California Department of Public Health Food and Drug Branch

1
California Department of Public HealthFood and
Drug Branch

• San Joaquin County
• All Hazards Workshop
• August 2008

2
Food and Drug Branch

• Three sections Food Safety, Drug Safety, and
  Medical Device Safety
• Food Safety includes
• Processed food registration and inspection
• Industry education and training
• Bottled and vended water program
• Seafood inspection
• Emergency response and food security
• Retail food program
• Consumer complaint program

3
Food and Drug Lab Branch

• Public health reference and research lab
• Sister agency to Food and Drug Branch
• Includes Chemistry, Microbiology, and Abused
  Substances Analysis Sections
• Analyzes food, drugs, cosmetics, medical devices,
  and environmental samples
• Supports FDB in outbreak investigations and
  inspection activities

4
Emergency Response

• Emergency Response Unit in the Food Safety
  Section
• Investigates foodborne illness outbreaks
• Investigates tampering incidents
• Participates in preventive outreach efforts
  including food defense

Before
After
5
Tampering cases
6
How does this protect public health?

• Outcomes from previous investigations
• Almond industry has adopted a kill step for raw
  almonds
• Strawberry industry has modified the method of
  harvest of strawberries for processing
• New commodity-specific guidelines for sprouts,
  tomatoes and lettuce
• Produce industry has begun to think of harvest
  workers as food handlers, enforcing hand washing
  procedures and harvest equipment sanitation

7
How are local health jurisdictions involved?

• Illnesses are reported by local public health to
  state health Division of Communicable Disease
  Control (DCDC) and by DCDC to CDC
• DCDC provides information to FDB about clusters
  of illnesses where food may be the vehicle
• If a food vehicle is implicated by
  epidemiological investigation (statistically
  significant association), FDB begins an
  environmental investigation
• FDA is informed, and if interstate commerce is
  involved, becomes the lead agency

8
How are local health jurisdictions involved?

• Local health department will be asked to supply
  information about the Point of Service (POS) for
  select case-patients
• Those with clear recall of where/when they ate
  the implicated food
• If it is necessary to visit the retail POS, local
  environmental health will be invited to
  participate
• Environmental health may be asked to collect
  documentation, such as invoices. The time period
  for which the documentation is needed is critical.

9
Foodborne outbreak investigations

• The environmental investigation may include
• Environmental investigation at the point of
  service
• Traceback to manufacturer and/or farm
• Environmental investigation at the manufacturer
• Sampling product
• Environmental sampling
• Farm investigation
• Collection and examination of records

10
How does FDB relate to other state agencies
dealing with food?

• Dairy products are regulated by California
  Department of Food and Agriculture (CDFA) and US
  FDA
• Many egg ranches participate in the California
  Egg Quality Assurance Program (CEQAP), a CDFA
  program intended to control SE
• Foodborne illness investigations involving dairy
  and egg products are conducted jointly with CDFA
• Fruit and vegetable growers must follow
  guidelines regarding pest control overseen by the
  county Agricultural Commissioner
• FDB advises CDFA of illness investigations
  involving California produce

11
What is CalFERT?

• The California Food Emergency Response Team is a
  group of state and federal Investigators and
  Scientists that conduct environmental
  investigations of foodborne illness outbreaks.
• Food and Drug Investigators from state Food and
  Drug Branch (FDB) are peace officers and have the
  authority to embargo food products that may be
  contaminated.
• Investigators/Consumer Safety Officers from FDA
  are associated with the Los Angeles and San
  Francisco District Offices
• Scientists include microbiologists associated
  with FDA labs, and research scientists associated
  with the Emergency Response Unit in FDB

12
What outbreaks has the team investigated?

• State and federal investigators have worked side
  by side on investigations in the past.
• During the Salmonella Enteritidis outbreak
  associated with almonds in 2004, investigators
  and laboratorians from both agencies worked
  together as a team
• In 2005, the team was formally established and
  met together outside of outbreak situations to
  develop protocols
• In the fall of 2005, those protocols were put
  into practice for the first time during the E.
  coli O157H7 outbreak associated with bagged
  lettuce and a Salmonella Enteritidis outbreak
  associated with tomatoes

13
What outbreaks has the team investigated?

• In the fall and winter of 2006-2007, the team
  investigated E. coli O157H7 outbreaks associated
  with spinach and shredded lettuce (Taco Bell and
  Taco John)
• Follow-up to the outbreaks associated with leafy
  greens has included review and input by CDHS-FDB
  and US FDA of the document that became the Best
  Practices for safe growing and handling under
  the Leafy Greens Marketing Agreement.
• Most recent investigation was a
  romaine-associated E. coli O157H7 outbreak in
  the state of Washington

14
Questions?
FDB Website contains food defense brochures in
four languages, outbreak investigation reports,
and posters on CalFERT and the Taco John
investigation http//www.cdph.ca.gov/programs/Page
s/FDB20Food20and20Drug20Branch.aspx See
http//www.cdph.ca.gov/programs/bes/Pages/default.
aspx for CDHS Bioterrorism Surveillance and
Epidemiologic Response Plan Contact Mary
Palumbo, [phone] or mary.palumbo_at_cdph.ca.go
v