The first response to an emergency is EMERGENCY ASSESSMENT. FOOD AND WATERBORNE OUTBREAK INVESTIGATION

1. EHS 314: ENVIRONMENTAL
HEALTH SERVICES IN
EMERGENCY SITUATIONS
LECTURER: Ms. OLULEGAN

2. The first
response to an
emergency is
EMERGENCY
ASSESSMENT.

3. Emergency
assessments
should allow
the following:

4. An initial decision
to be made on
whether
assistance is
needed

5. A decision to be
made on whether
local capacity is
adequate or
external resources
are required

6. Priorities for
intervention
is to be
established

7. An intervention
strategy should
be identified

8. Necessary
resources to
be identified

9. Base-line data to
be collected, to
facilitate
monitoring

10. Information to
be collected for
fund-raising and
advocacy work.

15. Foodborne diseases,
intoxications or
infections are terms
applied to illnesses
acquired by
consumption of
contaminated food or
water.

16. Foodborne disease outbreaks
are recognized by the
occurrence of gastrointestinal
illness within a variable time
period (minutes to days) after
consumption of shared or
similar food or water sources
among individuals.

17. Specifically, the
occurrence of the
potential for
foodborne illness
must be considered
when two or more
individuals:

18. Have symptoms
of diarrhea
and/or vomiting

19. Have similar
incubation
periods

20. Have a
shared food
and/or water
source

21. Have symptoms of
flushing, burning of
mouth and throat,
parasthesia of lips,
mouth or face.

22. Persons with vomiting and/or
diarrheal symptoms may spread
the causative agent from person
to person. This may occur in the
following settings: food
establishments, childcare settings,
schools, camps, board and
lodging facilities, private parties,
caterers or at water activity
facilities.

23. The time period may be
variable because the
illness may occur for some
time before it reaches a
“critical mass” to be
identified or a person is
diagnosed with a
pathogenic organism.

24. Actions to prevent
further
transmission and
control strategies
may include:

25. Exclusion of
individuals with
diarrhea and/or
vomiting

26. Following proper
hand washing
and cleaning/
disinfecting
procedures,

27. Identification of the
causative agent
(laboratory
confirmed or
epidemiological
data),

28. Avoidance of
contaminated
food or water,

29. Destruction
of
contaminated
food,

30. Closure of
facility
pending
action.

32. In a situation that has
resulted in foodborne
illness, the following
objectives need to be
addressed
immediately:

33. 1.
Identify conditions
that may have
contributed to the
outbreak.

34. 2.
Identify and
eliminate the factors
that could lead to
further transmission.

35. 3.
Clarify the nature
and mechanism of
disease
transmission.

36. 4.
Provide information
need to design
effective strategies
to prevent future
outbreaks.

37. 5.
Evaluate food
facilities or
water sources.

39. COMMUNICATE
1. Maintain frequent
communication
(conference calls,
emails, faxes) with all
involved agencies.

40. COMMUNICATE
2. Give input to
epidemiologists
regarding patron and
food service worker
interviews.

41. COMMUNICATE
3. Provide menus
from the facility
or event to
epidemiologists.

42. COMMUNICATE
4. Provide patron
names and/or
reservation lists to
epidemiologists.

43. COMMUNICATE
5. Provide
liaison with
facility.

44. COMMUNICATE
6. Use authority
to close/reopen
facility as
needed.

45. If a situation requires
a response beyond
environmental
health’s capacity, the
following actions will
be conducted:

46. • Request activation of
incident command.
• Provide input into press
release.
• Provide just-in-time
training.
• Provide regular
sanitation-status reports to
incident command.

47. Enforcement actions
against a food service
establishment implicated in
a foodborne disease
outbreak should focus on
operations and behaviors
that are the likely cause of
the outbreak.

48. All observed risk
factors or critical
violations must be
noted and orders
issued for immediate
correction of each.

49. Enforcement actions may include:
− closing the facility,
− excluding or restricting
workers,
− issuing embargo orders,
− condemning food, and
− issuing correction orders