1999 Winner
U.S. Department of Health and Human Services
Innovations in American Government Awards
Innovations in American Government Awards
From November 15, 1992, through February 28, 1993, more than 500 laboratory-confirmed infections of E. coli and four associated deaths occurred in four states: Washington, Idaho, California, and Nevada. After six weeks of investigation, the CDC discovered that this outbreak of foodborne illness resulted from consumption of hamburgers from a fast food restaurant chain. The origin's identification was made possible when the Centers for Disease Control and Prevention (CDC) applied a new DNA technology that could link interstate outbreaks by locating the disease's genetic fingerprint. Thus, the source of the disease was located and the outbreak successfully terminated. After witnessing the success of DNA fingerprinting, state public health departments began to inundate the CDC with requests for genetic typing of other foodborne bacteria for their other ongoing disease investigations.
Dr. Bala Swaminathan, Chief of the Foodborne and Diarrheal Diseases Laboratory Section of the CDC decided that it was time to transfer the DNA technology to selected state health departments to empower their investigations. But when they decentralized the typing process, Dr. Swaminathan also managed to standardize the typing process through computer analysis, so that the CDC could compare regional fingerprints. Thus the National Molecular Subtyping Network for Foodborne Disease Surveillance, later known as PulseNet, was created.
The standardization of procedure and fingerprinting has permitted state laboratories to produce results in one day; before it took four. The program has also developed a digital method for describing the DNA fingerprint so that a fingerprint can be sent electronically instead of exchanging the actual specimens among labs. This reduced the comparison process from several days to less than 24 hours. This increase in the ability to detect and contain foodborne illness has had a powerful, positive effect on pubic health.
Another positive result is that the U.S. ground beef supply is safer. Using outbreaks identified by PulseNet, the U.S. Department of Agriculture is aggressively identifying production and processing practices that lead to contamination of the U. S. meat supply.
When outbreaks do occur, the CDC and state health services are much better prepared to respond. For instance, in 1998 an outbreak of E. Coli. similar to the outbreak of 1993, occurred in the Northeastern U.S. The outbreak occurred in several states and its origin was a fast food restaurant chain. In this new outbreak, only ten days elapsed between recognition and the subsequent recall of the meat: 35 days sooner than in 1993.
Had the CDC been able to intervene as quickly in 1993, they estimate that they could have prevented more than 500 infections and saved the lives of several children whose infections had developed into hemolytic uremic syndrome. PulseNet is literally saving lives.
The CDC is taking the success of PulseNet even further. There are over 30 laboratories participating in the United States, and to date, the CDC has shared PulseNet protocols with national public health laboratories in Canada, the United Kingdom, France, Germany, Denmark, Sweden, Finland and Japan. With its implementation of medical and computer technology, as well as its interstate and international collaboration, PulseNet has created an unprecedented worldwide efficiency in monitoring and investigating foodborne illness.


Related Documents