Abstract
Infections caused by pathogens commonly acquired from consumption of food are not always transmitted by that route. They may also be transmitted through contact to animals, other humans or the environment. Additionally, many outbreaks are associated with food contaminated from these non-food sources. For this reason, such presumed foodborne outbreaks are best investigated through a One Health approach working across human, animal and environmental sectors and disciplines. Outbreak strains or clones that have propagated and continue to evolve in non-human sources and environments often show more sequence variation than observed in typical monoclonal point-source outbreaks. This represents a challenge when using whole genome sequencing (WGS), the new gold standard for molecular surveillance of foodborne pathogens, for outbreak detection and investigation. In this review, using recent examples from outbreaks investigated in the United States (US) some aspects of One Health approaches that have been used successfully to solve such outbreaks are presented. These include using different combinations of flexible WGS based case definition, efficient epidemiological follow-up, traceback, surveillance, and testing of potential food and environmental sources and animal hosts.
Highlights
Infections caused by pathogens commonly transmitted by food are common, potentially all preventable and of major public health importance
The examples provided in this paper illustrate that zoonotic outbreaks and outbreaks with a persistent environmental focus, which is typical for outbreaks in the One-Health context, are often not tightly monoclonal and may be difficult to recognize through laboratory based surveillance by whole genome sequencing (WGS)
In the examples provided in this paper, PFGE mostly provided too much discrimination between isolates or the opposite, failed to differentiate isolates that were unrelated: multiple PFGE patterns were identified in the Campylobacter outbreak but only three clones were observed by WGS with so much variation in two of them that it would have been difficult to recognize them without additional resistance and exposure information
Summary
Infections caused by pathogens commonly transmitted by food are common, potentially all preventable and of major public health importance. Outbreaks associated with contact to small pet turtles are common [(25, 26), https://www.cdc.gov/salmonella/agbeni-0817/index.html] Their characteristics are similar and here we focus on four multi-state outbreaks caused by Salmonella in 2015–16 [26] and in particular, the WGS results in one of them, a polyclonal outbreak, caused by ser. This way, four multistate outbreaks with 143 case patients from 25 states of three serotypes, Sandiego, Pomona and Poona, representing six PFGE patterns were identified This outbreak investigation included testing of human, animal and environmental isolates. The allele variation in each subcluster was
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