C-EnterNet News
Canada’s National Integrated Enteric Pathogen Surveillance System

Volume 6, Summer 2008
PDF Version - 5 pages, 229 KB

• Editor's Note
• Notes from C-EnterNet Central
• Notes from C-EnterNet Sentinel Site 1: The Region of Waterloo
• Note from C-EnterNet’s Retail Food and Agriculture Component
• Note from C-EnterNet’s Water Component
• Note from C-EnterNet’s Source Attribution Component
• C-EnterNet: Knowledge Exchange and Dissemination
• Contact

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Editor’s Note

New for the 2007 sampling year, C-EnterNet released a short report of preliminary findings http://www.phac-aspc.gc.ca/c-enternet/pdf/sr2007-eng.pdf to be followed later in the year by a long report. The purpose of the short report is to present the main findings from the 2007 surveillance year in Sentinel Site 1 in a timely manner. The long report will include more extensive analyses of temporal trends and subtyping information for an integrated perspective on enteric disease from exposure to source.

As C-EnterNet transitions from its pilot phase and AAFC’s APF funding (2003-2008), it is currently looking at alternate funding structures. The first sentinel site has been successfully piloted in the Region of Waterloo, Ontario, thanks to the strong collaboration and support of many stakeholders. We’ve proven that a) the information is needed, b) the design works, and c) one pilot site is not enough! In its full implementation, C-EnterNet is designed to encompass up to 5 or 6 sentinel sites across Canada.  C-EnterNet is currently working on an expansion plan towards the development of a national call for future partnerships and sentinel sites.

I hope that you enjoy reading about the activities highlighted in this newsletter. Feel free to contact us for further information.

Dr. Frank Pollari
C-EnterNet Program Lead

Notes from C-EnterNet Central

Because the C-EnterNet program is based on the US CDC FoodNet model, we regularly liaise with CDC scientists to learn from their experience and expertise. Dr. Frank Pollari and Dr. André Ravel provided an update on C-EnterNet at the annual CDC FoodNet Vision meeting in Denver, Colorado, March 6-7, 2008. Representatives from FoodNet’s 11 states and the CDC, FDA and USDA-FSIS were in attendance.

Frank Pollari and André Ravel at CDC FoodNet
Vision Meeting in Denver, Colorado

In February, C-EnterNet’s Barb Marshall along with Rachel McCormick (Federal Field Epidemiologist) helped Dr. Lisa Indar of the Caribbean Epidemiology Centre (CAREC/PAHO/WHO) and the Caribbean Alliance for Sustainable Tourism (CAST) teach the Advanced Food Safety Training and Certification course held in Barbados, to environmental health officers and hotel personnel from 10 Caribbean countries.

Barb Marshall, Rachel McCormick and Lisa Indar with
students at Food Safety Training in Barbados

As an enhancement to on-going surveillance activities, C-EnterNet provides a robust platform for various collaborative research initiatives. Currently, C-EnterNet is exploring ways to combine C-EnterNet’s surveillance data with climate data. Collaborating with Dr. Jan Sargeant, Director of the new Centre for Public Health and Zoonoses, University of Guelph, and fourth-year biomedical science student, Kate Smolina, the current project aims to examine the relationship of mean monthly temperature and rainfall with human Salmonella cases and the level of Salmonella on chicken breasts in the sentinel site. Kate recently won a prestigious Rhodes scholarship to pursue graduate studies in global health science at the University of Oxford, one of 11 Canadian Rhodes Scholars.

Angela Cook, Kate Smolina, Jan Sargeant,
Barb Marshall & Frank Pollari

C-EnterNet continues to work with NML’s Dr. Cliff Clark on the comparison of molecular typing methods that could be used to detect clusters of Campylobacter jejuni isolates. We look forward to contributing substantially to the 2008 Canadian Campylobacter Conference, jointly organized and hosted by the Public Health Agency of Canada and the Universities of Sherbrooke and Montreal, September 2008 in Montreal.

C-EnterNet is linked to an innovative, multidisciplinary group, initiated by Sandy Isaacs (CFEZID), who is developing a collaborative research program - Integrating Our Understanding of Food Safety Across the Cultures. There are wide knowledge gaps in the area of traditional foods and food safety, and partnerships between communities, food safety professionals, practitioners and academics can create mutual learning opportunities and facilitate the exchange of knowledge to bridge these gaps.

Andrea Nesbitt, epidemiologist at CFEZID has accepted a new position on the National Enteric Surveillance program (NESP) but continues to provide her expertise to C-EnterNet.

