Crosswalk - Requirements for Foodborne Illness Training Programs Based on Standard 5

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Crosswalk - Requirements for Training Programs Based on Standard 5 Introduction: The 2012 2014 Interdisciplinary Training Committee (IFITC) obtained the FSMA 205 C(1) Phases of a Food Incident (CIFOR/RRT/MFRPS/VNRFRPS Crosswalk) and used this Crosswalk as the response to the Charge to identify essential education content of foodborne disease outbreak training programs. The 2014 2016 Interdisciplinary Training Committee (IFITC) was now charged with developing a Crosswalk that would identify areas where training programs could be compared to Standard 5 of the Voluntary National Retail Food Regulatory Program Standards. Using the CIFOR/RRT/MFRPS/VNRFRPS Crosswalk as a base, the Committee revised the Crosswalk to compare additional training programs that were identified. In addition to the training programs identified in the CIFOR/RRT/MFRPS/VNRFRPS Crosswalk, the IFITC also reviewed: 1. National Health Association () course 2. National Health Association () Epi-Ready Strategies, June 2006 The resulting Crosswalk now identified the content of all the training programs and indicated, using a table format, how these compared to Standard 5. This Crosswalk is called Crosswalk Requirements for Training Programs Based on Standard 5. The Committee also recognized that in the process of determining gaps the Crosswalk could now have an expanded purpose of (1) identifying available resources related to Training; (2) setting a content baseline for the development of Training Programs; (3) establishing some consistency for training programs as a whole. The Committee considered this a more powerful interpretation of the first Charge and as such did not include any references to best practices.

The Committee also agreed that this document will be useful to regulators, academics and NGO s when new training programs are being considered especially as it would introduce consistency, a much needed component in Training Programs. In 2016-2018, the Program Standards Committee (PSC) was now charged with maintaining the document. The chart below is an updated version with current references for the training materials. Acronyms Used: RRT: Rapid Team CIFOR: Council to Improve MFRPS: Manufactured Food Regulatory Program Standards IAFP: International Association of Food Protection NASDA: National Association of State Departments of Agriculture Food Emergency Plan Template http://www.nasda.org/file.aspx?id=4065 Ready: National Health Association : Industry- Investigation Training and Recall Center for Disease Control VNRFPS: Voluntary National Retail Food Regulatory Program Standards Standard 5

STANDARD 5 - Voluntary National Retail Food Regulatory Program Standards 1. Investigative procedures. Standard 5 RRT CIFOR MFRPS IAFP a. The program has written operating procedures for responding to and /or conducting investigations of foodborne illness and foodrelated injury*. The procedures clearly identify the roles, duties and responsibilities of program staff and how the program interacts with other relevant departments and agencies. The procedures may be contained in a single source document or in multiple documents. II. A. Chapter 1 NASDA Version 4.0. August 2011 3.1 5.3 Page 3-4 III, V, VI, VII, IX, X, Modules 1, 2, 3, 4,5, 6, 7 Module 1 Building a Partnership: Who and Why? b. The program maintains contact lists for individuals, departments, and agencies that may be involved in the investigation of foodborne illness, food-related injury* or contamination of food. II.B. Chapters 2&3 3.6.2.1 5.3.1.2.6 Page3-4 VI, XIV Module 1 Module 1 Building a Partnership: Who and Why?

Standard 5 RRT CIFOR MFRPS IAFP NASDA Version 4.0. August 2011 c. The program maintains a written operating procedure or a Memorandum of Understanding (MOU) with the appropriate epidemiological investigation program/department to conduct foodborne illness investigations and to report findings. The operating procedure or MOU clearly identifies the roles, duties and responsibilities of each party. d. The program maintains logs or databases for all complaints or referral reports from other sources alleging food-related illness, food-related injury* or intentional food contamination. The final disposition for each complaint is recorded in the log or database and is filed in or linked to the establishment record for retrieval purposes. II.A. Chapter 1 II. E. Chapter 11 3.1 5.3.1.1 V, VI, IX, XIII Module 1 Building a Partnership: Who and Why? 4.3.4.9 5.5 Page 2,3,4 Example logs: page 139-140 Module 4 Epidemiologic Investigation Module 2 Module 2 How Do You Recognize a?

Standard 5 RRT CIFOR MFRPS IAFP NASDA Version 4.0. August 2011 e. Program procedures describe the disposition, action or follow- Chapter Chapter 4, 5.5 Page3-11 VI, IX Module 2 Module 2 up and reporting required for 9,10,11 & 4.3, How Do You each type of complaint or 13 Chapter 5 Recognize a referral report.? f. Program procedures require disposition, action or follow-up Chapters 9, Chapter 4,5 5.5 on each complaint or referral 10, 11 & 13 report alleging food-related (pg.212) illness or injury within 24 hours. Subsection D g. The program has established procedures and guidance for Chapters Chapter 4, 5.5 Pages 41-45 Module 3,5, 8 Module 3 Lesson 4, 5 collecting information on the 9,10, 11 & 5 suspect food s preparation, 13 Assessment storage or handling during on- (Page 212) Exercise site investigations of food- Subsection related illness, food-related D injury*, or outbreak investigations. h. Program procedures provide guidance for immediate Chapter 6, 3.1, 3.10, 5.5 Pages 99-, V, VI, IX, Module 7 notification of appropriate law 10 6.3 103 enforcement agencies if at any time intentional food contamination is suspected.

