Bringing a wealth of experience in food safety work — from fresh foods to inspecting restaurants — and years of experience coordinating investigations of food and waterborne disease outbreaks for the Florida Department of Health, Roberta Hammond, PhD, RS, joined FDA’s Center for Food Safety and Applied Nutrition (CFSAN) almost two years ago. At the time of this interview, Dr. Hammond was into her third week as Agency Incident Coordinator for the Salmonella Bareilly Incident Management Group (IMG), tracking the source of a recent outbreak of Salmonella infections.
FDA Voice: Dr. Hammond, thank you for meeting with us during your hectic day. Can you tell us about this recent salmonella outbreak? How are things going? Do you know what caused it yet? How many people have been affected?
Dr. Hammond: Well, we began tracking this outbreak in early April. So far, we are aware of 148 affected individuals, with 21 hospitalizations. We’re always concerned when food makes someone sick, but so far in this outbreak there have been no deaths, thank goodness. Our field investigators have led us to frozen, raw, ground tuna that was used in sushi and possibly other sushi-related dishes. The source appears to be a company in India that supplies mostly restaurants with this product. We had a real breakthrough on this investigation — sometimes they are inconclusive, or we never find the source.
Nevertheless, the outbreak has presented its own set of challenges. Most of the identified cases were along the Eastern seaboard of the US, with a few in Texas and a few as far west as Missouri. Strangely, there is no evidence of Salmonella Bareilly on the West Coast or in Hawaii, which is interesting because in the past, we’ve found those areas to have the highest concentration of people who eat sushi.
FDA Voice: You are the Agency Incident Coordinator for this particular Incident Management Group. What does that entail?
Dr. Hammond: FDA has an excellent incident management process, with an established structure, a clear set of procedures, and an established chain of command. The Office of Crisis Management (OCM) is our focal point for coordinating responses to natural emergencies or emergencies like the Gulf Oil Spill. FDA’s Coordinated Response and Evaluation Network, what we call CORE, is an agency outbreak-related activities network that was launched in 2011. CORE typically receives the first news of a human or animal food incident. CORE begins the investigation, and if the incident begins to escalate through a broader scope, greater severity, increased number of illnesses, or rise in deaths, we have the option to establish an Agency Incident Management Group, or IMG — this is the first IMG activation since CORE’s launch. If OCM’s Emergency Operations Center approves the formation of the IMG, most of the staff in CORE who have been working on the issue move into the Agency’s IMG center. Having the multidisciplinary team members working together in the same room enhances rapid information exchange and provides the group with additional operational support so the investigators can focus on their individual tasks.
We start by looking at the places where people think they may have eaten food that made them ill. From there, we use invoices and other records to trace the suspect food back to suppliers and then to where the food was produced. State and local health officials and FDA field staff do this work. They also collect samples of the suspect products that are tested for the presence of the pathogen –the infectious agent suspected of making people sick. For Salmonella Bareilly, we drew on the expertise of more than 60 trained and experienced investigators in 7 FDA district offices and 20 states and the District of Columbia.
The investigation involves close coordination with FDA partners, with Federal partners like the Centers for Disease Control and Prevention, with our State partners, and anyone else who needs to be pulled into the collaboration. FDA’s response is a well-oiled machine, if I may use a well-worn analogy.
FDA Voice: What is your specific role during this emergency?
Dr. Hammond: I help set up the IMG investigative team and then get out of the way. This is the first time I have coordinated a major outbreak within the Agency IMG structure, and I’m very impressed — the staff at the Emergency Operations Center are outstanding at what they do as are the CORE staff. I try to stay in the background, making sure the information gets to everyone who needs it. I see to it that people have what they need to do their jobs. And I watch for burn-out. I am also the primary IMG spokesperson on any calls with other Federal agencies and States, and I provide information to FDA leadership. I’d say one of my most important roles is to listen.
FDA Voice: Can you tell us what a typical IMG day looks like, if there is such a thing?
Dr. Hammond: First comes the daily kick-off meeting. I then meet with the section chiefs — planning, operations, logistics, and others. Then we watch over the work of the nearly 30 people who are tracking down clues about what might be the cause of the outbreak and identifying the steps we need to take to keep the food supply safe. I attend meetings and conference calls whenever needed, including meeting with the Agency Executive Group and FDA’s senior leadership to consider strategic options for the short and the long term.
FDA Voice: Dr. Hammond, when does an IMG deactivate?
Dr. Hammond: You can tell when things begin to wind down. People are no longer working at breakneck speed. Once the IMG has slowed and no longer requires the intense level of activity, it is transferred back to the CORE staff who tie up the loose ends. I will sit down with the IMG Section Chiefs and do what’s commonly referred to as a “hot wash.” We carefully go over everything that has happened — the planning, the logistics, the operations, the communications. We hope to glean any new understandings that can help us the next time. And, whether another foodborne illness or a natural disaster, we know there will always be a next time.