Nancy Maddox 2016-03-21 11:43:42
Assuring the Foods You Love Won’t Make You Sick Multistate foodborne disease outbreaks are becoming more common and more deadly, according to CDC. “They can be big, and they can be lethal,” said agency Director Thomas Frieden, MD, MPH, in a 2015 press briefing at which he announced CDC had documented 120 multistate outbreaks during 2010–2014. Although the multistate outbreaks comprised just 3% of all US foodborne disease outbreaks during this period, they accounted for 56% of foodborne outbreak deaths and were linked to a wide range of foods, including cucumbers, cantaloupes and ice cream. Fortunately, public health authorities are becoming more and more adept at detecting — and ending — foodborne disease outbreaks in their earliest stages. As co-founder and continuing sponsor of the United States’ first nationwide, laboratory-based network for foodborne disease surveillance — PulseNet — APHL has been helping keep tainted food off grocery shelves for decades. More recently, APHL has expanded its role with new partnerships and new initiatives. York, Pennsylvania 39.9628° N, 76.7281° W Champaign, Illinois 40.1150° N, 88.2728° W In 2012, APHL’s food safety program took a giant leap forward with the award of a five-year, US FDA cooperative agreement to strengthen the US food safety system together with two stalwart partners: the Association of American Feed Control Officials (AAFCO) in Champaign, IL, and the Association of Food and Drug Officials (AFDO) in York, PA. A particular cooperative agreement focus is support for US food and animal feed laboratories seeking to attain or expand accreditation for their testing programs in compliance with ISO Standard 17025:2005 — the gold standard in the field. Importantly, accreditation ensures the acceptability of laboratory data to support cross-jurisdictional food safety investigations and regulatory interventions. In 2015, this partnership had much to showcase: An APHL consultant providing on-site technical assistance to accreditation seeking laboratories An online repository of more than 200 accreditation resources, including sample work plans, a collection of best practices and more Training webinars and an online discussion board on the APHL website A subject matter expert registry of food and feed laboratory professionals An AFDO-developed competency framework for food and feed testing laboratories and curriculum framework for regulatory food safety training Expansion of AAFCO’s accredited proficiency testing programs for feed, food and pet food AAFCO’s GOODSamples guidance, detailing techniques for obtaining legally defensible food and feed analytes. National Collaborations A second APHL effort to safeguard the US food supply is its long-term participation in the Council to Improve Foodborne Outbreak Response (CIFOR) — a national collaboration of laboratorians, epidemiologists and food safety inspectors across all levels of government. In 2015, three important APHL CIFOR projects came to fruition: Outbreaks of Undetermined Etiology Guidelines. These guidelines provide recommendations on the proper handling of foodborne outbreak specimens, so they are not degraded or used up before scientists can perform second-tier testing, when an etiology proves elusive. Yardstick Self-Assessment Tool for Public Health Food Safety Testing. This valuable resource went online in 2015 to make it even easier for laboratories to measure and monitor their performance in key areas, such as surge capacity and data accuracy. The tool was designed for use by any laboratory that tests for chemicals, toxins, radiation or foodborne pathogens in human specimens, food or environmental samples to support public health. CIFOR Metrics Entry Tool (C-MET). What training, tools and resources do foodborne disease outbreak responders need? C-MET was created to find out. The online tool, developed with the Minnesota Integrated Food Safety Center of Excellence, enables food safety officials to enter data on 16 CIFOR metrics with target ranges, including test turnaround time and the percentage of microbes subtyped for PulseNet. Not only can users compare their progress with aggregate data for each metric, but select database administrators can access stratified data (e.g., for geographic regions) to identify common gaps. Moving PulseNet into the Future The PulseNet surveillance network has traditionally relied on a technology called pulsed-field gel electrophoresis (PFGE). Once considered state-of-the-art, PFGE is gradually being replaced by whole genome sequencing (WGS), which offers greater discriminatory power to identify specific foodborne pathogens. In 2015, APHL coordinated the effort to certify 12 PulseNet laboratories in WGS for Salmonella, E. coli O157:H7, C. jejuni and L. monocytogenes, one of the deadliest foodborne bugs. The association also: Supported ten pilot sites in the PulseNet network to begin WGS for Salmonella and Shiga toxin-producing E. coli and equipped those sites with $430,000 worth of testing reagents and supplies Proposed a Harmonized WGS Quality Assurance Plan for PulseNet and FDA’s GenomeTrakr laboratory network Convened the 2015 Integrated Foodborne Outbreak Response and Management Conference in Phoenix, AZ. This cross-discipline meeting — organized by three federal agencies and five associations — brought together over 475 public health authorities to discuss WGS implementation and other salient topics Assisted with bench training on WGS, as well as training on Applied Maths’ BioNumerics software, which offers push-button analysis of complex WGS data, eliminating the need for a laboratory bioinformatician. APHL also purchased BioNumerics 7.5 upgrades for many member laboratories. “APHL’s Food and Feed Testing Subcommittee walked our staff through the ISO accreditation process, from the ‘big picture’ of how ISO works to the incremental steps needed to achieve it. Our NDA food and residue laboratories achieved ISO accreditation in November 2015, and we couldn’t be happier.” Dirk Shoemaker, laboratory administrator, Nebraska Department of Agriculture
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