Presentation title: CIFOR consensus guidelines for foodborne disease outbreak and detection

CAPT Don Sharp, MD

George Nakamura


The Council to Improve Foodborne Outbreak Response (CIFOR) is a multidisciplinary collaboration organized in 2006 that is composed of seven national associations and three federal agencies.  The purpose of CIFOR is to identify barriers in the food safety system (disease surveillance, outbreak detection, investigation, reporting, control, and prevention) and to develop a variety of practical products that address these barriers. CIFOR is especially focused on speeding up the detection and investigation of outbreaks of foodborne illness. Members include the Association of Public Health Laboratories (APHL), the Association of State and Territorial Health Officials (ASTHO), the Association of Food and Drug Officials (AFDO), the Council of State and Territorial Epidemiologists (CSTE), the National Association of County and City Health Officials (NACCHO), the National Association of State Departments of Agriculture (NASDA), and the National Environmental Health Association (NEHA). Federal agencies include the Food Safety and Inspection Service (FSIS) in the United States Department of Agriculture (USDA) and the U.S. Food and Drug Administration (FDA), and the Centers for Disease Control in the Department of Health and Human Services.  CIFOR has just published the Foodborne Disease Response Guidelines, a 200-page document that was three years in the making and provides in-depth, practical information on many outbreak-related topics.  Chapters include planning and preparation, foodborne disease surveillance and outbreak detection, investigation, multijurisdictional outbreaks, outbreak reporting, control and prevention issues, program performance indicators, industry relationships, and legal considerations. 


The Guidelines are intended to be used by staff involved in food safety and foodborne illness investigation programs at the local, state, and federal levels.  Recommended roles are discussed for laboratorians, environmental health specialists, and epidemiologists. The Guidelines are a product of an extensive development process: literature review, 19 key informant interviews, roundtable discussions at national meetings, drafting of chapters by technical experts, review of drafts by CIFOR Workgroup members and the public, and final approval by CIFOR in March, 2009. CIFOR is funded primarily by CDC with critical funds from FDA for Workgroup meetings.  CIFOR is also working on several other products to improve outbreak investigation and these will also be briefly presented.