Screen Shot 2015-11-13 at 3.34.32 PMHilary N. Karasz just posted “You heard it here first: Changing our food borne illness public notification process.” Because it is so good, and because Seattle/King County Department of Health is moving forward with an increasing degree of transparency, I thought I would post most of her post. I also, must say, great job Dr. Duchin!

Why have we publicized some investigations but not others?

As the health department, our top priority is to keep the public safe and healthy, including preventing and responding to disease outbreaks.  When we hear about possible outbreaks from individuals, healthcare providers, laboratories or businesses that report cases of illness to us, we investigate but we don’t divulge the ill person’s identity, even if it is a communicable disease. Not only are people’s identities protected by state and federal law, breaking confidentiality could discourage people from reporting diseases – putting us all at risk.

Similarly, if we learn from a food business or from its customers that people got sick from eating at the restaurant, we want that food business to work with us to figure out what happened, confident that we will not prematurely place blame before we have done an investigation to evaluate all possible causes, including (but not limited to) restaurant food safety practices that could have contributed, contamination of a commercial food product the restaurant may have received, and other causes unrelated to the restaurant, business or organization. But if there’s ongoing risk we’re going to tell you about it. 

We will always make a public announcement (including names of implicated restaurants and commercial entities) when there is an ongoing outbreak or risk that people need to know about in order to protect their health. We’ll provide information on how to avoid illness and what to do if you’ve been exposed.  We may also make a public announcement if it will help us solve an ongoing investigation. In addition, we can inspect and close restaurants immediately if we find food safety violations contributing to an outbreak.  We post these closures on our website and publicize with Facebook and Twitter.

Providing more information on outbreaks`

But here’s where Public Health Insider gets philosophical. We are learning that people want to know more about our outbreak investigations, above and beyond our public alerts when there’s an immediate heath risk, and we respect that interest. This is part of a larger trend toward greater openness from government, which values the public’s right to know. Conversations with local media that also value public access to information, including the Seattle Times, raised issues that helped our Health Officer, Dr. Jeff Duchin to decide in July 2015 to develop a way to routinely provide public information about outbreaks.

Information about the causes of outbreaks is occasionally straightforward, but more often is unclear and/or inconclusive. In order to provide information about the circumstances and possible causes of outbreaks responsibly, we need to provide important context and background. We don’t want readers to confuse associations, (which are relationships between two or more events or other variables that may or not indicate cause and effect), with actual causes. For example, in many investigations we are not able to identify the cause or source with certainty. This typically happens when there is simply not enough epidemiologic and/or laboratory evidence available to draw reliable conclusions.

We will need to present information in a way that would incorporate at minimum the key facts of an outbreak as well our conclusions regarding potential causes and limitations of the available information. We are going to approach this work thoughtfully and seek input from experts in both public health and communications, and hope to have this ready to roll out in January 2016.

In addition, we are currently in the process of expanding how restaurant inspection information is made available to the public – via storefront signs and improved online access. This will be an update to our current practice of posting inspections online – we were one of the very first health departments to do this way back in 2001!