CORE Network Background Paper
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Coordinated Outbreak Response & Evaluation (CORE) Network
FDA's Dedicated Team Fights Foodborne Illness Outbreaks
When the Food and Drug Administration (FDA) began operating CORE, the Coordinated Outbreak Response and Evaluation Network, in August 2011, it brought together a full-time team with expertise in medicine, public health and science that is constantly looking for potential outbreaks in the U.S., investigating those outbreaks, and developing policies and guidance to prevent future outbreaks.
In the past, FDA would assemble a response team once an outbreak was identified, and those staff would go back to their usual jobs once the response was over. Now full-time teams work on various aspects of investigations from Signals to Post-Response, and can hit the ground running on new outbreaks. This new structure speeds the response, ensures continuity, and standardizes processes.
Just weeks after CORE became operational, proof of the concept was evident in the response to the tragic outbreak of listeriosis which was linked to whole cantaloupe from Jensen Farms and more than 30 deaths nationwide. The quick, coordinated response by CORE, state health agencies and the Centers for Disease Control and Prevention (CDC) is widely acknowledged to have reduced the severity of the outbreak. This new approach saved lives.
Three-pronged effort: Detection, response, prevention
CORE includes a Signals and Surveillance Team, three Response Teams, and a Post-Response Team. These teams can include epidemiologists, microbiologists, veterinarians, environmental health specialists, consumer safety officers, and policy analysts. Diversity and continuity are the keys to the efficient and successful operation of this three-pronged effort to fight foodborne illness. CORE Communications Specialists work across all team activities, coordinating communications and outreach.
On the lookout
It all starts with the Signals and Surveillance Team. This team is all about early detection that will limit or prevent illness linked to dietary supplements, cosmetics, and foods for both people and animals regulated by the FDA.
Team members comb through information that is reported into various databases by local and state health agencies and even search through news stories. The team members are looking for “signals” or “red flags” that could be an early warning of a pending outbreak. They discuss emerging disease surveillance trends directly with CDC and, through FDA field offices, with state health agencies. In addition, the Signals Team searches FDA data for historical information on firms, such as past inspections or sampling results, all in an effort to “connect the dots.”
Once an outbreak related to an FDA-regulated product is identified, all of the available information is handed over to one of the three response teams.
On the hunt
Response Teams have one goal: to control and stop the outbreak. First, they must find the source and then they must ensure contaminated product is taken out of circulation. To do that, a Response Team works directly with the FDA field offices and their investigators on a response strategy. In a combined effort, the team, field offices and state and local agencies track down leads, and trace product distribution. The information provided through this detective work is evaluated against the information on illnesses to make sure the investigators are on the right track. Close coordination among the FDA, CDC, and state and local regulatory, public health and agriculture departments is crucial to stopping an outbreak. CORE is the coordination point for all FDA resources.
An eye to prevention
What did we learn? How can we prevent this from happening again? These questions guide the mission of the Post-Response Team. This team looks at all aspects and factors of the outbreak, from ingredient sourcing to production and distribution, including from foreign countries. Team members work to identify the source of an outbreak and how the contamination could be prevented in the future. Their work may lead to new research on how contamination can occur, or it may lead to outreach to industry and other food safety agency partners on new ways to prevent future outbreaks. Improving FDA internal processes is also a key interest of the team, which evaluates, along with other federal and state partners, the FDA response in order to incorporate lessons learned and constantly improve future responses.
Part of a nationwide, integrated food safety system
In addition to partners in regulatory, public health and agricultural agencies at the federal, state and local levels, the CORE network includes all the key, strategic FDA resources in place in the field – the District offices and their Regional Emergency Response Coordinators who work with our state partners; the Office of Crisis Management at FDA; FDA’s Offices of Public Affairs and External Relations; the subject matter experts at FDA’s Center for Food Safety and Applied Nutrition and the Center for Veterinary Medicine.
When President Obama signed the Food Safety Modernization Act into law, the FDA was tasked with building an integrated national food safety system in partnership with state and local authorities. The CORE Network is proving to be a successful step in that direction.