5 th world congress on foodborne infections and intoxications berlin, 7 - 11 june 2004
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2004
Pan AmericanHealthOrganization
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5th World Congress on Foodborne Infections and Intoxications
Berlin, 7 - 11 June 2004
5th World Congress on Foodborne Infections and Intoxications
Berlin, 7 - 11 June 2004
2004
Pan AmericanHealthOrganization
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Network and Epidemiological Surveillance of Foodborne Diseases
Claudio AlmeidaDirector INPPAZ
Network and Epidemiological Surveillance of Foodborne Diseases
Claudio AlmeidaDirector INPPAZ
2004
Pan AmericanHealthOrganization
OutlineOutline
• Data of foodborne diseases in WHO/AMRO Region• PAHO/WHO strategy to improve FBD surveillance• Networks
– INFAL– WHO-Global Salm Surv (LAC)– EpiEta– PulseNet LA– SIRVETA
• Data of foodborne diseases in WHO/AMRO Region• PAHO/WHO strategy to improve FBD surveillance• Networks
– INFAL– WHO-Global Salm Surv (LAC)– EpiEta– PulseNet LA– SIRVETA
2004
Pan AmericanHealthOrganization
SIRVETA WHO/AMRO Region (1993-2003)
SIRVETA WHO/AMRO Region (1993-2003)
• Outbreaks 6511
• Cases 232,576
• Deaths 317
• Outbreaks 6511
• Cases 232,576
• Deaths 317
Fuente: SIRVETA Fuente: SIRVETA
2004
Pan AmericanHealthOrganization
SIRVETA WHO/AMRO Region (1993-2003)
SIRVETA WHO/AMRO Region (1993-2003)
Known70.63%
Unknown29.37%
Bacteria57.08%
Vegetal Toxins0.93%
Parasites3.59%
Chemicals4.76%
Marine Toxins21.37%
Virus12.27%
2004
Pan AmericanHealthOrganization
SIRVETA WHO/AMRO Region (1993-2003)
SIRVETA WHO/AMRO Region (1993-2003)
Known90.94%
Unknown9.06%
Other20.52%
Schools19.49%
Social-Restaurant
13.47% Restaurant6.94%
Health Units2.24%
Household36.09%
Street Vendors
1.25%
2004
Pan AmericanHealthOrganization
PAHO strategy for strengthening foodborne disease surveillance PAHO strategy for strengthening foodborne disease surveillance
• Technical aspects:– Improve outbreak detection and notification– Improve outbreak investigation– Promote quality assurance in diagnosis– Promote active surveillance of selected
pathogens (Salmonella, E..coli 0157 :H7, Listeria , Campylobacter.)
– Promote studies on social and economic impact of foodborne diseases
• Managerial aspects– Improve intra-sectoral coordination to address
efficiently the food chain – Promote local surveillance systems
• Technical aspects:– Improve outbreak detection and notification– Improve outbreak investigation– Promote quality assurance in diagnosis– Promote active surveillance of selected
pathogens (Salmonella, E..coli 0157 :H7, Listeria , Campylobacter.)
– Promote studies on social and economic impact of foodborne diseases
• Managerial aspects– Improve intra-sectoral coordination to address
efficiently the food chain – Promote local surveillance systems
2004
Pan AmericanHealthOrganization
How networking supports this strategy?How networking supports this strategy?
