APHL 2019 POSTER ABSTRACTS
Food Safety
Meet Me in St. Louis to Learn About Exciting New
Foodborne Outbreak Tools and Resources!
K. Larson 1 , R. Atkinson Dunn 2 , A. Woron 3 , D. Boxrud 4 , S. Shea 1 ;
1
Association of Public Health Laboratories, 2 Utah Public Health
Laboratory, 3 Hawaii Public Health Laboratory, 4 Minnesota
Department of Health
Background: The food safety landscape is rapidly evolving due
to emerging pathogens, changing consumer practices and
food manufacturing processes, and globalization of the food
supply. Public health personnel must implement updated testing
technologies, strategies and tools to continue to identify, control,
and prevent foodborne disease outbreaks (FBO).
Since 2006, the Council to Improve Foodborne Outbreak Response
(CIFOR) has been working to improve methods to detect, investigate,
control and prevent FBO. CIFOR develops guidelines, processes
and products that facilitate effective foodborne outbreak response
among all disciplines- epidemiology, environmental health and
public health laboratory.
Products: The CIFOR Guidelines for Foodborne Disease Outbreak
Response is a comprehensive best-practices document intended
to improve the performance of foodborne disease surveillance
and outbreak response across local, state and federal public
health agencies. The Third Edition of the CIFOR Guidelines will
incorporate new information on complaint systems and food safety
testing practices including whole genome sequencing and culture
independent diagnostic tests. The Third Edition will also include
updated performance indicators for foodborne disease programs
including the laboratory.
The Outbreaks of Undetermined Etiology (OUE) Guidelines
provides adequate specimens for second-tier testing and pathogen
discovery should an etiology prove elusive. The guidelines provide
recommendations on the collection, shipment and storage of
foodborne outbreak specimens based on syndromes and specific
outbreak profiles. A companion OUE Agent List provides detailed
information on each agent including incubation period, primary
signs and symptoms, primary specimen(s), and key epidemiological
information.
The Food Safety Programs Reference Guide provides a snapshot
of current governmental food safety efforts aimed at detecting,
investigating, controlling or preventing foodborne disease in the US.
The Programs Reference Guide will help public health agencies to
align activities, carry out collaborative projects, implement common
strategies and avoid costly duplication of efforts.
Presenter: Kirsten Larson, Association of Public Health
Laboratories, Silver Spring, MD, [email protected]
50
LAB MATTERS Summer 2019
A. Woron, K. Kubota and CID Subcommittee, Association of Public
Health Laboratories
PulseNet, a key component of our national food safety surveillance
system since 1996 is an isolate based surveillance system for
bacterial enteric pathogens. Beginning in 2013, culture independent
diagnostic testing (CIDT) for enteric pathogens has challenged this
network and others which depend on isolates for public health
surveillance. APHL’s CIDT Subcommittee surveyed local and state
public health laboratories specifically looking at the implementation
of multi-analyte gastrointestinal (GI) diagnostic panels by clinical and
public health laboratories. Obtaining this information offers the CIDT
Subcommittee the ability to assess the current use of these tests
in the clinical laboratory setting and develop guidance to address
any laboratory surveillance implications, especially as related to the
PulseNet network as well as to measure the use of multi-analyte GI
diagnostic panels within the public health setting.
An online survey was distributed to local and state public health
laboratory directors in January 2019. The survey consists of five
main sections as follows: Results Reporting; Use of Multi-analyte GI
Diagnostic Panels in Clinical Laboratories; Transport; Resources and
Guidelines and Use of Multi-analyte GI Diagnostic Panels in Public
Health Laboratories. Bacterial, viral and parasitic enteric pathogens
are included in the survey and epidemiologist input is requested on
policies and processes.
We present a national view of the implementation of gastrointestinal
CIDT in clinical, local and state public health laboratories. We also
present current and anticipated needs as reported by public health
laboratories in the form of staffing, resources and guidance with
regard to gastrointestinal CIDTs.
The ability for clinical laboratories to provide isolates to public health
for PulseNet and other isolate-based surveillance systems has
proven to be invaluable. As CIDT becomes the mainstream practice
in clinical laboratories, public health surveillance will need to adapt
to culture-independent methods such as metagenomics to continue
critical surveillance activities. We present information on how local
and state public health laboratories are adapting to new changes in
clinical diagnostics and how this technology is transforming current
surveillance practices today and in the future.
Presenter: Amy Woron, Hawaii State Laboratories Division, Pearl
City, HI, [email protected]
Rise in Polymicrobial Detections Driven by Increased
Use of Culture-Independent Diagnostic Tests by Clinical
Laboratories, Foodborne Diseases Active Surveillance
Network (FoodNet) — 2011–2017
K. Barrett 1 , M. Harrigan 2 , K. Wymore 3 , B. LaClair 4 , D. Olson 5 , C.
Nicholson 6 , M. Decuir 7 , M. McMillian 8 , S. McGuire 9 , J. Hatch 10 , E.
Wilson 11 , A. Geissler 1 ; 1 Centers for Disease Control and Prevention,
2
Nothrop Grumman, 3 California Emerging Infections Program,
4
Georgia Department Public Health, 5 Yale Emerging Infections
Program, 6 New Mexico Emerging Infections Program, 7 Minnesota
Department of Health, 8 Tennessee Department of Health, 9 New
York State Emerging Infections Program, 10 Oregon Health Authority,
11
Colorado Department of Public Health and Environment
PublicHealthLabs
@APHL
APHL.org
Methods: CIFOR projects are submitted to the Council for
consideration and approval and must align with CIFOR’s vision
and mission. CIFOR member-led work groups comprised of
epidemiologists, laboratorians, environmental health specialists and
regulators provide a well-rounded perspective to foodborne outbreak
tool and product development. All final tools and products are vetted
through CIFOR member organizations.
Current State of Gastrointestinal CIDT Testing