EMERGENCY RESPONSE.

EHS 314: ENVIRONMENTAL HEALTH SERVICES IN

EMERGENCY SITUATIONS

LECTURER: Ms. OLULEGAN

The first response to an emergency is EMERGENCY

ASSESSMENT.

Emergency assessments should allow the following:

An initial decision to be

made on whether

assistance is needed

A decision to be made on whether local capacity is

adequate or external resources

are required

Priorities for intervention

is to be established

An intervention strategy should

be identified

Necessary resources to be identified

Base-line data to be collected,

to facilitate monitoring

Information to be collected for fund-raising and advocacy work.

FOOD AND WATERBORNE

OUTBREAK INVESTIGATI

ON

Foodborne diseases, intoxications or infections are terms applied to illnesses acquired by consumption of contaminated food or water.

Foodborne disease outbreaks are recognized by the occurrence of gastrointestinal illness within a variable time period (minutes to days) after consumption of shared or similar food or water sources among individuals.

Specifically, the occurrence of the potential for foodborne illness must be considered when two or more individuals:

Have symptoms of diarrhea

and/or vomiting

Have similar incubation

periods

Have a shared food and/or water

source

Have symptoms of flushing,

burning of mouth and throat,

parasthesia of lips, mouth or

face.

Persons with vomiting and/or diarrheal symptoms may

spread the causative agent from person to person. This may occur in the following

settings: food establishments, childcare settings, schools, camps, board and lodging facilities, private parties,

caterers or at water activity facilities.

The time period may be variable because the illness may occur for some time before it

reaches a “critical mass” to be identified or a

person is diagnosed with a pathogenic organism.

Actions to prevent further

transmission and control

strategies may include:

Exclusion of individuals with diarrhea and/or

vomiting

Following proper hand washing and cleaning/disinfecting procedures,

Identification of the causative

agent (laboratory confirmed or

epidemiological data),

Avoidance of contaminated food or water,

Destruction of

contaminated food,

Closure of facility

pending action.

EMERGENCY RESPONSE OBJECTIVES

In a situation that has resulted in

foodborne illness, the following

objectives need to be addressed immediately:

1.Identify

conditions that may have

contributed to the outbreak.

2.Identify and

eliminate the factors that could

lead to further transmission.

3.Clarify the nature and

mechanism of disease

transmission.

4.Provide

information need to design effective

strategies to prevent future

outbreaks.

5. Evaluate food

facilities or water

sources.

PRIORITY ACTIVITIES

There are a number of specific tasks that city and county environmental

health professionalscould do when responding to a

foodborne illness

COMMUNICATE

1. Maintain frequent communication

(conference calls, emails, faxes) with

all involved agencies.

COMMUNICATE

2. Give input to epidemiologists regarding patron and food service

worker interviews.

COMMUNICATE

3. Provide menus from the facility

or event to epidemiologists.

COMMUNICATE

4. Provide patron names and/or

reservation lists to epidemiologists.

COMMUNICATE

5. Provide liaison with

facility.

COMMUNICATE

6. Use authority to close/reopen

facility as needed.

If a situation requires a response

beyond environmental

health’s capacity, the following actions will be conducted:

• Request activation of incident command.• Provide input into press release.• Provide just-in-time training.• Provide regular sanitation-status reports to incident command.

Enforcement actions against a food service

establishment implicated in a foodborne disease

outbreak should focus on operations and behaviors that are the likely cause

of the outbreak.

All observed risk factors or critical

violations must be noted and orders

issued for immediate

correction of each.

Enforcement actions may include:− closing the facility,− excluding or restricting workers,− issuing embargo orders,− condemning food, and− issuing correction orders