Collaboration Underlies the Success of Outbreak Investigation Team in Contra Costa County, California

Fewer residents of a San Francisco Bay Area county experience food or other outbreak illnesses as a result of the extraordinary collaborative approach of the Outbreak Investigation Team. In Contra Costa County, a San Francisco Bay Area county, the needed experts are spread across Health Services, the largest county department with 3,500 employees. Though in one department, the needed experts are located in large divisions of the department at facilities in different cities, structural impediments to coordination. And given the targeted, regulatory responsibilities, the Environmental Health Division has limited overlap with the Public Health Division.

Though this team approach was born in the early 2000s, events in this past year poignantly demonstrate the impact of the collaborative approach. The team approach was instrumental in assisting state and federal officials investigating five young children (two in Contra Costa County) that became sick from a unique strain of E. coli 0157:H7, which was eventually linked with a common exposure to raw milk. More recently, Environmental Health’s ability to protect the public by closing a popular restaurant due to employee sickness which made many sick (we now have reports of more than 100 sick) would not have been possible without the Outbreak Investigation Team.

The ability to respond to these large events is rooted in the on-going communication and cross-training to which all parts of the team contribute and participate. In the early 90s, managers from both divisions recognized the importance of collaboration, and initiated a monthly meeting of public health, environmental health, and public health laboratory experts. After September 11, 2001, emergency preparedness staff from public health, environmental health, and the sheriff’s office joined the meetings. The meetings continue, though many staff changes have occurred, sustaining, and further strengthening the collaborative relationship and the effective response.

The Outbreak Investigation Team collaboration is most appreciated by Environmental Health as we respond to indications that someone is getting sick from food. The presentator will describe a food-borne illness tracking tool developed the team and elaborate on how the team approached the outbreak associated with the raw milk and the large restaurant outbreak investigation.