1. CIFOR Guidelines for Foodborne Disease Outbreak Response and the CIFOR Toolkit: Focus Area 5: Pathogen-Specific Surveillance
New York Integrated Center of Food Safety Center of Excellence – October 12, 2016
Shelley M Zansky, PhD
Bureau of Communicable Disease Control
New York State Department of Health

2. Background
This is the sixth webinar in a series of monthly webinars from the New York Integrated Food Safety Center of Excellence (CoE)
Session will cover the CIFOR Toolkit Focus Area 5: Pathogen-Specific Surveillance
Supplementary sessions will be devoted to assist states that wish to complete internal evaluations using the metrics and target ranges developed for the 16 CIFOR performance measures.
Additional topics will focus on emerging issues in food safety including culture‐independent diagnostic testing, antimicrobial resistance, and advanced molecular detection/whole genome sequencing.
All webinars will be recorded and available through the CoE website at

3. How to Use the CIFOR Toolkit
Describe Your Current Activities and Procedures in relation to the Focus Area.
Complete the Worksheet as a Team (Workgroup)
Epidemiology, Laboratory and Environmental Health
Refer to written protocols/procedures
Describe your agency’s/jurisdiction’s current activities and procedures based on the Focus Area.

4. How to Use the CIFOR Toolkit
Prioritize CIFOR Recommendations to Address Needed Improvements
Review the CIFOR recommendations related to the Focus Area of interest
Identify activities and procedures in need of improvement
Rate the priority for implementing each recommendation based on its likely impact on foodborne outbreak response

5. Objectives for Focus Area 5: Pathogen-Specific Surveillance
Purpose of Pathogen-Specific Surveillance
Goals for Pathogen-Specific Surveillance
Define and Review “Keys to Success”

6. What is Focus Area 5?
Purpose: To systematically collect, analyze and disseminate information about laboratory confirmed illnesses or well-defined syndromes as part of prevention and control activities.
Goals: Agency/jurisdiction receives from health-care providers and laboratories reports on all cases of disease when certain foodborne pathogens are identified in patients specimens or specific clinical syndromes are recognized (e.g. HUS) and obtains case information in ways that allows timely follow-up of patients and quick detection and investigation of possible outbreaks

7. Keys to Success Reporting/submission of isolates Testing of specimens
Are activities, relationships, and resources that are critical to achieving success in a Focus Area.
Applying metrics and measures can help you identify the success of your program or investigation process.
Reporting/submission of isolates
Testing of specimens
Collection of exposure information
Detection of clusters/outbreaks
Communication
Making changes

8. Reporting/Submission of Isolates
State has mandatory reporting of diseases that are likely to have been foodborne, as well as mandatory submission of pathogen isolates or clinical specimens associated with these disease cases.
Staff actively solicit case reports and submission of specimens/isolates to improve completeness of reporting.
Agency/jurisdiction has a system to rapidly transport specimens/isolates from clinical laboratories to the public health laboratory.

9. Reporting/Submission of Isolates

10. Testing of Specimens
Public health laboratory has the capacity to quickly process and test specimens/isolates submitted by clinical laboratories, including pathogen confirmation and subtyping.

11. Testing of Specimens

12. Collection of Exposure Information
Staff collect sufficient demographic and exposure information from patients to recognize possible patterns and associations between cases in a timely fashion.

13. Collection of Exposure Information

14. Collection of Exposure Information

15. Collection of Exposure Information

16. Detection of Clusters/Outbreaks
Staff analyze case information (e.g., demographics, exposure information, subtyping results) to rapidly identify possible clusters or outbreaks.

17. Detection of Clusters/Outbreaks

18. Communication
Public health laboratory shares test results with epidemiology staff in a timely fashion.
Public health laboratory reports test results to national databases in a timely fashion.

19. Communication

20. Making Changes
Agency/jurisdiction has performance indicators related to pathogen-specific surveillance and routinely evaluates its performance in this Focus Area.

21. Performance Measure

22. Performance Measure

23. Performance Measure

24. Performance Measure

25. Performance Measure

26. Helpful Tips for Using the Toolkit
Don’t get distracted by the volume
Be clear on the process
Keep moving – don’t get caught up in too much detail
Focus on a few realistic changes
End with specific action plans with time frames and responsible persons
Appoint a facilitator and a recorder for each discussion

27. Why Should My State Use the Toolkit?
Improve overall foodborne outbreak investigation and response
Enhance partnerships with agencies/partners in foodborne outbreak investigations
Identify areas needing improvement that may have gone unrecognized

28. Where to Find the CIFOR Products
Online at:
Paper copies are also available from CSTE
Contact Dhara Shah at
Examples of CIFOR product use by other states:

29. Next Scheduled NY CoE CIFOR Webinars
Still being finalized
Course announcement and link to register is posted on the DOH Learning Management System (LMS):

30. Resources Comments or questions for NY CoE can be directed to:
Paula Huth, NY CoE Program Coordinator or
Integrated Food Safety CoE Websites:
NY CoE:
CDC:

31. Questions