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

Part 1.<br/>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.<br/><br/>Part 2.<br/>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.