Improving Foodborne Disease Outbreak Response Capacity in State and Local Health Departments Through the Foodborne Diseases Centers for Outbreak Response Enhancement (FoodCORE)

Background:  Each year foodborne diseases (FBD) cause approximately 48 million illnesses, 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 provides targeted resources to state and local health departments to improve the completeness and timeliness of laboratory, epidemiology, and environmental health activities for FBD surveillance and outbreak response.      

Methods:  FoodCORE centers implement work plans to make outbreak response faster and more complete in their jurisdiction.  Centers work collaboratively to develop and implement metrics and model practices for FBD response that are designed to be replicable in other jurisdictions.  The current centers are Connecticut, New York City, Ohio, South Carolina, Tennessee, Utah, and Wisconsin. 

Results:  Since the program began in October 2010, centers reduced the time to subtype Salmonella by more than 60%, from 13 days to 5 days, and attempted interviews for a higher proportion of Salmonella case-patients, from 88% to 98%.  The centers document the practices that result in improvements.  An interviewing model practice describes triage and routing of case-patient reporting and the process of attempting interviews with case-patients, recommends categories and essential elements to ascertain during an initial enteric disease interview, and provides a checklist to determine alignment of initial interview practice.  A laboratory model practice describes practices for specimen receipt and subtyping and strategies for cluster detection and reporting results.

Conclusions: By conducting fast, thorough investigations, the centers contribute critical information to help solve outbreaks quickly and ultimately help stop the spread of foodborne disease.  FoodCORE strategies and model practices could be replicated in state and local health departments or international public health settings with similar infrastructures to improve FBD response.