Resources for Public Health Partners
Foodborne Illness Investigation
When notifying FSIS of a foodborne illness outbreak, provide as many details about the outbreak and the investigation as possible, including some of the specific details outlined in the subsections below.
Information in the recommended template (see Template section below) may be adapted by public health partners for including FSIS in foodborne illness outbreak response procedures.
In addition to following established procedures for notifying other entities (e.g., CDC), public health partners should notify FSIS as soon as possible of illness outbreaks potentially associated with FSIS-regulated products (including meat, poultry, and egg products). An entity/person should be designated to have primary responsibility for notifying FSIS. Ideally, contacts should be established prior to an outbreak. Here is how to notify FSIS:
- Send an email to: FoodborneDiseaseReports@usda.gov. This email account is monitored by the Office of Public Health Science, Applied Epidemiology Staff (OPHS-AES) during both normal work hours and after hours (evenings, weekends, and holidays). You may also contact individual OPHS-AES members by phone or email.
- Include on the email your contact(s) in the Office of Enforcement, Investigation, and Audit, Compliance and Investigations Division (OIEA-CID). See CID Regional contacts.
- You may also contact the local Office of Field Operations (OFO) District Office. See OFO District contacts.
Listed below, by foodborne illness–related topic, are primary FSIS program areas with relevant contact information, FSIS Directives and Notices (FSIS policies and procedures), and additional resources. (FSIS Directives and Notices are provided in PDF.)
Epidemiology and Laboratory Analysis of Suspect Food Products
Office of Public Health Science (OPHS) | E-mail: FoodborneDiseaseReports@usda.gov
- FSIS Directive 8080.3: Foodborne Illness Investigations
- FSIS Directive 10,000.1: Policy on Use of Results from Non-FSIS Laboratories
- Fact Sheets: Foodborne Illness and Disease
Traceback/Traceforward Investigations of Suspect Food Products
Office of Investigation, Enforcement, and Audit (OIEA) – Regional Contacts
- FSIS Directive 8010.2: Investigative Methodology
Meat, Poultry, and Egg Products Inspection and Recalls
Office of Field Operations (OFO) – District Office (Regional) Contacts
- FSIS Directive 5100.4: Establishment Public Health Risk Evaluation (PHRE) Methodology
- FSIS Directive 5100.1: Establishment Food Safety Assessment (FSA) Methodology
- FSIS Directive 5500.2: Significant Incident Response (Emergency Management Committee [EMC])
- FSIS Directive 5500.3: Incident Investigation Team (IIT) Reviews
- FSIS Directive 10,300.1: Intensified Verification Testing (IVT) (Product/Food Contact Surface/Environmental Sampling)
- FSIS Directive 8080.1: Recall of Meat and Poultry Products
- FSIS Directive 5100.2: Recall Investigations and Effectiveness Checks
- Establishment Directory | Production and Inspection | FSIS Food Recalls | State Inspection Programs
To request foodborne illness outbreak–related information from FSIS, send an email to: FoodborneDiseaseReports@usda.gov. You may also contact individual OPHS-AES members by phone or email. See FSIS Directive 2620.5.
