Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, Maryland, United States.
Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, Maryland, United States.
J Food Prot. 2023 Jun;86(6):100089. doi: 10.1016/j.jfp.2023.100089. Epub 2023 Apr 5.
Foodborne outbreak investigations have traditionally included the detection of a cluster of illnesses first, followed by an epidemiologic investigation to identify a food of interest. The increasing use of whole genome sequencing (WGS) subtyping technology for clinical, environmental, and food isolates of foodborne pathogens, and the ability to share and compare the data on public platforms, present new opportunities to identify earlier links between illnesses and their potential sources. We describe a process called sample-initiated retrospective outbreak investigations (SIROIs) used by federal public health and regulatory partners in the United States. SIROIs begin with an evaluation of the genomic similarity between bacterial isolates recovered from food or environmental samples and clusters of clinical isolates while subsequent and parallel epidemiologic and traceback investigations are initiated to corroborate their connection. SIROIs allow for earlier hypothesis generation, followed by targeted collection of information about food exposures and the foods and manufacturer of interest, to confirm a link between the illnesses and their source. This often leads to earlier action that could reduce the breadth and burden of foodborne illness outbreaks. We describe two case studies of recent SIROIs and present the benefits and challenges. Benefits include insight into foodborne illness attribution, international collaboration, and opportunities for enhanced food safety efforts in the food industry. Challenges include resource intensiveness, variability of epidemiologic and traceback data, and an increasingly complex food supply chain. SIROIs are valuable in identifying connections among small numbers of illnesses that may span significant time periods; detecting early signals for larger outbreaks or food safety issues associated with manufacturers; improving our understanding of the scope of contamination of foods; and identifying novel pathogen/commodity pairs.
食源性疾病暴发调查传统上包括首先检测到一组疾病，然后进行流行病学调查以确定相关食品。越来越多的临床、环境和食品食源性致病菌全基因组测序（WGS）亚型技术的应用，以及在公共平台上共享和比较数据的能力，为更早地发现疾病及其潜在来源之间的联系提供了新的机会。我们描述了一种称为样本启动回顾性暴发调查（SIROI）的方法，该方法由美国联邦公共卫生和监管伙伴使用。SIROI 从评估从食品或环境样本中回收的细菌分离物与临床分离物簇之间的基因组相似性开始，同时启动后续和并行的流行病学和追溯调查以证实它们之间的联系。SIROI 允许更早地提出假设，然后有针对性地收集有关食物暴露和相关食品及制造商的信息，以确认疾病与来源之间的联系。这通常会导致更早的行动，从而减少食源性疾病暴发的范围和负担。我们描述了两个最近的 SIROI 案例研究，并介绍了其益处和挑战。益处包括深入了解食源性疾病归因、国际合作以及加强食品行业食品安全工作的机会。挑战包括资源密集度、流行病学和追溯数据的可变性以及日益复杂的食品供应链。SIROI 对于识别跨越较长时间跨度的少数疾病之间的联系、检测与制造商相关的更大暴发或食品安全问题的早期信号、提高我们对食品污染范围的理解以及识别新的病原体/商品对非常有价值。
