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

第一部分美属维尔京群岛的圣托马斯岛在过去的一个月里连续遭受5级飓风的破坏，伊尔玛和玛丽亚。自飓风伊尔玛以来，圣托马斯岛上的电力供应有限，这是人口最多的岛屿。洪水泛滥，再加上水处理缺乏电力，有可能造成广泛的水道污染，随后暴露于未经处理的废水中的微生物病原体。了解这类事件的潜在影响的一个主要问题是，这些事件发生的频率相对较低，持续时间太短，无法使用传统的提案评估和供资程序进行数据收集和科学评估。该提案力求从数量上描述这种微生物暴露风险，并提供有关飓风过后岛屿社区水污染的重要数据，以便更好地了解和准备应对未来的灾害。这里提出的项目将通过在恢复水电基础设施之前在灾区开展实地活动来填补这一关键空白，并为随后关于环境随时间恢复的研究提供一个比较基础。第二部分的具体项目目标是i)进行卫生和供水基础设施调查；ii)调查居民的用水行为和水相关活动；iii)量化全岛水样中的微生物病原体；iv)通过暴露评估和剂量反应模型对疾病负担进行定量的微生物风险评估。为了克服现场采样后勤的挑战，将使用一艘考察船从大陆运送研究设备、用品、研究人员、燃料、食物和水，从海路到达圣托马斯。我们会收集水样(即从排污口或化粪场收集的水样)，利用最先进的核酸扩增技术，针对目标军团菌、大肠杆菌、沙门氏菌、贾第鞭毛虫、腺病毒和诺沃克病毒，检测与水有关的重要微生物病原体。疾病风险评估将结合每日接触水的量、不同水域中病原体的浓度分布以及临床试验中现有的剂量-反应关系。该项目的成果将帮助这个贫困的岛屿社区加快恢复进程，同时也有助于培养一名研究生来应对现实世界？该领域的研究挑战。

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.