Foodborne Outbreak Investigation, Hanoi, Vietnam 01 – 05 June 2009 WHO Global Salm-Surv (WHO GSS) Building capacity to detect, control and prevent foodborne

Foodborne Outbreak Investigation, Hanoi, Vietnam 01 – 05 June 2009

WHO Global Salm-Surv(WHO GSS)

Building capacity to detect, control and prevent foodborne and other

enteric infections

Dr Danilo Lo-Fo-Wong



enteric infections

Dr Danilo Lo-Fo-Wong


What is WHO GSS?What is WHO GSS?

A network of institutions and individuals working in veterinary, food and public health disciplines committed to enhancing capacity of countries to conduct integrated foodborne and other enteric infections surveillance


WHO Global Salm-Surv VisionWHO Global Salm-Surv Vision

Foodborne and other enteric infectious diseases are a common cause of illness, disability, and death worldwide.

We believe they are preventable, and therefore, place an unnecessary burden on society.

Our vision is that all countries will prevent and control these diseases.


WHO Global Salm-Surv MissionWHO Global Salm-Surv Mission

Enhance the capacity of countries to detect, respond, and prevent foodborne and other enteric infections.

Foster intersectoral collaboration – human health, veterinary, and food-related disciplines

To promote integrated, laboratory-based surveillance

FDA Center for Veterinary MedicineFDA Center for Veterinary Medicine


WHO GSS main activitiesWHO GSS main activities

Focused Regional and National Projects

Reference Services

Communication

(Inter)national Training Activities

External Quality Assurance System (EQAS)

Country Data Bank (CDB)

> 1 200 Members

> 700 Institutions

158 Member StatesArgentina

Mexico

Poland

ThailandTrinidadCameroon

Egypt

Russia, St. Petersburg

China

Training Site

Proposed Training Site

Kazakhstan

Kenya

Brazil

Tunisia

South Africa

Russia, Moscow

Fiji

Guatemala

Madagascar

IndiaGuam

MozambiquePapua New Guinea

Costa Rica

Argentina

Mexico

Poland


Egypt


China

Training Site


Kazakhstan

Kenya

Brazil

Tunisia

South Africa

Russia, Moscow

Fiji

Guatemala

Madagascar

IndiaGuam


Costa Rica

Argentina

Mexico

Poland


Egypt


China

Training Site


Kazakhstan

Kenya

Brazil

Tunisia

South Africa

Russia, Moscow

Fiji

Guatemala

Madagascar

IndiaGuam


Costa Rica


1 .Thailand-Level 1-December 1999 2 .Argentina-Level I-June 2000

3. Middle East-Level I-July 2000 4 .China-Level I-April 2001

5. Thailand-Level II-June 2001 6. Argentina-Level II-Sept 2001 7. Mexico-Level I-July 2001

8 .Thailand-Level III-Jan 2002 9. Poland-Level I-April 2002 10. Middle East-Level II-June 2002 11. Caribbean-Level I-Sept 2002 12. Cameroon-Level I-Nov 2002 13. China-Level II-Nov 2002

14 .Mexico-Level II-March 2003 15. Moscow-Level I, Part I-May 2003 16. Argentina-Level III-May 2003 17. Poland-Level II-June 2003 18. Middle East-preLevel III-July 2003 19. Kazakhstan-Level I-July 2003 20. Thailand-Advanced Wksp I-Aug 2003 21. Cameroon-Level II-Dec 2003

22 .Middle East-Level III-Feb 2004 23. Caribbean-Level II-March 2004 24. Poland-Level III-April 2004 25. China-Level III- May 2004 26. Mexico-Level III-Sept 2004 27. Russia-St. Pete-Level I-Oct 2004 28. Cameroon-Level III-Dec 2004

29 .Caribbean-Level III- May 2005 30. Russia-St. Pete-Level II-June 2005 31. Brazil-Level I,Part I-Sept 2005 32. China Advanced Wksp I- Dec 2005 33. Cameroon-Level IV-Dec 2005

34 .Poland-Adv Wksp-I-Feb 2006 35. Russia-St. Pete-Level III-May 2006 36. Argentina-Adv Wksp I-May 2006 37. Brazil-Level I-Part II-Sept 2006 38. Pacific-Level I-Oct 2006 39. Antisera Training Course-Nov 2006 40. China-Adv Wksp II-Nov 2006

41 .Thailand-Adv Wksp II-Jan 2007 42. Madagascar-Level I-Jan 2007 43. Guatemala-Level III-March 2007 44. Egypt-Adv Wksp I-March 2007 45. Russia-St. Pete-Adv Wksp I-Sept 2007 46. Caribbean-Adv Wksp I-Sept 2007 47. Kenya-Level I-Oct 2007 48. Brazil-Level II-Nov 2007 49. China-Adv Wksp III-Nov 2007

50 .Poland-Adv Wksp-II-Feb 200851 .Cameroon-Adv Wksp I-March 2008

52 .Moscow-Level I-March 200853 .Argentina-Adv Wksp II-May 2008

54 .Papua New Guinea-Level I-June 200855 .Brazil-Level III-Sept 2008

56 .China-Adv Wksp IV-Oct 200857 .Kenya-Level II-Jan 2009

58 .Guam-Level I-Feb 200959 .Thailand-Adv Wksp III-March 200960 .Costa Rica-Adv Wksp I-April 2009

