Model Practices Communicate Strategies for Improved Foodborne Disease Outbreak Response

Background:  Foodborne disease (FBD) sickens approximately 1 in 6 Americans each year, resulting in 128,000 hospitalizations and 3,000 deaths. Decreased resources have reduced the ability of state and local public health officials to identify, respond to, and control disease outbreaks. This decreased capacity can directly impact the timeliness and completeness of FBD outbreak response.

Program background:  Foodborne Diseases Centers for Outbreak Response Enhancement (FoodCORE) provide targeted resources for participating health departments to test innovative practices that may improve the completeness and timeliness of laboratory, epidemiology, and environmental health activities for FBD surveillance and outbreak response. FoodCORE centers analyze their systems and implement practices designed to strengthen outbreak response activities in their jurisdiction. The centers document successful strategies as model practices, which are communicated to other state and local FBD programs to inform efforts to improve outbreak response.

Evaluation Methods and Results:  FoodCORE centers use performance metrics for ongoing process evaluation to identify practices that effectively improve completeness and timeliness for outbreak response activities that are consistently successful across the various public health infrastructures represented within the program. From these experiences and successes, three model practices that include checklists of tasks, examples of implementation, and resources, have been developed. The first model practice presents interviewing strategies used by FoodCORE centers that resulted in increasing the proportion of case interviews from 93% to 99% and simultaneously reduced the average time to attempt an interview from 3.7 to 0.9 days. The second summarizes laboratory practices that were implemented to reduce the average time to complete bacterial serotyping from 6.5 to 3.5 days. The third model practice describes how to establish and maintain a team of students to support routine and surge capacity. The model practices are distributed by FoodCORE to over 1,000 state and local public health officials through the centers’ partnership networks, email listservs of other FBD programs, and social media targeting public health practitioners. FoodCORE centers also work directly with other public health partners, including the Integrated Food Safety Centers of Excellence, to foster peer-to-peer learning. Additionally, the model practices are publically available on the FoodCORE website and have been viewed over 750 times.

Conclusions:  FoodCORE model practices, validated by performance metrics, describe efficient and improved practices which have resulted in faster, more complete detection, investigation, response, and control of outbreaks of FBD. These readily available resources are shared with other state and local FBD programs to implement in their own jurisdictions to increase capacity and achieve faster, more thorough investigations to ultimately help stop the spread of FBD.

Implications for research and/or practice:  FoodCORE centers continue to contribute to the improvement of outbreak response at the state and local level by identifying, documenting, and distributing replicable model practices. Elements of the model practices may be applied in other public health settings, enabling other jurisdictions to make process and system changes that have been shown to be effective at improving completeness and timeliness of surveillance and response activities. Continued communication of evidence-based practices between health departments facilitates a network of peer-to-peer education and increases the availability of resources.