“Just the fact that the meeting was held was an important sign that the issue is being taken seriously,” he said. Coalition offers resourcesTim Jones, MD, state epidemiologist for the Tennessee Department of Health, attended the meeting and gave the group an overview of projects launched by the Council to Improve Foodborne Outbreak Response (CIFOR). The group is led by the Council of State and Territorial Epidemiologists and the National Association of County and City Health Officials. It receives funding from the CDC and collaborates with a host of other federal agencies and public health organizations. The FSIS plans to publish reports on the meeting and exercise within the next few months, he said. For example, he said the group learned that local authorities need to know more specific details when food products are recalled in the event of an illness outbreak. “Sometimes they don’t hear from federal or state officials” and don’t know what has been recalled, he said. CIFOR’s work is one example of how seriously public health groups are taking the need to improve outbreak investigations, Jones said. Others include the EpiReady program, which teaches authorities how to conduct investigations, and various tabletop exercises. David Goldman, assistant administrator in the FSIS office of public health, told CIDRAP News that the 2-day event sparked robust discussions about a range of topics. “What we wanted the presenters to do was be candid about the problems they confront,” he said. The meeting was held in St Louis on May 15 and was followed the next day by a tabletop exercise that simulated a multistate Escherichia coli outbreak involving ground beef. The 2-day event was attended by officials from the US Department of Agriculture’s Food Safety and Inspection Service (FSIS), the Food and Drug Administration, and the Centers for Disease Control and Prevention, plus state and local public health officials, food industry groups, university researchers, and consumer groups. Goldman said the tabletop exercise afterward was useful because it raised all of the concerns that had been discussed during the meeting. “And people who were unfamiliar with outbreak investigations learned a lot about them. It illuminated the problems and the obstacles,” he said. Some participants shared their frustrations about difficulties in getting information from regulatory agencies and industry. “Some of the information can’t be shared readily due to the laws that regulatory agencies operate under,” Hedberg said. Apr 25 USDA press release on outbreak investigation meeting (Problems in the dissemination of food safety information were the topic of a lengthy report released yesterday by a group called the Food Safety Research Consortium. See May 22 story link below for more information.) Oct 23, 2007, CIDRAP News story “USDA announces plans to reduce E coli contamination in ground beef” Recall messages could be better crafted to reflect more clearly that the recalled product is harmful and should not be consumed, Hedberg said. “The focus should be on the desired behavior of the consumer.” May 23, 2008 (CIDRAP News) Federal agencies that play key food safety roles recently held a public meeting to clarify the obstacles public health officials encounter in investigating foodborne disease outbreaks and to build support for measures to improve the process. Craig Hedberg, PhD, associate professor of environmental health sciences at the University of Minnesota School of Public Health in Minneapolis, attended the meeting and took part in the tabletop exercise. He said the discussions were useful for charting the patterns that have occurred in outbreak investigations and fleshing out plans for improving them. Jones said CIFOR, now in its third year, has established an online source for questionnaires and outbreak training resources, has developed guidelines for multistate outbreak investigations, and is working on several other initiatives. Hedberg said that though many important issues were raised at the meeting, it’s clear that quick fixes are unrealistic. “Part of it is changing people’s normal work patterns. A lot of it is culture change that has to occur across the system,” he said. “Everyone is in theory committed to better communication and more transparencythe devil is in the details.” The FSIS had announced that it would explore how to improve outbreak investigations last October, as it unveiled measures to address a spike in E coli outbreaks linked to ground beef. See also: Whether a food recall is voluntary or mandatory is largely a technical issue, he said. However, focusing on whether a recall is voluntary or mandatory can lead some of the public to think that the associated outbreak isn’t an important public health problem. Hedberg also said a focus on the role of local officials was a useful outcome of the meeting. “People from local departments describe how they feel left out of larger multistate outbreak investigations, but local agencies are the ones interviewing the cases,” he said. “And sometimes it’s not apparent why the case should be at the top of their priorities.” Other issues that were raised at the meeting, Hedberg said, included the need to improve methods for assessing case-patients’ food exposures and the view of some experts that food recalls, as currently administered, don’t convey an adequate level of warning to consumers. May 22 CIDRAP News story “Experts propose steps to ease food safety info flow” All outbreaks start locallyOne of the major themes that participants emphasized was the important role of local public health officials, Goldman said. “Outbreak investigations can be quite complex, but everything starts locally with one or two cases,” he said. CIFOR Web site
