March Activity at NL Associates, Episode 2

by admin on 19/04/2012

CDC Atlanta

In early March Professor Lightfoot attended the International Conference on Emerging Infectious Diseases run by CDC Atlanta. CDC, founded in 1942, is the United States’ national public health institute and Atlanta it’s founding headquarters – due in part to the fact that malaria was once endemic in the Southern states.

The 2012 conference marked the eighth ICEID, organised in collaboration with public health partners including the American Society for Microbiology, the Council of State and Territorial Epidemiologists, the Association of Public Health Laboratories, and the World Health Organization. The conference brought together over two thousand public health professionals from around the world to foster knowledge exchange on global infectious disease issues.

It was a vast conference with a wide-ranging subject base – antimicrobial resistance, bioterrorism, respiratory infections, foodborne and waterborne illnesses, global health equity, influenza, international health regulations, vaccine preventable diseases, vector-borne and zoonotic diseases – presented through panel sessions with invited speakers, as well as oral and poster presentations on emerging infections.

Professor Lightfoot thoroughly enjoyed the experience and armed with a very weighty book of abstracts, focused in on his own areas of special interest – Salmonella, E Coli and Anthrax.

Christopher Lane of the UK Health Protection Agency presented on ‘Salmonella Enteritidis Epidemic in the UK Poultry Industry’, giving a description of the successful interventions that have been made to reduce high contamination rates in eggs and chickens since 1995. Interventions included improved poultry handling practices and vaccination strategy.

The most interesting part of these sessions is often the Q&A. Professor Lightfoot congratulated the HPA on their progress towards eradicating Salmonella, but mentioned the problem of Campylobacter, which 90% of chickens continue to be infected with. The speaker’s answer to his comment was an honest one, ‘that’s more difficult’.

Gerard Krause spoke about the 2011 German outbreak ‘STEC 0104-H4 Associated with Fenugreek seeds’, focusing in on investigation and epidemiological methods and concluding with lessons learned. NL Associates has recently produced an ebooklet on the E Coli infection, drawn from situation reports Professor Lightfoot issued at the time of outbreak, (to find out more click here) so this session was of special interest. Professor Lightfoot raised the question of how the fenugreek seeds became infected in the first place and the audience went on to address the key challenge for the future: how can we prevent the next large outbreak? This concept of first principles is, at its core, the bedrock of Emergency Preparedness.

As demonstrated by the German E Coli outbreak, the production of food is a whole series of steps from farm to plate. As soon as people begin to cut corners, be that through lack of training or investment, it is inevitable that something will go wrong. Professor Lightfoot has learnt from experience that outbreaks often occur due to a series of coincidences and that prevention is both simple and complex – a system must contain enough checks to ensure that errors are unable to stay undetected and mount up.

In the poster sessions Professor Lightfoot saw many interesting aspects of public health worldwide, but was drawn in particular to T.H. Whalen’s ‘Microbial Risk Assessment by Extrapolating Base Response Curve Lessons from Anthrax’ – a fascinating insight into the historic Anthrax outbreak of 1957 in a mill processing goat hair.

All in all, the CDC conference was a fantastic few days, from informal chats over coffee to high-level presentations drawing on cutting edge research. This is exactly the international network that Professor Lightfoot draws strength from in his work and gives clients unique access to in his consultancy work.  When you work with NL Associates, you’re working with the best in the field.

A conference such as CDC reports what has happened in the past and is a great chance to reflect, analyse and process. However, the next step must be to direct international energy towards early detection and prevention strategies.

Next Up: The importance of Intelligence Gathering

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