1507979<br/>Yan<br/><br/>Enteric and diarrheal diseases are a major cause of human illness in the United States and around the world. Major challenges in effectively combating infectious enteric diseases include the lack of real-time information about disease outbreaks and the incapability of quantifying baseline community disease burdens using traditional clinic-based approaches. A novel approach is proposed to transform municipal wastewater treatment systems into community enteric disease information networks, taking advantage of the unparalleled capability of municipal wastewater treatment systems in collecting accurate and real-time enteric disease information from the communities. Preliminary data demonstrated the utility of using molecular tools to quantify and study enteric bacterial pathogens in municipal wastewater, and also showed the possibility of establishing real-time correspondence between pathogen strains in wastewater and in health clinics.<br/><br/>The research goal of this project is to firmly establish the feasibility of using municipal wastewater treatment systems for community disease monitoring. The research hypothesis is that enteric pathogens in municipal wastewater are reliable, quantitative, and real-time indicators of enteric diseases in a community. To test the hypothesis, three specific research objectives, each corresponding to one desirable feature of the hypothesis, will be achieved: (1) determine the decay rates of target bacterial pathogens and reference fecal indicator bacteria in wastewater, (2) determine the quantitative relationship between wastewater pathogen concentration and community enteric disease burden, and, (3) verify real-time detection of community disease outbreaks using Salmonella in municipal wastewater. Overall, this project will investigate the feasibility of a novel approach to address major challenges in community disease monitoring by using existing wastewater infrastructure. This novel approach has the potential to transform the landscape of community disease monitoring, providing game-changing capabilities in understanding the origin, transmission, and evolution of enteric diseases as well as in protecting the public from disease outbreaks. If proven feasible, this will greatly expand the role of wastewater infrastructure in public health protection and provide strong impetus for upgrading and adequately maintaining the wastewater infrastructure. This project will also test and optimize a new high throughput microfluidic qPCR technology for simultaneously quantifying multiple pathogens in municipal wastewater. This will also be the first attempt to determine the quantitative relationships between pathogens in municipal wastewater and corresponding community diseases. Finally, DNA fingerprinting technologies will be used to establish real-time detection of clinically relevant pathogens in municipal wastewater at the strain level. The project proposes a comprehensive plan that will (1) involve Native Hawaiian students in environmental research, and (2) conduct outreach activities to local high school students.