61 .Madagascar-Level II-April 200962 .China-Focussed Wksp-May 2009

63 .Poland – Adv Wksp-May 2009

WHO GSS Training activities2000 - 2009

WHO GSS Training activities2000 - 2009

Food Safety, Zoonoses and Foodborne Diseases (FOS) | 09 April 2009, Geneva, Switzerland


International Training CoursesInternational Training Courses

Microbiology training– Salmonella diagnostics– Campylobacter diagnostics– Region-specific pathogens

(e.g. E. coli O157, Vibrio Cholerae, S. Typhi, Bacillus anthracis, Brucella, Shigella)

– Antimicrobial Susceptibility Testing

Epidemiology training– Outbreak detection and response– Evaluation of surveillance systems– Study design– Source attribution – Burden of disease

Joint Epidemiology and Laboratory– Integrated surveillance – Risk assessment– Country Plans of Action– Advocacy and communication– Information sharing networks


www.antimicrobialresistance.dk/who/protocols.html

Laboratory ManualsLaboratory Manuals

By pathogen– Salmonella– Campylobacter – E. coli O157– Shigella

By basic and molecular methods

– Isolation, ID, Serotyping– AST, PCR, PFGE

Various languages– English, French, Spanish,

Russian, Chinese


Advanced workshops activities– Regional projects / surveillance enhancement– Conference style / workshop– Training in advanced methods

Advanced WorkshopsAdvanced Workshops


Participating provinces

Henan

Fujian

Shanghai

Chongqing

Sichuan

Guangdong

Guangxi

Beijing

Workshops (all sites)

Guangdong, 2006

Guilin, Guangxi, 2007

Beijing, 2008

Enhanced Salmonella Surveillance Project-China

Enhanced Salmonella Surveillance Project-China


WHO GSS – Country DatabankWHO GSS – Country Databank

To improve the understanding of the global and regional epidemiology of Salmonella serotypes and lead to the prevention and control of this pathogen.

To provide food safety professionals with contact information of all WHO GSS members around the world

> 900 data sets > 80 countries > 1.5 million human isolates ~ 360 000 non-human isolates

Distribution of Salmonella serotypesSouth America, 2001

41%

16%8%

4%

4%

4%

22%EnteritidisTyphimuriumTyphiAgonaInfantisParatyphi BOther

Distribution of human Salmonella serotypes North America, 2001

29%

24%12%

10%

4%

3%

19% Typhimurium

Enteritidis

Newport

Heidelberg

Javiana

Thompson

Other


Opportunities to Apply Skills from TrainingOpportunities to Apply Skills from Training

External Quality Assurance System – Results entered at secured website– Instant report with suggestions for corrective action

Focused Regional /National Projects– Pathogen-specific Projects (e.g. S Weltevreden, S Lamphun, S Corvalis)– Burden of Illness Studies (e.g. Jordan, Slovenia, the Caribbean)– Enhanced Surveillance Studies (e.g. China, Fiji, Philippines, Kazakhstan)

Reference Services– Verification of findings– Reply to questions– Individual lab. courses or site visits – Participation in regional projects


S.Weltevreden: Characterization by PFGE and risk factor study – Southeast Asia, Western Pacific, North America and Denmark.

S.Corvallis: Characterization of ESBL resistance and clonality – Bulgaria, Thailand and Denmark.

S. Concord: description of spread of multidrug resistant S. Concord in Europe and the US among children adopted from Ethiopia

S.Typhimurium: Characterization of ESBL resistance and clonality - Gomel region, Belarus.

S.Schwarzengrund: Clonality study in relation to trade in strains from Thailand, Denmark and the US.

Campylobacter ssp.: MIC determination of strains collected by AFRIMS in Thailand.

Regional and national projectsRegional and national projects


CommunicationCommunication

Electronic Discussion Group– Moderated listserv in English, Spanish, French, Portugese, Chinese, Russian– Since 2000 ca. 200 messages sent on foodborne diseases,

programmatic issues, training information, and outbreaks

Newsletter– Update on WHO GSS activities– In English, French, Chinese, Spanish, Arabic

Web sites– www.who.int/salmsurv/en/ (English)– www.panalimentos.org/salmsurv/ (Spanish)– whogss.eu (English)– www.antimicrobialresistance.dk/who/protocols.html

(laboratory protocols, English)


PerspectivesPerspectives

Assure sustainability

Integrate with other FOS and IHR activities

– Help countries meet IHR core-capacities

Liaise with FAO, OIE and others (e.g. EFSA)

Increase input to the CDB

Increase impact– National and regional political

support– Region-specific programme– Participants (train-the-trainer)

Increase output of programme– Update and translate training

manuals– Newsletter, update website(s),

EDG messages, articles


PerspectivesPerspectives

Regionalize activities

Target new geographical areas for training and EQAS

Capacity-building platform– IHR (i.e. core capacities)– One World – One Health – SPS (i.e. development & health) – Burden of Disease– Early Warning & Emergency

Communication (i.e. INFOSAN, GLEWS)




enteric infections



enteric infections


Global Foodborne Infections Network

(GFN)


enteric infections from farm to table

Global Foodborne Infections Network

(GFN)


enteric infections from farm to table


Thank you for your attention

Documents

Foodborne Outbreak Investigation, Hanoi, Vietnam 01 – 05 June 2009 WHO Global Salm-Surv (WHO GSS) Building capacity to detect, control and prevent foodborne