Genomic Epidemiology to underpin One Health surveillance for rabies

基因组监测，即利用病原体的遗传蓝图跟踪其传播以应对控制措施，已成为当代疾病管理的关键工具。这种方法现在几乎可以在任何地方部署，并几乎实时地进行，为快速和有针对性的干预提供信息。然而，基因组监测通常适用于高收入国家具有大流行潜力的新发疾病（例如SARS-COV-2）。我建议重新调整基因组监测的目的，以监测地方性人畜共患病，即狂犬病等从动物传播给人的疾病，这些疾病在许多低收入和中等收入国家造成了重大的可预防疾病负担。这种办法将同时通过加强与当地有关的能力，改善对新出现的传染病的监测，并提供在“大流行病和平时期”发展尖端方法和能力的手段，同时对公共卫生产生明显、切实的影响。我的建议侧重于开发和优化一个可获取的工具包，用于生成和解释狂犬病毒基因序列数据，支持到2030年实现人类因家养狗传播狂犬病而零死亡的全球战略。基因组监测可以在解决复杂的传播动力学，检测引入和确定其来源方面发挥关键作用。了解流行病学对于设计和评估国家消除狂犬病规划非常重要，因为这些规划正在越来越多地推广。拟议的工作包括在资源匮乏环境中生成序列的新型实验室技术，以及分析这些数据以跟踪狂犬病在社区内的本地传播和跨国家和地区的较长距离传播和持续的现代方法。我将通过在非洲、亚洲和拉丁美洲开展广泛的国际合作，部署这一工具箱，以解决具体问题，在实践中支持消除狂犬病规划，建设当地常规国内基因组监测的能力和专门知识。

Genomic surveillance, i.e. using a pathogen's genetic blueprint to track it's spread in response to control measures, has become a key tool in contemporary disease management. This approach can now be deployed almost anywhere and conducted in near real-time to inform rapid and targeted interventions. Yet genomic surveillance is typically applied to emerging diseases with pandemic potential (e.g. SARS-COV-2) in high-income countries. I propose repurposing genomic surveillance for endemic zoonoses, diseases that spread from animals to people, such as rabies, that inflict a major preventable disease burden in many low- and middle-income countries. Such an approach would simultaneously improve surveillance for emerging infectious diseases through locally relevant capacity strengthening and provide the means to develop cutting-edge methodologies and capacities in "pandemic peacetime", whilst generating visible, tangible impacts on public health. My proposal focuses on developing and optimising an accessible toolkit for generating and interpreting rabies virus genetic sequence data, supporting the global strategy to achieve zero human rabies deaths from rabies spread by domestic dogs by 2030. Genomic surveillance can play a key role in resolving complex transmission dynamics, detecting introductions and identifying their sources. This epidemiological understanding is important for both designing and evaluating national rabies elimination programmes, as they are increasingly rolled out. The proposed work encapsulates novel laboratory techniques to generate sequences in resource poor settings, and contemporary methods for analyzing these data to track rabies spread and persistence, both locally within communities and longer-range movement across countries and regions. I will deploy this toolbox through my extensive international collaborations across Africa, Asia and Latin America to address specific questions to support rabies elimination programmes in practice, building local capacity and expertise for routine in-country genomic surveillance.