Patricia is a European Programme for Intervention Epidemiology Training (EPIET) Fellow. She is based in the the Republic of Ireland’s Health Protection Surveillance Centre (HPSC) in Dublin.
The role of the HPSC is to provide information on infectious diseases, primarily through surveillance, but also through expert advice and research. I've been here for 13 years as a surveillance scientist. Currently, I'm on a two-year European training programme called EPIET. This provides additional training and practical experience in field epidemiology.
Previously, I was based in the gastroenteric team. The HPSC has a wide remit and is governed by Infectious Diseases Regulations 1981, most recently amended by S.I. No. 452 of 2011. The legislation specifies the diseases that are under surveillance. My main interests are in the surveillance and epidemiology of food-related and waterborne diseases, particularly verotoxigenic E. coli, Cryptosporidium and Salmonella.
My role at national level is to collate and analyse the data for specific diseases. To do this, we have a computerised disease reporting system. This large database is managed by the HPSC in partnership with a number of organisations. From this, we produce weekly, quarterly and annual reports.
Monitoring trends
We also look at the trends in the burden of disease or specific patterns that are occurring over time. As some of the gastroenteric diseases have outbreak potential, we also examine the data for any change in disease pattern that might indicate an outbreak is happening.
The vast majority of outbreaks are local and are investigated by the local public health department, meaning the HPSC will not have a role. The type of outbreaks in which the HPSC gets involved tend to be those affecting several areas across the country as a whole or international outbreaks.
To investigate the cause of the outbreak, we generally interview individual cases. We look for a commonality between people, be it a food or some other exposure they might have in common.
If you identify an exposure reported by many of the cases, you may consider this as a hypothesis for what caused the outbreak. You then need other evidence to support that hypothesis such as microbiological evidence or an epidemiological study. A team of people, not just the HPSC, are involved in an outbreak investigation as you need an interdisciplinary approach.
Learning from anthropology
I learnt some interesting techniques at a recent workshop in London, 'Outbreak Anthropology for Epidemiologists', with thanks to a bursary from the safefood Training and Mobility Programme. It looked at the social determinants to disease.
While we usually use very structured interviews, the presenters were interested in semi-structured and unstructured interviews, and the idea of focus groups. Those are the kind of tools that are used by anthropologists and could be helpful for environmental exposures such as food preparation behaviour.
The HPSC is a very dynamic place to work. It's important to be able to contribute to the advice on food safety either through information we have gathered ourselves or from information we have received through other infectious disease surveillance institutes.
Outside work, I like swimming and running, and I'm also a very keen gardener.
Comments