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
WHO Global Salm-Surv(WHO GSS)
Building capacity to detect, control and prevent foodborne and other
enteric infections
Dr Danilo Lo-Fo-Wong
Foodborne Outbreak Investigation, Hanoi, Vietnam 01 – 05 June 2009
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
Foodborne Outbreak Investigation, Hanoi, Vietnam 01 – 05 June 2009
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.
Foodborne Outbreak Investigation, Hanoi, Vietnam 01 – 05 June 2009
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
Foodborne Outbreak Investigation, Hanoi, Vietnam 01 – 05 June 2009
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
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
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
Foodborne Outbreak Investigation, Hanoi, Vietnam 01 – 05 June 2009
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
Foodborne Outbreak Investigation, Hanoi, Vietnam 01 – 05 June 2009
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
Foodborne Outbreak Investigation, Hanoi, Vietnam 01 – 05 June 2009
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
Foodborne Outbreak Investigation, Hanoi, Vietnam 01 – 05 June 2009
Advanced workshops activities– Regional projects / surveillance enhancement– Conference style / workshop– Training in advanced methods
Advanced WorkshopsAdvanced Workshops
Foodborne Outbreak Investigation, Hanoi, Vietnam 01 – 05 June 2009
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
Foodborne Outbreak Investigation, Hanoi, Vietnam 01 – 05 June 2009
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
Foodborne Outbreak Investigation, Hanoi, Vietnam 01 – 05 June 2009
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
Foodborne Outbreak Investigation, Hanoi, Vietnam 01 – 05 June 2009
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
Foodborne Outbreak Investigation, Hanoi, Vietnam 01 – 05 June 2009
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)
Foodborne Outbreak Investigation, Hanoi, Vietnam 01 – 05 June 2009
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
Foodborne Outbreak Investigation, Hanoi, Vietnam 01 – 05 June 2009
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)
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
WHO Global Salm-Surv(WHO GSS)
Building capacity to detect, control and prevent foodborne and other
enteric infections
Foodborne Outbreak Investigation, Hanoi, Vietnam 01 – 05 June 2009
Global Foodborne Infections Network
(GFN)
Building capacity to detect, control and prevent foodborne and other
enteric infections from farm to table
Global Foodborne Infections Network
(GFN)
Building capacity to detect, control and prevent foodborne and other
enteric infections from farm to table
Foodborne Outbreak Investigation, Hanoi, Vietnam 01 – 05 June 2009
Thank you for your attention
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