Approximately two weeks later, LCHD staff revisited the food facilities to determine if knowledge and preparation procedures had improved.
LCHD staff received training in epidemiological concepts and foodborne-illness investigation.
Since 1995, LCHD has presented a no-cost Annual Food Handlers' Workshop, to which food service workers are invited.
By creating a partnership with the community and the food industry, and by revising the Food Program, LCHD has improved food safety for the county in the following ways:
An LCHD investigation of potential sources of nitrate contamination of the household wells indicated that the probable source of groundwater contamination was animal waste from the hog-confinement facility.
After completing the investigations of patients 1-3, LCHD investigated a fourth case of spontaneous abortion in a 35-year-old woman who lived approximately 10 miles from the other three women.
Possible explanations for the cases of spontaneous abortion investigated by LCHD are that they may represent an otherwise unrelated cluster or that they may have been related to ingestion of nitrate-contaminated drinking water.
Due to the large population of Hispanics in the county, LCHD has aggressively recruited sanitarians fluent in Spanish and provided them with a salary increase.
LCHD sanitarians are now viewed as consultants and individuals who are available to provide assistance when needed.
Also, the LCHD hired a trained epidemiologist in 1996 who will track and assist in the investigation of foodborne diseases.
Another tool is that LCHD tracks those violations which most often contribute to outbreaks - time/temperature, etc.
Copies of the program are available, provided the individual making the request has Excel and provides LCHD with three 3-1/2[inches] computer diskettes.