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Inside Health Inspections, Part 1

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MEDFORD, Ore – It’s inspection time for a popular Medford restaurant. Over the next half hour the inspector walks unannounced and unimpeded, clipboard in hand, through every nook and cranny of the kitchen. Every date will be checked, every cook greeted, and every food item examined.

The restaurant inspection is one small part of what Jackson County’s Environmental Public Health service does. The organization has its inspectors in nearly every public facility in the county.

It’s a system of checks and balances that health experts say allows thousands of people use the same facilities without having to constantly worry about a disease outbreak.

“We’re used to it, we’ve taken it for granted, but it’s absolutely key,” said Dr. Jim Shames, the Medical Director with Jackson County Health and Human Services.

The organization’s three-and-a-half full time inspectors are responsible for nearly all of the county’s restaurants, pools, day cares, schools, food trucks, hotels, and much more. That’s roughly 1,200 facilities and 2,400 inspections each year.

The hope is to prevent an outbreak from ever occurring, but those facilities get at most two inspections a year. And each inspection is just one snapshot in time.

“We make the assumption that we’re only seeing the tip of the iceberg,” said Shames.

Outbreaks of foodborne illness are generally rare in the United States Oregon due in part to the prevalence of public health organizations, and Oregon is no exception. Jackson County alone saw four confirmed outbreaks in foodborne illnesses in 2012, the most recent reporting year.

When that happens inspectors have access to a full array of lab testing equipment at a partnering agency in Portland. By understanding the infectious agent, how it spreads, and where it came from, they’re able to prevent it from getting worse.

“It takes a lot of detective work to figure out,” said Shames. “Is it because somebody who was preparing the food is sick? Is it because that shipment of broccoli that came in might have been contaminated?”

That detective work, which includes everything from stool sampling to genetic testing of infectious agents, was applied to 138 complaints of illness in Jackson County in 2012. The vast majority of those complaints turned out to be false alarms.

But public health officials say the goal is to never have to see a true outbreak, and to ensure that takes more than just checking off items on a checklist.

“Our challenge as inspectors is not necessarily enforcing the code, but getting the buy-in from these facilities and operators,” said Chad Peterson, Manager of Jackson County Environmental Public Health.

Inspectors say that buy-in is all they can guarantee, but simple practices like washing hands, using the right mix of chemicals in a pool, or cooking food to the proper temperature can usually prevent an outbreak from ever occurring. And they say the more the public reports illness, the better they can follow up and the better they can get that message of safety to stick.