• INFAL and diagnosis quality assurance:– Developed an information system among member
laboratories– Facilitates availability of reference materials and
participation in inter-laboratory testing– Organizes and promotes programs for training and
education promoting the sharing of experiences and resources available
– Promotes and strengthens the intersectoral participation in building and operating national networks
– Promotes and strengthens integration of member laboratories food safety programs and epidemiological surveillance
• INFAL and diagnosis quality assurance:– Developed an information system among member
laboratories– Facilitates availability of reference materials and
participation in inter-laboratory testing– Organizes and promotes programs for training and
education promoting the sharing of experiences and resources available
– Promotes and strengthens the intersectoral participation in building and operating national networks
– Promotes and strengthens integration of member laboratories food safety programs and epidemiological surveillance
2004
Pan AmericanHealthOrganization
Sub-networksLabs
Labs
Labs
National Networks Labs
LabsLabs
Labs
INFAL
Country - Labs
Country - Labs
Country - Labs
Country - Labs
Country - Labs
Structure of INFAL
•Assembly
•Excecutive Committee
•Technical Working Groups
•Ex-officio Joint Secretariat (FAO/PAHO)
•Advisory Board
2004
Pan AmericanHealthOrganization
How networking supports this strategy?How networking supports this strategy?
• WHO-GLOBAL SALM SURV (Central America, South America and Caribbean (CAREC):– Training in standardized protocols in
Salmonella sp and Campylobacter sp.– Training in epidemiology of FBD and
outbreak investigation– Inclusion of managers component (Directors
of Labs and Epi)– Regional database – Quality assurance program– Improve communication between labs
(http://www.panalimentos.org/salmsurv/)
• WHO-GLOBAL SALM SURV (Central America, South America and Caribbean (CAREC):– Training in standardized protocols in
Salmonella sp and Campylobacter sp.– Training in epidemiology of FBD and
outbreak investigation– Inclusion of managers component (Directors
of Labs and Epi)– Regional database – Quality assurance program– Improve communication between labs
(http://www.panalimentos.org/salmsurv/)
2004
Pan AmericanHealthOrganization
WHO Global Salm-SurvSout America
Argentina•Inst. Nac. de Enfermedades Infecciosas (INEI) - ANLIS “Dr.Carlos G. Malbran”•Inst. Nac. de Producción de Biológicos (INPB)- ANLIS “Dr. C G. Malbran”• Instituto Nacional de Alimentos (INAL) •Servicio Nac. de Sanidad Animal (SENASA)
Bolivia•Instituto Nacional de Lab. de Salud (INLASA)•Lab. de Investigación y Diagnóstico Veterinario (LIDIVET)
Brasil •Inst.Oswaldo Cruz - Centro de Referencia Nac. de Colera y Enteroinfeccoes Bacterianas (FIOCRUZ – RJ)•Ministério da Agricultura e do AbastecimentoSecretaria de Defesa AnimalDepartamento de Defesa animal
Colombia •Instituto Nacional de Salud•Inst. de Vig. de Medicamentos y Alimentos (INVIMA) •Instituto Colombiano Agropecuario (ICA)
Chile •Instituto de Salud Pública de Chile •Servicio Agrícola Ganadero
Paraguay•Laboratorio Central de Salud Pública•Ministerio de Agricultura y Ganadería
Peru•Inst. Nac. de Salud – Centro Nac. Lab. Salud Publica.- Div de Bacteriologia – Lab Enteropatogenos •Inst. Nac. de Salud -Centro Nac. de Alimentación y Nutrición
Uruguay•Centro Nacional de Salmonella, Inst. de Higiene •Min.de Ganaderia, Agricultura y Pesca (DILAVE)
Venezuela •Instituto Nacional de Higiene “Rafael Rangel”
REGIONAL CENTER: Instituto Nacional de Enfermedades Infecciosas (INEI) - ANLIS “Dr.Carlos G. Malbran”
Ecuador•Instituto Nacional de Higiene
2004
Pan AmericanHealthOrganization
How networking supports this strategy?How networking supports this strategy?
