PulseNet and the Changing Paradigm of Laboratory-Based Surveillance for Foodborne Diseases

• Published in: Public health reports (1974) Vol. 134; no. 2S; pp. 22S - 28S
• Main Authors: Kubota, Kristy A., Wolfgang, William J., Baker, Deborah J., Boxrud, David, Turner, Lauren, Trees, Eija, Carleton, Heather A., Gerner-Smidt, Peter
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA Sage Publications, Inc 01.11.2019; SAGE Publications; SAGE PUBLICATIONS, INC
• Subjects: Agriculture departments; Case Study/Practice; Clusters; Disease; Disease control; Disease Outbreaks - prevention & control; Electrophoresis; Electrophoresis, Gel, Pulsed-Field; Epidemiology; Federal agencies; Food; Food contamination & poisoning; Food safety; Food service; Foodborne diseases; Foodborne Diseases - epidemiology; Gel electrophoresis; Gene sequencing; Genomes; Health care policy; Health surveillance; Humans; Identification methods; Illnesses; Inspection; Laboratories; Prevention; Public Health; Public health administration; Public Health Surveillance; Pulsed-field gel electrophoresis; Salmonella; Surveillance; United States - epidemiology; Whole Genome Sequencing; United States; United States > US; foodborne diseases; laboratory; surveillance
• ISSN: 0033-3549; 1468-2877
• DOI: 10.1177/0033354919881650

PulseNet, the National Molecular Subtyping Network for Foodborne Disease Surveillance, was established in 1996 through a collaboration with the Centers for Disease Control and Prevention; the US Department of Agriculture, Food Safety and Inspection Service; the US Food and Drug Administration; 4 state public health laboratories; and the Association of Public Health Laboratories. The network has since expanded to include 83 state, local, and food regulatory public health laboratories. In 2016, PulseNet was estimated to be helping prevent an estimated 270 000 foodborne illnesses annually. PulseNet is undergoing a transformation toward whole-genome sequencing (WGS), which provides better discriminatory power and precision than pulsed-field gel electrophoresis (PFGE). WGS improves the detection of outbreak clusters and could replace many traditional reference identification and characterization methods. This article highlights the contributions made by public health laboratories in transforming PulseNet’s surveillance and describes how the transformation is changing local and national surveillance practices. Our data show that WGS is better at identifying clusters than PFGE, especially for clonal organisms such as Salmonella Enteritidis. The need to develop prioritization schemes for cluster follow-up and additional resources for both public health laboratory and epidemiology departments will be critical as PulseNet implements WGS for foodborne disease surveillance in the United States.