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Med-Vet-Net introduce two new research workpackages
med-vet-net Med-Vet-Net is a European Network of Excellence that aims to improve research on the prevention and control of zoonoses by integrating veterinary, medical and food science research. Comprising 16 European partners and over 300 scientists, Med-Vet-Net will enable these scientists to share and enhance their knowledge and skills, and develop collaborative research projects. Med-Vet-Net officially commenced on 1 September 2004, and is funded to the value of €14.4 million for five years.
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Workpackage (WP) 32 - Validation of public health surveillance Public health surveillance National food and public health authorities request information on the incidence and cause of zoonotic bacterial infections. Currently, collection of data on human infections, such as the food-borne pathogens Campylobacter and Salmonella, is not sensitive enough to give an accurate picture of the magnitude of the problem. Most countries do not have systems that determine the exact number of human infections, but use passive surveillance that relies on physicians and microbiology laboratories reporting infections. This data cannot be compared between European countries as each uses different methods, and physicians have different practices for the management of patients with suspected foodborne infections. More accurate surveillance of these infections would allow better control methods to be implemented. Workpackage 32, ‘Public health surveillance for foodborne infections: Design of epidemiological studies and applying seroepidemiology to validate the surveillance pyramid’ was devised to look at this problem. In June 2006 an open invitation was issued to all EU member states and associated countries to participate in the project. Interested parties were invited to a workshop, where the selection criteria for serum banks and a tentative study design were agreed. Efforts to identify additional serum banks were made through a presentation at the EnterNet meeting in 2006, through literature research and personal contacts. The workpackage officially started on 1 September 2006 with participation of five EU countries and the US. Laboratory work has started and negotiations about access to existing serum banks in five other European countries are ongoing. Approach The project will use a cost-effective technique — sero-epidemiology — which has previously been used to study infections in animals, to detect human infections. By testing for bacterial infections in human sera, such as blood already stored in medical facilities, researchers aim to fill the missing gaps in health surveillance data. Concentrations of specific antibodies will be measured in sera from existing populationrepresentative serum banks, and based on these June 2007
results, incidence estimates will be generated with the help of a stochastic back calculation model, which accounts for inter-individual variations in antibody response. “This project brings together experts in serology, epidemiology, mathematical modelling and community-based studies allowing us to integrate information from different approaches of studying human infection” says workpackage leader Dr Kåre Mølbak, Director of the Department of Epidemiology, Statens Serum Institut, Copenhagen: “By making full use of existing European studies and new data we will be able to calculate the ratios between infected cases, cases with symptoms in the community and lab reports.” Research Plan A detailed research plan was developed during the kick-off meeting, which was held on 20 — 21 September 2006 in Prague, Czech Republic. In preparation for this meeting, the project team explored the availability of population-based serum collections and embarked on validation of the mix-ELISA for S. Enteritidis/S. Typhimurium. Once they have agreed testing methods for sera, researchers will plan and agree protocols for community-based studies of these bacteria. The group plan to conduct a pilot study based on sera stored in a number of different countries. Information on the level of antibodies to food-borne pathogens will be translated to measures of disease frequency, which again will be compared with the officially reported figures. This will pave the way for the creation of novel, more accurate Europe-wide surveillance systems for gastrointestinal illnesses. Major elements of the research plan include: 1. Preliminary development of resources and tools for sero-epidemiology. 1.1 An inventory of serum-banks 1.2. Analyses of an existing collection of patient-sera (follow-up study of 300 patients), to determine antibody decay profiles after Salmonella infection using a mix-ELISA rather than ELISA with serotype-specific LPS catching antigen. 1.3. Draft consensus protocols for the epidemiological, mathematical and serological methods will be developed by the team. After final acceptance, we will invite different European countries, where adequate sera are available to participate in the pilot study. 2. Laboratory analysis of sera from selected countries 2.1 Selection of sera collections. 2.2 Completion of serological tests for antibodies directed against S. Enteritidis/ S. Typhimurium in selected sera. 2.3 Completion of serological tests for antibodies directed against Campylobacter