Andrea Nesbitt (left) discusses human
risk factor analysis results with Popy
Dimoulas-Graham and Nancy Sittler

 

Notes from C-EnterNet Sentinel Site 1: The Region of Waterloo

Popy Dimoulas-Graham, ROWPH epidemiologist, along with the Region’s Epidemiology and Data Support Team, has developed a new initiative, in which analysis of human data entered into EpiData http://www.epidata.dk/ is reported monthly via the new Communicable Disease Surveillance Report. This report includes a section highlighting C-EnterNet's human data analysis and enteric disease incidence. The sixth training workshop - The Usual Suspects: An Enteric Disease Refresher, was held on May 14, 2008. The focus of the workshop was to strengthen the investigation of cases of reportable enteric illness and cluster identification; further the understanding of the prevention and control of enteric disease and ultimately enhance epidemiological skills of public health inspectors in the region and beyond. Visiting speakers, Dr. Jan Sargeant (U of G) and Yvonne Whitfield (OMOH&LTC), gave dynamic presentations on historical and contemporary issues related to VTEC including new research in on-farm control, and Salmonella, highlighting recent recalls and outbreaks.  C-EnterNet's Frank Pollari and Katarina Pintar provided information on Campylobacter, Cryptosporidium and Giardia from C-EnterNet’s sentinel site data and recent literature.  The workshop deemed the best so far by participants, hosted members from two other Ontario networks and from CIPHI - Ontario (Canadian Institute of Public Health Inspectors).

Frank Pollari and Barb Marshall attended the inaugural meeting of the Region of Waterloo Travel Medicine Network to present on C-EnterNet enteric diseases linked to travel entitled, Under the Microscope: Travel-related Enteric Disease in the Region of Waterloo. In attendance was the Travel Clinic staff of ROWPH, the Region’s Medical Officer and Associate Medical Officer of Health, and community physicians with a specific interest in travel related diseases. ROWPH is embarking on a project to collect and analyze data from their telephone complaint line related to foodborne illness. Modelled after the Minnesota Department of Health’s complaint line data analysis, ROWPH is in the initial planning to begin analyzing the data received from complaint line calls. The standardized, enteric investigation worksheets developed and updated, at the Region in partnership with PHAC, have recently been shared with the OMOH&LTC to augment the development of a provincial standard questionnaire.

Katarina Pintar explains quantitative risk assessment modelling
to Chris Komorowski, Barb Marshall
& Nancy Sittler at the Region

 

Note from C-EnterNet’s Retail Food and Agriculture Component

Dr. Angela Cook and Katarina Pintar previewed the 2007 results of the C-EnterNet Short Report to representatives of the federal and provincial commodity groups, during a teleconference on May 15, organized by the Canadian Animal Health Coalition (CAHC), prior to the report’s release. Angela attended the Canadian Meat Council Training Seminar: Updated E. coli Policy Implementation and Control Measures, which was held in Toronto on June 11, and presented on the work of C-EnterNet - E. coli O157:H7 Human Incidence and Integrated Surveillance.

Note from C-EnterNet’s Water Component

Spring of 2008 signalled some changes in the water component, as we welcomed a new and integral partner to the source water monitoring program. The Ontario Ministry of Environment (OMOE) is now collaborating with C-EnterNet on the Grand River sampling, providing both technical assistance and field staff expertise for sample collection and submission to our primary isolation laboratories. Janis Thomas, an OMOE surface water specialist, is leading this collaborative initiative. We continue to sample at the same five sample locations within the Grand River watershed. We also welcome the University of Guelph Laboratory Services Division and Hyperion Research Ltd as our two new water labs. We are extremely pleased to be expanding our collaborative networks as we move into our fourth sampling year!

On a research note, the paper summarizing the water consumption survey results in Waterloo Region was accepted for publication. Currently, we are in the process of developing quantitative risk assessment models to compare the role of various exposure routes (drinking and recreational water to start) to the risk of Cryptosporidium infection in Waterloo Region, as a means of informing our source attribution initiatives. We hope to submit these papers for publication by the end of the year. In conjunction, C-EnterNet is developing Salmonella and Campylobacter risk assessment models in partnership with Aamir Fazil, within the Microbial Risk Assessment Unit at the Laboratory for Foodborne Zoonoses, PHAC.

Katarina Pintar surveying one C-EnterNet
sample site in the Grand River watershed

