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

2. 2004 Pan American Health Organization.... Network and Epidemiological Surveillance of Foodborne Diseases Claudio Almeida Director INPPAZ Network and Epidemiological Surveillance of Foodborne Diseases Claudio Almeida Director INPPAZ

3. 2004 Pan American Health Organization 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 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. 2004 Pan American Health Organization SIRVETA WHO/AMRO Region (1993-2003) Outbreaks 6511 Cases 232,576 Deaths 317 Outbreaks 6511 Cases 232,576 Deaths 317 Fuente: SIRVETA

5. 2004 Pan American Health Organization SIRVETA WHO/AMRO Region (1993-2003)

6. 2004 Pan American Health Organization SIRVETA WHO/AMRO Region (1993-2003)

7. 2004 Pan American Health Organization 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

8. 2004 Pan American Health Organization 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

9. 2004 Pan American Health Organization Sub-networks Labs National Networks Labs INFAL Country - Labs Structure of INFAL Assembly Excecutive Committee Technical Working Groups Ex-officio Joint Secretariat (FAO/PAHO) Advisory Board

10. 2004 Pan American Health Organization 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/)

11. 2004 Pan American Health Organization WHO Global Salm-Surv Sout 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 Abastecimento Secretaria de Defesa Animal Departamento 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

12. 2004 Pan American Health Organization 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

13. 2004 Pan American Health Organization www.epi-eta.org

14. 2004 Pan American Health Organization 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

15. 2004 Pan American Health Organization Conclusions of the first meeting December 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

16. 2004 Pan American Health Organization 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) 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. 2004 Pan American Health Organization SIRVETA 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

18. 2004 Pan American Health Organization Hierarchical Screens with drop-down lists to assure input consistency

19. 2004 Pan American Health Organization Hierarchical Screens Place of Consumption Place of contamination Contaminant Risk factor, proliferation Risk factor, survival

20. 2004 Pan American Health Organization Conclusions 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

21. 2004 Pan American Health Organization Thank you very much!