Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, Guelph, Ontario, Canada.
Foodborne Pathog Dis. 2013 Sep;10(9):747-56. doi: 10.1089/fpd.2012.1438. Epub 2013 Jun 20.
Most bacterial pathogens associated with human enteric illness have zoonotic origins and can be transmitted directly from animals to people or indirectly through food and water. This multitude of potential exposure routes and sources makes the epidemiology of these infectious agents complex. To better understand these illnesses and identify solutions to reduce human disease, an integrative approach like One Health is needed. This article considers the issue of Salmonella in Canada and interprets data collected by several Canadian surveillance and research programs. We describe recovery of Salmonella from various samples collected along the exposure pathway and compare the serovars detected in the different components under surveillance (animal, food, environment, and human). We then present three examples to illustrate how an approach that interprets multiple sources of surveillance data together is able to address issues that transcend multiple departments and jurisdictions. First, differences observed in recovery of Salmonella from different cuts of fresh chicken collected by different programs emphasize the importance of considering the surveillance objectives and how they may influence the information that is generated. Second, the high number of Salmonella Enteritidis cases in Canada is used to illustrate the importance of ongoing, concurrent surveillance of human cases and exposure sources to information domestic control and prevention strategies. Finally, changing patterns in the occurrence of ceftiofur-resistant Salmonella Heidelberg in retail meats and humans demonstrates how integrated surveillance can identify an issue in an exposure source and link it to a trend in human disease. Taken together, surveillance models that encompass different scales can leverage infrastructure, costs, and benefits and generate a multidimensional picture that can better inform disease prevention and control programs.
大多数与人类肠道疾病相关的细菌病原体都具有动物源性,并可直接从动物传播给人类,或通过食物和水间接传播。这些潜在的暴露途径和来源众多,使得这些传染病病原体的流行病学情况非常复杂。为了更好地了解这些疾病并找到减少人类疾病的方法,需要采用“同一健康”等综合方法。本文考虑了加拿大的沙门氏菌问题,并解释了几个加拿大监测和研究计划收集的数据。我们描述了从暴露途径中收集的各种样本中回收的沙门氏菌,并比较了在监测下(动物、食品、环境和人类)检测到的不同血清型。然后,我们提出了三个示例,说明如何通过综合解释多个监测数据源的方法来解决跨越多个部门和管辖范围的问题。首先,不同监测计划收集的不同部位新鲜鸡肉中回收的沙门氏菌的差异,强调了考虑监测目标及其如何影响生成的信息的重要性。其次,加拿大大量的肠炎沙门氏菌病例说明了对人类病例和暴露源进行持续、同步监测的重要性,这有助于了解国内控制和预防策略的信息。最后,零售肉类和人类中头孢噻呋耐药的海德堡沙门氏菌发生模式的变化表明,综合监测如何能够发现暴露源中的问题,并将其与人类疾病的趋势联系起来。总之,涵盖不同规模的监测模型可以利用基础设施、成本和效益,并生成多维图像,从而更好地为疾病预防和控制计划提供信息。