Expedited information gathering efforts, including regulatory tracebacks, may be needed to more formally document the distribution of implicated products. The determination of what regulatory response is appropriate is made on a case-by-case basis and is often based on several factors including but not limited to: The certainty of the evidence, the severity of the disease, the potential for ongoing exposure, and the availability of effective control measures that could prevent additional illnesses and/or deaths. Epidemiological Investigation Deciding when to initiate an Investigational Traceback Whenever possible, these investigations should be closely coordinated with partner agencies. In addition to the factors identified in and , there are also a number of conditions that, when some or all occur, indicate that an investigational traceback may be warranted: 1. Linked cases occur in multiple locations or jurisdictions (particularly if they occur in multiple states); 2. A vehicle cannot be clearly implicated with traditional epidemiologic, laboratory, and environmental investigation methods alone; 3. More information is needed to determine if similar food items from different establishments/stores/firms can be linked to a distributor or processor. The decision to conduct an investigational traceback should be influenced jointly by the public health and regulatory agencies. Joint epidemiology and regulatory meeting Review and discuss epidemiology data If an epidemiologic investigation meets the above criteria to initiate an investigational traceback, the appropriate regulatory agency(ies) – most likely Georgia DPH – should be contacted. If GDA has any details about the outbreak (such as number of cases, earliest/latest dates of onset, points of exposure, symptoms, geographic distribution of cases, etc.), a summary report should be given to DPH for review. DPH will work with the CDC to gather additional data, such as case interviews, line list of cases, case-control study results (if conducted), and an epi curve (if applicable). DPH should be requested, if/when making contact with new potential cases in the investigation, to: Identify any cases with product available for testing (with permission for regulatory agency to contact the individual and obtain samples). Product description: type of food (as specific as possible), brand name, labeling, lot codes, and any other unique identifiers that might be available – UPC, PLU, etc.).
Expedited information gathering efforts, including regulatory tracebacks, may be needed to more formally document the distribution of implicated products. The determination of what regulatory response is appropriate is made on a case-by-case basis and is often based on several factors including but not limited to: The certainty of the evidence, the severity of the disease, the potential for ongoing exposure, and the availability of effective control measures that could prevent additional illnesses and/or deaths. Epidemiological Investigation Deciding when to initiate an Investigational Traceback Whenever possible, these investigations should be closely coordinated with partner agencies. In addition to the factors identified in and , there are also a number of conditions that, when some or all occur, indicate that an investigational traceback may be warranted: 1. Linked cases occur in multiple locations or jurisdictions (particularly if they occur in multiple states); 2. A vehicle cannot be clearly implicated with traditional epidemiologic, laboratory, and environmental investigation methods alone; 3. More information is needed to determine if similar food items from different establishments/stores/firms can be linked to a distributor or processor. The decision to conduct an investigational traceback should be influenced jointly by the public health and regulatory agencies. Joint epidemiology and regulatory meeting Review and discuss epidemiology data If an epidemiologic investigation meets the above criteria to initiate an investigational traceback, the appropriate regulatory agency(ies) – most likely Georgia DPH – should be contacted. If GDA has any details about the outbreak (such as number of cases, earliest/latest dates of onset, points of exposure, symptoms, geographic distribution of cases, etc.), a summary report should be given to DPH for review. DPH will work with the CDC to gather additional data, such as case interviews, line list of cases, case-control study results (if conducted), and an epi curve (if applicable). DPH should be requested, if/when making contact with new potential cases in the investigation, to: Identify any cases with product available for testing (with permission for regulatory agency to contact the individual and obtain samples). Product description: type of food (as specific as possible), brand name, labeling, lot codes, and any other unique identifiers that might be available – UPC, PLU, etc.).
ga-sop_-_traceback_and_traceforward_investigations_procedures.docx