RAPID: Microbial Risk Assessment of Disease Burdens in St. Thomas, U.S. Virgin Islands Post Hurricanes Irma and Maria

在过去的一个月里，美属维尔京群岛的圣托马斯岛被接连发生的5级飓风厄玛和玛丽亚摧毁。自飓风厄玛以来，人口最多的岛屿圣托马斯的电力有限。严重的洪灾加上缺乏水处理电力，可能造成水道的广泛污染，并随后暴露于未经处理的废水中的微生物病原体。在理解此类事件的潜在影响方面存在的一个主要问题是，此类事件发生的频率相对较低，持续时间太短，无法利用传统的提案评估和供资程序进行数据收集和科学评估。该提案旨在定量描述这种微生物暴露风险，并提供有关岛屿社区飓风后水污染的关键数据，以更好地了解和准备未来的灾害应对措施。这里提议的项目将填补这一关键空白，在恢复水电基础设施之前在灾区开展实地活动，并为今后研究环境的长期恢复情况提供一个比较基础。项目合作者凯洛格博士非常熟悉维尔京群岛的圣托马斯岛，她在岛上的家人和朋友网络使这一实地活动成为可能。第二部分项目的具体目标是i）进行卫生和供水基础设施调查; ii）调查居民用水行为和与水有关的活动; iii）量化全岛水样中的微生物病原体;以及iv）通过暴露评估和剂量反应模型对疾病负担进行定量微生物风险评估。为了克服实地取样后勤方面的挑战，将使用一艘研究船从大陆运送研究设备、用品、研究人员、燃料、食品和水，经海路抵达托马斯。将收集水样（即来自污水排放口或化粪池），使用最先进的核酸扩增技术检测与水有关的重要微生物病原体，以检测目标军团菌、大肠杆菌。大肠杆菌、沙门氏菌、贾第虫、腺病毒和诺如病毒。疾病风险评估将综合每日暴露水量、不同沃茨中病原体浓度分布以及临床试验中现有的剂量-反应关系。这个项目的成果将帮助这个贫困的岛屿社区加快恢复进程，同时也有利于培养一名研究生来处理？真实的世界？实地研究的挑战。

Part 1.The island of St. Thomas in the U.S. Virgin Islands was devastated by back-to-back category 5 hurricanes, Irma and Maria, during the past month. There is limited electricity on St. Thomas, the most populated island, since hurricane Irma. Major flooding combined with a lack of electricity for water treatment has resulted in the potential to produce widespread contamination of waterways and subsequent exposure to microbial pathogens in untreated wastewater. A major issue with understanding the potential impact of such events is that they occur relatively infrequently and are of too short duration to allow for the data collection and scientific evaluation using the traditional proposal evaluation and funding processes. This proposal seeks to quantitatively characterize this microbial exposure risk and provide critical data on water contamination post-hurricane in an island community to better understand and prepare for future disaster responses. The project proposed here will fill this critical void by carrying out the field campaign in the disaster area before the restoration of electricity and water infrastructure, as well as to provide a base of comparison for subsequent studies of the recovery of the environment over time. This field campaign is only possible because of project collaborator Dr. Kellogg's intimate familiarity of St. Thomas, Virgin Islands and her network of family and friends on the island.Part 2.The specific project objectives are to i) conduct sanitary and water supply infrastructure survey; ii) survey residential water use behavior and water related activities; iii) quantification of microbial pathogens in water samples across the island; and iv) perform a Quantitative Microbial Risk Assessment (QMRA) of disease burdens through exposure assessment and dose-response models. To overcome the challenge of field sampling logistics, a research vessel will be used to carry research equipment, supplies, researchers, fuel, food and water from mainland to reach St. Thomas by sea. Water samples (i.e. from sewage outfalls or septic drain fields) will be collected for detection of important water-related microbial pathogens using state-of-the-art nucleic acid amplification for target Legionella, E. coli, Salmonella, Giardia, adenovirus and norovirus. The disease risk estimations will integrate the daily volume of water exposure with pathogen concentration distributions in various waters and existing dose-response relationship from clinical trials. The outcomes of this project will help this underprivileged island community accelerate the process of recovery, while also facilitate the training of a graduate student to deal with ?real world? research challenges in the field.