During the recent E. coli spinach contamination outbreak, officials at the Wisconsin state public health lab posted E. coli patterns on a PulseNet list serve that helps track this pathogen. Not long after, health department analysts in Oregon were alerted to this information, and linked an E. coli case in their state to a possible bag of spinach.

This is a concrete example of how the online public health network – PulseNet — is helping officials track disease outbreaks, says Sarah Pressman Lovinger. PulseNet is a national network of public health and food regulatory agency laboratories coordinated by the Centers for Disease Control and Prevention. The network consists of: state health departments, local health departments, and federal agencies including the CDC, USDA/FSIS, and FDA.

PulseNet participants perform standardized molecular subtyping of foodborne disease-causing bacteria by pulsed-field gel electrophoresis. PFGE can be used to distinguish strains of organisms such as Escherichia coli O157:H7, Salmonella, Shigella, Listeria, or Campylobacter at the DNA level. DNA "fingerprints," or patterns, are submitted electronically to a dynamic database at the CDC. These databases are available on-demand to participants—this allows for rapid comparison of the patterns.
 

Change in food-borne illness control became necessary because of the way food is distributed in the United States, reports Susan Brink of the Times. In the old days of food poisoning, the source usually could be traced back to a local event: potato salad at a family picnic or bad chicken at a church supper. Today, with massive amounts of food going from farms to food processing centers and then mixing with food from other farms before heading to tables in all 50 states, outbreaks are far less likely to be local, and thus, far more difficult to notice.

The change that came out of the 1993 Jack-In-The-Box tragedy is called PulseNet, a partnership between the CDC and state health departments. Stool samples are sent to state public health departments by doctors. The health departments then use DNA analysis to subtype pathogenic bacteria present in the stools. The resulting DNA fingerprints can identify not only species but also strains of such bacteria as E. coli, salmonella, shigella, listeria and Campylobacter.

Then the information gets sent to a central CDC database. This can quickly let public health officials know if cases strewn far and wide across the country carry identical fingerprints.

Epidemiologists also weigh in, fanning out within affected states and using food questionnaires to find out what people had eaten before getting sick (in the current outbreak, identifying pre-washed, bagged spinach).

But this is still not a perfect system, says Bala Swaminathan, acting senior advisor for laboratory science at CDC’s division of food-borne safety.. It typically takes three to four days for a patient’s symptoms to kick in, a day or two before the patient seeks medical care, then up to three days for results from a stool sample to reach the physician. And frustrating slowdowns can come from something as simple as how long it takes for positive results to make their way from a physician’s office to state labs and then into the PulseNet database.

In some states, reporting can happen the same day the physician gets lab results. In others, it can take up to a week. And all this time, Americans — oblivious to any problem — continue to eat the contaminated food.

This September is National Food Safety Education Month.

It is estimated by the Centers for Disease Control and Prevention that 76 million people get sick, more than 300,000 are hospitalized, and 5,000 Americans die each year from food-borne illness.

The Jefferson County Department of Health and Environment is celebrating food safety month with educational displays and the Leader in Food Safety Award. The Food Safety Program works to prevent food-borne illness outbreaks and assure that Jefferson County citizens and visitors are provided with safe food. Staff routinely inspect the over 1,800 food service establishments in the County to insure compliance with state regulations and to educate about food safety.

Throughout the month of September, the public is encouraged to visit one of the six educational displays set up in the Jefferson County libraries. This year’s display theme "Don’t Let Food-borne Illness Spoil a Good Meal" highlights the most common food borne illnesses and how to prevent them; the importance of proper hand-washing in fighting the spread of disease as well as information on getting the most nutrition out of your meals. An additional food safety display will be in the atrium of the Jefferson County Courts and Administration Building.