1. Food Supply Defense Plan: Lessons from Oregon Public Health
James C. Mack, M.P.A., R.S.
Foodborne Disease Outbreak Investigator EHS-Net Site Coordinator
State of Oregon

2. Public Health Food Defense Emergency Response Plan
Presentation outline:
Describe the complex nature of Public Health Food Defense Emergency Response.
Review the overview of the State of Oregon Public Health Food Defense Emergency Response Plan.
List the diverse roles, responsibilities, and methods of communication of local, state, federal, industry, and private entities in food defense.
Identify resources to aid in the improvement or development of Public Health Food Defense Emergency Response Plans.

3. Feedback Poll
My jurisdiction has a public health food defense emergency response plan.
Yes
B. No

4. Public Health Food Defense Emergency Response Plan
Complex nature of food defense
Federal
State
Local
Industry

5. Complex Nature of Food Defense
Federal
The Centers for Disease Control & Prevention (CDC)
Food and Drug Administration (FDA)
Food Emergency Response Network (FERN)
Federal Bureau of Investigation (FBI)
United States Department of Agriculture (USDA)
Department of Homeland Security: Science and Technology (S&T) Directorate
Department of Homeland Security: Information
Analysis and Infrastructure Protection (IAIP) Directorate
Environmental Protection Agency (EPA)

6. Complex Nature of Food Defense
State
Oregon Public Health Division
Foodborne Illness Prevention Program
Acute and Communicable Disease Program
Office of Family Health
Public Health Emergency Preparedness Program
Oregon State Public Health Laboratory
Oregon Department of Agriculture

7. Complex Nature of Food Defense
Local
Health departments
Hospitals and health care systems
Emergency medical services

8. Feedback Poll
The ongoing relationship between food industry representatives and public health within my jurisdiction is:
A. Positive
B. Uncertain
C. Negative
D. None of the above

9. Complex Nature of Food Defense
Industry
Retail food establishments
Associations that support restaurants

10. Writing a Food Defense Emergency Response Plan
Step 1:
Follow the food flow from farm to table.
Partnerships are important.
All players must be engaged.

11. Writing a Food Defense Emergency Response Plan
Step 2:
Focus on your part of food defense.
LOCAL
STATE
FEDERAL
INDUSTRY

12. Writing a State Food Defense Emergency Response Plan
Step 3: Identify state public health programs with food defense responsibilities.
State of Oregon Public Health, Offices of:
Public Health Preparedness (Preparedness)
Multicultural Health (Multicultural)
Public Health Laboratories (Labs)
Family Health (Family)
Community Health & Health Planning (Community)
Environmental Public Health (Environmental)
Disease Prevention & Epidemiology (Epi)

13. Writing a Food Defense Emergency Response Plan
Step 4:
Organize a working group.

14. Writing a Food Defense Emergency Response Plan
Step 5:
Write a draft public health food defense plan.

15. Public Health Roles and Responsibilities at the Federal Level
Coordinate national and international surveillance, monitor health impacts, and provide laboratory support.
Lead public health communications among states and other public health agencies.
Provide legal advice and policy guidance on food response activities.

16. Operational Priorities
Mitigate the health effects in retail food establishments.
Provide information regarding the scope and health effects of the contamination.
Coordinate with Oregon Department of Agriculture (ODA) and other appropriate state agencies on threat assessment and resource needs.
Assist LHDs in field assessments and investigations involving retail food establishments.

17. Public Health Roles and Responsibilities at the State Level
Public Health Director,
State Health Officer,
Susan Allan, M.D., J.D., M.P.H.
Authorized the Public Health Food Defense Response Plan

18. State Office of Multicultural Health
Identifies credible voices in:
Special populations
Diverse communities
Helps to develop appropriate messages that are:
Linguistically and culturally oriented
In communication formats specific to food defense incident and the affected populations

19. State Office of Public Health Preparedness
Provide information on:
Food process being used to confirm or rule out contamination of the food supply
When/where the presumed incident took place
When additional information will be available
Precautions taken to prevent additional contamination

20. State Office of Public Health Laboratories
Participates in the systematic sampling of enteric isolates sent to CDC for antimicrobial susceptibility testing.
Screen meat and poultry samples that are collected monthly for selected pathogens and indicator bacteria.
Subtype Escherichia (E. coli) O157,Salmonella, and Shigella isolates by Pulse Field Gel Electrophoresis.

21. State Office of Family Health
Provides LHDs with emergency checklists.
Assists Foodborne Illness Prevention Program and Acute Communicable Disease Program in outbreak interviews and surveillance.
Assists OEPH and LHDs in monitoring members of the public in their preparation and serving of preserved food.

22. Feedback Poll
In my opinion, coordination between state and local public health regarding public health food defense in my area is:
A. Excellent
B. Okay
C. Weak
D. Non-existent

23. State Office of Community Health and Health Planning
As a liaison to other counties:
Develop communication link with LHDs.
Assist in surge capacity for ICS.

24. State Office of Environmental Public Health
Foodborne Illness Prevention Program
Conduct situation (disaster) assessment of retail food establishments.
Provide technical advice to LHDs.
Support field assessments and outbreak investigation of retail food establishments.
Provide scientifically-based guidance concerning disposition of food.

25. State Office of Environmental Public Health
Environmental and Occupational Epidemiology (EOE)
Liaison between the public and health care workers.
Provides clinical expertise in the area of medical toxicology including chemical, toxin, and food poisoning.
Interfaces with the public, other state agencies and the public regarding media communications.

26. State Office of Disease Prevention and Epidemiology
Acute and Communicable Disease Prevention Program
Assists LHDs in investigating of outbreaks.
Collaborates with the ODA and the FDA.
Leads in food contamination epidemiology investigations.
Is one of eleven Foodborne Diseases Active Surveillance Network (FoodNet) sites in the United States.

27. Training
Regional food defense emergency training of first receivers, responders, and local health departments will be completed on a yearly basis.

28. Exercise Design Exercise Design Committee will design and deliver:
Exercise orientations
Tabletop exercises
Functional exercises
Full-scale exercises
Homeland Security Exercise Evaluation Program (HSEEP)

29. Feedback Poll
Which of the following exercise related activities has the most practical value in my jurisdiction?
A. Tabletop exercises
B. Functional exercises
C. Full-scale exercises
D. Other

30. Special Populations
The young and the elderly should be given the highest priority for evaluation due to the following:
Higher risk of rapid dehydration due to vomiting or diarrhea.
Higher risk of shock or death from blood loss resulting from foodborne illness.
Children and the elderly need special considerations for medical treatment.

31. Plan Maintenance Revised annually.
Revised from previous year exercises or emergencies.
Food Program will conduct this review.

32. Public Food Defense Emergency Response Plan