brent gilpin, lisa mccallum, virginia hope institute of environmental science & research limited
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PulseNet Asia Pacific – Using KAREN to help advance international collaborations for analysis of disease causing bacteria for both research and public health action. Brent Gilpin, Lisa McCallum, Virginia Hope Institute of Environmental Science & Research Limited. E. coli O157:H7. - PowerPoint PPT PresentationTRANSCRIPT
Manaaki Tangata Taiao Hokiprotecting people and their environment through science
Specialist Science Solutions
PulseNet Asia Pacific – Using KAREN to help advance
international collaborations for analysis of disease causing
bacteria for both research and public health action.
Brent Gilpin, Lisa McCallum, Virginia Hope
Institute of Environmental Science & Research Limited
© ESR 2008
E. coli O157:H7
© ESR 2008
Western USA, 1993
726 cases identified4 deaths$160 million cost to company
E. coli O157:H7
© ESR 2008
0
10
20
30
40
50
60
70
1 8 15 22 29 36 43 50 57 64 71
Day of Outbreak
Nu
mb
er o
f C
ases outbreak
detected 1993Meat recall
1993 Western States E. coli O157 Outbreak
726 cases4 deaths
39 d
Slide courtesy Bala Swaminathan, CDC Atlanta
PFGEPulsed field gel electrophoresis
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 171 3 4 6 7
© ESR 2008
Loading into well
© ESR 2008
PFGE Pulsed Field Gel Electrophoresis
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PulseNet in action
Pathogens isolated from faecal sample
E. coli O157, Listeria,
Salmonella, Campylobacter
PFGE DNA fingerprints compared
using electronic databases
PFGE analysis of all isolates
Initiate and guide epidemiological
investigations of outbreaksInterventions
Preventative measures
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E. coli O157:H7 from Fresh Spinach
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© ESR 2008
Many other examples…
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S. Enteriditis• 12 May, 9:30 PM–1 AM
- Discussions with Costco led to local recall
- Nut-specific questionnaire developed
- E-mail bulletin to all states, CDC, FDA, Canada
• 13 May- PulseNet query finds matching cases elsewhere
- Traceback implicates Paramount; other brands
- National recall initiated
© ESR 2008
© ESR 2008
0
10
20
30
40
50
60
70
1 8 15 22 29 36 43 50 57 64 71
Day of Outbreak
Nu
mb
er o
f C
ases outbreak
detected 1993Meat recall
1993 Western States E. coli O157 Outbreak
726 cases4 deaths
39 d
Slide courtesy Bala Swaminathan, CDC Atlanta
2002 Colorado E. coli O157 Outbreak
0
10
20
30
40
50
60
70
1 8 15 22 29 36 43 50 57 64 71
Day of Outbreak
Nu
mb
er o
f C
as
es
outbreak detected
18 dWith
Pul
seN
et
Initial recall of 354,200pounds of ground beefExpanded to 18.6 million pounds38 cases from 11 states, 17 hospitalizations, one death
© ESR 2008
Austria, Belgium, Bulgaria, Czech Republic, Denmark, England, Finland, France, Germany, Greece, Hungary,
Iceland, Ireland, Italy, Luxembourg, Norway, Poland, Portugal, Romania, Scotland, Slovenia, Spain, Sweden, The
Netherlands28 public health labs, 17 veterinary labs
Uruguay, Chile, Argentina, Columbia, Mexico, Brazil
Vietnam, Thailand, Taiwan, The Philippines, the People’s Republic
of China, New Zealand, Malaysia, Korea, Japan, India, Hong Kong,
Bangladesh, and Australia
© ESR 2008
© ESR 2008
PulseNet Asia Pacific• Vietnam, Thailand, Taiwan, The
Philippines, the People’s Republic of China, New Zealand, Malaysia, Korea, Japan, India, Hong Kong, Bangladesh, and Australia
© ESR 2008
USDA product testing - E. coli O157:H7
Meat Processor A Meat Processor B
SupplierA
SupplierB
SupplierC
New Zealand
PFGE-XbaI
20.0
0
40.0
0
100.
00
150.
00
200.
00
250.
00
400.
00
500.
00
600.
00
800.
00
1500
PFGE-BlnI
20.0
0
40.0
0
100.
00
150.
00
200.
00
300.
00
400.
00
500.
00
600.
00
1000
2000 Key
USDA_OB060047
USDA_OB060052
WA___9681
LabID
.
.
.
LabNoSampledDatePFGE-XbaI-pattern
EXHX01.1401
EXHX01.0074
EXHX01.1401
SourceType
.
