Inform 2013 San Antonio, TX, USA November 18-21, "Innovative platforms for training and communications in PulseNet Latin America and Caribbean"

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1 Inform 2013 San Antonio, TX, USA November 18-21, 2013 "Innovative platforms for training and communications in PulseNet Latin America and Caribbean"

2 PulseNet Latin America and Caribbean Participants México Cuba Caribbean (CARPHA) Guatemala Nicaragua Costa Rica Venezuela Panama Colombia Ecuador Perú 17 National Reference Labs from 16 countries of LA & 1 Regional Reference Center from the Caribbean Chile Coordinated by - PAHO / WHO - INEI-ANLIS r. Carlos G. Malbrán Brazil (2) Bolivia Paraguay Uruguay

3 PulseNet Latin America and Caribbean Key elements: QA/QC Program Training Communication Regional atabases

4 PulseNet Latin America and Caribbean Annual meetings s Communication Since August 2008 Online meetings via Elluminate Blackboard Collaborate platform!! (hosted by PAHO)

5 Blackboard collaborate PulseNet LA & C virtual room

6 Recorded meetings

7 PulseNet LA & C Communication: Online Meetings August 2008 November 2013: 28 online conferences (6/year) Average number of participants: 12 laboratories / meeting Items discussed: - Outbreaks and IHR application. Update from the countries (Salmonella, Shigella, STEC, Vibrio cholerae) - Troubleshooting PFGE and analysis - Certification and Proficiency Test - News: training opportunities, updates from PN International Summaries sent to all the members of PN LA & C

8 PulseNet Latin America and Caribbean Training Bench and hands on analysis courses and workshops In 2010 VIEO with all the steps of PFGE protocol distributed to the PN LAC members and to representatives of PN International

9 PFGE on You Tube!!

10 PulseNet Latin America and Caribbean In 2010 Training 1st Online course on BioNumerics for PFGE analysis and data sharing Online platform hosted by PAHO/WHO. The course included 4 sessions, with examples and exercises, for the participants to complete and submit. Objectives: to strengthen the capacities for gel analysis, National atabase Management, access and queries to the Regional atabases; and to facilitate and promote analysis certification. 36 participants from 11 countries

11 Impact of innovations in PulseNet LA & C Communications strengthened (at the online meetings and interconferences). Impact on surveillance and research of FBP Improvements in capacities for PFGE gels and analysis (QA/QC program: 4 countries certified in 2008 for Salmonella, 14 in 2013) Information submitted to the Regional atabases increased (from 7 countries participating in 2008 to 14 in 2012 and from 227 isolates of Salmonella spp. uploaded to the RB from one country in 2008 to 2735 isolates from eleven countries in 2013) Furthermore, as reported by PN LAC members, 57 outbreaks were investigated in six countries applying PFGE in 2008, while in 2012, 611 outbreaks were studied in ten countries.

12 PulseNet LA & C QA/QC Certification Organisms for which certification is possible Number of laboratories certified for gels Number of laboratories certified for analysis Salmonella E. coli O Listeria monocytogenes 3 3 Shigella sonnei 9 9 Vibrio cholerae 9 6

13 PulseNet LA & C Regional atabases Up to June 2013 Pathogen # isolates submitted # PFGE patterns (first enzyme) # submitting laboratories Salmonella (Bolivia, Brasil-2 labs-, Chile, Colombia, Costa Rica, Guatemala, Paraguay, Perú, Uruguay, ) STEC O157 Listeria monocytogenes Shigella sonnei (, Chile, Cuba, Paraguay) (Chile, Costa Rica, ) 5 (Brasil, Costa Rica, Perú, Chile, ) Vibrio cholerae (Perú,, Paraguay) Campylobacter C.jejuni: 210 C.jejuni: (Paraguay, ) C.coli: 41 C.coli: 25

14 PulseNet LA & C Highlighted outbreaks and events Vibrio cholerae: study of cholera cases in Venezuela and link to Haiti strain. Over 400 patients attended a wedding in ominican Republic. January In 2013, cases in Mexico and Chile. Salmonella Typhi: outbreak in NorthEast Brazil, reported to PN LA and C. 55 cases, new subtype in the RB. January-March Salmonella Kentucky: multiresistant isolate in imported chicken. Costa Rica. Communication to PN LA and C and PN USA. March Shigella flexneri 3: outbreak in, after an event with attendance of people from Chile. Communicated to Chile and PN LA and C.

