Figure 1 represents the general operating procedures for coordinating the response to a potential multi-jurisdictional food-borne illness outbreak.
The procedure would typically begin with the notification of the partners to identify an issue with the potential to become a multi-jurisdictional food-borne illness outbreak. A potential multi-jurisdictional food-borne illness outbreak may come to the attention of public health or food regulatory agencies through notifications from partners, reports of human illness (surveillance), a routine inspection that reveals a potential for human illness, or a food safety investigation.
Once a potential multi-jurisdictional food-borne illness outbreak has been identified, there is a requirement to examine the current available information and determine if it is sufficient to indicate the presence of a potential multi-jurisdictional food-borne illness outbreak that requires a collaborative investigation and the activation of an Outbreak Investigation Coordinating Committee (OICC).
A teleconference call will be held among affected partners (those with cases of human illness or relevant food-borne hazard information) to review the available information and assess whether or not an OICC is required.
If the initial assessment and review of available information indicates that an OICC should be activated, the FIORP duty officers will be notified by the OICC lead and asked to inform their senior officials. The OICC lead will initiate a teleconference call with the affected partners’ identified representatives to activate the OICC and begin the coordination of the investigation.
The composition of and collaboration with an OICC involves stakeholders such as provincial/territorial officials, local/regional officials, HC, the CFIA, PHAC, and law enforcement (if required). The composition of the OICC will depend on the nature of the outbreak and may evolve as knowledge related to the source of the outbreak is generated during the outbreak. At varying times, it should have representatives that provide epidemiological, food safety, laboratory, and communication expertise from the different levels of government required.
OICC collaboration includes
Most multi-jurisdictional food-borne illness outbreak investigations do not require the use of an incident command system (ICS) and activation of emergency operations centres (EOCs). However, agencies may consider using such an approach for some public health emergencies, including food-borne illness outbreaks, to help coordinate the response.
Figure 2 describes the way partners communicate and share information when an issue is identified with the potential to become a multi-jurisdictional food-borne illness outbreak.
Local, provincial/territorial and/or federal officials should notify their appropriate partners when there is a potential multi-jurisdictional food-borne illness outbreak and exchange relevant information.
Public Health Alerts can be used by stakeholders to share information. They are an effective communication tool used for early notification of possible or confirmed outbreaks with the potential to be multi-jurisdictional among local/regional and F/P/T health officials (some F/P/T agricultural authorities also have access).
This figure represents the microbiological flow that occurs between federal laboratories.
Health Canada, the Public Health Agency of Canada, and the Canadian Food Inspection Agency each work together to share and compare data. The points of contact are the laboratory groups of each agency. Data is shared electronically in real time via PulseNet Canada, and laboratory information is shared at weekly food safety and zoonoses meetings.
Appendix A represents the general process for directing food samples collected during an epidemiological/public health/food safety investigations to the Federal Laboratory Network.
The procedure would typically begin with a provincial/territorial/municipal/public health/agriculture (P/T/M) inspector taking a food sample, related to a possible food safety incident, for testing and then completing a sample collection form (see Appendix C).
The first question that needs to be addressed is whether this is a sample to be tested for Clostridium botulinum. If Yes, then inquires are to be directed immediately to the Botulism Reference Service. The Botulism Reference Service notifies partners of receipt of sample (HC, PHAC, CFIA, P/T/M, etc.). The laboratory performs the test and shares the results with P/T/M inspector (originator of the sample), PHAC, HC and CFIA.
There is an exception: if the sample to be tested for Clostridium botulinum is from British Columbia the P/T/M inspector would contact the BCCDC, Environmental Microbiology Lab. The BCCDC laboratory notifies partners of receipt of sample (HC, PHAC, CFIA, P/T/M, etc.), performs the test and shares the results with P/T/M inspector (originator of the sample), PHAC, HC and CFIA.
If the test is not for Clostridium botulinum then the P/T/M inspector determines if there is local/provincial public health laboratory (PPHL) expertise and capacity for the agent/test of interest. If Yes, then the sample is sent to the PPHL Labs. If No, then the P/T/M inspector needs to contact CFIA Operations (see Appendix B).
CFIA-P/T/M inspector will then make a decision whether the sample needs to be sent to a federal laboratory. If No, then the sample will be redirected to another PPHL or Provincial Agri-food Laboratory. If the sample needs to be sent to a federal laboratory then CFIA regional operations contacts the CFIA FSSD (see Appendix D) to determine if CFIA Lab has the required expertise and capacity to test the sample. If Yes, then the sample is sent to CFIA laboratory. The CFIA lab notifies partners of receipt of sample (HC, PHAC, CFIA, P/T/M, etc.), performs the test and shares the results with P/T/M inspector (originator of the sample), PHAC, HC and CFIA.
If the CFIA Lab is not able to test the sample then the FSSD contacts Health Canada or PHAC laboratories. The designated federal laboratory notifies partners of receipt of sample (HC, PHAC, CFIA, P/T/M, etc.). The laboratory performs the test and shares the results with P/T/M inspector (originator of the sample), PHAC, HC and CFIA.
For suspected sporadic listeriosis cases, food samples may be directed to the Listeriosis Reference Service.