The Council to Improve Foodborne Outbreak Response (CIFOR), The Council to Improve Foodborne Outbreak Response) brings together laboratorians, epidemiologists and environmental health specialists to develop and share guidelines, tools and products that promote faster, more effective response to foodborne outbreaks.

As a founding member of CIFOR, APHL works to identify barriers to rapid, accurate detection and investigation of foodborne disease outbreaks. APHL also proposes projects to address these barriers, notably those that impede laboratory response to foodborne illness.

The CIFOR products described below can assist public health laboratories and other agencies involved in response to foodborne outbreaks to:

  • Evaluate program performance
  • Enhance collaboration among stakeholders
  • Identify model practices

Outbreaks of Undetermined Etiology (OUE) Guidelines

The CIFOR OUE Guidelines are designed to provide recommendations on "universal" collection, shipment, testing and retention of foodborne outbreak specimens in the event that an etiology is elusive, even in the early stages of an investigation.

In collaboration with the CIFOR OUE Guidelines Work Group, APHL worked with the Oregon Department of Health to develop an application-based, interactive version of the OUE Guidelines. The electronic tool will provide guidance on:

  • Recommended "universal" outbreak specimen collection
  • Shipping information
  • Recommended rule-out testing
  • Long-term storage for negative specimens

The OUE Guidelines cover both infectious and non-infectious agents. A companion OUE Agent List provides detailed information on each agent including incubation period, primary signs and symptoms, primary specimen(s) and key epidemiological information.

For more information and access to the tool, visit CIFOR's website.

 CIFOR Metrics Entry Tool (C-MET)

 "The Development of Target Ranges for Selected Performance Measures in the CIFOR Guidelines" (CIFOR Metrics) provides 16 selected performance indicators and corresponding target ranges developed to assist state and local public health agencies in evaluating the performance of their foodborne disease surveillance, outbreak investigation and control programs, and to identify needs for improvement. Laboratory performance indicators include:

  • Isolate/ CIDT-positive clinical specimen submissions to PHL
  • PFGE subtyping of isolates
  • Isolate/CIDT-positive clinical specimen submission interval
  • Isolate subtyping interval
  • PHEP E. coli O157 and Listeria subtyping interval
  • Outbreak clinical specimen collections

In collaboration with the CIFOR and Food Safety Centers of Excellence Metrics Work Groups, APHL developed an interactive, web-based version of the CIFOR Metrics. The CIFOR Metrics Entry Tool (C-MET) allows public health officials to enter data from multiple time periods to measure progress over time. C-MET also allows officials to compare their data with data aggregated data from other C-MET users.

To access C-MET and obtain additional information, please visit CIFOR's website.