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5. Response to an outbreak of foodborne disease

In this section Introduction 1. Preventive food safety measures in the aftermath of natural disasters 2. Consumer education and information 3. Inspecting and salvaging food 4. Provision of food after a natural disaster 5. Response to an outbreak of foodborne disease Annex: "5 Keys for Safer Food - in regions hit by disasters"

It is vital to detect foodborne diseases as early as possible. Indications of a foodborne disease outbreak that should trigger an investigation include:

• increase in diseased persons visiting clinics
• reports from health workers of foodborne disease symptoms,
• reports from pharmacists of an unusual demand for anti-diarrhoeal agents, anti-emetics or other medication for gastrointestinal problems, e.g. antibiotics
• an upsurge in inexplicable customers’ complaints to a food supplier, food industry
• reports of unusual death
• unusual absenteeism from schools and the workplace, especially in large industries

Detection may also be through existing communicable disease surveillance systems if the cluster is large enough (and there is no separate foodborne disease surveillance system).

Investigation of and response to a suspected food safety emergency involves:

• timely treatment of exposed people
• removal (recall) of the contaminated food from circulation. This should be coordinated by the national food safety agency in collaboration with the food industry and other food providers.
• rapid identification of the causative agent and the suspected foods by patient interviews and by appropriate diagnostic laboratory testing
• epidemiological investigation to identify the causative agent, the responsible food and the manner of contamination including: collection, transport and processing of samples; collation of information about sources of contamination and coordination with law enforcement, food safety regulatory authorities, industry, emergency medical response agencies, and (when imported food may be involved) quarantine and customs agencies (swift communication among all these entities is essential)
• timely provision of information to the public on food-related risks and the actions they should take to minimize those risks; the information must be conveyed in a manner that is culturally appropriate and does not cause unnecessary anxiety

The effectiveness of response depends to a great extent on preparedness including:

• the capacities for investigation and verification, and
• coordination between relevant government and other agencies that contribute to managing the public health consequences.

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