Public Health Laboratory, HSE - EUPHEM

Contact person

Dr. Eleanor McNamara, Director

Tel: +353 7669 55175/6

Fax +353 1 6231908

Description of the institute 

The main designated training site for the EUPHEM Fellow is at the PHL, HSE, Dublin. In addition the Fellow will also attend, as part of the training consortium partnerships, other Reference laboratories in the city and for epidemiology training be assigned to the HPSC (Health Protection Surveillance Centre) in Dublin.

The aim of the PHL HSE, DUBLIN is to provide the most effective and efficient public health microbiology service to support the diagnosis, prevention and control of infectious gastro-enteric diseases together with food and water borne illnesses, both nationally and regionally. It also incorporates de national VTEC reference service.

The Public Health Laboratory is accredited by INAB to ISO 17025 and also ISO 15189 standards providing a unique clinical and environmental public health microbiology scope. It is an EU Official designated Food testing laboratory (S.I. 85 of 1998 and S.I. 117 of 2010), and has developed robust operational protocols implemented by a highly skilled Medical and Scientific staff experienced in standard methodologies, the development of new molecular methodologies, surveillance, and the investigation of numerous outbreaks of gastro-enteric disease. Close working liaisons are established with the Public Health Medical Service, Environmental Health Service, Food Safety Authority of Ireland, Safe Food, and Health Protection Surveillance Centre, all of which are major stake holders in public health nationally. Its staff participate in an active research programme, training (Medical and Scientific) and lecturing commitments to Trinity College Dublin at both undergraduate and Post graduate level. The laboratory is located on the west side of Dublin on the campus of Cherry Orchard Hospital, which is a 205 bedded Long Term Care of the elderly facility and is administered by the HSE Regional Dublin Mid-Leinster office. The Health Service Executive (HSE) was established in 2005 and has the operational responsibility for the running of the health services in Ireland for its population of over 4 million.

The consortium partners are located in different sites across the city. St James’s hospital, (15 min. from PHL) is the largest tertiary referral hospital in the country (946 in-patient beds) with a number of national clinical specialties. It is also the site of the Mycobacterial, and MRSA reference laboratories along with an extensive virology service provision. Both Consultant Microbiologists at PHL, HSE, Dublin have joint appointments in St James’s hospital and the Fellow will spend a significant time at this site. Training will also be provided at the Meningococcal and meningitis reference laboratory located in the Children’s University Hospital, Temple St, a paediatric hospital site with scope for specialist projects. The Fellow will also attend the HPSC, our national epidemiology institute for epidemiology training along with EPIET fellows and have the opportunity to participate in combined EUPHEM-EPIET projects.

The microbiological scope of the PHL, HSE, Dublin includes:

1. A National Reference laboratory service for Verocytotoxin E. coli infections.
   Ireland has for many years had the highest incidence of VTEC infections in the EU. The national VTEC laboratory surveillance database was set up de-novo in this PHL, HSE Dublin, in 2001. It first provided diagnostic facilities with enhanced culture methodologies in its newly commissioned biosafety level 3 laboratory for this pathogen. Since then it has developed an international reputation for the pathogensis, phenotypic and genotypic typing and detailed investigation of the many national VTEC outbreaks.
   In close collaboration with HPSC it has documented the unique risks of VTEC associated with potable waters (private group water schemes and private wells) and childcare facilities in Ireland. National and regional VTEC surveys have been conducted on raw and ‘ready-to-eat’ foodstuffs to influence risk reduction measures.
   Collaboration with national VTEC network and international colleagues in the ECDC, FWD network have resulted in many presentations and research publications. Enhancement and implementation at PHL, HSE, Dublin of VTEC diagnostic methods now includes utilisation of Culture, immunomagnetic separation, seroagglutination, DNA magnapure extraction, PCR for verotoxin genes, VT subtyping and detection of virulence factors along with molecular typing by PFGE to ‘Pulsenet’ protocol. This has resulted in a unique highly specialised accredited national VTEC scope that supports our colleagues in Public Health and other national agencies to address the disease burden caused by these pathogens. The clinical and environmental VTEC service is routinely accessed by Consultant Microbiologists, Laboratory Directors, Public Health Doctors, the Environmental Health Service, State agencies; Food Safety Authority of Ireland (FSAI), HPSC and other agencies as required, e.g. The Dept. of Agriculture, Food and the Marine (DAFM). The PHL Director is the National Contact point for VTEC/EHEC to the ECDC FWD Network and has experience of being the National Microbiology focal point contact to ECDC from participating in EU laboratory capacity surveys and identifying the public health laboratory needs of the country.
2. A regional Public Health Microbiology service, both clinical and environmental for a broad range of other enteric pathogens accessed by the Environmental Health Service and Public Health Doctors). Collaboration with other public health laboratories and agencies also occurs through our participation in the “Safefood” sponsored ‘all-Ireland’ gastro-enteric networks.
   This facilitated research and surveillance into VTEC and campylobacter. The PHL Director, as a member of a number of HPSC national scientific committees (VTEC, Cryptosporidium and Water healthcare-associated infections), collaborates on the development of national enteric disease specific guidelines.
3. A National and Regional Food testing surveillance programme along with other Public health laboratories under contract to the FSAI. This programme includes risk based sampling from Food business operators, both retailers and manufacturer’s and targeted national food surveys conducted in compliance with EC Regulation NO 882 OF 2004.
4. A regional water testing legislative compliance service, including potable (public waters, group waters, private wells), therapeutic (hydrotherapy pools) recreational (swimming pools, bathing waters) and Healthcare facilities water testing services (washer disinfectors terminal rinse waters, Legionella water testing and water from cardiac heater cooler units for slow growing mycobacteria).
5. A local routine clinical microbiology diagnostic service for long-term care Cherry Orchard hospital in-patients (205 beds) which is also accessed by General Practitioners in the surrounding region.

