From 2003-2007, researchers from Japan and the United States examined the occurrence of new toxigenic serogroups of Vibrio cholerae in the Southeastern United States. The cases discussed within the study reveal that toxigenic Vibrio cholerae 075 may be an emerging infectious disease capable of capable of causing severe diarrheal illness.
Clinical Infectious Diseases article
PFGE analysis performed according to the PulseNet Salmonella protocol by researchers in Europe and the United States, and shared through the PulseNet International network and the former European Enter-net, was instrumental in delineating this outbreak caused by Salmonella Senftenberg and confirming its source: fresh basil from Israel.
In November 2006, PulseNet USA detected a cluster of indistinguishable PFGE patterns of Salmonella Tennessee in ten states. This cluster triggered an epidemiologic investigation that determined a common exposure among all the cases in the United States to two brands of peanut butter produced at the same facility. The plant was closed and the peanut butter recalled. Alerts that included the PFGE outbreak pattern were issued to PulseNet International participants since the brands had been exported to various countries around the world. No case-patients were identified outside the United States but the outbreak strain was detected by the Philippine participant in a peanut butter jar exported to this country indicating the international dimension of the outbreak.
Two outbreaks of Shigella sonnei infections simultaneously detected in Denmark and Australia were found to be linked to the same baby corn packing house in Thailand. PulseNet played a key role in confirming this link when isolates from Denmark and Australia were found to display indistinguishable PFGE patterns.
A joint investigation between the Canadian Food Inspection Agency and the USA Department of Agriculture's Food Safety and Inspection Service (USDA/FSIS) identified a likely source of a multi-state outbreak of Escherichia coli O157:h7 infections linked to a meat company in the USA, which had imported beef trim from a Canadian beef-producing firm. The outbreak was significant in terms of both its economic and public health impact as 21.7 million pounds of meat were recalled (one of the biggest ever in the USA), and a total of 40 cases of E. coli O157:h7 infection were identified. PulseNet USA and PulseNet Canada played an instrumental role in linking the human cases of E. coli O157 to the contaminated ground beef originating in Canada and distributed in the United States. Using the PulseNet system, investigators compared the DNA fingerprints of E. coli O157 strains found in the beef trim in the Canadian firm and the ground beef in the American plant, with those of E. coli O157 strains isolated from ill persons in both countries.
In September 2004, investigations of two outbreaks of Shigella sonnei took place simultaneously in Japan and the United States. The collaboration through PulseNet International linked both outbreaks to the same source: air travel to Hawaii. In the United States, the Hawaii Department of Health contacted the Minnesota Department of Health (MN) to inform them of a potential outbreak of S. sonnei associated with domestic and international air travel to Hawaii. PulseNet USA participants in the MN laboratory alerted the rest of PulseNet USA via the PulseNet listserv by posting two different S. sonnei patterns digested with XbaI that were obtained from patients who had recently traveled to Hawaii. In response to the posting, the public health laboratories in Hawaii, Michigan, New Jersey and Texas reported similar patterns, all of which were associated with Hawaii travel. Concurrently, investigators in Japan investigated a similar S. sonnei outbreak, and alerted PulseNet USA about it due to a suspected link to travel to Hawaii. The link was microbiologically confirmed through exchange of PFGE patterns and strains between the countries using PulseNet International. The epidemiological investigation pointed to salad served on-board the associated airplanes leaving from Hawaii as the most likely source of the outbreak. PulseNet data was instrumental in providing the microbiological evidence for a link between Japanese and US shigellosis cases. This outbreak illustrates how the increase in world travel increases the opportunity for dispersion of bacterial disease. It is also a good example of the key role that PulseNet International plays in the investigation of foodborne disease outbreaks with global implications.
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