COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health System

DATE:

August 11, 2010

BOARD MEETING DATE:

September 28, 2010

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Jean S. Fraser, Chief, Health System

Brian J. Zamora, Director, Community Health

SUBJECT:

Acceptance of a Grant from the Centers for Disease Control and Prevention

RECOMMENDATION:

Adopt a Resolution authorizing the:

A)

Acceptance of a grant from the Centers for Disease Control and Prevention in an amount not to exceed $745,390, for term of July 1, 2010 through June 30, 2015; and

B)

Chief of the Health System or designee to execute all necessary applications, agreements, amendments, payment requests, and all documents necessary to secure funds to implement the approved projects and carry out the purposes specified in the applications effective until June 30, 2015.

BACKGROUND:

Campylobacter is the most common cause of acute bacterial infection in the United States. There are an estimated 2.4 million Campylobacter infections reported in the United States yearly, associated with an estimated 124 deaths. There are significant social and economic consequences of Campylobacter infection, including but not limited to resources spent on medical care, lost productivity due to missed work and lost income, and physical and psychological costs. The annual combined medical and lost productivity cost in the United States due to Campylobacter is estimated to be $1.3 to $6.2 billion.

DISCUSSION:

In San Mateo County, the annual number of culture-confirmed Campylobacter infections voluntarily reported to Public Health (PH) from 2000 to 2009 averaged 218. In 2009 there were 238 reported cases in a population of 712,690, or 33 cases per 100,000. This is more than 2.5 times the Centers for Disease Control (CDC) Healthy People 2010 National Objective of 12.3 cases per 100,000. Because many cases are not reported, a projection model based on research data was issued to determine the estimated true number of Campylobacter infections that occurred for each reported culture-confirmed case. The estimated Campylobacter infection count in 2009 was 7,786, or more than 1,000 cases per 100,000.

A large case-control study indicates that exposure to Campylobacter from raw chicken prepared at retail food establishments may account for up to 45% of infections.

Under the CDC grant, Environmental Health (EH) will implement a broad-based intervention and prevention strategy to significantly lower the incidence of Campylobacter illness in the County. The key components of the strategy are to: 1) investigate and track culture-confirmed cases of Campylobacter reported to PH to determine possible food-borne routes of exposure and to identify sub-populations that are at increased risk for the disease, 2) conduct focused assessments as part of routine inspections to assess the risk of exposure to Campylobacter at all retail food facilities that handle raw chicken, 3) enlist assistance and support of local community groups, including hospitals, educational institutions, congregations, libraries, trade groups, and community-based organizations, to educate and inform the County’s population about the risks of Campylobacter and about safe food handling practices.

This project is designed to increase the capacity of EH to address health issues in the community. The strategies implemented under the grant will be presented as a model for other jurisdictions to improve their environmental health programs.

The Grant Agreement and Resolution have been reviewed and approved by County Counsel.

The ability to apply for and manage the grant from CDC contributes to the Shared Vision 2025 outcome of an Environmentally Conscious Community by securing funding that will enable EH to implement system-wide interventions that decrease the risks of Campylobacter and other food borne illness in the County. It is anticipated that 94% of permitted facilities in the County will receive an annual inspection.

Performance Measure:

Measure

FY 2009-10
Actual

FY 2010-11
Projected

Percent of permitted facilities receiving an annual inspection

93%

94%

FISCAL IMPACT:

The budgeted amount for FY 2010-11 is $149,078. The revenue and expenditures will be included in the FY 2010-11 budget through September revisions. The program is funded for five years in an amount not to exceed $745,390. Funding for future years is dependent on availability of funds and satisfactory progress of the project. Appropriations and revenue for future years will be included in subsequent budgets. There is no Net County Cost associated with this grant program.