California Food Emergency Response Team

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California Department of Public
Health
Food and Drug Branch
San Joaquin County
All Hazards Workshop
August 2008
Food and Drug Branch
 Three sections: Food Safety, Drug Safety, and
Medical Device Safety
 Food Safety includes
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Processed food registration and inspection
Industry education and training
Bottled and vended water program
Seafood inspection
Emergency response and food security
Retail food program
Consumer complaint program
Food and Drug Lab Branch
 Public health reference and research lab
 Sister agency to Food and Drug Branch
 Includes Chemistry, Microbiology, and
Abused Substances Analysis Sections
 Analyzes food, drugs, cosmetics, medical
devices, and environmental samples
 Supports FDB in outbreak investigations
and inspection activities
Emergency Response
 Emergency Response
Unit in the Food Safety
Section
– Investigates foodborne
illness outbreaks
– Investigates tampering
incidents
– Participates in
preventive outreach
efforts including food
defense
Before
After
Tampering cases
How does this protect public health?
 Outcomes from previous investigations
– Almond industry has adopted a “kill step” for raw
almonds
– Strawberry industry has modified the method of harvest
of strawberries for processing
– New commodity-specific guidelines for sprouts,
tomatoes and lettuce
– Produce industry has begun to think of harvest workers
as food handlers, enforcing hand washing procedures
and harvest equipment sanitation
How are local health jurisdictions
involved?
 Illnesses are reported by local public health to
state health Division of Communicable Disease
Control (DCDC) and by DCDC to CDC
 DCDC provides information to FDB about clusters
of illnesses where food may be the vehicle
– If a food vehicle is implicated by epidemiological
investigation (statistically significant association), FDB
begins an environmental investigation
– FDA is informed, and if interstate commerce is involved,
becomes the lead agency
How are local health jurisdictions
involved?
 Local health department will be asked to supply
information about the Point of Service (POS) for
select case-patients
– Those with clear recall of where/when they ate the
implicated food
 If it is necessary to visit the retail POS, local
environmental health will be invited to participate
 Environmental health may be asked to collect
documentation, such as invoices. The time period
for which the documentation is needed is critical.
Foodborne outbreak investigations
The environmental investigation may include
– Environmental investigation at the point of
service
– Traceback to manufacturer and/or farm
– Environmental investigation at the manufacturer
– Sampling product
– Environmental sampling
– Farm investigation
– Collection and examination of records
How does FDB relate to other state
agencies dealing with food?
 Dairy products are regulated by California
Department of Food and Agriculture (CDFA) and
US FDA
 Many egg ranches participate in the California Egg
Quality Assurance Program (CEQAP), a CDFA
program intended to control SE
 Foodborne illness investigations involving dairy
and egg products are conducted jointly with CDFA
 Fruit and vegetable growers must follow guidelines
regarding pest control overseen by the county
Agricultural Commissioner
 FDB advises CDFA of illness investigations
involving California produce
What is CalFERT?
 The California Food Emergency Response Team is a
group of state and federal Investigators and Scientists that
conduct environmental investigations of foodborne illness
outbreaks.
 Food and Drug Investigators from state Food and Drug
Branch (FDB) are peace officers and have the authority to
embargo food products that may be contaminated.
 Investigators/Consumer Safety Officers from FDA are
associated with the Los Angeles and San Francisco District
Offices
 Scientists include microbiologists associated with FDA
labs, and research scientists associated with the
Emergency Response Unit in FDB
What outbreaks has the team
investigated?
 State and federal investigators have worked side by side
on investigations in the past.
 During the Salmonella Enteritidis outbreak associated with
almonds in 2004, investigators and laboratorians from both
agencies worked together as a team
 In 2005, the team was formally established and met
together outside of outbreak situations to develop protocols
 In the fall of 2005, those protocols were put into practice for
the first time during the E. coli O157:H7 outbreak
associated with bagged lettuce and a Salmonella
Enteritidis outbreak associated with tomatoes
What outbreaks has the team
investigated?
 In the fall and winter of 2006-2007, the team
investigated E. coli O157:H7 outbreaks associated
with spinach and shredded lettuce (Taco Bell and
Taco John)
 Follow-up to the outbreaks associated with leafy
greens has included review and input by CDHSFDB and US FDA of the document that became
the “Best Practices” for safe growing and handling
under the Leafy Greens Marketing Agreement.
 Most recent investigation was a romaineassociated E. coli O157:H7 outbreak in the state
of Washington
FDB Website contains food defense brochures in four
languages, outbreak investigation reports, and posters
on CalFERT and the Taco John investigation
http://www.cdph.ca.gov/programs/Pages/FDB%20Food%20and%20Drug%
20Branch.aspx
See http://www.cdph.ca.gov/programs/bes/Pages/default.aspx
for CDHS Bioterrorism Surveillance and Epidemiologic
Response Plan
Contact: Mary Palumbo, (916) 650-6623 or
mary.palumbo@cdph.ca.gov
Questions?
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