UNS: Transform Municipal Wastewater Treatment Systems into Community Enteric Disease Information Networks

[1507979]在美国和世界各地，肠道和腹泻疾病是人类疾病的主要原因。有效防治感染性肠道疾病的主要挑战包括缺乏疾病暴发的实时信息，以及无法使用传统的基于诊所的方法量化基线社区疾病负担。利用城市污水处理系统在收集社区准确、实时的肠道疾病信息方面无与伦比的能力，提出了一种将城市污水处理系统转变为社区肠道疾病信息网络的新方法。初步数据表明，利用分子工具量化和研究城市废水中的肠道细菌病原体是可行的，也显示了在废水和卫生诊所病原体菌株之间建立实时对应关系的可能性。本项目的研究目标是牢固确立城市污水处理系统用于社区疾病监测的可行性。研究假设城市污水中的肠道病原体是社区肠道疾病的可靠、定量和实时指标。为了验证这一假设，将实现三个具体的研究目标，每个目标对应于假设的一个理想特征：(1)确定废水中目标细菌病原体和参考粪便指示菌的腐烂率；(2)确定废水病原体浓度与社区肠道疾病负担之间的定量关系；(3)验证利用城市废水中的沙门氏菌实时检测社区疾病暴发。总体而言，该项目将研究利用现有废水基础设施解决社区疾病监测主要挑战的新方法的可行性。这种新方法有可能改变社区疾病监测的格局，在了解肠道疾病的起源、传播和演变以及保护公众免受疾病暴发的影响方面提供改变游戏规则的能力。如果证明可行，这将大大扩大废水基础设施在公共卫生保护方面的作用，并为废水基础设施的升级和充分维护提供强大动力。该项目还将测试和优化一种新的高通量微流控qPCR技术，用于同时定量城市污水中的多种病原体。这也将是首次尝试确定城市废水中病原体与相应社区疾病之间的定量关系。最后，利用DNA指纹技术建立城市污水中临床相关病原体在菌株水平上的实时检测。该项目提出了一个全面的计划，将(1)让夏威夷土著学生参与环境研究，(2)向当地高中生开展外展活动。

1507979YanEnteric and diarrheal diseases are a major cause of human illness in the United States and around the world. Major challenges in effectively combating infectious enteric diseases include the lack of real-time information about disease outbreaks and the incapability of quantifying baseline community disease burdens using traditional clinic-based approaches. A novel approach is proposed to transform municipal wastewater treatment systems into community enteric disease information networks, taking advantage of the unparalleled capability of municipal wastewater treatment systems in collecting accurate and real-time enteric disease information from the communities. Preliminary data demonstrated the utility of using molecular tools to quantify and study enteric bacterial pathogens in municipal wastewater, and also showed the possibility of establishing real-time correspondence between pathogen strains in wastewater and in health clinics.The research goal of this project is to firmly establish the feasibility of using municipal wastewater treatment systems for community disease monitoring. The research hypothesis is that enteric pathogens in municipal wastewater are reliable, quantitative, and real-time indicators of enteric diseases in a community. To test the hypothesis, three specific research objectives, each corresponding to one desirable feature of the hypothesis, will be achieved: (1) determine the decay rates of target bacterial pathogens and reference fecal indicator bacteria in wastewater, (2) determine the quantitative relationship between wastewater pathogen concentration and community enteric disease burden, and, (3) verify real-time detection of community disease outbreaks using Salmonella in municipal wastewater. Overall, this project will investigate the feasibility of a novel approach to address major challenges in community disease monitoring by using existing wastewater infrastructure. This novel approach has the potential to transform the landscape of community disease monitoring, providing game-changing capabilities in understanding the origin, transmission, and evolution of enteric diseases as well as in protecting the public from disease outbreaks. If proven feasible, this will greatly expand the role of wastewater infrastructure in public health protection and provide strong impetus for upgrading and adequately maintaining the wastewater infrastructure. This project will also test and optimize a new high throughput microfluidic qPCR technology for simultaneously quantifying multiple pathogens in municipal wastewater. This will also be the first attempt to determine the quantitative relationships between pathogens in municipal wastewater and corresponding community diseases. Finally, DNA fingerprinting technologies will be used to establish real-time detection of clinically relevant pathogens in municipal wastewater at the strain level. The project proposes a comprehensive plan that will (1) involve Native Hawaiian students in environmental research, and (2) conduct outreach activities to local high school students.