5 th World Congress on Foodborne Infections and Intoxications Berlin, 7 - 11 June 2004

1. . . 5th World Congress on Foodborne Infections and Intoxications Berlin, 7 - 11 June 2004

2. . . Network and Epidemiological Surveillance of Foodborne Diseases Claudio Almeida Director INPPAZ

3. Outline • 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

4. SIRVETA WHO/AMRO Region (1993-2003) • Outbreaks 6511 • Cases 232,576 • Deaths 317 Fuente: SIRVETA

5. SIRVETA WHO/AMRO Region (1993-2003)

6. SIRVETA WHO/AMRO Region (1993-2003)

7. 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

8. 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

9. Labs Labs Sub-networks Labs Labs Labs National Networks Labs Labs Country - Labs Country - Labs INFAL Country - Labs Country - Labs Country - Labs • Structure of INFAL • Assembly • Excecutive Committee • Technical Working Groups • Ex-officio Joint Secretariat (FAO/PAHO) • Advisory Board

10. 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/)

11. WHO Global Salm-SurvSout America • Ecuador • Instituto Nacional de Higiene • Venezuela • Instituto Nacional de Higiene “Rafael Rangel” • Colombia • Instituto Nacional de Salud • Inst. de Vig. de Medicamentos y Alimentos (INVIMA) • Instituto Colombiano Agropecuario (ICA) • Brasil • Inst.Oswaldo Cruz - Centro de Referencia Nac. de Colera y Enteroinfeccoes Bacterianas (FIOCRUZ – RJ) • Ministério da Agricultura e do Abastecimento • Secretaria de Defesa Animal • Departamento de Defesa animal • 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 • Paraguay • Laboratorio Central de Salud Pública • Ministerio de Agricultura y Ganadería • Uruguay • Centro Nacional de Salmonella, Inst. de Higiene • Min.de Ganaderia, Agricultura y Pesca (DILAVE) • Bolivia • Instituto Nacional de Lab. de Salud (INLASA) • Lab. de Investigación y Diagnóstico Veterinario (LIDIVET) REGIONAL CENTER: Instituto Nacional de Enfermedades Infecciosas (INEI) - ANLIS “Dr.Carlos G. Malbran” • Chile • Instituto de Salud Pública de Chile • Servicio Agrícola Ganadero • 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)

12. 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

13. www.epi-eta.org

14. 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

15. 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

16. Action 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)

17. SIRVETA • About improvements • Data collection • New online interfaces • Data analysis • New queries capability designed by the user • New export capabilities • ASCII format, Spreadsheet format

18. Hierarchical Screens with drop-down lists to assure input consistency

19. Hierarchical Screens Place of Consumption Place of contamination Contaminant Risk factor, proliferation Risk factor, survival

20. Conclusions • It is clear that networking improves national capability for surveillance and laboratory confirmation of FBD • Training • Standardization • Quality assurance • Scientific advice

21. Thank you very much!