- FSIS Directive 2620.5: Sharing Information with Local, State, and International Partners
- Foodborne Outbreak Investigation Outcomes - Response and Prevention (response actions, after-action reviews, and policy implications)
- Establishment-Specific FSIS Sampling Results
- Salmonella Categorization of Individual Establishments (young chicken/turkey carcasses)
- Subscribe to FSIS Constituent Updates (updates on policies, procedures, and food safety issues)
- Centers for Disease Control and Prevention (CDC): Investigating Foodborne Outbreaks
- Food and Drug Administration (FDA): Recalls, Outbreaks & Emergencies | Resources for Regulatory Partners
- Foodsafety.gov: Websites of State Health Departments and State Agriculture Departments | Selected Federal Agencies with a Role in Food Safety (including product jurisdiction)
- Council to Improve Foodborne Outbreak Response (CIFOR): Products and Resources for Outbreak Response
- Association of Food and Drug Officials (AFDO): Directory of State and Local Officials | State Jurisdiction and Enforcement Directory
- National Association of City and County Health Officials (NACCHO): Directory of Local Health Departments
Information Collection That is Helpful to FSIS During Foodborne Illness Investigations
If possible, provide the following information in a "line list" spreadsheet
- Number of ill persons (suspect vs. probable vs. laboratory-confirmed)
- Patient demographics (e.g. sex, age, residence)
- Illness onset date(s) (estimated or known)
- Symptoms and severity (hospitalizations, complications [e.g. HUS, miscarriage], deaths)
- Etiology and clinical laboratory results (details of microbiological, chemical, or physical etiology; clinical specimen type; pathogen genus, species, serotype, molecular subtype, antimicrobial susceptibility profile)
- Exposure history of ill persons (dates, locations, number and percent of ill persons exposed to suspect foods and other exposures)
- Number of non-ill persons exposed to suspect foods
- Case definition
- Results of analytical studies (e.g. case-control, cohort)
- Other agencies (local, state, federal) collaborating on the investigation
- Results/reports of environmental investigations
- Details regarding ill food handlers (see "Epidemiologic Investigation," above; additional details regarding food handling duties)
- Suspect food product conditions from manufacturing through consumption (time/temperature, holding/handling/cooking methods, cross-contamination potential)
For traceback/traceforward and sample collection:
- Commodity type (e.g. pork, turkey)
- Detailed product description (e.g. 8-oz. rib eye steak, 90% lean ground beef)
- Brand name
- Size of product and packing details (net weight, count per package/case)
- Cooking/temperature status when distributed/stored/sold/consumed (e.g. distributed raw, frozen; consumed after cooking)
- Establishment number (e.g. "P-123" or "9876 M")
- Manufacturing codes (production code, lot number, sell by/use by/best by date)
- Photographs/copies of product labeling and packaging
- See "Details of Suspect Food Products," above
- Details of consumer purchase
- Names of purchase location (e.g. store, restaurant)
- Addresses (street number, city, state, zip code)
- Amounts of product
- Documentation of purchase (e.g. receipts, shopper/club card history)
- Documentation of shipment/distribution (e.g. invoices, bills of lading, packing slips)
- Results of traceback/traceforward investigations already conducted (including for products not regulated by FSIS, if relevant)
- Have samples been collected? If so:
- See "Details of Suspect Food Products," above
- What are the sample ID numbers?
- Which agency(ies) collected the samples?
- When (date and time) and where were the samples collected?
- At the time of collection, had the samples’ original packaging been opened?
- What amounts were collected?
- Are sample collection forms (filled by the collectors) available?
- Are chain of custody forms (filled by collector and/or lab) available?
- What were the storage conditions (e.g. temperature) at the locations of collection and during previous distribution?
- Were the product and storage temperatures recorded at the times of collection? If so, what were the temperatures?
- If in opened packaging, had anyone handled the sampled products after they were originally consumed or prepared?
- If in opened packaging, had ill persons handled the sampled products after illness onset?
- How, when, and by whom (include affiliation) were the samples transported to the laboratory?
- Were the samples shipped under seals?
- When did the laboratory(ies) receive the samples?
- Are there any product samples available for collection (whether in opened or closed packaging)? If so, would you like FSIS assistance with sample collection and testing of these products?
- See "Details of Suspect Food Products" and "Collection of Samples of Suspect Food Products," above
- Have samples been analyzed? If so:
- Where were the analyses conducted? Please provide the name of the laboratory, agency/group affiliation, and point of contact information.
- What were the methods? If possible, please provide written procedures that describe how samples are prepared and analyzed.
- What were the results? If possible, please provide copies of laboratory worksheets with results from the analyses.
- What are the details of the laboratory’s quality assurance program (e.g. proficiency testing, accreditation, use of controls for analyses and media preparation, training for technicians)?
- For the samples that were analyzed, are there any leftover products available for enumeration? If so, do you plan to perform enumeration on the remaining products or can the products be sent to FSIS for enumeration?
Template for Including FSIS in Foodborne Illness Outbreak Response Procedures
When notifying FSIS of a foodborne illness outbreak, public health partners should provide as many details about the outbreak and the investigation as possible, as outlined above.
FSIS has a process for assessing results from non-FSIS (e.g., state) laboratories for potential use during foodborne illness outbreak investigations. During such assessments, FSIS may ask for additional information from laboratory or other staff. See FSIS Directive 10,000.1
Following foodborne outbreak investigations, public health partners should collaborate with FSIS on after-action reviews to identify model practices and lessons learned to help prevent future illnesses and improve response processes. To see posted FSIS after-action review reports and examples of how FSIS applies outbreak lessons learned toward illness prevention, visit Foodborne Outbreak Investigation Outcomes - Response and Prevention