This article was co-authored by Dr. Kathleen Vidoloff, Emergency Risk Communication Officer for Oregon Public Health Division, and Dr. Jean O’Connor, former Oregon Deputy Public Health Director. One of the many roles of public health is to protect consumers from threats like foodborne outbreaks. Much of this hinges on quickly getting out clear messages to the public that provide simple steps to help stem the spread of disease. This is something public health professionals have been doing for over a hundred years, but a recent outbreak of Salmonella Heidelberg got us wondering, “Are we doing enough to keep the public safe? Are we too slow? And, how can we improve?” That’s not to say there weren’t triumphs in this outbreak, but like most responses we had a moment of self-reflection when the crisis was over and we were able to take a step back and consider our methods. What we found was a need for stronger policies and faster messaging to the public. The Outbreak Between June 2012 and January 2013 epidemiologists with Oregon Public Health, along with the Washington State Department of Health, CDC, and the US Department of Agriculture independent of each other, began noting increases in the number of Salmonella infections. Thanks to surveillance systems like CDC’s Pulsenet and National Retail Monitoring System (NARMS), epidemiologists were able to narrow down the specific genetic make-up of the Salmonella in question (Salmonella Heidelberg) and link it to raw or undercooked Foster Farms brand chicken. The Pros and Cons For decision-making and public information, we did several things right. Including:
- Communicating with the company responsible for the tainted chicken, which helped provide critical information needed to confirm the source.
- Developing simple messages that explained the outbreak and how individuals could prevent Salmonella were developed. These messages followed the Crisis & Emergency Risk Communication framework, which encourages the use of transparent messaging that provides the public with meaningful actions to protect themselves from harm.
- Growing a strong partnership between our epidemiologists, leadership, and risk communication officer over the course of the investigation provided a basis for mutual trust and respect. This rapport led to faster message development.
- Finally, by following Incident Command System principles, we were able to better coordinate communication activities across the several agencies involved.
Although we were successful in getting the message out, there were several factors that we felt slowed this outbreak response down:
- Despite having several state and federal agencies collecting clues, we weren’t doing it together, which meant more time was spent on the backend to get everyone on the same page.
- Not all staff had been trained on the laws and policies related to release of information, which was needed for rapid decision-making during the outbreak.
- Oregon Public Health (as we suspect is the case with many state health departments) has no risk communication policy, which meant not everyone was on the same page about how and when we would share information and release information to our partners and the public.
- Political happenings unrelated to the outbreak ended up blocking the release of important health messages by two days — another all-too-common experience for many risk communicators.
How Can We Improve? Given these pros and cons, we still think much can be done to improve decision-making and risk communication during an outbreak. The federal Food Safety and Modernization Act of 2011 was an important step toward improving the safety of our nation’s food supply. However, our experience responding to Salmonella Heidelberg outbreak in Oregon also suggests that additional state and federal policies are needed not only to prevent outbreaks, but also to help public health authorities implement best practices in risk communications and public health responses when outbreaks do occur. No state health department funded with federal dollars — CDC or otherwise — should be without a well-developed risk communications plan that can be operationalized at a moment’s notice. Similarly, states should be held accountable to ensure information about emerging outbreaks is shared between epidemiologists, other partners, and response staff, and to identify the triggers for public warning and messaging about health risks. Depending on the risk, even a one day delay in response could mean more sick people, and in turn more health care and social costs.
Dr. Kathleen Vidoloff is the Emergency Risk Communication Officer for Oregon Public Health Division where she oversees the development, implementation and evaluation of risk communication activities. She is also an Adjunct Professor of risk communication at the University of Oregon. Dr. Vidoloff previously worked as a contractor at the U.S. Centers for Disease Control and Prevention evaluating emergency risk communication strategy for international and domestic emergency responses. Dr. Jean O’Connor was Oregon’s Deputy Public Health Director and the Principal Investigator for Oregon’s public health preparedness and infrastructure improvement funding awards from 2011 to 2013. She has more than 15 years of experience with CDC, state public health agencies, and non-profit organizations, including work on numerous responses to domestic and international public health events. She is also an Adjunct Associate Professor at Emory University’s Rollins School of Public Health where she teaches law and policy. Disclaimer: This blog post does not represent the official views of the Oregon Public Health Division or the Oregon Health Authority Editor’s Note: This article originally appeared on CDC’s Public Health Matters Blog May 1, 2013.