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Surveillance
CDC currently has six surveillance systems for obtaining information
about E. coli O157:H7. They serve different purposes and
provide information on various features of the organism's epidemiology.
- Public Health Laboratory Information System (PHLIS)
PHLIS is a passive, laboratory-based surveillance system that
collects data about many infections, including E. coli O157:H7.
Reporting is limited to illnesses that are confirmed by culture
and verified at the state public health laboratory. After verification,
information about the infection is reported electronically to
CDC by the state http://www.cdc.gov/ncidod/dbmd/phlisdata.
- National Electronic Telecommunications System for Surveillance
(NETSS)
NETSS is a passive, physician-based surveillance system that
captures both laboratory-confirmed and clinically suspected
cases of all nationally notifiable diseases, including E.
coli O157:H7. The number of illnesses reported through NETSS
tends to be higher than the number reported through PHLIS because
NETSS does not require confirmation by the state public health
laboratory. More information on NETSS can be found at http://www.cdc.gov/epo/dphsi/netss.htm.
E. coli O157:H7 infections and other surveillance data collected
by NETSS is published weekly in the CDC Morbidity and Mortality
Report (MMWR) and can be found at http://www2.cdc.gov/mmwr.
The MMWR also publishes an annual summary of the NETSS E.
coli O157:H7 surveillance data; this information can be
found at http://www2.cdc.gov/mmwr/summary.html.
- FoodNet
The Foodborne Diseases Active Surveillance Network (FoodNet)
is an active surveillance system for identifying and characterizing
culture-confirmed infections that may be foodborne, including
E. coli O157:H7. FoodNet workers regularly contact more
than 300 laboratories for confirmed cases of foodborne infections
in several states encompassing a population of more than 25
million persons. In addition to monitoring the number of E.
coli O157:H7 infections, investigators monitor laboratory
techniques for isolation of bacteria, perform case-control studies
of ill persons to determine foods associated with illness, and
administer questionnaires to people living in FoodNet sites
to better understand trends in the eating habits of Americans.
Annual FoodNet reports that include data about E. coli
O157:H7 can be found at http://www.cdc.gov/foodnet/annuals.htm.
More information on FoodNet can be found at http://www.cdc.gov/foodnet.
- National Molecular Subtyping Network for Foodborne Diseases
Surveillance (PulseNet)
PulseNet is a national network of public health laboratories
that perform pulsed-field gel electrophoresis (PFGE), a type
of DNA "fingerprinting", on certain foodborne bacteria, including
E. coli O157:H7. PFGE "fingerprint" patterns are submitted
electronically to CDC and can be compared rapidly with others
in a large database. This system can help determine if individual
infections are related or if an outbreak is occurring. PulseNet
is not a surveillance system itself but a laboratory subtyping
method used in surveillance. More information on PulseNet can
be found at http://www.cdc.gov/pulsenet
- National Antimicrobial Resistance Monitoring System (NARMS)
NARMS is a passive surveillance system that monitors antimicrobial
resistance of E. coli O157:H7 and selected other bacteria
that cause human illness. NARMS is a collaboration between CDC,
16 state and local health departments, the Food and Drug Administration
(FDA), and the United States Agricultural Department (USDA).
More information on NARMS can be found at http://www.cdc.gov/narms.
- Foodborne Outbreak Detection Unit
CDC monitors outbreaks of foodborne disease, including outbreaks
caused by Shigella. Each year, state and territorial
epidemiologists voluntarily (passively) report the results of
outbreak investigations to CDC. While outbreaks account for
a small percentage of the total number of illnesses that occur
each year, these investigations provide valuable information
about sources of foodborne infection and often highlight important
prevention opportunities. The latest summaries of foodborne
outbreaks can be found at http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/ss4901a1.htm.
Annual summaries of E. coli O157:H7 outbreaks are reported
to the Council of State and Territorial Epidemiologists. The
most recent annual reports can be found at the following links:
MMWR Articles
Outbreaks of Escherichia coli O157:H7 Infections Among
Children Associated With Farm Visits --- Pennsylvania and Washington,
2000 MMWR
April 20, 2001 / Vol. 50 / No. 15
Outbreak of Escherichia coli O157:H7and Campylobacter
Among Attendees of the Washington County Fair --- New York, 1999
MMWR
September 17, 1999/ Vol. 48 / No. 36
Outbreaks of Escherichia coli
O157:H7 Infection and Cryptosporidiosis Associated with Drinking
Unpasteurized Apple Cider - Connecticut and New York, October
1996
MMWR
January 10, 1997 / Vol. 46 / No. 1
Outbreak of E. coli
O157:H7 Infections Associated with Drinking Unpasteurized Commercial
Apple Juice - October 1996
MMWR
November 9, 1996 / Vol. 45 / No. 44
Outbreak of Acute Gastroenteritis Attributable to Escherichia
coli Serotype O104:H21 - Helena, Montana, 1994
MMWR
July 14, 1995 / Vol. 44 / No. 27
Enhanced Detection of Sporadic Escherichia coli O157:H7
Infections - New Jersey, July 1994
MMWR
June 9, 1995 / Vol. 44 / No. 22
Escherichia coli O157:H7 Outbreak at a Summer Camp -
Virginia, 1994
MMWR
June 9, 1995 / Vol. 44 / No. 22
Links
FoodNet
PulseNet
E. coli
Index
References
Bender JB, Hedberg CW, Besser JM, et al. Surveillance for Escherichia
coli O157:H7 infections in Minnesota by molecular subtyping.
N Engl J. Med 1997; 337:388-94.
Mahon BE, Griffin PM, Mead PS, Tauxe RV. Hemolytic uremic syndrome
surveillance to monitor trends in infection with Escherichia
coli O157:H7 and other shiga toxin-producing E.coli.
Emerg Infect Dis 1997; 3:409-12.
Mead PS, Griffin PM. Escherichia coli O157:H7. Lancet
1998; 352: 1207-12.
Slutsker L, Ries AA, Greene KD, et al. Escherichia coli O157:H7
diarrhea in the United States: clinical and epidemiologic features.
Ann Intern Med 1997; 126:505-13.
Boyce TG, Pemberton AG, Wells JG, Griffin PM. Screening for Escherichia
coli O157:H7-a nationwide survey of clinical laboratories. J Clin
Microbiol 1995; 33:3275-7.
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