Editor’s note on the author: Michéle Samarya-Timm, a health educator and Registered Environmental Health Specialist working for Somerset (NJ) County Department of Health, originally wrote this column for barfblog.com. It is reprinted here with permission of barfblog founder Doug Powell.
Baking pumpkin pies with Aunt Kay’s secret recipe. Watching “Miracle on 34th Street.” Preparing the dining room with the good china. Diffusing political conversations at the dinner table. Some traditions give a sense of warmth, connection, and continuity, and regularly define a family’s holiday. Unfortunately, there is now a need to add an additional tradition to the season – actively checking for foodborne outbreaks and recalls to prevent folks from getting sick.
Last week, on Tuesday, Nov.20 at 2p.m., two days before Thanksgiving, the CDC posted a media statement with advice to consumers, restaurants, and retailers:
“CDC is advising that U.S. consumers not eat any romaine lettuce, and retailers and restaurants not serve or sell any, until we learn more about the outbreak.”
The need to release such a notice, right before a major holiday is an unpropitious scenario. It was also very concerning in its specificity to consumers, retailers and restaurants:
“Wash and sanitize drawers or shelves in refrigerators where romaine was stored.”
Such an alert is most effective if it reaches the intended audiences. Folks at my holiday table did not hear about the outbreak. Neither did many local health departments.
Do they hear what you say
Issuing media releases is one way for public health agencies to reach large groups of people. However, distracted by holiday preparations, travel, shopping, family, football and bad weather this advisory was only partially disseminated to the public. A person had to be following news outlets or social media to receive timely notice. I heard about the recall from the woman next to me while I was getting a haircut – not from the CDC or FDA, or any other federal or state agency.
It’s disturbing. The CDC could have sent this info directly to local health departments, or notify them that a news release was issued. This was not the first time as a local public health official that I received delayed – or no – official communication about a national foodborne issue.
Local public health professionals rely on communications systems established by federal and state oversight agencies. Most commonly, if a verified or suspect foodborne contamination or outbreak has occurred, the Centers for Disease Control and Prevention, the U.S. Department of Agriculture, or the Food and Drug Administration will ascertain the appropriateness of information release. If this information is deemed credible, notification is forwarded individually or en masse to state departments of health. The states, in turn, push this information down to local regulators. Each step in the process contains elements that may delay the rapid dissemination of outbreak information. The ability and willingness of all stakeholders to quickly and readily share incident particulars with fellow responding agencies can enhance effectiveness and amplify response efforts.
Electronically sending this advisory directly to the nearly 3,000 local health departments in the U.S. would provide the opportunity for hundreds of health inspectors, health educators, epidemiologists and others to reach the hospitals, food banks, schools, mom and pop establishments and local residents who may not have otherwise received the alert. This was a missed opportunity, and hopefully one that didn’t cause additional cases of illness.
As I’ve written before, coordinated communication strategies within and between public health agencies is less robust than it should be. As a result, state and local public health officials may hear about foodborne disease issues first from other sources, such as the media, word of mouth, public complaints, or the food industry.
We need to learn how to communicate better with each other. Local public health shouldn’t have to keep an eye on the news media, Twitter or Facebook for information pertinent to protecting the people in our jurisdictions. A multitude of electronic portals exist for purposes of interagency communication. CDC, FDA, USDA and the public health system should collectively define how pertinent information – such as this romaine advisory – rapidly and routinely gets to the grass roots public health workforce. Continuously improving interagency coordination and communication is a goal that is fundamental to increasing the effectiveness of this nation’s food safety systems. I’m putting this out there, because I’m willing to help with the solution. That way, in future years, I can spend my holidays perfecting Aunt Kay’s pie recipe.
This holiday, I’m thankful for public health influencers and amplifiers – like barfblog – that act as outbreak aggregators, and push out info to local public health types like me.
Some background information and recommendations on this topic can be found in “Getting the message across: An analysis of foodborne outbreak communications between federal, state, and local health agencies” at https://calhoun.nps.edu/handle/10945/49379
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