PulseNet International: 2006/2007 Update

Ahmed ElSedawy, MPH

PulseNet International Coordinator

Centers for Disease Control and Prevention

Why Should We Go International With PulseNet?

We live in a global communityFoods produced on one continent may be consumed and cause disease in another—a global issueNeed an effective global early warning systemGlobal networking to utilize scarce public health resources effectivelyRespond to other emerging infectious diseases or acts of bioterrorism

PulseNet InternationalGoals

Perform molecular surveillance of foodborne infections at the global level in order to facilitate international outbreak detection and investigation by:

–– Partnering with public health laboratories Partnering with public health laboratories throughout the worldthroughout the world

–– Building capacity for molecular surveillance of Building capacity for molecular surveillance of foodborne infectionsfoodborne infections

The PulseNet International Vision

“Worldwide regional networks utilizing standardized identification and isolate characterization methods and sharing information in real-time to provide early warning on foodborne disease outbreaks, emerging foodborne infections, and acts of food bioterrorism”

Current Status of PulseNet International

6 networks: USA, Canada, Latin America, Europe, Asia Pacific and Middle East

67 total participating countries

PulseNet International Steering Committee

Consists of network coordinators and chaired by CDC

Provides guidance and makes recommendations about the strategic development of the network

Holds conference calls on a quarterly basis and convenes annually at Update Meetings

PulseNet USA

PulseNet USA Update

79 participants– State and local health departments– Federal regulatory agencies– Agricultural and veterinary labs

Training– Since 1996, trained ~400 participants in PFGE

laboratory protocols, MLVA laboratory protocols, and beginning and advanced software analysis

– Helped coordinate 7 international training workshops

PulseNet USA Update (Cont’d)

Databases– Salmonella database reached over 150,000

entries

– E. coli and Shigella have over 25,000 entries

– V. cholerae and Y. pestis protocols validated and databases created

– MasterScripts created in collaboration with Applied Maths for use by all PulseNet participants

PulseNet USA in PulseNet International

Support and participate in strategic planning meetings in the regionsTrain international participants at CDCSupport and participate as trainers in regional workshopsShare protocols and BioNumerics customizations QA/QC for international networks

PulseNet Canada

PulseNet Canada Update

MOU for database information sharing was signed in 2005 with PulseNet USA

PN Canada and PN USA can now query each other’s databases like any client in the states (US).

PulseNet Canada Update (Cont’d)

Salmonella database contains PFGE patterns of ≈10,000 isolates from 10 provinces since 2000≈56% of Salmonella isolates were subtyped by PFGE during 2006PFGE performed on 100% of E. coliO157:H7 cases in 2006 994 E. coli O157 patterns were uploaded to the E. coli database in 2006

PulseNet Canada Update (Cont’d)

117 human isolates of Listeria uploaded to the Listeria database in 2006

The National Microbiology Laboratory has participated in the validation of the PulseNet USA MLVA protocol for STEC

PulseNet Europe

PulseNet Europe Update

15 partners trained in PFGE and BioNumerics in 2006 MoU between PN Europe and PN USA has been drafted and is currently under review by HHSECDC to take over PN Europe responsibilities in 2007PN Europe central database contains specific databases for Salmonella, Shiga toxin-producing Escherichia coli and Listeria

PulseNet Europe Update (Cont’d)

Central database functional in October 2006

PN Europe Forum (listserv) established in 2006– Currently has 106 registered users

By the end of 2006, four alerts were posted on the PN Europe Forum– Spinach-associated E. coli O157 outbreak in the USA – S. Java (nat’l outbreak) – S. Enteritidis (nat’l outbreak) – S. Anatum (nat’l outbreak)

PulseNet Europe Participants

PulseNet Asia Pacific

PulseNet Asia Pacific Update

In 2006, PFGE capacity in all participating laboratories28 participants trained during 3 PFGE workshops held from 2004-06 7 participants trained in BioNumerics in February 2007QA/QC program set up through the PICWG (Platform for Inter-laboratory Comparison Working Group)

PulseNet Asia Pacific Update (Cont’d)

Evaluated and validated PFGE protocols for Vibrio cholerae and parahaemolyticus together with PulseNet USA

PulseNet Asia Pacific Discussion Forum is primary tool for communication among network participants

The Fourth Meeting of PulseNet Asia Pacific

Nanjing, China – December 2006

PulseNet Asia Pacific BioNumerics

Workshop - Hong Kong, 2007

PulseNet Latin America

PulseNet Latin America Update

2 regional PFGE/BioNumerics training courses in 2004-05

BioNumerics-only course held in 2006

Regional database for Salmonella and E. coli curated by Institute Malbran(Argentina) and BioNumerics server maintained by WHO PAHO (Brazil)

PulseNet Latin America Update (Cont’d)

Technical support missions to Venezuela, Uruguay and Mexico from 2004-06 First 5 member countries certified in PFGE of one or more organism(s) in 20064 countries established national databases for one or more organism(s) in 2006 2 staff members from regional reference laboratory received training at CDC in database management in 2006

PulseNet Middle East

PulseNet Middle East Update

PulseNet Middle East established during a consultation held in Cairo, Egypt (WHO EMRO) in December 2006

Representatives from 8 countries attended consultation

Training and capacity building are a priority for the network

PulseNet Middle East Update (Cont’d)

Interim network coordinator: – Dr. Suleiman Al-Busaidy, Central Public Health

Laboratory in Oman

Action plan and recommendations to be implemented in 2007NAMRU-3 assuming leadership role in initial PFGE/BioNumerics training and capacity building2nd Strategic Planning Meeting to be held at end of 2007

PulseNet Middle East Consultation

Cairo, Egypt – December 2006

PulseNet International New Initiatives

Validation of PulseNet PFGE protocol forShigella flexneriPulseNet International Forum (Canada)PulseNet International/WHO Global Salm-Surv (GSS) collaborationGlobal PulseNet Salmonella Typhi Database

Global PulseNet Salmonella Typhi Database

Established in 2006 and coordinated by CDCIn December 2006:– Total Entries: 342 (2004 data only)– Number of Participating countries: 4

Today:– Total Entries: 538– Number of Participating countries: 8

PulseNet International…

A Family of Networks…