Modeling the Public Health System Response to a Terrorist Event in the Food Supply

Abstract

We have developed a simulation model to quantify and characterize the response of the public health system and the impact of public health advisories in the event of an intentional contamination of the food supply. The model has three components: (1) definition of individual exposure over time and the outcomes of exposure, (2) definition of the geographical dispersal of exposures, and (3) response of the public health authorities to symptomatic individuals. The model explicitly considers the variation in the multiple interrelated facets of the response system, including differences among individuals' responses to exposure, variation between health care providers, and the subsequent processing of samples and confirmation of cases. To illustrate use of the model, case studies with Escherichia coli O157:H7 and Salmonella spp. in three categories of food vehicle were compared. The level of detail required to run the public health component of the model is not trivial. While some data may not be available for hazards of particular interest in potential bioterrorism events, the application of expert judgment permits comparisons between different agents, different system reactions, and other assumptions within the system. The model provides the capacity to study the impact of system changes, to compare scenarios and to quantify the benefits of improvement in terms of averted exposures and risk reduction, and constitutes a significant aid to understanding and managing these threats. Essentially, the model provides an explicit valuation of time saved in the identification and intervention in terrorist events in the food supply.

Public Health in the Field and the Emergency Operations Center: Methods for Implementing Real-Time Onsite Syndromic Surveillance at Large Public Events

“…In a large-scale foodborne outbreak, the majority of those affected will not go to an ED or will seek medical care later; therefore, information about a potential exposure can be delayed or lost. 16 Another advantage of this new system is the rapid availability of data. For most large-scale events, a joint operations center (JOC) is activated.…”

Discrimination of healthy versus sick steers by means of continuous remote monitoring of animal activity

“…[4][5][6][7] Food animal production systems in the United States are vulnerable to terrorist attacks. Such an attack could destroy wholesome food supplies or contribute to foodborne illness through exposure to zoonotic agents.…”

The Potential Capability of Social Media as a Component of Food Safety and Food Terrorism Surveillance Systems

“…Early detection of both unintentionally and intentionally caused foodborne disease outbreaks (i.e., outbreaks associated with food safety issues or food terrorism acts, respectively) offers potentially significant targets for effective public health intervention (Khan et al, 2001). Modeling studies have estimated that early outbreak detection of terrorism events involving food result in reduced morbidity and mortality (Hartnett et al, 2009;Wein and Lui, 2005). Rapid detection of these events can reduce the number of exposed individuals via contaminated product removal from retail and food service outlets, public notification and education, and a more timely dissemination of preventative and therapeutic measures to exposed individuals.…”