PulseNet Lebanon: An Overview of Its Activities, Outbreak Investigations, and Challenges

Abstract

Background: Foodborne diseases are still a major health issue in Lebanon, although some steps have been taken forward in food safety. To this purpose, PulseNet Lebanon, a foodborne diseases tracking network, was established in 2009, through the collaboration between the Ministry of Public Health (MoPH) and the American University of Beirut (AUB). Materials and Methods: Three papers published regarding the PulseNet project were summarized. Initially, clinical and food samples, collected within the surveillance network scope, were identified by using the respective API for Salmonella and Listeria spp. Salmonella spp. were further serotyped by using the Kauffman and White method. Campylobacter spp. were determined by the 16 S rRNA sequencing method. Antimicrobial susceptibility to a number of antibiotics was determined by using the disk diffusion method for Samonella and Campylobacter spp. Genomic diversity was determined by using pulsed field gel electrophoresis (PFGE) and random amplified polymorphic DNA (RAPD). Results: Results indicated that 290 clinical and 49 food isolates were identified as Salmonella . Serotyping revealed the prevalence of ten and seven serotypes in the clinical and food samples, respectively. Fifty-one isolates from chicken ceca and carcass were identified to be Campylobacter spp. Fifty-nine samples were identified to be Listeria monocytogenes . Antimicrobial susceptibility testing revealed a wide range of resistance among the different samples. PFGE showed a variation in pulsotypes among the Salmonella serotypes. PFGE also linked certain outbreaks to their food sources. This method also demonstrated 13 subtypes with 100% similarity among the L. monocytogenes isolates. Finally, the Camplyobcater spp. were grouped into nine clusters with a minimum similarity of 43.5% using RAPD. Conclusion: This summary of results shows the importance of implementing a “farm-to-fork” approach in the surveillance of foodborne disease outbreaks in Lebanon, allowing the detection of pathogens causing foodborne disease outbreaks in a timely fashion.

Characterization of Clinical Salmonella entericas Trains in Huzhou, China

“…PFGE analyzes the relationships among strains at the molecular level and can monitor, trace, and identify strains [ 24 ]. It is considered the “gold standard” for bacterial molecular typing because of its high repeatability and reliability.…”

First Nation-Wide Analysis of Food Safety and Acceptability Data in Lebanon

“…Given the status of the economy and the current increase in the cost of medical care in Lebanon, these food contaminants might inflict higher mortalities and morbidities in susceptible populations. This scenario is even more plausible because of the proliferation of antimicrobial resistance in food systems in Lebanon [ 14 , 21 , 22 , 28 , 29 , 32 , 49 ], which can lead to recalcitrant and hard-to-treat infections [ 50 ].…”

“…Currently, there are a plethora of factors that contribute to the status of food safety in Lebanon, including (1) absence of national baseline data on chemical and microbiological food contaminants, (2) insufficient scientific and technical expertise in the field, (3) scant financial support, (4) poor foodborne illness/outbreak surveillance, (5) inconsistent governmental oversight, transparency, and implementation and enforcement of policies and laws, (6) overlapping and conflicting jurisdictions of governmental agencies that oversee food safety, and (7) weak awareness of safety procedures in small food businesses [ 9 ]. Furthermore, there is limited support for academic research on the prevalence and properties of food contaminants and subsequent control mechanisms [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. Taken together, these issues have left their mark on both the national economy and public health [ 33 ].…”

Assessment of the Microbiological Acceptability of White Cheese (Akkawi) in Lebanon and the Antimicrobial Resistance Profiles of Associated Escherichia coli

“…However, Lebanon is currently facing major challenges to food safety due to weak governmental oversight, outdated national standards for microbiological and chemical contaminants, scarcity of baseline data, under-developed food safety monitoring systems, frail enforcement of food safety laws, and widespread pollution among others [ 14 ]. Due to these deficiencies, 42 outbreaks of foodborne disease, mainly associated with Salmonella infections, were reported in 2010, which is notable for a small country like Lebanon [ 15 ]. Additionally, the average number of reported food poisoning cases in Lebanon was 449 (±143) per year from 2012 to 2022 [ 16 ].…”