1. United States Department of Agriculture Food Safety and Inspection Service Stage 1: Epidemiology and Identify the Food

2. United States Department of Agriculture Food Safety and Inspection Service FSIS Applied Epidemiology Division

3. United States Department of Agriculture Food Safety and Inspection Service How does FSIS become aware of clusters (potential outbreaks)? Reports from local, state, territorial public health partners CDC and PulseNet Consumer Complaint Monitoring System Other federal agencies (e.g. FDA, military, National Park Service) News reports, listservs, etc.

4. United States Department of Agriculture Food Safety and Inspection Service How is product tracing used by FSIS when investigating outbreaks? Determine the source of product causing illness (as far back as records allow) Identify distribution of potentially adulterated product (trace forward) During hypothesis generation, help rule in or out certain vehicles based on distribution patterns, supplier commonality

5. United States Department of Agriculture Food Safety and Inspection Service “As far back as records allow” If records do not exist or are of very poor quality, determining which product to recall is often impossible Poor quality records often slow traceback and, therefore, delay regulatory action

6. United States Department of Agriculture Food Safety and Inspection Service FSIS Investigations and Watches Fiscal Years 2007-2009

7. United States Department of Agriculture Food Safety and Inspection Service Epidemiology & Traceback 2008 Salmonella Typhimurium –FSIS carried out traceback when poultry initially suspected, results assisted hypothesis- generation –Outbreak ultimately linked to contaminated peanut butter

8. United States Department of Agriculture Food Safety and Inspection Service Epidemiology & Traceback 2009 E. coli O157:H7 –Two outbreaks linked to ground beef in the Northeast –Traceback carried out in tandem with epidemiologic investigation led to more timely in-plant action by FSIS

9. United States Department of Agriculture Food Safety and Inspection Service Some real traceback scenarios Trace to retail level: no grinding logs Trace to retail level: multiple suppliers Trace to processor: multiple suppliers or can’t determine specific dates of production Trace to slaughter plant, can’t determine specific dates of production Trace to farm?

10. United States Department of Agriculture Food Safety and Inspection Service Reasons for unsuccessful investigations* 4 - Insufficient Product Information Provided by Public Health Partner 12 - Insufficient Product Information Provided by Retail or Distributor 4 - Lack of Epidemiologic Information 2 - Unable to Locate Product for Testing *Not included: investigations hampered by poor information, but not completely unsuccessful. Most investigations suffer at least partially from poor product information.

11. United States Department of Agriculture Food Safety and Inspection Service Additional Information Robert Teclaw, DVM, PhD Director, Applied Epidemiology Division Robert.Teclaw@fsis.usda.gov / (202) 690-6045 http://www.fsis.usda.gov