Foodcore: Foodborne Diseases Centers for Outbreak Response Enhancement - Improving Foodborne Disease Outbreak Response Capacity in State and Local Health Departments

BACKGROUND:  Each year foodborne diseases (FBD) cause illness in approximately 1 in 6 Americans, resulting in 128,000 hospitalizations and 3,000 deaths. Decreasing resources impact the ability of public health officials to identify, respond to, and control FBD outbreaks. FoodCORE was established during 2010 to address gaps in FBD outbreak response by improving capacity in three core areas: laboratory, epidemiologic, and environmental health activities. The current FoodCORE centers are: Connecticut, New York City, Ohio, South Carolina, Tennessee, Utah, and Wisconsin.

METHODS: From 10/1/2010—09/30/2011, FoodCORE centers continued to work collaboratively to develop and implement best practice models for surveillance and rapid, coordinated, and standardized for and response to FBD outbreaks. Successes are documented using performance metrics based on the Council for Improving Foodborne Outbreak Response Guidelines. FoodCORE metrics are an essential tool in evaluating the impact and effectiveness of activities, documenting successes, identifying gaps, and quantifying the scope of work and resources necessary to have a complete FBD response program.  FoodCORE centers convene regularly, provide quarterly reports, and collaborate with other FBD programs to discuss, document, and share best practices. The centers work to develop and hone cluster detection and data management methodologies based on locally available data.     

RESULTS:  Since implementation, centers have improved completeness and timeliness for laboratory and epidemiologic activities. The laboratories received a total of 8,264 Salmonella, 916 Shiga toxin-producing Escherichia coli (STEC), and 89 Listeria (SSL) submissions. Laboratories were able to increase and maintain the proportion of isolates subtyped by serotyping and PFGE.  Epidemiology programs were notified of 7,951 SSL cases (7,039 Salmonella, 820 STEC, and 92 Listeria). Combining data from the laboratory and epidemiologic interviews and investigations, FoodCORE centers identified 510 potential food poisoning clusters. Centers were able to identify a suspect vehicle for 17.5% (89/510) of these investigations, and a confirmed vehicle for 8.4% (43/510). FoodCORE centers routinely engage environmental health and/or regulatory partners, and are active participants in national outbreak surveillance. 

CONCLUSIONS: FoodCORE continues to promote the evaluation and application of surveillance and investigation strategies to improve the detection, investigation, and control of FBD outbreaks. Laboratory, epidemiologic, and environmental health best practices continue to be shared in implementing and evaluating what works best across diverse food safety jurisdictions. Enhanced outbreak response efforts can shorten the time it takes to identify a source of infection and pinpoint how and why contamination occurred, in order to limit additional illnesses and help prevent future FBD outbreaks.