Integration of PulseNet with PA-NEDSS

Pennsylvania's electronic disease reporting and case management system, PA-NEDSS, has been in production since 2003.  It includes integrated electronic laboratory reporting and online case reporting by providers.  Public health staff also use the system to record information obtained during their case investigations, such as food histories and other risk factor information.  PulseNet is a national network of public health and food regulatory agency laboratories coordinated by the Centers for Disease Control and Prevention (CDC).  PulseNet participants perform molecular subtyping of foodborne disease-causing bacteria by pulsed-field gel electrophoresis (PFGE).  PFGE patterns are submitted electronically to a database at the CDC, where they are compared to other submissions and assigned pattern numbers.  Clusters of cases sharing the same PFGE pattern are likely to have been exposed to a common risk factor. 

Pennsylvania's state public health laboratory has been submitting PulseNet molecular subtyping information to PA-NEDSS via electronic laboratory reporting since 2005.  Having both PFGE pattern and risk factor information in the same database has allowed the Pennsylvania Department of Health to rapidly form hypotheses regarding potential common exposures in PFGE-identified clusters of foodborne illness.  Preliminary measures of association between PFGE patterns and risk factors can also be calculated rapidly, using information already in the system to compare cases to others with the same disease but different patterns, or with other enteric illnesses.  The presentation will describe the processes that have been developed to evaluate risk factor information in conjunction with PulseNet and other laboratory information.  In addition, case studies of the use of integrated information in outbreak investigations, including Salmonella Schwarzengrund in dog food, will be presented.