Public Health Control Measures for GI Illness Michelle Malavet, MSA Foodborne Disease Surveillance Coordinator NJDHSS, Communicable Disease Service ID Summit Spring 2007 Goal of Investigation = Identify potential source and implement public health control measures to stop the spread of the disease Control Measures " Restrict/exclude infectious individuals from work or school " Cohort infectious individuals in an institutional setting " Remove implicated source from food supply " Correct deficient food handling or manufacturing practices " Remediate environment " Institute barrier controls and hygienic practices " Educate cases and contacts Sporadic Cases (e.g. STEC) " Determine if case is a potential source for others (food handler, daycare attendee/provider, patient care) 3 Exclude from work/daycare " Determine potential sources of exposure (food history, events attended, travel, animal contact, water contact, contact with other cases) 3 Identify source and remove/abate " Identify other related cases (close contacts, classmates in school/daycare, co-workers) 3 Determine if cases are a potential source for others 3 Determine common sources 3 Determine if an outbreak exists Institutional Outbreak (e.g. FDU) " GI illness reported among students " Interview cases to determine potential exposures " Obtained clinical samples to determine pathogen ( Norovirus ) " Control measures: Environmental ... more. less.
remediation, institution of hygienic practices, education, exclusion from school Salmonellosis Outbreak Associated with a Diner in Northern NJ-2006 " Single case investigation reveals potential sources of exposures (meal consumed at a local diner) " Two other related cases identified (not confirmed) " One additional related case identified by PFGE 3 common source: same food item at same diner " Source investigated and food handling mistake abated Multi-state Salmonellosis Outbreak Associated with Peter Pan Peanut Butter " Cases with matching PFGE patterns identified in several states " Gather epi information from each state on cases and look for links " Administered hypothesis generating questionnaire and compare results to population 3based surveys " Develop hypothesis and tested using case- control study " Confirm food product by lab testing " Removed product from food supply " Corrected manufacturing deficiency<br><br>