Speaking notes for Dr. Martin Preston
Walkerton Inquiry Town Hall in Toronto
October 29, 2001
Role of Public Health Laboratories in Public Health and Safety
In the Canadian system, provincial governments are responsible for public health and safety.
• Physicians and other health care providers provide medical care to individuals in our society.
• Local health units monitor health and safety issues in their own regions.
• The Federal government plays a coordinating role in national health issues and in investigating national outbreaks of infections.
• But provincial health authorities, including those in public health labs provide the first line of response to public health emergencies such as outbreaks of infectious diseases.
• We have just heard from Ms. Bartlett as to the valuable role played by technologists in the public health labs in responding to the Walkerton crisis.
• And as our Commissioner knows the public health labs provided vital data to those investigating the outbreak including the isolation and identification of E.coli 0157 in water samples and patient specimens.
• The public health labs also provided vital information to investigators concerning the origin of the Walkerton outbreak.
• This was done by genetic fingerprinting of hundreds of bacterial isolates isolated from both water samples and patient specimens.
• By comparing these fingerprints, investigators were able to identify the most likely sources of contamination of the Walkerton water supply.
• This brings me to the role of scientists in the public health labs in general and in the Walkerton outbreak in particular.
• In the early 1990s, scientists throughout North America and other regions of the world recognized the increasing threat of E.coli 0157.
• At that time, there was no suitable laboratory method for tracking outbreaks of infection caused by this incubi.
• We could not assist health officials trying to pinpoint the source of outbreaks caused by E.coli 0157.
• In the mid 1990s, I developed and introduced into the public health lab a method for fingerprinting these bacteria.
• Over the next few years, this method was used to successfully assist in the investigation of several outbreaks in Ontario.
• And with the assistance of scientists at Health Canada, we were able to validate the use of this method and to publish our findings in the scientific journal.
• So by the time the Walkerton outbreak occurred, the groundwork at the public health lab had already been done.
- The technology for doing genetic fingerprinting of E.coli was in place.
- The technologists (such as Ms. Bartlett) who actually performed the procedure had been well trained and were ready to go.
- In short, the expertise needed to respond to the outbreak and to provide answers for the investigations had been developed.
• Mr. Commissioner, this is what scientists are paid to do.
• We look ahead, we observe what's coming down the track and we try to develop laboratory procedures to meet these threats.
• We provide expertise!!!
• In recent years the world has seen continual parade of new or re-emerging microbial threats including E.coli 0157, West Nile virus, antibiotic-resistant superbugs and now anthrax.
• In my opinion, we need skilled individuals in our provincial health labs to anticipate these threats and to develop means of dealing with them.
• At the present time, these labs do not provide the necessary environment for these individuals to work.
• Indeed, there are no longer any scientific positions left at the public health labs in Ontario.
• This is in sharp contrast to the situation in other provincial and state labs. For example, in New York State PHL there are 150 PHD level scientists working in all areas of public health.
To conclude, Mr. Commissioner, I would suggest that the Ontario government has an obligation to the people of Ontario to maintain a high level of scientific expertise in its public health labs in order to be prepared for the Walkertons of the future.
Thank you.
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