Standard 5 RRT CIFOR MFRPS IAFP NASDA Version 4.0. August 2011 i. Program procedures provide guidance for the notification of Chapter 6, 3.1, 3.10, 5.3.1.2.2 Pages 6-7 IV, V, VI, IX, Module 7 Lesson 7 appropriate state and/or federal 10 7.3 XII, XV agencies when a complaint involves a product that originated outside the agency s jurisdiction or has been shipped interstate. 2. Reporting a. Possible contributing factors to the food-related illness, food- Chapters 9, 5.2 5.3 Pages 34- Modules 5, 8 Module 3 Lesson 2 related injury* or intentional food 10, 11 41 contamination are identified in Assessment each on-site investigation Exercise report. b. The program shares final reports of investigations with the Chapter 3, 4.2, 4.3, 5.5 Page 75 Module 8 Module 7 Lesson 8 state epidemiologist and reports 6, 13 4.4, 7.5, 9.1 Final Report & of confirmed foodborne disease Recovery outbreaks* with.

Standard 5 RRT CIFOR MFRPS IAFP NASDA Version 4.0. August 2011 3. Laboratory Support Documentation a. The program has a letter of Module 5 understanding, written 4.2, 4.3, 5.3.3.4 VI Modules 4, 5 Collecting procedures, contract or MOU 4.4, 9.1, Samples and acknowledging, that a laboratory(s) is willing and able to provide analytical support to the jurisdiction s food program. The documentation describes the type of biological, chemical, radiological contaminants or other food adulterants that can be identified by the laboratory. The laboratory support available includes the ability to conduct environmental sample analysis, food sample analysis and clinical sample analysis. Laboratory Testing b. The program maintains a list of alternative laboratory 4.2, 4.3, 5.5 VI contacts from which assistance 4.4, 9.1 could be sought in the event that a food-related emergency exceeds the capability of the primary support lab(s) listed in paragraph 3.a. This list should also identify potential sources of laboratory support such as FDA,

USDA,, or environmental laboratories for specific analysis that cannot be performed by the jurisdiction s primary laboratory(s). 4. Trace-back Standard 5 RRT CIFOR MFRPS IAFP a. Program management has an established procedure to address the trace-back of foods implicated in an illness, outbreak or intentional food contamination. The trace-back procedure provides for the coordinated involvement of all appropriate agencies and identifies a coordinator to guide the investigation. Trace-back reports are shared with all agencies involved and with. Chapter 9 5.2 5.3.3.3 Forms J 1, 2 & 3 (pg. 152 154) NASDA Version 4.0. August 2011 VI, IX Module 5 Module 8 Food Recalls Lesson 7

5. Recalls Standard 5 RRT CIFOR MFRPS IAFP a. Program management has an established procedure to address the recall of foods implicated in an illness, outbreak or intentional food contamination. NASDA Version 4.0. August 2011 Chapter 12 5.2.4.1.1 5.3.2.2 VI, IX Module 5 Module 8 Food Recalls b. When the jurisdiction has the responsibility to request or monitor a product recall, written procedures equivalent to 21 CFR, Part 7 are followed. Chapter 12 5.2 VI, IX Module 8 Food Recalls c. Written policies and procedures exist for verifying the effectiveness of recall actions by firms (effectiveness checks) when requested by another agency. 6. Media Management a. The program has a written policy or procedure that defines a protocol for providing information to the public regarding a foodborne illness outbreak or food safety emergency. The Chapter 12 5.2 Chapter 3, 6 3.6 5.3.4.2 Page 73 and 105 Module 8 Food Recalls VI, IX, XI Module 8 Module 6 Control Measures Module 8

policy/procedure should address coordination and cooperation with other agencies involved in the investigation. A media person is designated in the protocol. 7. Data Review and Analysis Standard 5 RRT CIFOR MFRPS IAFP a. At least once per year, the program conducts a review of the data in the complaint log or database and the foodborne illness and food-related injury* investigations to identify trends and possible contributing factors that are most likely to cause foodborne illness or food-related injury*. These periodic reviews of foodborne illnesses may suggest a need for further investigations and may suggest steps for illness prevention. b. The review is conducted with prevention in mind and focuses on, but is not limited to, the following: 1) Disease s*, Suspect s* and Confirmed Disease s* Chapter 13, 14 Chapter 13, 14 4.3, Chapter 8 5.2.9 4.3, Chapter 8 NASDA Version 4.0. August 2011 2&3 XIV Module 2 Food Recalls

in a single establishment; 2) Disease s*, Suspect s* and Confirmed Disease s* in the same establishment type; 3) Disease s*, Suspect s* and Confirmed Disease s* implicating the same food; 4) Disease outbreaks*, Suspect s* and Confirmed Disease s* associated with similar food preparation processes; 5) Number of confirmed foodborne disease outbreaks*; 6) Number of foodborne disease outbreaks* and suspect foodborne disease outbreaks*; 7) Contributing factors most often identified; 8) Number of complaints involving real and alleged threats of intentional food contamination; and 9) Number of complaints involving the same agent and any complaints involving unusual agents when agents are identified.

Standard 5 RRT CIFOR MFRPS IAFP c. In the event that there have been no food-related illness or Chapter 8 food-related injury* outbreak investigations conducted during the twelve months prior to the data review and analysis, program management will plan and conduct a mock foodborne illness investigation to test program readiness. The mock investigation should simulate response to an actual confirmed foodborne disease outbreak* and include on-site inspection, sample collection and analysis. A mock investigation must be completed at least once per year when no foodborne disease outbreak* investigations occur. NASDA Version 4.0. August 2011