Eurosurveillance
Volume 18, Issue 4, 24 January 2013
http://www.eurosurveillance.org/Public/Articles/Archives.aspx?PublicationId=11678

Editorials
From molecular to genomic epidemiology: transforming surveillance and control of infectious diseases
M J Struelens 1, S Brisse2
European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
Institut Pasteur, Paris, France

The use of increasingly powerful genotyping tools for the characterisation of pathogens has become a standard component of infectious disease surveillance and outbreak investigations. This thematic issue of Eurosurveillance, published in two parts, provides a series of review and original research articles that gauge progress in molecular epidemiology strategies and tools, and illustrate their applications in public health. Molecular epidemiology of infectious diseases combines traditional epidemiological methods with analysis of genome polymorphisms of pathogens over time, place and person across human populations and relevant reservoirs, to study host–pathogen interactions and infer hypotheses about host-to-host or source-to-host transmission [1-3]. Based on discriminant genotyping of human pathogens, clonally derived strains can be identified as likely links in a chain of transmission [1-3]. In this two-part issue of Eurosurveillance, Goering et al. explain that such biological evidence of clonal linkage complements but does not replace epidemiological evidence of person-to-person contact or common exposure to a potential source [3]. Muellner et al. provide clear examples how prediction about infectious disease outcome and transmission risks can be enhanced through integration of pathogen genetic information and epidemiological modelling to inform public health decisions about food-borne disease prevention [4].

Perspectives
The need for ethical reflection on the use of molecular microbial characterisation in outbreak management
B Rump1, C Cornelis2, F Woonink1, M Verweij2,3
Municipal Health Service (GGD) Midden-Nederland, Zeist, the Netherlands
Department of Philosophy, Utrecht University, Utrecht, the Netherlands
Ethics Institute, Utrecht University, Utrecht, the Netherlands

Abstract
Current thinking on the development of molecular microbial characterisation techniques in public health focuses mainly on operational issues that need to be resolved before incorporation into daily practice can take place. Notwithstanding the importance of these operational challenges, it is also essential to formulate conditions under which such microbial characterisation methods can be used from an ethical perspective. The potential ability of molecular techniques to show relational patterns between individuals with more certainty brings a new sense of urgency to already difficult ethical issues associated with privacy, consent and a moral obligation to avoid spreading a disease. It is therefore important that professionals reflect on the ethical implications of using these techniques in outbreak management, in order to be able to formulate the conditions under which they may be applied in public health practice.