Investigating foodborne gastroenteritis outbreaks
- ORS 333-018-0015 authorizes local health departments to investigate foodborne and other common source outbreaks by requiring health care providers to report all such suspected outbreaks immediately.
- ORS 333-019-0010 imposes work restrictions on persons who work at food service facilities whilst in a communicable stage of any illness accompanied by diarrhea or vomiting.
- ORS 6-24-080 authorizes local health departments to collect stool specimens from food handlers.
Definition, suspect foodborne outbreak
- > 2 non-householders who develop gastroenteritis (acute onset vomiting, diarrhea or both) at about the same time after eating food from the same source
- Collect preliminary data, specifically
- are there > 2 non-householders with gastroenteritis?
- what are the percentages of:
- severe abdominal cramps?
- where did the > 2 non-householders eat?
- when did they eat (date and time)?
- when did they start vomiting or experiencing diarrhea (date and time)?
- what did they eat?
- with whom did they eat?
- did they share other meals in the past week?
- Call ACDP (971-673-1111) for referral, if indicated, to the ACDP Urgent Epidemiologic Response Team (UERT).
- Conduct a conference call in accordance with the Outbreak Communication Agreement and following the Outbreak Conference Call Agenda if the outbreak is in Clackamas, Multnomah, or Washington counties.
- Get patron information and menus from the restaurant using the Foodborne Outbreak Restaurant Checklist (which can and should be used for evaluating other food service establishments).
- Expand the investigation with ACDP/UERT assistance and in accordance with Outbreak Investigation guidelines.
- Give outbreak-affected persons Instructions for Collecting Stools for Viral Culture and PCR
- Use secure, leak-proof containers with screw tops, not flip tops, labeled with name, collection date, and outbreak number.
- Collect specimens of walnut-size stool, 3 tbsp of diarrheal stool (or vomitus) or 3-4 rectal swabs from six outbreak-affected persons up to four days after onset. Collecting >6 does not increase the chance of finding something.
- Use proper containers for shipping stool and include OSPHL Virology/Immunology Request Form. Keep fresh stool specimens cold from the time they are produced until the time they reach OSPHL. (Instructions for Stool Collection.)
- Also send OSPHL scoops of fecal matter plopped into Clair Blair transport media (for bacteriology testing if norovirus tests are negative and include the Microbiology Request Form.