sequencer platforms• Dye chemistries and size standards used for fragment analysis• Differences in interpretation of loci where incomplete TRs or TRs of heterogeneous
sequence occur, and • Different ways of assigning allele numbers
means comparison of data between laboratories can be problematic.