INPPAZ - PAHO - WHO
BIREME - PAHO - WHO

GuiaVETA
Guidelines of Surveillance System for Foodborne Diseases and Investigation of Outbreaks

CHAPTER V.

ACTIONS RESULTING FROM THE OUTBREAK INVESTIGATION

Follow-up

The appropriate service monitors the progress of the outbreak and the adoption of recommended measures while conducting complementary research, evaluating the changes in patients, and carrying out other pertinent activities. Obviously, none of these tasks is separate from evaluation of the control measures for an outbreak of FBD; they are also indicated for non-epidemic situations. The number of cases may undergo variations in frequency, geographical distribution, frequency of complications and case-fatality. Some outbreaks may last for days, weeks, or months. In a prolonged outbreak, the working team may be fatigued, requiring renewal or reinforcements. If it is decided that the control measures were not effective, the options for subsequent action are:

Analyze the available data again.

        - Get new recommendations for control measures.

Step 9

Make conclusion and recomendations

Analysis and Conclusion

When all the data have been analyzed, the working team meets to make an overall interpretation and arrive at final conclusions on the outbreak. It is of major importance that surveillance personnel from the `Food Safety` Program and from the laboratories participate in this meeting. Data analysis and the conclusions to be made are never effectively reached by only a single member of the team.

Recommendations

Based on the final analysis, definitive measures should be recommended for the places where the food is produced and prepared, including training of handlers and other personnel, upgrading of installations, procurement of new equipment, and introduction of sampling techniques through surveying of the critical control points. The following should also be taken into account: orientation for administrators and managers, adoption of more modern technologies, legal actions, periodic control of carriers, and support for rehabilitation and other indicators for each specific case.

Step 10

Make a final report

Final report from the local to other levels

The format for a final report on FBD outbreaks as proposed in Annex B FBD Surveillance 9 should be used. Where necessary, other information can be attached to improve the presentation (epidemic curves, brief descriptive reports and control measures). This report should be sent to the next higher level, to FBD Surveillance staff members, and to all the groups and persons involved in the outbreak survey and other activities.

Public Dissemination

Full dissemination should take place via the mass media. This information strengthens the notification system, motivates the population to continue to collaborate, and allows for diffusion of general prevention measures.

File

All the data compiled should be filed. This ensures preservation of the information for retrospective studies, the resolution of legal problems and various queries and the consolidation of a database on FBD.

Public appearances

In special cases the outbreak can lead to members of the working team making public appearances in several places, including the place where the outbreak occurred, and inviting food handlers, administrators, and family members to appear with them. Making use of discussions, carried on at a level of language appropriate to the participants, and employing audiovisual materials, the events that occurred and the mistakes made can be presented and correct procedures in food handling and processing emphasized.

Final report to the Regional Information System for FBD Surveillance (SIRVIETA).

FBD Surveillance Form 9, in Annex B, has been agreed upon by countries for use in submitting quarterly information on outbreaks of which they have been notified.