Appendix F: Evaluation of food-borne enteric illness prevention, detection and response activities at the Public Health Agency – Surveillance systems 

Appendix F: Surveillance Systems Description

The Public Health Agency coordinates surveillance systems in the prevention, detection and response to food-borne enteric illness.

Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS)

CIPARS analyses and communicates trends in antimicrobial use and resistance in selected bacteria from humans, animals, and animal-derived food sources across Canada. Emerging bacteria resistant to antibiotics is of increasing concern for public health. Use of antibiotics in humans as well as food animals can create food related antimicrobial resistance, which can spread to humans. CIPARS provides a unified approach to monitor trends in antimicrobial resistance and antimicrobial use in humans and animals. Information about these trends is intended to contribute to evidence-based policies to manage antimicrobial use in human medicine, veterinary medicine, and agricultural sectors and the assessment of these control measures.Footnote 109

National Integrated Enteric Pathogen Surveillance (C-EnterNet) Program

The C-EnterNet program supports activities intended to reduce the burden of food-borne enteric illness. The program detects trends in human enteric illness and identifies the proportion of a particular disease acquired from a specific source. It is an active surveillance system that collects data from specific communities participating as sentinel sites. There are two sentinel sites: the Regional Municipality of Waterloo, Ontario and the Fraser Valley in the lower mainland of British Columbia.Footnote 110 C-EnterNet coordinates the collection of pathogens in water, retail food and on the farm in collaboration with regional and provincial partners at the sentinel sites. Cases of human enteric illness are identified based on the province’s passive surveillance reporting system. Isolates from suspect cases of enteric illness are further tested by provincial and federal laboratories and sent back to the sentinel site to link with other data. Surveillance data are used for source attribution research and other targeted research related to food and water consumption.Footnote 111

National Enteric Surveillance Program (NESP) and PulseNet Canada

NESP provides weekly analysis and reporting for laboratory-confirmed enteric pathogens in Canada. Laboratory and epidemiological national surveillance is coordinated through and the National Microbiology Laboratory’s PulseNet Canada and NESP where enteric food-borne illnesses are monitored and clusters are identified. The PulseNet discussion board is updated several times each day and includes discussion threads that are unique to each pathogen. Two or more cases of the same type and same DNA fingerprinting patterns are considered a cluster. The DNA fingerprinting test is performed on cases of food-borne illness at provincial public health laboratories and results are sent in real-time to PulseNet Canada.

Compilation and analysis of these weekly data are then conducted jointly between the National Microbiology Laboratory and the Centre for Food-borne, Environmental and Zoonotic Infectious Diseases. These weekly reports provide the Public Health Agency and the provincial partners with the first triggers that a significant food-borne disease trend is emerging. PulseNet Canada then utilizes these data in conjunction with laboratory DNA fingerprinting testing to detect clusters of outbreaks at the earliest possible stage, and to serve as a primary data sharing and communications link between all provincial public health microbiology laboratories, the Canadian Food Inspection Agency and Health Canada.Footnote 112 The Canadian Food Inspection Agency performs the same DNA fingerprinting tests on pathogens found in food products; results are posted on the PulseNet discussion board. Public health investigators use the DNA fingerprinting tests to pinpoint which patients are ill with the same pathogen, and then trace back the source of these illnesses by matching to the fingerprint of pathogens from food or water samples.

These two complementary laboratory surveillance networks lead to information sharing and a coordinated assessment of the laboratory evidence during multi-jurisdictional epidemiologic investigations.

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