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

BACKGROUND:  Each year approximately 1 in 6 Americans get sick with a foodborne disease (FBD), resulting in 128,000 hospitalizations and 3,000 deaths. Decreased resources have negatively impacted the ability of public health officials to identify, respond to, and control FBD outbreaks. FoodCORE provides targeted resources to state and local health department participants to improve the completeness and timeliness of laboratory, epidemiology, and environmental health activities for FBD surveillance and outbreak response. Current FoodCORE centers are Colorado, Connecticut, Minnesota, New York City, Ohio, Oregon, South Carolina, Tennessee, Utah, and Wisconsin. 

METHODS:  FoodCORE centers were selected through a competitive award and implemented work plans to make outbreak response activities faster and more complete in their jurisdiction. Performance metrics, based on Guidelines of the Council to Improve Foodborne Outbreak Response, are used to quantitatively evaluate the impact and effectiveness of their activities. Strategies resulting in faster, more complete surveillance and response are documented and shared with local and state FBD programs across the country.

RESULTS:  

From the first year (Y1) of the program in October 2010 to the end of the fourth year (Y4) in December 2014, the centers reduced the average time to complete Salmonella and Shiga toxin-producing Escherichia coli (STEC) serotyping from 6.5 days to 3.5 days. The centers attempted to interview an average of 99% of Salmonella, STEC, and Listeria patients while continuing to reduce the average time to attempt an interview from 3.7 days to 0.9 days. In Y4, vehicles were confirmed for 35% more Listeria clusters than in Y3. Between Y3 and Y4, the average number of norovirus investigations per FoodCORE center increased from 37 to 93. Even with a greater number of investigations, FoodCORE centers conducted analytic studies for 50% of these investigations in Y4, nearly 13% more than Y3. Based on their experiences and successes, model practices were developed on streamlining and standardizing patient interviewing, isolate receipt and testing, and establishing student interview teams.

CONCLUSIONS:  FoodCORE centers demonstrate that targeted investments can improve the completeness and timeliness of FBD surveillance and outbreak response. By conducting fast, thorough investigations, the centers contribute critical information to help solve outbreaks quickly, remove contaminated foods from commerce, and ultimately help stop the spread of FBD. FoodCORE centers continue to document lessons learned while strengthening their systems as model practices to inform efforts to improve outbreak response in other state and local health departments or international public health settings.