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FREE-B: A New Tool for Outbreak Readiness

Firefighters train by burning empty houses and pilots practice emergency landings. But foodborne illness response teams aren’t called into action until a real crisis is at hand. Until now, that is.

The Food and Drug Administration (FDA) this week launched the Food Related Emergency Exercise Boxed set, or “FREE-B,” a set of five simulated foodborne illness scenarios available for free online. The trainings are intended for organizations involved at any level of an outbreak situation, from food companies to public health officials to medical communities.

The program is designed to help such groups understand what responsibilities fall under their jurisdiction during an outbreak, and how to improve communication with one another.

“Anyone within the public health arena, whether it’s food protection and response or emergency response folks … the first and foremost issue that always comes to bear is communications,” said Jason Bathura, a General Health Scientist at FDA’s Food Defense Oversight Team and co-developer of the series in an interview with Food Safety News.
Communication breakdowns come in many forms, Bashura says, from technical problems – being on different radio wavelengths or not having someone’s cell phone number, to lacking consistent terminology for sharing information, to misunderstanding which task belongs to which people or agencies.

“There’s that what-if component — the communication that might have been incorrect or information that came in that didn’t get funneled to the incident commander,” says Bashura.
The virtual situations offered by FREE-B, however, can include interested parties from any sector. For example, a local public health agency could participate with two companies in a supply chain.

“The beauty of Free-B is that it’s scalable for the smallest of jurisdictions or firms to the largest, with 100 people in a conference room sitting around 10 tables,” Bashura says. Emergency responders in different locations might have different methods of dealing with the same situation, he says.

“So by having multiple disciplines and geographic areas represented,” he says, “you begin to look at the horizontal integration of emergency plans, which then makes the ultimate response to the real life event that much more predictable and hopefully manageable.”

This effort to standardize responses to foodborne epidemics can be seen in the FREE-B program itself, which was developed through a collaboration among FDA, the Food Safety Inspection Service (FSIS), the Centers for Disease Control and Prevention (CDC) and Animal and Plant Health Inspection Services (APHIS), all of whom may be called into action in an outbreak situation.

“Working with our stakeholder partners within FSIS, APHIS and CDC (to create the program), that really pulled us all together,” Bashura says.

Using this varied expertise, the coalition was able to create extremely realistic situations, says Bashura.

“I know what it’s like when we’re out there in the trenches, and early on trying to investigate an outbreak. I could see colleagues and representatives from the regulatory industry out there doing this,” he says.

The Food Safety Modernization Act, signed into law this January, calls for a more coordinated foodborne illness response system. FDA hopes that FREE-B will move the government one step closer to achieving this goal.

Another perk of the program is evident in its name — it’s free for anyone to download. And while organizing a scenario takes time and some money, “We’ve got lots of programmatic folks at the local level that just don’t have training dollars, and this program’s going to help them significantly with pulling together an exercise for little or no cost,” says Bashura.

Costs include the time and resources needed to implement a scenario workshop, which will vary depending on type and size of the organization.

In its first few days in action, the toolkit has been met with enthusiasm from companies and public health officials alike. Bashura says upwards of 150 groups have already registered for the first webinar on FREE-B.

“The comments and the feedback have been very positive. In just the last 12 hours I’ve had at least a dozen or so comments from international folks,” said Bashura.

And despite international interest, Bashura says, this program was not created in response to the current E. coli epidemic linked to sprouts grown from contaminated seeds in Europe.

However, he says, “The outbreak did help us think prospectively about how we could create scenarios with what we’ve learned that might lend itself to a learning experience to be shared with our state and local constituents.”

And in the meantime, feedback is still the name of the game. FDA has created a site for commentary on the FREE-B exercises, and the activities themselves are designed to show businesses, regulators and emergency responders how they can improve their techniques. It includes a document from the Department of Homeland Security detailing how to enhance food protection.

FREE-B currently offers guided instructions for five foodborne illness emergencies, both intentional and accidental. They are:

– How Sweet it Isn’t: This scenario focuses attention on the regulatory traceback investigation that occurs after standard product testing shows that an FDA regulated food product contains excessive levels of a contaminant, as well as a recall of contaminated food from commerce.

– Stealthy Situation: This exercise is a comprehensive scenario and includes the epidemiological investigation, traceback and recall identification and implementation, role of regulatory agencies, and highlights nuances associated when a cluster of illness is associated with a foodservice establishment and an FDA regulated product.

– Wilted Woes: This scenario begins at the outset of early signal detection with clinical illness reports, and focuses on the epidemiological investigation process to identify the food vehicle, when there is a human health emergency caused by an unintentional contamination of produce (FDA regulated product) with E. coli O157:H7.

– High Planes Harbinger: This scenario focuses on the investigation of animal disease (USDA / APHIS jurisdiction) caused by intentional infection of cattle with Foot and Mouth Disease (FMD) virus, highlighting the various animal agriculture agencies (federal, state, local, territorial, and tribal) and their roles and responsibilities, as well as introducing the roles and responsibilities of law enforcement agencies during an animal health emergency.

– Insider Addition:  This scenario focuses attention on the intentional aspect of contamination of a raw meat product at the processor (USDA / FSIS jurisdiction) with a chemical agent, including the various nontraditional organizations and expertise needed to investigate intentional contaminations, the establishment of collaborative processes and roles and responsibilities with the traditional public health and regulatory partners.

© Food Safety News