Page 27 - Driving Public Health in the Fast Lane

bioinformatics use high performance computing methods to analyze vast quantities of genetic data.
When epidemiologists investigate foodborne outbreaks, they can now leverage AMD to quickly link
genetically related clusters of illness to contaminated food. AMD is replacing the less accurate PulseNet
15
technology developed in the 1990s for foodborne outbreak detection and response. However, like PulseNet
data, AMD data cannot not stand on its own. It still needs to be linked to other epidemiological data such
as case interviews and environmental tests in order to pinpoint the cause or source of the outbreak and
implement optimal control measures. A comprehensive public health response will require interoperable
data systems between the public health laboratory and epidemiologists.

Follow the Data

While the exchange of data from local and state public health laboratories to federal agencies has been
well established, substantive limitations in overall data exchange during foodborne outbreaks still exist.
In addition to sending data to federal agencies, the public health laboratory must also share that data
with epidemiologists in their local jurisdictions. Food exposure information, which is necessary to link
disease clusters to the contaminated food source, is collected in the field through case interviews and
requires data exchange between epidemiologists, laboratories, and federal agencies. Although some
public health laboratories have set up electronic systems to exchange foodborne data to epidemiologists,
this is not widespread. Public health laboratories still rely heavily on time-consuming manual data entry
into spreadsheets, phone calls, faxes and emails. In some instances, an epidemiologist will drive to the
public health laboratory twice per week to physically pick up lab reports and bring them back to the
health department for manual data entry. As a result, real-time data are not exchanged, creating a traffic
jam of information. Anecdotes from the field have also highlighted situations where the quickest way to
share outbreak-related data was to email a cell phone photo of a computer screen because the software
and system between the sender and receiver
were not interoperable, and thus incapable of
data exchange. When time is of the essence In some instances, an
in a foodborne outbreak for both preventing
further illness and not adversely impacting or epidemiologist will drive to the
implicating the wrong industry, these methods public health laboratory twice
delay responses and leave important health
information vulnerable to human error such per week to physically pick up
as inaccurate transcription, keying errors,
duplicated or incomplete data entry, or no lab reports and bring them back
information. to the health department for

Measles Resurgence manual data entry.

The nation is in the midst of a massive measles
resurgence and cases are at the highest since
the United States eliminated the disease in 2000. A vaccine-preventable disease, measles is a highly
contagious infection that causes high fever, coughing, conjunctivitis, and rashes. Complications can range
from mild to severe, including ear infections, pneumonia, encephalitis, and death. Since one infected
person can spread the disease through coughing and sneezing to 90 percent of unvaccinated people
around them—even two hours after leaving a room or defined air space—a timely and swift public health
response to a measles outbreak is critical.

15 Advanced Molecular Detection: An In-Depth Look. cdc.gov. https://www.cdc.gov/amd/pdf/amd-indepth-look-P.pdf..

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