title: Improving Response to Foodborne Disease Outbreaks in the United States: Findings of the Foodborne Disease Centers for Outbreak Response Enhancement (FoodCORE), 2010-2012.
abstract: BACKGROUND
  Each year foodborne diseases (FBD) affect approximately 1 in 6 Americans, resulting in 128 000 hospitalizations and 3000 deaths. Decreasing resources impact the ability of public health officials to identify, respond to, and control FBD outbreaks. Geographically dispersed outbreaks necessitate multijurisdictional coordination across all levels of the public health system. Rapid response depends on rapid detection.
  
  
  OBJECTIVE
  Targeted resources were provided to state and local health departments to improve completeness and timeliness of laboratory, epidemiology, and environmental health (EH) activities for FBD surveillance and outbreak response.
  
  
  METHODS
  Foodborne Disease Centers for Outbreak Response Enhancement (FoodCORE) centers, selected through competitive award, implemented work plans designed to make outbreak response more complete and faster in their jurisdiction. Performance metrics were developed and used to evaluate the impact and effectiveness of activities.
  
  
  METHODS
  Departments of Health in Connecticut, New York City, Ohio, South Carolina, Tennessee, Utah, and Wisconsin.
  
  
  RESULTS
  From the first year (Y1) of the program in October 2010 to the end of the second year (Y2) in December 2012, the centers completed molecular subtyping for a higher proportion of Salmonella, Shiga toxin-producing Escherichia coli, and Listeria (SSL) isolates (86% vs 98%) and reduced the average time to complete testing from a median of 8 to 4 days. The centers attempted epidemiologic interviews with more SSL case-patients (93% vs 99%), and the average time to attempt interviews was reduced from a median of 4 to 2 days. During Y2, nearly 200 EH assessments were conducted. FoodCORE centers began documenting model practices such as streamlining and standardizing case-patient interviewing.
  
  
  CONCLUSIONS
  Centers used targeted resources and process evaluation to implement and document practices that improve the completeness and timeliness of FBD surveillance and outbreak response activities in several public health settings. FoodCORE strategies and model practices could be replicated in other jurisdictions to improve FBD response.
authors.affiliation: Outbreak Response and Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Gwen Kathryn
authors.initials: GK
authors.lastname: Biggerstaff
mesh_terms: D004196:Disease Outbreaks / Q000517:prevention & control*; D005517:Foodborne Diseases / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D011159:Population Surveillance / Q000379:methods; D015397:Program Evaluation; D011634:Public Health / Q000379:methods / Q000592:standards*; D011930:Reaction Time; D014481:United States / Q000453:epidemiology