Molecular surveillance of shiga toxigenic Escherichia coli O157 by PulseNet USA.
PulseNet USA is the national molecular subtyping network system for foodborne disease surveillance. Sixty-four public health and food regulatory laboratories participate in PulseNet USA and routinely perform pulsed-field gel electrophoresis of Shiga toxigenic Escherichia coli isolated from humans, food, water, and the environment on a real-time basis. Clusters of infection are detected in three ways within this system: through rapidly alerting the participants in the electronic communication forum, the PulseNet Web conference; through cluster analysis by the database administrators at the coordinating center at the Centers for Disease Control and Prevention of the patterns uploaded to the central server by the participants; and by matching profiles of strains from nonhuman sources with recent human uploads to the national server. The strengths, limitations, and scope for future improvements of PulseNet are discussed with examples from 2002. In that year, notices of 30 clusters of Shiga toxigenic E. coli O157 infections were posted on the Web conference, 26 of which represented local outbreaks, whereas four were multistate outbreaks. Another 27 clusters were detected by central cluster detection performed at the Centers for Disease Control and Prevention, of which five represented common source outbreaks confirmed after finding an isolate with the outbreak pattern in the implicated food. Ten food isolates submitted without suspicion of an association to human disease matched human isolates in the database, and an epidemiologic link to human cases was established for six of them.
Gerner-Smidt
Peter
P
Centers for Disease Control and Prevention, National Center of Infectious Diseases, Division of Bacterial and Mycotic Diseases, Foodborne and Diarrheal Diseases Branch, Atlanta, Georgia 30333, USA. plg5@cdc.gov
Kincaid
Jennifer
J
Kubota
Kristy
K
Hise
Kelley
K
Hunter
Susan B
SB
Fair
Mary-Ann
MA
Norton
Dawn
D
Woo-Ming
Ann
A
Kurzynski
Terry
T
Sotir
Mark J
MJ
Head
Marcus
M
Holt
Kristin
K
Swaminathan
Bala
B
D015373:Bacterial Typing Techniques; D016000:Cluster Analysis; D019992:Databases as Topic; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field / Q000379:methods*; D019453:Escherichia coli O157 / Q000145:classification / Q000302:isolation & purification*; D005516:Food Microbiology; D007255:Information Services; D011159:Population Surveillance; D011634:Public Health; D011786:Quality Control; D014481:United States