The PulseNet USA WebBoard A Rapid Alert and Information Sharing System

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The PulseNet USA WebBoard A Rapid Alert and
Information Sharing System

• Peter Gerner-Smidt
• CDC, Atlanta, USA
• 5th Annual Meeting PulseNet America Latina,
  October 23, 2007

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Communication Within PulseNet

• Submission of patterns to a PulseNet Server
• By email to the database management
• By uploading the patterns directly to the server
• Discussion forum
• The WebBoard
• The PulseNet Web-site
• www.cdc.gov/pulsenet
• The PulseNet Newsletter
• Meetings workshops training courses
• Direct communication between participants

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What is the WebBoard?

• The PulseNet Listserv
• A closed non-moderated electronic discussion
  forum (password protected)
• Available to PulseNet participants and foodborne
  epidemiologists
• Rapid alert system for outbreaks of foodborne
  infection
• Discussion and information sharing forum

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PulseNet WebBoard

• All participants at the same time
• PulseNet participants get access to the WebBoard
  by sending an email to the PFGE mailbox
  (PFGE_at_cdc.gov)
• Must sign a non-disclosure agreement for access
• PulseNet participants approve access to the
  WebBoard of foodborne epidemiologists in their
  region
• Foodborne epidemiologists must also sign a
  non-disclosure agreement for access

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PulseNet WebBoard Entry Screen
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PulseNet WebBoard Entry Screen- The alternate
(blue) version
A third version is under way and will be
implemented in 2008
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WebBoard Conferences
Some of the conferences on the PulseNet USA
WebBoard
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Update Meeting 2006
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General PulseNet Information
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Important PulseNet Documents
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PulseNet QA-QC Manual
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Salmonella Cluster Alert
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Cluster Detection

• A cluster is detected
• By PulseNet (state lab or CDC)
• By epidemiologists (state or CDC)
• Cluster is posted on WebBoard
• CDC database manager verifies patterns and
  assigns outbreak code
• Patterns that are not verified by CDC database
  team should only be reported as possible
  matches
• CDC database manager posts results to WebBoard
  and notifies epi liaison at CDC
• PulseNet labs respond to posting
• CDC database manager updates as necessary

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WebBoard Alert Protocol

• For initial postings for clusters or outbreaks
• Submit information to the appropriate PulseNet
  database or
• E-mail to the PulseNet database manager
  (PFGE_at_CDC.gov) and
• Then submit information to the WebBoard
• Initial postings should contain this information
• State(s) included in cluster
• Serotype and Shiga toxin type for E. coli
  (O157H7 or other STEC)
• TIFF must be included with lane identification
  (enzyme and standard lanes) indicate if second
  enzyme is pending
• PulseNet bundle file (if available)
• Identify lanes that contain cluster isolates
• Additional information such as more isolates
  pending, isolation date, frequency of pattern and
  epi information

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WebBoard Alert ProtocolResponse Postings

• For response postings number of matches to the
  cluster pattern within the past 60 days for E.
  coli, Salmonella, Shigella, Vibrio and
  Campylobacter or 120 days for Listeria
• Isolate numbers and/or TIFF name should also be
  provided in the response posting

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E. coli O157H7 in Vacuum-packed Steaks,
2003 WebBoard Within 5 days there were 20
response postings.
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Steak Outbreak-Associated E. coli O157H7 Cases,
2003
1
1
8
8
1
1
1
2
1
1
1
1
1
1
1
1
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USDA Investigation of Processing Plant

• Flavoring Injection and/or Needle-Tenderizing
  Transferred E. coli O157H7 to the Interior of
  the Steaks.

Recall occurred 12 days after WebBoard posting
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PulseNet Outbreak Codes

• Basic code
• ltDate yymmgtltGeographic locationgtltserotype
  (Salmonella and Shigella)gt ltnumber of outbreak in
  monthgt
• In some cases the basic code will include
• ml to indicate multi-locational (multi-state)
• c to indicate that it is a cluster that has not
  yet been confirmed by epis as an outbreak
• ? to indicate that the status is not firmly
  established
• PulseNet guidelines for naming outbreak
  codes/clusters is posted on the WebBoard under
  the conference Important PulseNet Documents

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PulseNet Outbreak Codes

• Examples
• 0406FL-1c is the first cluster that was
  discovered in Florida in June 2004
• If this cluster becomes an outbreak, the code
  will become 0406FL-1
• If this outbreak becomes multi-state, the code
  will become 0406FL-1ml
• If another cluster appears in FL during the same
  month, the second cluster code will be 0406FL-2c

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Pulling it all Together

• Recommendations
• Request WebBoard access via PulseNet lab
• Unsubscribe to mailing lists to avoid receiving
  hundreds of emails
• Check WebBoard daily if involved in an outbreak
• make note of outbreak code
• How it works at CDC
• Database manager sends updated spreadsheets to
  PulseNet liaison and copies CDC epidemiologists
• CDC epidemiologists send updates to the PulseNet
  liaison and copies database manager

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Comments on WebBoard

• We encourage PulseNet participants to use the
  WebBoard
• Queries
• Pattern comparisons
• Troubleshooting assistance
• Share unusual findings
• Remember replies to the WebBoard will go to all
  WebBoard members on the conference--not just the
  message originator

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PulseNet USA Web-Sitewww.CDC.gov/pulsenet
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PulseNet USA Newsletter
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Questions?

• Thank you!