Texas Rapid Response Team for Foodborne Illness

Julie Loera and Debbra Callan

Texas Department of State Health Services

April 5, 2012

Foodborne Illness in the US

Each Year

48 million people (1 in 6)128,000 Hospitalized

3000 deaths

Source: Centers for Disease Control and Prevention www.cdc.gov

Multi-State Foodborne Illness Outbreaks -2011

• Ground Beef - Salmonella Typhimurium

• Romaine Lettuce - Escherichia coli O157:H7

• Kosher Broiled Chicken Livers - Salmonella Heidelberg

• Turkish Pine Nuts - Salmonella Enteritidis

Jensen Farms Cantaloupes - Listeria monocytogenes

• Ground Turkey - Salmonella Heidelberg

Whole, Fresh Imported Papayas - Salmonella Agona

• Alfalfa and Spicy Sprouts – Salmonella Enteritidis

• Turkey Burgers - Salmonella Hadar

• Lebanon Bologna - Escherichia coli O157:H7

• Del Monte Cantaloupe - Salmonella Panama

• Hazelnuts - Escherichia coli O157:H7

Source: Centers for Disease Control and Prevention www.cdc.gov

Notable Past Outbreaks • 2010

– Shell Eggs - Salmonella Enteritidis • 1939 cases in ~11 states

2009– Peanut Butter - Salmonella Typhimurium

• 714 cases in 46 states 2008

– Raw Produce - Salmonella Saintpaul• 1442 cases in 43 states

Source: Centers for Disease Control and Prevention www.cdc.gov

Takes a Multi-level Team EffortFederal, State, Local

Epidemiologists LaboratoriansEnvironmental

SpecialistsSubject Matter

ExpertsRegulatory Officials

PFGE – Food CSI

Pulse Field Gel Electrophoresis

Links human casesLinks human cases to food

Links food to a facility (plant or farm)

http://www.cdc.gov/pulsenet/

PFGE Results

Source: Texas Department of State Health Services Laboratory Services

Importance of Solving the Outbreak

Message to consumers Stop the source

Prevent recurrence

National Rapid Response Team Concept

• Surveillance, investigation, and response, to alleged food-related incidents and emergencies

• Collection, analysis, and dissemination of information that may prevent recurrence

• Response to all food hazard incidents in the farm to table continuum using ICS

• Operate in conjunction with other food and feed agencies, other state RRTs, FDA district offices, and state emergency response operations centers.

Rapid Response TeamsCurrently 9 active teams nationwide

• 6 states piloted in 2008• 3 additional states added in 2009

9 states coordinate• Yearly meetings• Work groups to produce standard

documentsRequest for proposal open for additional

teams

Texas Rapid Response Team (TRRT)Texas Department of State Health Services

• Infectious Diseases Branch• Laboratory Services• Regulatory Division

Office Of the Texas State ChemistUS Food and Drug Administration

• Dallas District Office• Southwest Import District• Southwest Regional Office• Food Emergency Response Network (FERN)

Scope of Team Operations

The purpose of the TRRT is to provide preparedness, prevention, and timely response to food and/or feed related disasters that may affect the citizens of Texas.

The TRRT may respond to large scale investigations involving food and/or feed and large scale recalls of food and/or feed. It is not intended to include a natural disaster (hurricane, forest fire, etc.). However, there may be outcomes of a natural disaster that require the activation of all or portions of the TRRT under the State of Texas Emergency Operations Command.

Highlights of the TRRT

• ICS Structure– Combined Federal/State Team

• Response Operating Guidelines• Communication Platform – Traction®

Software – Allows remote uploading – Sharing of extensive traceback records– Ability to pull in other RRT States

Incident Commander

Operations Chief

Animal Feed Branch

Human Food Branch

Planning Chief

Situation Unit (SMEs)

Documentation Unit

Resource Unit

Logistics Chief

Service Support Unit

IT Unit (As needed)

Finance Chief

Public Information

OfficerSafety Officer

Liaison Officer

Texas Rapid ResponseTeam

Agency RepresentativesState Agency Directors FDA District DirectorFDA Director/InvestigationsFDA Director/ComplianceFDA Director FERNTDA Emergency Response Coordinator

Texas RRT Response Operating GuideTable of Contents

I. Authority II. Purpose & Scope III. Acronyms and Definitions IV. Situations and Assumptions V. Concept of Operations

A. Operations B. Communications C. Working with Other Agencies

VI. Document Control VII. Appendices

A. TRRT Distribution Lists B. Activation and Deactivation Standard

Operating Procedure C. Communication Standard Operating

Procedure

Our Long Hard Road – Step 1

Our Long Hard Road – Step 2

Source: Centers for Disease Control and Prevention www.cdc.gov

We’ve Made It Halfway– Step 3

TRRT – Step 4

• ROG - APPENDIX B – Activation/Deactivation SOP – approved March 2012– Describes potential triggers for team activation– Delineates the process for team activation– Delineates the process for team deactivation

• All Team training and meeting in Austin November 2011

• Working on Sampling, Training, and Traction® SOPs

Next Steps

• Food Emergency Response Plan – Annex O- Appendix to the State Emergency Response Plan – in draft

• TRRT Table Top – April 28th, 2012– Austin• Functional Exercise – Fall 2012 • Continue Work on TRRT Standard Operating

Procedures• Potential National Exercise with all Rapid

Response Teams

Questions??

Contact Information

Julie Loera

512-834-6770 ext 2342

julie.loera@dshs.state.tx.us

Debbra Callan

512-834-6770 ext 2484

debbra.callan@dshs.state.tx.us