Impacts of Human Movement on Regional Strain Distribution of Diarrheagenic E.coli

描述(由申请人提供)：本建议书描述了埃默里大学罗林斯公共卫生学院环境卫生系助理教授Karen Levy博士的职业发展和培训计划。利维博士的职业目标是成为传染病流行病学和生态学的独立研究员，专注于肠道疾病。K01导师职业发展奖将使她能够在正在进行的合作的基础上，与新的导师发展关系，并保护时间来制作科学手稿，这将增强她已经强劲的出版记录。利维博士将通过以下方式接受分子流行病学和细菌遗传学方面的培训：(1)参加一系列短期课程；(2)获得微生物基因组学方面的经验和培训；(3)接受由资深教员组成的杰出团队的指导。通过这一培训计划，利维博士将提高她整合社会、流行病学和分子数据以了解传染病传播和传播机制的能力。她的指导团队包括传染病流行病学专家：埃默里大学的Uriel Kitron博士和Les Real博士，以及密歇根大学的Betsy Foxman博士。环境：埃默里大学为利维博士提供了一个发展独立调查员职业生涯的绝佳场所，该大学已表示将致力于利维博士的职业发展。Emory在水和健康研究以及疾病生态学方面的优势使其特别适合在肠道疾病流行病学领域孵化职业生涯。研究：拟议的研究项目将使用精细的遗传数据来了解从地方到全国的多个空间尺度上的传播过程，影响厄瓜多尔埃斯梅拉达斯省波本地区的致泻性大肠杆菌菌株的分布。这项研究的目的是调查城市和农村地区之间的人类旅行在确定致病性大肠杆菌循环菌株分布方面所起的作用。这是 这一点很重要，因为流通中的菌株会影响自然人群中腹泻病的发生。该研究方法将经典的流行病学病例对照研究设计与全基因组测序、系统发育分析和人类活动数据相结合，以解决以下具体目标：(1)调查旅行是肠道疾病，特别是致泻性大肠杆菌的危险因素；(2)检查区域人口中心作为边远农村流行的致泻性大肠杆菌菌株的共同枢纽的作用；(3)调查 致病性大肠杆菌菌株的遗传相似性与全国范围内人类运动模式之间的相似之处。这项研究将拓宽观察和设计肠道疾病控制的最佳控制策略的视角。这些结果将为投资于人口稠密中心控制病原体的基础设施提供洞察力，是否也会通过限制不同致泻性大肠杆菌菌株的区域传播来影响边远农村地区的情况。

DESCRIPTION (provided by applicant): This proposal describes a career development and training plan for Dr. Karen Levy, Assistant Professor in the Department of Environmental Health at Emory University's Rollins School of Public Health. Dr. Levy's career goal is to become an independent investigator in the epidemiology and ecology of infectious diseases with a focus on enteric diseases. The K01 mentored career development award will allow her to build on ongoing collaborations, develop relationships with new mentors, and have protected time to produce scientific manuscripts that will bolster her already strong publication record. Dr. Levy will receive training in molecular epidemiology and bacterial genetics by (1) participating in a series of short courses; (2) gaining experience and training in microbial genomics; and (3) receiving mentoring from an exceptional team of senior faculty. Through this training program, Dr. Levy will increase her capacity to integrate social, epidemiological, and molecular data towards understanding mechanisms of infectious disease transmission and spread. Her mentoring team includes experts in infectious disease epidemiology: Drs. Uriel Kitron and Les Real at Emory University and Dr. Betsy Foxman at University of Michigan. ENVIRONMENT: Emory University provides an excellent venue for Dr. Levy to develop a career as an independent investigator and the university has signaled its commitment to Dr. Levy's career development. Emory's strengths in water and health studies and disease ecology make it especially suited to incubation of a career in the epidemiology of enteric diseases. RESEARCH: The proposed research project will use fine-scale genetic data to understand transmission processes at multiple spatial scales, from local to country-wide, affecting the distribution of diarrheagenic E. coli strains in the Borbon region of the Ecuadorian province of Esmeraldas. The goal of the research is to investigate the role that human travel between urban and rural regions plays in determining the distribution of circulating strains of pathogenic E. coli. This is important because the strains in circulation affect the occurrence of diarrheal illness in na¿ve populations. The research approach combines a classic epidemiological case-control study design with whole genome sequencing, phylogenetic analysis, and data on human movement to address the following Specific Aims: (1) Investigate travel as a risk factor for enteric diseases, specifically diarrheagenic E. coli; (2) Examine the role of a regional population center as a common hub of diarrheagenic E. coli strains circulating in outlying rural villages; (3) Investigate parallels between genetic similarity of pathogenic E. coli strains and human movement patterns on a country-wide scale. This research will widen the lens by which to view and design optimal control strategies for the control of enteric diseases. The results will provide insights into whether investing in infrastructure to control pathogens in dense population centers could also affect conditions in outlying rural areas by limiting regional circulation of diverse strains of diarrheagenic E. coli.