Appendix G: Evaluation of food-borne enteric illness prevention, detection and response activities at the Public Health Agency – Use of evidence

Appendix G: Use of Evidence at the Public Health Agency of Canada

Evidence on public health food safety risks is generated and used in detecting and responding to food-borne illnesses and some upstream prevention activities.

Science: Evidence produced by the Public Helath Agency Federal Public Health Action
The National Microbiology Laboratory posted a notification of a cluster of isolates to PulseNet Canada discussion board following identification of similar isolates in Quebec and Ontario. An Outbreak Investigation Coordinating Committee was activates and launched to examine this issue further. Canadian Food Inspection Agency issued a recall of certain bulk and prepackaged raw shelled walnut products, and the Public Health Agency issued a public health alert.
The Laboratory for Food-borne Zooonoses and the national Microbiology laboratory collaborated on the development of public health genomics. The National Microbiology Laboratory received Listeriosis funding to continue to devope genomics by testing on Listeria genomes. The Public Helath Agency and the province of Ontario were successful in identifying the one Canadian illness linked to the Germany Ecoli outbreak in June of 2010 - the Public Health Agency advised WHO under IHR obligations.
CIPARS examined antimicrobial resistance in chickens and the transfer of resistance of a particular antibiotic to humans - demonstrating the possible transfer of resistant strains from retail chicken to humans, and that the voluntary withdrawal of specific antibiotic at the hatchery level decreased human exposure to retail chicken. Health Canada amended the antibiotic label for the drug ceftiofur warning against use of ceftiofur outside its labelled indication.

Although a considerable amount of information is generated as a result of some upstream prevention activities, little evidence is available on the use of this information.

Science: Evidence produced by the Public Health Agency Federal Public Health Action
Research synthesis analyzes the scientific literature on food safety risk to determine the best scientific evidence. This work is usually undertaken to inform the work of other activities, especially health risk modelling activities. These activities can then rely on 'sound' literature to undertake further research and make decisions (evidence-based decision making). Information produced by research synthesis activities is not well known to the majority of food safety partners. There is limited demonstraton of use of informatin produced by this activity.
Risk modeling predicts the points in the entire system where interventins would reduce risk to public health. It includes the development of quantitative risk assessments and models. Risk assessments look at identifying specific hazards (e.g. its location, its exposure route and any potential human exposure). The analysis looks at multiple interventions and estimates which intervention would provide the optimal solution for reducing human illnesses and saving costs. Although this work has been acknowledged internationally, there is limited demonstration of use by federal food safety partners.
C-EnterNet detects changes in trends in human enteric illness and in levels of pathogen exposure from food, animal and water sources in a defined population. Ultimately, C-Enternet seeks to attribute human illnesses to their potential sources (source attribution). C-EnterNet is not fully implemented. While source attriution data is used, federal partners are looking forward to nationally representative data if/when it becomes available.
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