Lab Matters Summer 2019 - Page 52

APHL 2019 POSTER ABSTRACTS Food Safety Meet Me in St. Louis to Learn About Exciting New Foodborne Outbreak Tools and Resources! K. Larson 1 , R. Atkinson Dunn 2 , A. Woron 3 , D. Boxrud 4 , S. Shea 1 ; 1 Association of Public Health Laboratories, 2 Utah Public Health Laboratory, 3 Hawaii Public Health Laboratory, 4 Minnesota Department of Health Background: The food safety landscape is rapidly evolving due to emerging pathogens, changing consumer practices and food manufacturing processes, and globalization of the food supply. Public health personnel must implement updated testing technologies, strategies and tools to continue to identify, control, and prevent foodborne disease outbreaks (FBO). Since 2006, the Council to Improve Foodborne Outbreak Response (CIFOR) has been working to improve methods to detect, investigate, control and prevent FBO. CIFOR develops guidelines, processes and products that facilitate effective foodborne outbreak response among all disciplines- epidemiology, environmental health and public health laboratory. Products: The CIFOR Guidelines for Foodborne Disease Outbreak Response is a comprehensive best-practices document intended to improve the performance of foodborne disease surveillance and outbreak response across local, state and federal public health agencies. The Third Edition of the CIFOR Guidelines will incorporate new information on complaint systems and food safety testing practices including whole genome sequencing and culture independent diagnostic tests. The Third Edition will also include updated performance indicators for foodborne disease programs including the laboratory. The Outbreaks of Undetermined Etiology (OUE) Guidelines provides adequate specimens for second-tier testing and pathogen discovery should an etiology prove elusive. The guidelines provide recommendations on the collection, shipment and storage of foodborne outbreak specimens based on syndromes and specific outbreak profiles. A companion OUE Agent List provides detailed information on each agent including incubation period, primary signs and symptoms, primary specimen(s), and key epidemiological information. The Food Safety Programs Reference Guide provides a snapshot of current governmental food safety efforts aimed at detecting, investigating, controlling or preventing foodborne disease in the US. The Programs Reference Guide will help public health agencies to align activities, carry out collaborative projects, implement common strategies and avoid costly duplication of efforts. Presenter: Kirsten Larson, Association of Public Health Laboratories, Silver Spring, MD, kirsten.larson@aphl.org 50 LAB MATTERS Summer 2019 A. Woron, K. Kubota and CID Subcommittee, Association of Public Health Laboratories PulseNet, a key component of our national food safety surveillance system since 1996 is an isolate based surveillance system for bacterial enteric pathogens. Beginning in 2013, culture independent diagnostic testing (CIDT) for enteric pathogens has challenged this network and others which depend on isolates for public health surveillance. APHL’s CIDT Subcommittee surveyed local and state public health laboratories specifically looking at the implementation of multi-analyte gastrointestinal (GI) diagnostic panels by clinical and public health laboratories. Obtaining this information offers the CIDT Subcommittee the ability to assess the current use of these tests in the clinical laboratory setting and develop guidance to address any laboratory surveillance implications, especially as related to the PulseNet network as well as to measure the use of multi-analyte GI diagnostic panels within the public health setting. An online survey was distributed to local and state public health laboratory directors in January 2019. The survey consists of five main sections as follows: Results Reporting; Use of Multi-analyte GI Diagnostic Panels in Clinical Laboratories; Transport; Resources and Guidelines and Use of Multi-analyte GI Diagnostic Panels in Public Health Laboratories. Bacterial, viral and parasitic enteric pathogens are included in the survey and epidemiologist input is requested on policies and processes. We present a national view of the implementation of gastrointestinal CIDT in clinical, local and state public health laboratories. We also present current and anticipated needs as reported by public health laboratories in the form of staffing, resources and guidance with regard to gastrointestinal CIDTs. The ability for clinical laboratories to provide isolates to public health for PulseNet and other isolate-based surveillance systems has proven to be invaluable. As CIDT becomes the mainstream practice in clinical laboratories, public health surveillance will need to adapt to culture-independent methods such as metagenomics to continue critical surveillance activities. We present information on how local and state public health laboratories are adapting to new changes in clinical diagnostics and how this technology is transforming current surveillance practices today and in the future. Presenter: Amy Woron, Hawaii State Laboratories Division, Pearl City, HI, amy.woron@doh.hawaii.gov Rise in Polymicrobial Detections Driven by Increased Use of Culture-Independent Diagnostic Tests by Clinical Laboratories, Foodborne Diseases Active Surveillance Network (FoodNet) — 2011–2017 K. Barrett 1 , M. Harrigan 2 , K. Wymore 3 , B. LaClair 4 , D. Olson 5 , C. Nicholson 6 , M. Decuir 7 , M. McMillian 8 , S. McGuire 9 , J. Hatch 10 , E. Wilson 11 , A. Geissler 1 ; 1 Centers for Disease Control and Prevention, 2 Nothrop Grumman, 3 California Emerging Infections Program, 4 Georgia Department Public Health, 5 Yale Emerging Infections Program, 6 New Mexico Emerging Infections Program, 7 Minnesota Department of Health, 8 Tennessee Department of Health, 9 New York State Emerging Infections Program, 10 Oregon Health Authority, 11 Colorado Department of Public Health and Environment PublicHealthLabs @APHL APHL.org Methods: CIFOR projects are submitted to the Council for consideration and approval and must align with CIFOR’s vision and mission. CIFOR member-led work groups comprised of epidemiologists, laboratorians, environmental health specialists and regulators provide a well-rounded perspective to foodborne outbreak tool and product development. All final tools and products are vetted through CIFOR member organizations. Current State of Gastrointestinal CIDT Testing