Asked about that statement, Roy Keane, who also played alongside Quinn and later accepted his offer of employment as Sunderland manager, said simply: “He’s a lot better than Niall Quinn.” As the younger man headed back across the Atlantic, the rest of the squad – barring midfielder Darron Gibson, who has returned to club Everton for treatment on a minor knee injury – were licking their wounds and starting to turn their attention to Tuesday night’s friendly against the United States in Dublin. Ireland were ultimately undone by a fine Shaun Maloney finish in Glasgow, which condemned them to their first Group D defeat and left them locked in a three-way battle with the Scots and world champions Germany for second place behind leaders Poland. They have been criticised for their direct approach against Gordon Strachan’s men, which failed to yield the number of opportunities for which they might have hoped in front of goal. But while there was disappointment within the camp, O’Neill’s number two was adopting a bullish approach to the recovery process. Roy Keane said: “I didn’t expect us to go through the whole campaign unbeaten, there were always going to be some points dropped. But we have to take our medicine, we have to take the criticism that’s coming our way and bounce back. “It’s very, very tight, absolutely. There’s not much between a lot of the teams. On paper Germany, you would still think, would be the favourites, but between Poland, ourselves and Scotland, I think it’s going to be very, very tight.” Four of the Republic’s next five qualifiers will take place at the Aviva Stadium and their form there is likely to go a long way towards deciding where they finish in the group. But as he and O’Neill prepared to bring an end to their 2014 fixtures less than a fortnight after celebrating a year in post, the assistant boss was happy enough with his lot. He said: “There have been no real surprises. You are always learning about the group, even the other night, lots round about the group. But no real shocks or surprises. “We have good teams coming to the Aviva, but with the home support and the lads will be licking their wounds for the next month or two, we will look to bounce back. That is what sport is all about, bouncing back, and we have got some good lads. “They were hurting pretty badly the other night, we know they were. If you think for one minute they are not hurt by the other night, then you don’t know the group.” Press Association Roy Keane has insisted Robbie Keane still has a significant role to play for the Republic of Ireland despite being dropped for the first time in 13 years. However, assistant manager Keane, a former Ireland team-mate, was adamant that the nation’s record cap-holder and goalscorer remains a key member of Martin O’Neill’s squad. He said: “Robbie Keane is massive for this team, absolutely massive. “Everyone keeps saying he was disappointed – of course he was. Tell me any player who is going to be left out of a big game who is not going to be disappointed. That’s what you expect from Robbie. “But Robbie is brilliant for the group and brilliant for the team. He’s a top, top player, he’s been doing it for years and hopefully he will score goals for the next number of years. “But you just pick a team for a certain game, and the way Robbie reacted to the disappointment to our training session yesterday was fantastic, absolutely different class. “Robbie Keane is as good a professional as I have come across and he will be disappointed, of course. But there are other players who were left out.” The frontman, who took his tally for his country to 65 goals with a hat-trick against Gibraltar last month, had only 12 minutes in which to try to make an impression as he won his 138th cap at Celtic Park, and his frustration was clear afterwards. He told reporters he needed to play as part of an attacking partnership and that he was not suited to a lone striking role, admitting he was “no Niall Quinn”, the towering striker whose previous Irish record of 21 goals he passed a decade ago. The 34-year-old LA Galaxy striker headed back to the United States on Saturday after being released from the squad a day after being used only as a substitute in Ireland’s 1-0 Euro 2016 qualifier defeat in Scotland. It was the first time the Dubliner, who will begin preparations for next Sunday’s MLS play-offs showdown with Seattle Sounders on his return, has been left out of the team for a competitive match when fit since a clash with Estonia in 2001.