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CIFOR Announces Upcoming Release of Third Edition Guidelines

Posted By India Bowman, MPH, Friday, July 10, 2020
Updated: Friday, July 10, 2020

CIFOR Announces Upcoming Release of 3rd Edition Guidelines.

The Council to Improve Foodborne Outbreak Response (CIFOR) has released the third edition of its internationally recognized CIFOR Guidelines for Foodborne Outbreak Response. The landmark edition of these Guidelines was published in 2009 and helped to set the tone for foodborne outbreak investigations across the U.S. Since development, CIFOR Guidelines have been widely accepted by public health officials and practitioners, which even resulted in its translation for use by the Chinese CDC. Because of increasing globalization of our food supply, updates to these Guidelines would follow in 2014 and now in 2020 for the third edition.


The third edition CIFOR Guidelines began in 2018 with the onboarding of lead author, Dr. Craig Hedberg of the University of Minnesota. With Dr. Hedberg’s direction, the third edition took a transformative shape distinguishing itself from the previous versions in several ways. Feedback from end users across the nation indicated a need to streamline the Guidelines to better illustrate how the fields of epidemiology, laboratory science, and environmental health work together in outbreak investigations. This streamlining resulted in the inclusion of detailed graphics to illustrate new or complex processes and points and the elimination of redundancy between chapters. Additionally, the evolution of advancing technology and methodology has had a significant impact on how surveillance is conducted; thus arose a need for the incorporation of updated sub-cluster investigation methodology, complaint systems information, product traceback methodology, and laboratory practices such as whole genome sequencing (WGS) and culture-independent diagnostic tests. An important distinction was also made in this edition between environmental assessments and investigations. 


The Guidelines are now organized into two main blocks of chapters: The first focuses on the foundational aspects of an investigative approach. These chapters (1-3) highlight the evolving challenges of foodborne outbreak response and outlines the tools investigative teams need to plan for investigations. The remaining five chapters (4-8) describe operational aspects of conducting an investigation, such as performing sub-cluster and traceback investigations, and then how to use after-action reviews and performance metrics procured from many foodborne illness programs to assess and improve response activities in the future. These chapters also contain communications sections that will foster more effective and timely communications between team members and various stakeholders. 


Major changes from the previous guidelines to current guidelines include:


  • The implementation of WGS, advanced molecular detection (AMD) and culture-independent diagnostic tests. 

  • The integration of consumer complaint systems with pathogen-specific surveillance. 

  • The importance of sub-cluster investigations and epidemiologic tracebacks. 

  • The importance of environmental assessments. 

  • The importance of after action reviews (AAR). 

  • More coordinated inclusion of communications sections. 

  • Elimination of CIFOR metrics and better referencing of existing program metrics.


With these new updates and changes, foodborne outbreak investigators will have updated guidelines on how to incorporate new investigative tools into their new or existing practices. Written during the period of transition from pulsed-field gel electrophoresis to WGS, these Guidelines are not intended to be a prescriptive guidance for one technological method over another, but rather are written in a way that makes allowances for incorporation of new technologies as they become available.  


It was the intention of the project team to describe a standard in investigative practice that most jurisdictions can use, regardless of if they are beginning to build their investigative teams or looking to improve their current practices. The complementary CIFOR Toolkit is designed to assist jurisdictions in putting these Guidelines into practice. The third edition of the Toolkit will be available soon at www.cifor.us.

India Bowman, MPH, is a CSTE program analyst focused on enteric disease epidemiology and AMD.


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