Good morning, ladies and gentlemen. It's a pleasure to be here. I thank you for the opportunity to talk to you today about how we use technologies.
We live in a remarkable time when it comes to technological advancements. Within the lifespans of most of us, we've gone from marvelling at a man on the moon, to people living on a space station; from computers that filled huge rooms, to having the world in the palm of our hand; and from the discovery of DNA, to being able to sequence a whole genome of an organism in a very short period of time.
To further illustrate this point and the rapidity of progress, in 2003, the genetic fingerprint or sequence of the SARS coronavirus was done in collaboration with the B.C. Genome Sciences Centre and the BCCDC , in less than two weeks, which was a remarkable feat at the time. By 2009, when we were in the middle of the H1N1 epidemic, it took us just a couple of days to sequence the pandemic H1N1 virus, and it would be even faster today.
These tools are extremely important in our ability to respond to infectious diseases. By various estimates, there have been between 35 and 50 newly discovered viruses and bacteria over the last 40 years. Some of the things we worry about a lot today, such as E. coli 0157, HIV, and so on, we didn't know about when I started medical school. These are all either newly discovered or new to humans. We have every reason to believe that more and more of them will be discovered. The rate of these new diseases happening is about one a year or so.
Why are these threats increasing? There are a number of reasons, including ecologic changes that make it possible for carriers of infections such as mosquitoes to inhabit new areas. We have dengue hemorrhagic fever, for instance, in Florida, for the first time in many years. There are also human demographic and behavioural changes: people becoming more concentrated in cities and moving away from an agricultural subsistence life; people moving into previously unsettled areas; and globalization, where the incubation time for most, not all, infectious diseases is less than the time it takes to get from point A in the world to point B.
We also have rapid growth in technologies, including health technology, which in spite of the improvements that they bring to our health also present new threats sometimes. And there is microbial adaptation and change; these bugs change much faster than we can change.
Infectious agents are an excellent example of Darwin's theory of evolution; it happens in a very short period of time with them. They are innately designed to adapt for survival by constantly evolving to beat human interventions. They have sex lives. They exchange genetic material, giving them new properties we haven't seen before.
We are kind of like the Red Queen in Through the Looking Glass. We need to run faster and faster to stay in the same place, to stay ahead of these threats. One of our biggest challenges in the public health realm of infectious diseases is to try to anticipate what's going to happen next. You can't really anticipate the specifics of it, but you have to be ready for pretty much anything.
I'll talk about five tactics that we use within the Public Health Agency and beyond to try to deal with these threats.
Tactic 1 is the rapid detection and alerting of infectious diseases. The Public Health Agency of Canada has a number of tools at its disposal for that, including some we developed ourselves to fill existing gaps. An important one is the Canadian network for public health intelligence, or CNPHI, as we call it. It's a secure, web-based system that compiles information from various surveillance platforms and issues alerts to users. We can use information, such as over-the-counter sales of antidiarrheal medication to detect aberrations. It doesn't tell you what is happening exactly, but it tells you that something is wrong. This was developed by the agency staff, and we currently have more than 4,000 public health officials across the country using it on a daily basis.
These tools also help us to determine the existence and extent of an outbreak through recognition of related cases across jurisdictions. This was used extensively during our response to the XL Foods E. coli issue a month ago or so.
Tactic 2 is rapid containment at source. Sometimes it's not possible to send the specimen to the lab, so we've developed a strategy for sending the lab to the specimen. Sometimes it's more expedient to send our people, with the necessary technology, to the site of an event rather than sending samples into the lab.
We've developed two very unique mobile laboratory systems. The first is a lab on a truck. This is a high-tech level 3 infectious disease laboratory that can travel to sites such as the Vancouver Olympics, and the G-8 and G-20 in Ontario, to monitor for acts of bioterrorism. Some of the work we do includes air sampling and testing of suspicious packages at such sites.
The other lab is kind of a lab in a suitcase, about 13 pieces of luggage that can be checked on a passenger flight. We respond to diseases such as Ebola in Africa. We recently had a team in the Democratic Republic of the Congo responding to an Ebola outbreak.
This is technology that has been adapted by our staff so they can safely work on specimens that may contain these agents. It allows the provision of rapid diagnostic tests at the site of outbreaks in the remotest areas of the world. This unit has been deployed to Angola, the Democratic Republic of the Congo, Congo, Kenya, Iran, and various other places.
It's really revolutionized the way the World Health Organization responds to an outbreak. You can imagine that getting a turnaround for a diagnostic test in two hours instead of two weeks, which was previously the case, makes a big difference to what you do on the ground in these situations.
Tactic 3 is using viruses to fight viruses. Our lab in Winnipeg is using the latest genetic engineering technologies to create new ways of developing vaccines. We're working on HIV vaccines and universal flu vaccines, but our most significant breakthroughs have been with two Ebola vaccines. In both cases we've used another virus, a virus that's harmless to humans, to deliver Ebola proteins and Marburg proteins to the body, basically fooling the immune system into thinking it's seeing the real virus and resulting in pretty robust immunity.
We're working with the private sector to commercialize these vaccines, which will have potential application for preventing biological warfare and responding to epidemics and accidental laboratory exposures.
Tactic 4 is using high throughput machines to understand genetics. Understanding the genetics of a virus as well as those of hosts, such as humans, helps us to identify further recurrences of the same outbreak, to create vaccines and treatments, to understand where the virus or bacteria originated, and in the case of a host, to understand how people become infected and why some people are susceptible when others are not.
This strategy was used extensively during the listeria outbreak in 2008, and also more recently with the XL Foods E. coli outbreak.
I've mentioned the technology we have in place for rapid genetic sequencing of viruses and bacteria. To complement that, we need capacity in what's called bioinformatics, which Dr. Marra and Dr. Huntsman have already referred to.
It is easy to generate large amounts of data these days, but understanding it is a huge challenge. We have a cutting-edge bioinformatics group that can analyze massive data sets using more than 1,200 central processing units and 250 terabytes of storage—not quite up to what Dr. Marra described, but pretty good.
In fact, this technology is so advanced that the Centers for Disease Control and Prevention in the U.S. came to us when they needed assistance in analyzing the genomes of cholera bacteria from the outbreak in Haiti.
Tactic 5 is using systems biology to understand infectious diseases. I mentioned the genetics of a host a moment ago. When we talk about hosts, usually we're talking about humans. Understanding our own biology and the interactions between biologic systems has provided a wealth of information related to understanding infection by pathogens such as HIV and influenza.
The agency has done considerable work in this field. We're hoping it will lead us to the key that stops the HIV pandemic altogether. There's a lot of hope being placed on drugs for HIV these days. Drugs are very important, but I don't believe we'll solve the problem with drugs. We need the vaccine.
These are some of the key tactics we use to stay ahead of outbreaks. I would like to talk a bit about some other ways in which technology is advancing public health.
We hear so much about social media these days and the impact it can have on opinions and the course of events. This technology presents, too, an opportunity along with a threat. New health threats arise because of these kinds of technologies. For instance, it has helped to promote the spread of sexually transmitted diseases. But social media can also be used for health promotion, for intervention, and potentially early warning purposes. During the H1N1 pandemic, the Public Health Agency used social media in its efforts to reach out to people through such tools as Facebook and Twitter.
With the time we have today, I've only been able to touch on some of the latest technologies using a few examples. From what you've heard, though, I think you'll agree that in a highly technical field where innovation is essential, the Public Health Agency is at the cutting edge of using these kinds of tools for public health.
Thank you.