Surveillance Of Food And Waterborne Diseases In The Eu

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ISBN 13 : 9789291933792
Total Pages : 69 pages
Book Rating : 4.9/5 (337 download)

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Download or read book Survey of National Reference Laboratory (NRL) Capacity for Six Food- and Waterborne Diseases in EU/EEA Countries written by and published by . This book was released on 2012 with total page 69 pages. Available in PDF, EPUB and Kindle. Book excerpt: Data from National Reference Laboratories (NRLs) play an important part in European surveillance of food- and waterborne infectious disease. In 2009, a survey was conducted to obtain an idea of the availability and capacity of services offered by National Reference-level Laboratories in EU and EEA countries in relation to six priority food and waterborne pathogens: Campylobacter, Listeria, Salmonella, Shigella, Shiga toxin/verotoxin-producing Escherichia coli (STEC/VTEC) and Yersinia. The survey was administered in the form of six questionnaires (i.e. one per pathogen) and sent to 118 contact points identified in the Member States on 2 July 2009. The deadline for returning the questionnaire to ECDC was 24 August 2009. The analyses were performed in 2010, and the interpretation of the findings started in January 2012. The survey covered a number of topics: pathogen-specific methods in use in the NRLs, for (a) detection and confirmation, (b) further characterisation and (c) antimicrobial susceptibility testing (AST); participation in External Quality Assessment (EQA) schemes and relationship of the NRL with national institutes of health. There were also questions on training and needs in relation to EQA schemes and method standardisation/harmonisation. The overall response rate was high (80% or more) although no responses were received from any contact points for any/most pathogens in some countries and incomplete responses from others. Despite this limitation, the survey is the most comprehensive to date of reference laboratory capacity for six food- and waterborne diseases in Europe and provides a baseline for assessing this capacity and identifying gaps. Designated NRL services are comparably most complete for Salmonella, even though there is considerable heterogeneity in the number and level of characterisation of the isolates. Campylobacter, the most common bacterial cause of diarrhoea, has a lack of designated NRLs in many countries, often concurrent with limited capacity to characterise (even to species level). STEC/VTEC detection and characterisation services are generally available but the characterisation varies from the ability to detect a single serotype (O157), without the capacity to confirm toxin gene, to the capacity to characterise all recognised variants of this complex group of pathogens. NRL services for Listeria, Shigella and Yersinia are similarly very diverse. Across all pathogens, antimicrobial susceptibility testing also varies widely from comprehensive in some laboratories to non-existent in others. For the emerging AMR threats amongst the Enterobacteriaceae, nearly all laboratories do susceptibility testing for one or more agents that would allow detection of extended spectrum beta-lactamases (ESBLs) but few are testing for agents that would allow detection of carbapenemase-producing Enterobacteriaceae (CPE). Molecular methods for characterisation are available in most but not all laboratories for some or all pathogens. A working relationship with the national institute of public health is generally in place. This is important to ensure that the NRL services function as part of a real-time public health protection infrastructure and not as an isolated exercise. Quality management systems are in place in many laboratories in the form of accreditation according to ISO standards (17025 or 15189) and most laboratories have both internal and external quality control systems in place. The extent to which NRL services depend on ECDC and the Global Foodborne Infections Network (formerly Global Salm Surv) for specialised EQA is highlighted by the findings of the survey. Laboratories generally acknowledge the need for further training and harmonisation/standardisation of methods across Europe to improve their contribution to the protection of public health. The most striking finding emerging from this survey is the lack of consistency in NRL capacity across Europe. Various European countries have little or no effective reference laboratory capacity to confirm or characterise some important food- and waterborne pathogens. In the context of European systems to support free movement of goods (food) and people, outbreaks of food-borne infectious disease or changing trends are European issues. However, at present, the capacity for laboratory detection and confirmation of outbreaks and changing trends in relation to food-borne infection is very weak across large parts of Europe. This divide in terms of NRL capacity represents a serious weakness in capacity for early detection and response. Although training and standardisation of methods and provision of external QA systems emerge from this survey as important supports that ECDC can provide to NRL services, the fundamental problem is the lack of laboratory capacity in some countries to support effective day-to-day public health action. This report highlights the urgent need to harmonise NRL services across Europe in terms of methods and to ensure the minimum operational capacity required to contribute to a Europe wide network for public health protection.