Note from C-EnterNet’s Source Attribution Component

Judy Greig and André Ravel have submitted a paper for peer-reviewed publication entitled, Analysis of foodborne outbreak data reported internationally for source attribution. Following that, André resumed the data analysis and writing related to the analysis of 30 years of Canadian foodborne outbreak data for the purpose of source attribution. André also joined an expert elicitation project on food attribution with Juliana Ruzante, post-doctoral fellow at the University of Guelph and Aamir Fazil, risk analyst at the LFZ. The group will seek opinions from Canadian food safety experts according to a methodology developed and applied in the US by Sandra Hoffmann, Resources for the Future, Paul Fishbeck, Carnegie Mellon University, and others. (Hoffmann S, Fishbeck P, Krupnick A, McWilliams M. Using expert elicitation to link foodborne illnesses in the United States to foods. J Food Prot. 2004, 70 (5): 1220-1229). In parallel, André has piloted the application of a human salmonellosis attribution model that was developed in Denmark for the attribution of human salmonellosis cases to their sources (meaning primarily their reservoirs) (Hald T, Vose D Wegener H C Koupeev T. A Bayesian Approach to Quantify the Contribution of Animal-Food Sources to Human Salmonellosis. Risk Analysis. 2004; 24, 255-269). National and representative data were sought and obtained from the National Microbiology Laboratory for the human component of the model and from the Laboratory for Foodborne Zoonoses and the Canadian Food Inspection Agency for the source component of the model. André adapted the original mathematical model to the data collected and has produced promising results. Various issues around data quality and the operation of the model have been raised during this pilot and need to be solved to ensure valid results. In relation to this modelling initiative, Sara Monteiro Pires visited André in St-Hyacinthe, Quebec on May 29-30 to help inform the development of the Canadian Salmonellosis attribution model. Sara, a Portuguese veterinarian, completed her PhD under the supervision of Tine Hald from the Danish Zoonosis Centre, Department of Microbiology and Risk Assessment, the Danish Institute for Food and Veterinary Research. Sara has developed a unique expertise on source attribution, in particular in running the human salmonellosis model developed in Denmark by her supervisor. André and Sara discussed the conceptual and methodological aspects of the source attribution scientific challenge as well as answers to technical questions related to the Danish human salmonellosis source attribution model.

C-EnterNet: Knowledge Exchange and Dissemination

Recent Publications and Reports by C-EnterNet scientists:

Cook, A., R. Reid-Smith, R. Irwin, S. McEwen, A. Valdivieso-Garcia and C. Ribble. 2008.
(Submitted) Antimicrobial resistance in Campylobacter, Salmonella and generic E. coli isolated from retail turkey meat from Southern Ontario, Canada. Journal of Food Protection.

Nesbitt, A., S. Majowicz, R. Finley, F. Pollari, K. Pintar, B. Marshall, A. Cook, J. Sargeant, J. Wilson, C. Ribble, and L. Knowles. 2008. Food Consumption Patterns in the Waterloo Region, Ontario, Canada: A Cross-sectional Telephone Survey. Accepted for publication – BMC Public Health.

Pintar, K.D.M., Waltner-Toews, D., Charron, D., Pollari, F., Fazil, A., McEwen, S.A., Nesbitt, A., Majowicz, S. 2008 (Submitted) Water consumption habits of a Southwestern Ontario community. Journal of Water and Health.

Conferences and Meetings Attended:

• Community Etiology Meeting, Winnipeg, March 31- April 2.
• Canadian Institute of Public Health Inspectors - Ont. Communicable Disease Conference, May 2.
• 2008 PulseNet Canada & Foodborne Epidemiologists Meeting, Toronto May 27-28.
• G8 Food Defense Exercise, Minneapolis, Minnesota, May 27-29.
• Canadian Public Health Association 2008 Annual Conference, Halifax, Nova Scotia, June 1-3.

Frank Pollari, Paul Sockett, Susanna Ogunnaike-Cooke,
Shannon Majowicz and Lai King Ng
at the Community Etiology meeting in Winnipeg

 

Presentations and Posters:

• Ryerson University, School of Occupational and Public Health, Toronto, January 31.
• Canadian Meat Council's 88th Annual Conference, Niagara Falls, May 7-9.
• Enteric Pathogen Refresher Workshop, Waterloo, May 14.
• C-EnterNet 2007 Short Report Preview, Guelph, May 15.
• 2008 PulseNet Canada & Foodborne Epidemiologists Meeting, Toronto, May 27- 28.
• Travel Medicine Network Meeting, Waterloo May 30.
• Canadian Meat Council Training Seminar: Updated E. coli Policy Implementation and Control Measures. Toronto, June 11.

Looking Ahead

• 2007 Annual Report*
• Standard Operating Procedures for C-EnterNet's Sampling and Laboratory Methods*
• C-EnterNet Expansion Plan

*Look for these on our website

For further details on C-EnterNet, please contact:

Anglophone spokesperson

Dr. Frank Pollari,
Project Lead
C-EnterNet Surveillance
Centre for Foodborne, Environmental and Zoonotic Infectious Diseases (CFEZID)
Public Health Agency of Canada
(519) 826-2184
Fax: (519) 826-2244
frank_pollari@phac-aspc.gc.ca

http://www.phac-aspc.gc.ca/c-enternet/index.html

Porte-parole francophone

Dr. André Ravel,
Projet de surveillance
Laboratoire de lutte contre les zoonoses d’origine alimentaire
Agence de la santé publique du Canada
Tel: +1 (450) 773-8521
(poste / ext. 0144)
Fax:+1 (450) 778-8129
andre_ravel@phac-aspc.gc.ca

http://www.phac-aspc.gc.ca/c-enternet/index_f.html