Part 5 - Rewind WPPC-FDA Meeting Sept. 11

John (Jack) Guzewich of the FDA continues his presentation to the WPPC attendees on Sept. 11. (much more to come)

As far as traceback is concerned, like I said, the role that FDA picks up on is when the food we regulate has been implicated by the epidemiologists, when the CDC or the states say to us, “Well it is the tomatoes.” Our job is to conduct a traceback. We try to respond as quickly as possible for public health reasons, and also to limit the scope of economic harm to companies and also to limit the scope to consumers so they don’t get sick but they are able to have access to saleable food in the market place.

This was a very difficult traceback for us.

Our tracebacks are conducted by going into places where the people were exposed. In other words, supermarkets where they bought the products or restaurants where they ate. Where the point of exposure is, our tracebacks begin there. First using bills of lading and invoices, which some people keep good records on and some people do not, we have to work our way back through the distribution system, step by step by step, and there are multiple suppliers all through the system at each node in the system. We have to sort which of the multiple sources was the one that was likely involved on the contaminated product we are tracing.

And so this was a very tedious process and time consuming process, it takes took days and weeks to complete, and that was with people working nights and weekends, people that didn’t take a break from early June to early August, including weekends and holidays.

Our traces were complicated. There are two kinds of cases; one is called sporadic case, sporadic cases are where one individual who is positive for the disease organism, this Salmonella Saintpaul, Not only that, they feel like they know where they got exposed, they know which meal they could have eaten. That could be problematic, though; if they are a tomato eater they could have multiple exposures.

In the tomato investigation, we had primarily sporadic cases.

We go from the point of where the person said he ate at a restaurant or purchased product at a supermarket. We collect records, working our way back through the system from node to node to node, back to where it came from as best we can.

The other kind of outbreak is cluster phase; this is where there are a number of people that may all have a common exposure, they could have eaten at the same restaurant or all purchases the product at the same supermarket or grocery store. W e have number of people that have that in common, along with the same organism, we have more confidence we’re tracing the right product, then, because we have a number of people involved rather than a single exposure. The traceback works the same, in terms of bills of lading, working our way back from node to node to node.

In the early part of this investigation, we had only sporadic cases to trace and that was problematic.

That’s a little bit we had about traceback. Some of the problems we had with traceback….