食品衛生分野における実践疫学教育

Abstract

In Japan, foodborne outbreak investigations tend to rely on pathogen detection from suspected foods, and rarely depend on epidemiological findings when implementing control measures. This often leads to a delay in outbreak response. In the United States and many countries in Europe, results from epidemiological investigations are more frequently used to control the outbreak in a timely manner.In June 1997, a major enterohemorrhagic Escherichia coli O157 foodborne outbreak struck Okayama city causing 125 illnesses. Despite a thorough investigation, health officials could not determine the direct cause of the outbreak due to insufficient epidemiological findings. Recognizing the need for epidemiological training, Okayama City Public Health Center, in collaboration with nearby universities, started hosting “Field Epidemiology Training” courses every year for food sanitation health officials not only of Okayama city, but also of other municipalities.The training course provides two three-day classes, “basic” and “advanced”, according to the knowledge level of the trainees.The “basic” class aims at understanding general concepts of epidemiology and mastering basic techniques in a foodborne outbreak investigation. An exercise session is held after each lecture, which helps the trainees to understand the concepts and how to implement them to foodborne outbreak investigations. The course is practical and trainees may use the techniques taught in this course as soon as they get back to their job, which is highly appreciated.In the “advanced” class, trainees are divided into groups to each analyze outbreak investigation data brought from each trainee’s health centers. Each group makes a presentation at the end of the course on how they analyzed the data and the reason for their final decision to manage the outbreak. They discuss the methods used and their decisions with the trainers and other groups.We believe that field epidemiology should play a more important role in foodborne outbreak investigation in Japan, and that field epidemiology training is becoming increasingly necessary.