i-sense: EPSRC IRC in Agile Early Warning Sensing Systems for Infectious Diseases and Antimicrobial Resistance

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In 2017 the need for disruptive sensing systems to detect and limit infectious outbreaks has taken centre stage - Zika virus and Ebola add to the threat of pandemic influenza, HIV and antimicrobial resistance, for which the world remains unprepared. Infections are a global problem and our response must therefore be global in nature. The House of Commons Ebola report recognised the 'heroic' work of scientists, researchers and agencies but highlighted that 'the UK response - like the international response - was undermined by systemic delay' and 'we must take the opportunity now to ensure that the UK is not caught unprepared when the next disease emergency strikes. Lives can be lost for every day of delay.' The i-sense2 EPSRC IRC aims to engineer a new generation of agile and globally impactful early warning sensing systems for infectious diseases and antimicrobial resistance. We are harnessing the power of mobile phones, biomedical engineering, nanotechnology, genomics and big data to detect outbreaks much earlier than ever before. Next Steps funding is pivotal to; maximising the impact of our current IRC research programme, retaining key staff and delivering a step change in our capabilities to respond to emerging infections and antimicrobial resistance. This will in-turn leverage over £10M in translational 'test bed' infrastructure, new laboratories, academic positions, studentships and industry partnerships to help ensure our sustainability as a National Centre of Excellence. We will build on our pioneering work within our current i-sense IRC which focused on three infectious diseases - influenza, HIV and C. difficile. The step change we now propose is to engineer more 'agile' systems that are rapidly adaptable to different diseases, antimicrobial resistant strains and different countries. Recognising the need to develop new systems through an understanding of context, i-sense2 brings together multiple disciplines, Public Health England, the Africa Health Research Institute, the Royal College of General Practitioners Research Surveillance Centre, the NIHR UCLH Biomedical Research Centre, and industry to: 1. Harness deep learning of millions of symptoms reported online (e.g. social media, searches) to track outbreaks, potentially before people visit their doctors and in resource-limited settings; 2. Build smartphone connected diagnostic tests to support front-line health-workers and self-testing. We will develop low-cost biobarcode paper microfluidic tests and handheld sequencing technologies to detect the earliest biomarkers of infection and drug-resistance, and securely send results to online infectious disease clinics;3. Create state-of-the-art visualisation tools to link patients to treatment and map disease 'hot spots' by fusing mHealth, genomic, clinical and epidemiological data; 4. Invest in the careers of our talented researchers to become future leaders;5. Grow a National Centre of Excellence supported by a plurality of funding. Our disease focus will expand to influenza-like-illnesses, sexually transmitted infections and resistant-bacteria, as exemplars of acute, chronic and emerging infections. We will build population-level 'test beds' in the UK and South Africa, to pilot our technologies and then bid for next stage translational funding for clinical trials and product development. Future 'IRC Next Steps Plus Awards' will explore new research directions e.g. sensing systems for Ebola and Zika virus.i-sense2 has the potential to bring major human and economic benefits to millions of people worldwide. Patients will benefit from receiving faster access to potentially life-saving treatment. Populations will benefit from reduced disease transmission, health systems will benefit from rapid diagnostics, and patient self-management. Industry will benefit from skilled people and new commercial opportunities. Public health will benefit from more timely interventions and pandemic preparedness.