Food Emergency Response Network

Recognizing the need to respond quickly to foodborne disease outbreaks, the federal government created the Food Emergency Response Network (FERN), an effort to integrate the nation's food testing laboratories and improve response to the contamination of food (also discussed in Chapter 8). Roughly analogous to the CDC's Laboratory Response Network (LRN), FERN's members include federal, state, and local agencies. They include the FDA, CDC, USDA, Environmental Protection Agency (EPA), Department of Defense, Federal Bureau of Investigation (FBI), and Department of Homeland Security (DHS), state departments of public health and agriculture, and diagnostic veterinary laboratories. FERN's goals are to enhance surveillance sampling activity; improve laboratory capabilities, including "surge'' capabilities (to handle a large outbreak); and help re-establish the safety of the food supply and consumer confidence. FERN improves laboratory capabilities through training, proficiency testing, method validation/development, improved surveillance, and communication. As of May 2005, 99 laboratories in 44 states and Puerto Rico operate in FERN. It is noteworthy that this laboratory network can also assist in evaluating water-borne contamination.

FERN's communication backbone is the Electronic Laboratory Exchange Network (eLEXNET), the first Internet-based food safety data network in the United States (Counter Terrorism Food Emergency Response Network, 2003). When launched in 2002, eLEXNET held data on Escherichia coli O157:H7, Listeria monocytogenes, Campylobacter jejuni, and Salmonella species (Levitt, 2003), but it has expanded to include thousands of analytes. eLEXNET's database of food sample and laboratory data is available online, and offers data mining and analysis tools such as On-Line Analytical Processing as well as a geographical information system. eLexNet communicates with LRN.

FERN intends to integrate three other communication and data networks under its organizational umbrella:

• FoodNet—In 1995, the FDA, USDA and CDC launched the Foodborne Disease Active Surveillance Network (FoodNet).

• PulseNet (discussed in Chapters 3, 5, and 8)—In May 1998, the federal government launched PulseNet, an Internet-based network and database linking food safety investigators at the CDC, FDA, USDA, and state public health laboratories. The network relied on pulsed-field gel electrophoresis (PFGE) to identify pathogen strains. By 2000, PulseNet linked all 50 states to a communication and laboratory data net, which reduced the time required to determine the strain of a microbe from 3 weeks to as little as 48 hours (Office of the Vice President, 1998). In 2001, PulseNet processed more than 25,000 pattern submissions (FDA, 2001). It is now possible to trace a contaminated source where, previously, (owing to the complex distribution system for food), we would not even have known that an outbreak had occurred. Agribusinesses may also detect outbreaks if they independently receive a report or reports of illness associated with a product.

• National Antimicrobial Resistance Monitoring Network (NARMS)—A joint effort by the CDC, FDA, USDA, and state health departments, the purpose of NARMS is to detect and characterize trends in bacterial resistance. Participating health departments forward every 20th non-typhi Salmonella isolate, every Salmonella typhi, every 20th Shigella isolate, and every 20th E. coli O157 isolate received at their public health laboratories to the CDC for susceptibility testing, which includes determination of the minimum inhibitory concentration (MIC) for 17 antibiotics: amikacin, ampicillin, amoxicillin-clavulanic acid, apramycin, cefoxitin, ceftiofur, ceftriaxone, cephalothin, chlorampheni-col, ciprofloxacin, gentamicin, imipenem, kanamycin, nalidixic acid, streptomycin, sulfamethoxazole, tetracycline, and trimethoprim-sulfamethoxazole. The FoodNet sites (California, Colorado, Connecticut, Georgia, Maryland, Minnesota, New York, New Mexico, Oregon, and Tennessee) also send one Campylobacter isolate each week to the CDC. Susceptibility testing of Campylobacter is performed to determine the MICs for these antibiotics: azithromycin, chloramphenicol, ciprofloxacin, clindamycin, erythromycin, gentamicin, nalidixic acid, and tetracycline (CDC, 2005).

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