• Epi-Eta– Defines an international community of foodborne
disease epidemiologists– Provides communication and discussion of topics of
international interest among foodborne disease epidemiologists by means of moderated electronic discussion site
– Provides a platform for exchange of scientific information among epidemiologists
– Provides a model of regional epidemiologic networks for other Regions
• Epi-Eta– Defines an international community of foodborne
disease epidemiologists– Provides communication and discussion of topics of
international interest among foodborne disease epidemiologists by means of moderated electronic discussion site
– Provides a platform for exchange of scientific information among epidemiologists
– Provides a model of regional epidemiologic networks for other Regions
2004
Pan AmericanHealthOrganization
www.epi-eta.orgwww.epi-eta.org
2004
Pan AmericanHealthOrganization
How networking supports this strategy?How networking supports this strategy?
• PulseNet Latin America (PAHO/CDC)– Training in pulse field gel
electrophoresis– Training in the use of biological
molecular techniques applied to FBD surveillance
– Regional database PFGE isolates– Quality assurance program
• PulseNet Latin America (PAHO/CDC)– Training in pulse field gel
electrophoresis– Training in the use of biological
molecular techniques applied to FBD surveillance
– Regional database PFGE isolates– Quality assurance program
2004
Pan AmericanHealthOrganization
Conclusions of the first meetingDecember 2003
Conclusions of the first meetingDecember 2003
All countries agreed on building up PulseNet in LA
The benefits pointed out were:• Strengthen the laboratory capabilities and the
interaction epidemiology-laboratory in the Region
• Improve FBD surveillance by incorporating PulseNet data into country surveillance systems
• Regional Steering Committee: Uruguay, Chile and Brazil
All countries agreed on building up PulseNet in LA
The benefits pointed out were:• Strengthen the laboratory capabilities and the
interaction epidemiology-laboratory in the Region
• Improve FBD surveillance by incorporating PulseNet data into country surveillance systems
• Regional Steering Committee: Uruguay, Chile and Brazil
2004
Pan AmericanHealthOrganization
Action Plan 2004-2005Action Plan 2004-2005
• 1st Training Course (7 countries, July 2004)• 2nd PulseNet LA meeting (approval of bylaws, July
2004)• Certification of the Malbran Institute (2004)• Send images from the 7 NRLs (2004)• Laboratory Certification of the 7 LA-NRLs (2005)• Emailing tiff files and text data / Establish the LA-
Data Bank (2005)• Consolidate the network (Follow-up missions, 2005)• Incorporate the Bio-Numerics (2005)• 2nd training course (incorporate new members,
2005)
• 1st Training Course (7 countries, July 2004)• 2nd PulseNet LA meeting (approval of bylaws, July
2004)• Certification of the Malbran Institute (2004)• Send images from the 7 NRLs (2004)• Laboratory Certification of the 7 LA-NRLs (2005)• Emailing tiff files and text data / Establish the LA-
Data Bank (2005)• Consolidate the network (Follow-up missions, 2005)• Incorporate the Bio-Numerics (2005)• 2nd training course (incorporate new members,
2005)
2004
Pan AmericanHealthOrganization
SIRVETASIRVETA
• About improvements– Data collection
• New online interfaces
– Data analysis• New queries capability designed by the
user• New export capabilities
– ASCII format, Spreadsheet format
• About improvements– Data collection
• New online interfaces
– Data analysis• New queries capability designed by the
user• New export capabilities
– ASCII format, Spreadsheet format
2004
Pan AmericanHealthOrganization
Hierarchical Screens with drop-down lists to assure input consistency
Hierarchical Screens with drop-down lists to assure input consistency
2004
Pan AmericanHealthOrganization
Hierarchical ScreensHierarchical ScreensPlace of Consumption
Place of contamination
Contaminant
Risk factor,proliferation
Risk factor, survival
2004
Pan AmericanHealthOrganization
ConclusionsConclusions
• It is clear that networking improves national capability for surveillance and laboratory confirmation of FBD
– Training– Standardization– Quality assurance– Scientific advice
• It is clear that networking improves national capability for surveillance and laboratory confirmation of FBD
– Training– Standardization– Quality assurance– Scientific advice
2004
Pan AmericanHealthOrganization
Thank you very much!Thank you very much!
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