.
.
SourceSite
.
.
.
TypeDetailsSurnameForenamesIsolationMethodProjectLocationPFGE-BlnI-pattern
EXHA26.0569
EXHA26.0569
EXHA26.0569
AB
© ESR 2008
NZ beef exports to USA
• USA 51% of total NZ beef exports• Value of approximately 1 billion dollars…
© ESR 2008
Findings• 12 human, 3 meat isolates same as US XbaI 74
- (This XbaI 5.9% of NZ isolates)
• All of have BlnI patterns different to US BlnI 569• No isolates with US XbaI pattern 1401• Two isolates with BlnI pattern 569 (different Xba)• No evidence to suggest isolates came from NZ
meat
PFGE-XbaI
20.0
0
40.0
0
100.
00
150.
00
200.
00
250.
00
400.
00
500.
00
600.
00
800.
00
1500
PFGE-BlnI
20.0
0
40.0
0
100.
00
150.
00
200.
00
300.
00
400.
00
500.
00
600.
00
1000
2000 Key
USDA_OB060047
USDA_OB060052
WA___9681
LabID
.
.
.
LabNoSampledDatePFGE-XbaI-pattern
EXHX01.1401
EXHX01.0074
EXHX01.1401
SourceType
.
.
.
SourceSite
.
.
.
TypeDetailsSurnameForenamesIsolationMethodProjectLocationPFGE-BlnI-pattern
EXHA26.0569
EXHA26.0569
EXHA26.0569
© ESR 2008
Key components• Standardised methodology for lab analysis• Computer software analyse data• Databases of patterns• Communication among participants
- Outbreaks
- Education and upskilling
© ESR 2008
Role of KAREN network• Communication among participants
- Outbreak investigations
- Education
• Regional and international databases
© ESR 2008
© ESR 2008
© ESR 2008
IDC
Asia-PacificDatabase Server
New Zealand
E. coli O157 Listeria Salmonella Shigella Neisseria Vibrio Campylobacter
PWR
OK
WIC0ACT/CH0
ACT/CH1
WIC0ACT/CH0
ACT/CH1
ETHACT
COL VPN
Japan China Hong Kong India Taiwan Bangladesh New Zealand
IDC
CDC Database ServerAtlanta, GA, USA
IDC
Canadian DatabaseServer
Winnipeg, MB, Canada
Asia-Pacific BackupDatabase Server
New Zealand
IDC
IDC
National DatabaseServer
Option 1
Hardware/SoftwareDatabase managers
Regional Databases
© ESR 2008
New ZealandMain Hub
IDC
IDC
IDC
IDC
IDC
IDC
IDC
IDC
JapanE. coli O157
ChinaListeria
Hong KongSalmonella
IndiaShigella
TaiwanNeisseria
BangladeshVibrio
New ZealandCampylobacter
Data CopyData Copy
Data Copy
Data Copy
Data Copy Data Copy
Data Copy
IDC
IDC
CDC NML
IDC
IDC
IDC
IDC
IDC
IDC
IDC
IDC
Backup Server
Backup Server
Backup Server
Backup Server
Backup Server
Backup Server
Backup Server
Backup Server
Option 2Regional Databases
© ESR 2008
Export data wish to submit(XML)
Upload to folder on PNAP forum
Participants
Database coordinator
Download new submission
1. Check “compatibility”2. Incorporate into
“Regional database”3. Post updated
database into PNAP forum folder
Download updated database
Participants
Open regional database as “local copy” using BioNumerics
• Very simple solution• Every country equally important• Ensures access and sharing of data• Allows distribution of work, lower commitment required
from coordinating lab.• Benefits
- Archive of genotypes
- Evaluations of variability in genotype
- Geographical and temporal spread of genotypes
- Get clues about potential sources
- Evaluate how common/rare a genotype is
© ESR 2008
PulseNet Asia Pacific portal• PNAP portal places NZ as the coordinating
hub for the region.• Communication forum • Provides a mechanism for regional
databases for Asia Pacific• Would like capacity for video meetings of
participants from Asia Pacific, and also PulseNet International.
• Would like capacity for educational sessions on both laboratory and computer analysis, and for research and outbreak seminars.
© ESR 2008
Research seminars
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Training sessions
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Video conferencing• Outbreak investigation• Coordination of activities
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• Connect New Zealand’s highest level bio-containment laboratory at Wallaceville to the rest of NZ and the world via video microscopy and video conferencing.
National Centre for Biosecurityand Infectious Disease - Wallaceville
© ESR 2008