Staff:

Currently the Public Health Laboratory, HSE, Dublin has 23 staff including:

• 2 Consultant Medical Microbiologists (1 WTE),
• 16 Medical Scientists (1 Chief),
• 1 Molecular Biologist- a 2015 graduate EUPHEM Fellow (see EUPHEM report web link below/Surveillance Scientist, 5 Seniors, and 9 Basics)
• 1 Laboratory Aide,
• 1 Infection Prevention Control clinical nurse specialist and
• 3 Clerical staff.

Staff are cognizant and supportive of the variety of trainee requirements and outputs to be achieved by the Fellow, while attending PHL.

The main public health programmes are:

• Gastrointestinal, food and waterborne infections at PHL, HSE Dublin.
• Healthcare associated infections and antimicrobial resistance at St James’s Hosp.
• Mycobacterial and MRSA reference laboratory services at St. James’s Hospital.
• Viral and sexually transmitted diseases at ST James’s Hospital
• Paediatric communicable diseases at Children’s University Hosp, Temple St. Dublin. Including the Meningococcal Reference laboratory.
• Epidemiology training at HPSC.

The main public health core-functions are:

• Surveillance of microbial infections.
• Investigation and management of communicable disease outbreaks.
• Public Health Laboratory quality management
• Public health microbiological research
• Lecturing and teaching of public health microbiology
• Biorisk management
• Communication and public health management. 

Training opportunities

PHL HSE, Dublin is in an excellent position as the main designated EUPHEM training site and to co-ordinate further multi-site training in all aspects of the EUPHEM core requirements. Significant closely supervised public health microbiology training opportunities are available to the Fellow. Emphasis on laboratory management coupled with participation in laboratory surveillance of both clinical and environmental matrices including development opportunities to also participate in the ECDC pathogen specific molecular typing programmes. We are fortunate to provide further surveillance opportunities at HPSC. Opportunities to be part of outbreak investigations nationally which include provision of specialist laboratory based advice and reference service will be exploited. Enteric pathogen research activities will be supervised and will build on the current research programme in place incorporating the use and management of our biosafety level 3 laboratory, molecular techniques and our Bionumerics software.

Quality assurance management will be emphasized and participation in EQA and IQC programmes already in place is expected, with consideration of setting up EQA with like institutes where no appropriate international accredited scheme exists. In addition attendance at the Dept. Of Clinical Microbiology in St James’s Hospital along with working in other Reference Laboratories to pursue specific projects will be organised. Presentations at national/international conferences and regional meetings will be encouraged facilitated as well as team collaborative report writing producing annual reports etc. Teaching of trainee Medical Scientists and Post-graduate Medical FRCPath. UK candidates who attend The Public Health Laboratory, HSE, Dublin will be included. 

Training supervision 

The EUPHEM Main Supervisor is Dr. Eleanor McNamara, Director of PHL, HSE, Dublin who is also a Consultant Microbiologist at St James’s Hospital, Dublin, the tertiary referral hospital, where the MRSA and Mycobacterial Reference Laboratories are also located.

The EUPHEM Co-Supervisor is Dr Robert Cunney, Consultant Microbiologist at HPSC and Director of the Meningococcal and meningitis Reference Laboratory, located at the Children’s University Hosp, Temple St. Dublin.

The EUPHEM Supervisor in epidemiology is Dr. Paul McKeown, Public Health Specialist, HPSC, Dublin.

There also will be a variety of Local Project specific Consultant Microbiology Supervisors. 

Language requirements

English

Training history

Number of EUPHEM fellows trained at institute: 1 (Cohort 2013). Fellow graduated 2015 and a permanent member of PHL, who will also be available to mentor the next Fellow.