'I object!'The impact of the legal system on an outbreak investigation

Introduction: Legal action can make an outbreak investigation politically sensitive and more complex.

Methods: In May 2006, the Maricopa County Department of Public Health (MCDPH) Office of Epidemiology (Epi) investigated an outbreak at a local restaurant. The restaurant was on probationary status with the Maricopa County Environmental Services Department (ES) for previous violations. Based on results of the outbreak inspection, ES temporarily revoked the restaurant's permit. Additionally, the Maricopa County Attorney's Office (MCAO) initiated prosecution of the restaurant for violations of the food code. A press conference was held to announce the prosecution, resulting in added attention from the general public, patrons of the restaurant, and the restaurant owners.

Results: The county attorney's prosecution, litigation by ill patrons, and the resulting media attention complicated the outbreak investigation with requests from attorneys for records, interviews of investigative staff by defense attorneys, irritated calls from owners and supporters of the restaurant, and added pressure to complete the narrative report more rapidly than the norm

Conclusions: The following are recommended for outbreak investigations involving legal action: 1. Plan additional time and resources to meet demand for information from attorneys, media, restaurant owners, and others. 2. As with all investigations, maintain frequently updated, easily accessible, and complete records. 3. Expect the investigation time table to speed up. 4. Prepare for investigator-attorney interviews by collecting and reviewing data.