15 PulseNet LA & C Cholera cases imported in Venezuela 2011 Vibrio cholerae: study of cholera cases in Venezuela and link to Haiti strain. Gel and analysis performed in Venezuela by Lic. Sandra Fernández, Instituto Nacional de Higiene Rafael Rangel, Venezuela. Submitted by ra. Eneida López, Instituto Nacional de Higiene Rafael Rangel

16 E. coli O157 isolates from Latin America ice (Opt:1.50%) (Tol 1.5%-1.5%) (H>0.0% S>0.0%) [0.0%-98.3%] PFGE-XbaI PFGE-XbaI ARG 556/04 ALEXHX eae / ehxa / stx2c (vh-a) HUS Paraguay ARG 798/08 ALEXHX HUS CABA ARG 01/03 ALEXHX B Paraguay ARG 1010/08 ALEXHX eae / ehxa / stx2c (vh-a) HUS Chubut ARG 793/07 ALEXHX eae / ehxa / stx2only / stx1only Cuba ARG E 136/08 ALEXHX eae / stx2 unknown Chile Mcentral ARG E 137/08 ALEXHX eae / stx2 Chile Moriente ARG E 167/08 ALEXHX eae / stx2 unknown Chile Coquimbo ARG 789/07 ALEXHX Cuba ARG 791/07 ALEXHX Cuba ARG 240/09 ALEXHX eae / ehxa / stx2 / stx2c(vh-a) Paraguay ARG 241/09 ALEXHX eae / ehxa / stx2 / stx2c(vh-a) Paraguay ARG 32/09 ALEXHX HUS Buenos Aires ARG 479/09 ALEXHX HUS Catamarca ARG E 169/08 ALEXHX eae / stx2 unknown Chile Valpo San Antonio ARG E 126/08 ALEXHX eae / stx2 unknown Chile Viña Quillota ARG 52/09 ALEXHX Contact Río Negro ARG 546/09 ALEXHX B Córdoba ARG 552/09 ALEXHX B Neuquén ARG E 119/08 ALEXHX eae / stx2 Chile Moriente ARG E 121/08 ALEXHX eae / stx2 Chile Mcentral ARG 244/09 ALEXHX eae / ehxa / stx2 / stx2c(vh-a) B Buenos Aires ARG 556/09 ALEXHX La Pampa ARG 504/09 ALEXHX B Buenos Aires ARG 91/09 ALEXHX HUS Buenos Aires City ARG 1008/08 ALEXHX HUS Chubut ARG 1009/08 ALEXHX HUS Chubut ARG 1011/08 ALEXHX Chubut ARG 02/03 ALEXHX Paraguay ARG 07/09 ALEXHX HUS Buenos Aires ARG 267/09 ALEXHX B Buenos Aires City

17 PulseNet LA & C Perspectives Continue improvements in: QA/QC growing number of labs certified for gels and analysis and more people certified per lab National and Regional atabases Participation in outbreak studies and surveillance Training for next generation subtyping methods and regional capacities building Publication and presentation of results at National and International Congresses Response to international alerts and requests Technical cooperation

18 PulseNet LA & C Acknowledgements PAHO / WHO - Enrique Pérez - Alberto Mendía Regional Reference Center Isabel Chinen, Mirian Moroni, Gisela Zolezzi, Anabella ella Gaspera All the members of the Network!! From Latin America and Caribbean Reference Laboratories

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