tail raw milk product processed by the
same firm. This time around, the firm
respectfully declined to issue a voluntary recall. Due to the possible public
health implications based on the positive sample results, WSDA developed
and distributed a public health alert, a
public information release that includes
the sample results, health information
on salmonellosis, and distribution information for the positive product.
Through coordination efforts led
by the Washington RRT, the WADOH
Food Safety Program notified local
health jurisdictions throughout the state
and provided them with a copy of the
alert to be used as a tool for notifying
retail points of sale.
After the four additional raw milk
samples were confirmed for the presence of Salmonella spp., Washington
Washington RRT: Creating Collaborations to Link Illnesses and Adulterated
Product across Time
Washington State has developed and continually improved their food and feed
Rapid Response Team (RRT) since 2009. As one of the original states to receive FDA
cooperative agreement funding, Washington has worked hard to create a flexible, capable response team to effectively mitigate public health threats associated with human and animal food. The Rapid Response Program, housed within the Washington
State Department of Agriculture (WSDA), maintains close collaborative relationships
with the FDA Office of Human and Animal Foods Division 6-West (OHAF-6W),
the Washington State Department of Health (WADOH), local health jurisdictions
in Washington State, industry, and other key partners to help safeguard the food and
One such capability of the Washington RRT is to quickly coordinate response
partners and leverage their resources to link pathogens found in food samples to human illnesses at the genetic level. These illnesses may even be “historical” in nature
in that they may have been reported months or years in the past. However, with
stronger technologies and methods such as WGS and bioinformatics, these illnesses
can now be associated with pathogens collected from current product and clinical
samples to a high degree of accuracy. Linking such illnesses to samples collected during current RRT responses may allow responders to identify chronic issues at a food
production facility such as a resident pathogen that is not being killed through current cleaning and sanitation procedures.
This type of “rapid response across
time” was exemplified through a multi-agency response coordinated by the
Washington RRT in September 2017.
Eight months earlier, the WSDA Rapid
Response Program was notified by foodborne illness epidemiologists at WADOH
that two human Salmonella Dublin cases
with indistinguishable pulsed-field gel
electrophoresis (PFGE) patterns and
similar illness onset dates had reported
consuming retail raw milk from a specific
licensed raw milk dairy in Washington
State. With proper licensing through
WSDA, retail raw milk and hand-skimmed
raw cream are legal in Washington State.
Approximately 32 firms were licensed to
produce and distribute these raw dairy
products within the state’s borders as of
Subsequent sampling of the finished
raw milk product processed by the dairy
in question did not indicate the presence
of Salmonella, but rather Shiga toxin-producing Escherichia coli. Based on these lab
results, the dairy decided to voluntarily
recall the implicated lots of their organic
retail raw milk in February 2017.
Fast-forwarding to September 2017,
routine surveillance sampling conducted
by WSDA subsequently confirmed results
for the presence of Salmonella spp. in re-
Environmental health: Sometimes referred to as sanitarians or environmental specialists. During an outbreak investigation, these individuals typically work with farms, firms,
and food establishments and complete on-site investigations and interviews, collect food
and environmental samples, and collect trace-back and trace-forward information. Typically, these professionals are employed by state departments of health or agriculture, or
local departments of health. The samples provided by environmental health are tested by
laboratory services, and the information obtained can help epidemiologists provide additional information to assist in working with ill individuals. Environmental health professionals frequently monitor consumer complaints and food sample and environmental sample
results, looking for potential outbreaks.
Epidemiology: Epidemiology in this context is the study of diseases and their causes.
Epidemiologists interview those who have become ill with a potential foodborne illness and
those with similar exposures, learning details about what they have eaten, where those
foods were from, and potentially obtaining purchase records to assist in determining exactly what was eaten and when. Typically, they also work with the data provided by ill and
well individuals to determine the most likely potential foods that cause the illness. Information provided by the epidemiologists can be used to help environmental health determine
areas of focus for investigation, taking samples, conducting interviews, and gathering additional information. Their work can also assist in prioritizing samples to be collected and
tested from ill individuals, foods, and the environment. These individuals typically work in
state and local health departments. Epidemiologists frequently monitor surveillance systems such as reportable illness test results, looking for potential outbreaks.
Laboratory services: Laboratorians analyze samples from ill people, foods, and the
environment. They look for bacteria, viruses, toxins, and chemicals that may cause illnesses. They type the samples, including the use of whole-genome sequencing (WGS) and
pulsed-field gel electrophoresis (PFGE). It should be noted that PFGE is currently being
phased out as WGS provides more complete information. In the interim, PFGE can be a fast
way to determine whether an organism is related among various samples. The information
provided by laboratorians assists both environmental health and epidemiologists in coming
to accurate conclusions. These individuals typically work in public health and state departments of agriculture laboratories.