Jul 15, 2009 (CIDRAP News) A national consortium of groups that have a stake in managing foodborne illness outbreaks today released guidelines for outbreak response, a document that includes model practices for each investigation stage, giving local and state officials a baseline for assessing their current procedures. However, he said public officials’ willingness to implement the model practices will be the factor that improves the nation’s overall outbreak response. “As noted in the forward, it will only be as effective as our commitment to turn the guidelines into action,” he said. He said the CIFOR guidelines also give local and state officials a solid framework for achieving federal standards that address outbreak response. In a nutshell, the guidance promotes faster and better response methods that revolve around better communication and more uniform reporting between local and state officials, he said. For example, surveillance systems and incident logs should be compiled in a manner that’s easily accessible to other agencies. “This truly would identify patterns that aren’t being identified now,” Holmes said. Scott E. Holmes, manager of the Lincoln-Lancaster County Health Department’s environmental public health division in Lincoln, Neb., told CIDRAP News that it took 2 years to develop the guidelines, which underwent rounds of extensive review and modification. Holmes is NACCHO’s representative on CIFOR. The US Department of Health and Human Services (HHS) and the US Department of Agriculture (USDA) today praised the new CIFOR guidelines. Tom Vilsack, USDA secretary, said in an HHS statement that was e-mailed to journalists that improving food safety is one of President Obama’s top priorities. In the overview section, the authors state that the guidelines are meant to be flexible and include a range of approaches with the rationale for each of them. For example, the guidance details the role of the Incident Command System (ICS), but acknowledges that not all agencies use this system. See also: Applying the guidelines isn’t going to be a major cost for local and state departments, he predicted. “It’s more a matter of doing the actions correctly,” he said, adding that adopting a model practice for some can be as simple as reorganizing how the response work gets done. Jul 7 CIDRAP News story “Officials release food safety plan, egg safety rules” Jul 15 CIFOR press release “The guidelines show that by working together, we can all dramatically improve our food safety system and further protect the public health,” she said. “We hope to further this collaborative effort through the Food Safety Working Group.” HHS Secretary Kathleen Sebelius thanked CIFOR for its vital contribution toward food safety. Sebelius and Vilsack cochair Obama’s food safety group. In March Obama created a Food Safety Working Group, and on Jul 7 it announced its key steps for improving food safety, which included tougher standards to reduce Salmonella contamination, tighter enforcement at beef facilities, building a new trace-back and response system, and improving federal food safety oversight. CIFOR guidelines for foodborne outbreak response The guidelines start with a chapter on the fundamental concepts of surveillance and foodborne disease, followed by sections on planning, outbreak detection, investigation, and control measures. It also includes sections on specific topics such as multijurisdictional outbreaks, legal considerations, and performance indicators for foodborne disease programs. The group that authored the 200-page guidance report, the Council to Improve Foodborne Outbreak Response (CIFOR), is a multidisciplinary partnership of seven professional organizations and three federal agencies that seek to increase collaboration among a range of food safety officials. Its cochairs are the Council of State and Territorial Epidemiologists (CSTE) and the National Association of County and City Health Officials (NACCHO). “The main thing is that this provides state and local departments with the best practices,” Holmes said, adding that there are currently no standardized methods for conducting a foodborne outbreak investigation. For example, some local and state departments use a shotgun approach with their food exposure surveys, while others typically use more targeted survey methods. Some states subtype isolates from patient specimens and submit them to national databases as soon as they receive them, rather than batching them. “Last week the Obama Administration took an important step forward by introducing tougher standards to reduce Salmonella contamination and E coli outbreaks, and the guidelines announced today will help government further that goal,” he said. Craig Hedberg, PhD, a foodborne disease expert at the University of Minnesota in Minneapolis, who wrote three of the guideline chapters and was a member of the CIFOR guidance work group, said the new document will serve as a yardstick for measuring future outbreak response activities.
Press Association Ultimately this was a game Cardiff needed to win, and one Villa were happy enough to avoid losing, and there is no question this result will be more warmly welcomed by Paul Lambert than Ole Gunnar Solskjaer. Villa climb five points clear of the drop zone, but Cardiff remain 19th with just two wins from their last 17 league games. They will also have to do without Craig Bellamy for their critical upcoming encounter with Hull after player and club “reluctantly” accepted a violent conduct charge and three-match ban from the Football Association for striking Swansea midfielder Jonathan de Guzman in Saturday’s south Wales derby defeat. Solskjaer was brave in his selection on the night, with Campbell, Noone, Wilfried Zaha, Kenwyne Jones and Jordon Mutch all starting, but there was never any real flow to their play, with Zaha and Jones worryingly ineffectual. Yet what chances there were during a first half devoid of any genuine quality fell to the home side. After a dull opening, enlivened only by a hopeful, and off-target Fabien Delph strike, the game briefly sprung to life in the 14th minute as Cardiff struck the woodwork twice within a matter of seconds. Zaha played in Campbell, but Brad Guzan did brilliantly to get a hand to the strike and push it onto the far post and away to Noone, the winger cut in and Guzan was beaten when his shot looped up off Ashley Westwood and onto the crossbar. Ron Vlaar had to be alert to block a Campbell effort from close range after Jones had wrestled clear of Nathan Baker, and Vlaar had to clear from Campbell once more when his horribly sliced clearance had played the striker onside. Cardiff dominated the opening half and struck the woodwork through Fraizer Campbell and a deflected Craig Noone shot, but could not find the net. Villa offered no threat during the opening 45 minutes but could have taken all three points had Leandro Bacuna and Gabriel Agbonlahor shown better composure in front of goal. Cardiff and Aston Villa played out a goalless draw at Cardiff City Stadium which does far more good for the visitors’ hopes of Premier League survival than their hosts. Zaha had the ball in the back of the net at the other end, but was a long way offside when Steven Caulker’s header fell to him in the six-yard box. Mutch did not last much longer as he limped off holding a hamstring, with Magnus Wolff Eikrem his replacement, before Villa had penalty appeals turned away after Kevin Theophile-Catherine had handled while heading clear under pressure from Benteke. Villa, doubtless with some harsh words from Lambert ringing in their ears, started the second period brightly and Cardiff skipper Caulker blocked a goalbound Benteke header from another pinpoint Albrighton centre. The hosts were soon back on the front foot with Campbell getting the better of Vlaar, thanks to a touch off his arm, but failed to work Guzan with his shot from the edge of the area. Bacuna was similarly wasteful at the other end as Agbonlahor’s intelligent turn and through ball went unrewarded thanks to a scuffed effort from the full-back. Jones headed directly at Guzan from Theophile-Catherine’s cross, while Benteke curiously opted to try and pull the ball back across goal when Bacuna’s pass had split the Cardiff defence and played him in on goal. As the game finally opened up Marshall was called upon to make his first save of the night as he stuck out a left-hand to keep out a Delph shot which had taken a wicked deflection off Gary Medel. But arguably the best chance of all fell to Agbonlahor in the dying minutes. Albrighton’s pass and Benteke’s flick found the striker free in front of goal, only for him to delay his shot long enough for Theophile-Catherine to make a crucial block. And then, with seconds remaining, Marshall pulled off a stunning save in stoppage time to deny Andreas Weimann as preserve Cardiff’s point. The goalkeeper changed direction in mid air to save Cardiff.