Environmental Health Specialist Network

描述（由申请人提供）： 拟议工作的长期目标是减少明尼苏达州和整个美国的食源性和水媒疾病，具体目标是：1）增加和改善食源性和水媒疾病爆发调查期间进行的环境评估，确定与爆发相关的风险因素，并实施适当的疾病预防措施; 2）通过专门研究确定和了解与散发性食源性和水传播疾病相关的环境因素; 3）评估明尼苏达州的食品安全和水安全计划;以及4）开发并向环境健康社区、食品服务行业以及饮用水和娱乐用水的供应商/用户传播EHS-Net研究项目的结果。 MDH自EHS-Net的食品和水安全部分开始以来一直是这两个项目的领导者和积极参与者，并将继续以同样的方式参与EHS-Net。MDH环境卫生司的环境卫生专家和MDH急性疾病调查和控制科的流行病学家将组成MDH EHS-Net小组，并将密切合作开展EHS-Net活动。将对可报告的细菌和原生动物病原体进行积极的基于人群的监测，同时沿着最先进的疫情检测和调查。将对商业食品机构的所有食源性爆发和所有水传播（即，饮用水和娱乐用水）的爆发在明尼苏达州使用的标准工具指定的EHS网络。将在先前选定的抽样框架内对餐馆进行随机抽样，进行专门研究，以确定导致散发性食源性疾病的做法、行为或其他风险因素。对隐孢子虫、产滋贺毒素E.大肠杆菌和弯曲杆菌感染由于饮用水，以及做法，行为，或其他风险因素，导致散发性水传播感染，将围绕采访所有报告的案件（包括有关井水和其他暴露的具体问题），并应用地理信息系统使用数据源，如牛的密度，地质敏感性地下水污染，和气候变量（例如，洪水）。 MDH将继续与EHS网络合作伙伴（其他州、CDC、FDA和EPA）建立沟通和合作，并将积极参与EHS网络指导委员会决定的多中心研究。根据EHS-Net的经验教训，将积极对明尼苏达州各地的环境健康专家和行业团体进行教育。. . 公共卫生相关性： 食源性和水传播疾病仍然是明尼苏达州重要的公共卫生问题。食源性和水传播的疫情经常发生，病例对照研究表明，在餐馆就餐是几种疾病病原体（例如，沙门氏菌、弯曲杆菌和E. coli O 157：H7）;这些研究是EHS-Net形成的主要原因。此外，明尼苏达州卫生部（MDH）和FoodNet进行的研究表明，饮用井水是隐孢子虫病和其他可能疾病的危险因素。

DESCRIPTION (provided by applicant): The long-term objective of the proposed work is to reduce foodborne and waterborne illness in Minnesota and the entire U.S. Specific aims are to: 1) increase and improve environmental assessments conducted during foodborne and waterborne outbreak investigations, identify risk factors associated with outbreaks, and implement appropriate disease prevention efforts; 2) identify and understand environmental factors associated with sporadic foodborne and waterborne illnesses through special studies; 3) evaluate food safety and water safety programs in Minnesota; and 4) develop and disseminate the findings from EHS-Net research projects to the environmental health community, food service industry, and providers/users of drinking and recreational water. MDH has been a leader and active participant in both the food and water safety components of EHS-Net since the inception of both programs and will continue EHS-Net involvement in the same fashion. Environmental health specialists from the MDH Division of Environmental Health and epidemiologists from the MDH Acute Disease Investigation and Control Section will comprise the MDH EHS-Net team and will work closely together to conduct EHS-Net activities. Active population-based surveillance for reportable bacterial and protozoal pathogens will be conducted, along with state-of the art outbreak detection and investigation. Environmental assessments will be conducted on all foodborne outbreaks in commercial food establishments and all waterborne (i.e., drinking and recreational water) outbreaks in Minnesota using the standard tools designated by EHS-Net. Special studies to identify practices, behaviors, or other risk factors that lead to sporadic foodborne illness will be conducted at random samples of restaurants in previously selected sampling frameworks. Special studies to identify the burden of Cryptosporidium, Shiga toxin-producing E. coli, and Campylobacter infections due to drinking water, along with practices, behaviors, or other risk factors that lead to sporadic waterborne infections, will revolve around interviews of all reported cases (including specific questions about well water and other exposures), and application of GIS using data sources such as cattle density, geologic sensitivity to groundwater contamination, and climate variables (e.g., flooding). MDH will continue to build communication and collaborations with EHS-Net partners (other states, CDC, FDA, and EPA) and will actively participate in multi-site studies decided on by the EHS-Net Steering Committee. Education of environmental health specialists and industry groups throughout Minnesota, based on lesson learned from EHS-Net, will be actively pursued. . . PUBLIC HEALTH RELEVANCE: Foodborne and waterborne illness continue to be important public health problems in Minnesota. Foodborne and waterborne outbreaks occur commonly, and case-control studies have implicated eating at restaurants as a source of nonoutbreak-associated infection with several disease agents (e.g., Salmonella, Campylobacter, and E. coli O157:H7); these studies were a primary reason for formation of EHS-Net. In addition, studies conducted by the Minnesota Department of Health (MDH) and FoodNet have implicated well water consumption as a risk factor for cryptosporidiosis and possibly other disease agents as well.