FOOD SAFETY
Cholera at a Wedding? Training the Next Generation
of Public Health Professionals in Outbreak Response
By Mackenzie Zendt, MPH, epidemiologist, contractor with IHRC, Inc. for the Division of Foodborne, Waterborne and Environmental Diseases, US Centers
for Disease Control and Prevention
Field epidemiology, laboratory or
veterinary training programs exist in 87
countries, most often as a collaboration
between the national Ministry of Health
and the US Centers for Disease Control
and Prevention (CDC). These two-year
workforce development programs
train local public health workers in
epidemiology, surveillance, laboratory
work and public health emergency
response. In August 2019, fellows
from Kenya’s Field Epidemiology and
Laboratory Training Program (FELTP)
participated in a full-day training
simulation where they investigated a
mysterious illness linked to a fictional
catered buffet at a wedding reception.
During this training exercise, FELTP
Fellows learned to define and find cases
of illness, generate and test hypotheses
about the source of the illness, identify
and control the source of illness, and
communicate their findings to the public.
In the exercise, they met with the catering
company to discuss how to prevent future
infections and walked through how they
would communicate their findings to the
public through television, radio and the
newspaper. By the end of the day, the
fellows were able to identify the source of
the outbreak—cholera contamination in
the hibiscus tea.
The cholera outbreak simulation was
only one part of a week-long training
on food and waterborne diseases.
Fellows were trained to conduct
outbreak investigations, design and
deploy questionnaires, and work with
various stakeholders in the government,
the media and the public. They also
received in-depth training on cholera
and hands-on practice testing water for
free chlorine level. Trainers from CDC’s
Division of Foodborne, Waterborne
and Environmental Diseases and the
Minnesota Department of Health brought
expertise from national and local
Cholera water testing instructors and participants at the Field Epidemiology and Laboratory Training Program (FELTP), Kenya.
Photo: CDC
investigations to teach the full spectrum
of outbreak response. By working with
a state health department, the CDC
team demonstrated the necessity of
communication between local and
national channels during an outbreak
investigation.
The outbreak response trainings couldn’t
have come too soon. In 2019, Kenyan
FELTP Fellows conducted outbreak
investigations for anthrax, chikungunya,
dengue and measles. Currently, 40 FELTP
Fellows are participating in Kenya’s
response to COVID-19. •
Sara Lowther, PhD, MPH, a CDC employee
in the Center for Global Health and former
Epidemic Intelligence Service officer who
passed away in June 2020, partnered with
CDC’s Division of Foodborne, Waterborne, and
Environmental Diseases to lead this annual
training. Lowther was the resident advisor
for Kenya’s FELTP program from 2016-2018,
during which time she trained and mentored
over 70 Kenyan health professionals.
This annual training is one of Lowther’s
many legacies.
FELTP Fellows train in water testing.Photo: CDC
DIGITAL EXTRA: Visit Kenya’s FELTP
program website for more information.
18 LAB MATTERS Summer 2020
PublicHealthLabs
@APHL APHL.org