Presented by:
Roberta Hammond, PhD, RS.
Food and Waterborne Disease Coordinator
Division of Environmental Health
Contact Number: 850-245-4116

Hi, my name is Roberta Hammond. I am the Statewide Food borne Coordinator for the Department of Health. In this presentation, we will cover current food regulations, food borne outbreak surveillance & investigation, and steps for food safety preparedness.

Food is regulated by three different agencies in Florida. The Department of Health regulates institutions like childcare facilities, schools, nursing homes, hospitals, prisons, and churches, as well as bars and lounges that serve only pre-packaged food.

The Department of Business & Professional Regulation regulates restaurants, caterers, mobile food carts, and some temporary events. The Department of Agriculture and Consumer Services regulates grocery stores, bakeries, food processors and fast food associated with gas stations.

In terms of food borne outbreak investigation in Florida: the Bureau of Community Environmental Health investigates all food & water borne disease outbreaks associated with any of these venues. We use Epi teams all over the state. The statewide Epi team is the statewide coordinator with the nine regional food & waterborne disease epidemiologists and the food & waterborne disease preparedness coordinator. Locally the Epi teams consist of 67 county health department, environmental health, nursing, and epidemiologist staff teams. Make sure that you can get in touch with yours at any time.

The regional environmental epidemiologist’s functions include surveillance, providing investigation assistance on request of the county health department, and training to develop and provide county health departments staff training as it is needed.

How successful are we at tracking outbreaks? Well, we are getting there! Reported outbreaks about half of our reported outbreaks have a known etiology and about half have an identified vehicle.

What can you do? Cover your basics, assess your area, and monitor surveillance.

In terms of the basics, every county should have a food borne outbreak investigation kit with sample containers or several.  These were distributed last year, in 2003, to everyone in the 67 county health departments, as well as to satellite offices.  Know where they are and how to find them. Know the lead food and waterborne investigator in your area and make contact with them now before you have to. Know who your regional environmental epidemiologist is. Make sure you have your emergency contact list for your area handy, including keeping them at home or in your car. You never know when you may need them.  Make sure food borne outbreaks are integrated with your all-hazards planning.

In terms of assessment: in assessing your area, a food borne terrorism event will most likely look like a standard outbreak at first, which counties will investigate. Outbreaks are likely to be reported initially to the health department, a restaurant or grocery store the inspecting agency (that might be any of the three agencies), poison control centers, the event organizer (if it a wedding or conference), and sometimes to the newspaper. That means that all of these entities are your partners in preparedness. Open your communication lines now before the event happens.

In terms of monitoring surveillance, you need to know the local data for potential food borne pathogens. Over the past ten years, Florida has averaged about 292 outbreaks a year with 2,172 cases a year. In 2003, we investigated 189 outbreaks with 1,654 cases and in 2002, 243 outbreaks with about 1,500 cases.

More than 337 large, that 10 or more cases, outbreaks during the 10 year period were investigated with more than 13,000 cases. Of those large outbreaks, 10 or more people, 36% of them were determined to be Norovirus outbreaks. This is also the highest nationally, as well, and 36% of the cases were also Norovirus. Salmonella follows Norovirus, followed by Clostridium Perfringens, unknown pathogens and then food borne Hepatitis A is at the bottom of the list with around 1% of the cases.

As far as surveillance goes: statewide about 80% of our outbreaks in the pass 10 years were at restaurants, 6% were at grocery stores, 4% were at homes, 2% at schools, 2% nursing home and hospitals, and waterborne outbreaks consisted of 2%, followed by 5% of other outbreaks.

As far as surveillance goes: statewide about 80% of our outbreaks in the pass 10 years were at restaurants, 6% were at grocery stores, 4% were at homes, 2% at schools, 2% nursing home and hospitals, and waterborne outbreaks consisted of 2%, followed by 5% of other outbreaks.