Environmental pathogen detection and control using instrumentation and surveillance

Investigators: Prof. K. Sankaran, Prof. P. Kaliraj, Dr. V. Murugan, and Dr. S. Meenakshisundaram,Centre for Biotechnology
Prof. S. Muttan,  Centre for Medical Electronics ssistant Professor, Institute of Remote Dr. R. Vidya, Assistant Professor, Institute of Remote Sensing
Collaborating Institutes: Centre for Cellular and Molecular Biology, Hyderabad; CSIO, CSIR Campus, Chennai;  Local hospitals, Veterinary College, Chennai and Tamil Nadu Public Health Department

Objective: Infectious diseases are still a major health burden as well as poverty promoting factor in India and other developing countries and a threat to even developed countries. Among these, neglected infectious diseases like diarrhea, elephantiasis and many zoonotic diseases have been ranked among the top in the goals for new millennium initiatives of WHO and UN; The magnitude of damage caused and their sheer persistence in environment  makes surveillance and eradication of these pathogens and their vectors at source as the best possible long-term and sustainable solution. Unfortunately this is a mammoth operation given our life style and when about 30% of the huge population is living in impoverished state in poor hygienic conditions sharing the habitat with animals. Added to the complication, we don't even have affordable detection system, leave alone surveillance tools.

As a new initiative taken in theAs a new initiative taken in the first phase of the programme, we developed a few innovative diagnostic methods and built immuno-biosensor based inexpensive portable fluorescence detector prototype for pathogen detection. We were also able to even conduct a limited field trial on such instrumentation and obtained promising results. The target pathogens include bacteria like pathogenic E. coli, Shigella, Salmonella, Leptospira, Vibrio and parasites like . This was feasible mainly because of well-networked project and this model is now being replicated nationwide for developing a variety of instrumentation tools for pathogens, especially with the support of DST.

In the 2nd phase of the CPEES programme of UGC we want to expand the scope and capability of this initiative by developing more instrumentation methods for infectious diseases, develop surveillance tools and use vector control measures. Strategy and Methodology 1) Cluster projects for developing instrumentation tools for pathogen detection: Biosensor based instrumentation for pathogen detection is obviously a multidisciplinary field, typically fitting into a programme like this, requiring the integration and networking of bioscience researchers, instrumentation engineers and clinicians. First such a brainstorming meeting sponsored by DST was conducted at Anna University on 29th and 30th of Jan 2007 and another investigator-investor meeting is planned for March 2009. Clusters formed in such meeting would generate the basic instrumentation tools for a variety of common infectious diseases prevalent in India. Such devices would be readily adapted for food and environmental samples. 2) Development of Surveillance tools: Whereas patient-level care or limited screening because of limitation of available instrumentation technology will have some impact, effective control is possible only if the source of spread is identified and eliminated, by available methods. This requires efficient surveillance with high-throughput tools, operations, data collection, quick processing of multitude of data and rapid dissemination of results for action. So the currently available instrumentation tools will be converted to high-throughput formats by modifying appropriately the technique as well as instrumentation. Non-invasive remote detection techniques are being contemplated as tools for surveillance initially for strategic locations such as in hospital environment or different water bodies in endemic areas. The data collected would be communicated through wired or wireless system to processing centre to disseminate information to various agencies. Such networked management successfully used in industrial production and energy management with one of the partners, CSIO, will be adapted for our purpose. 3) Field study incorporating GIS and RS tools: Ironically studies conducted by RS and GIS groups concentrate on environmental parameters and characteristics without worrying about how these could be linked to persistence and/or spread of pathogens in environment. Therefore in this programme we want to combine the strengths and capabilities of GIS and RS by training their filed workers in the tools that we develop so that the data that are generated could be viewed more collectively and holistically to identify environmental factors responsible for the persistence and spread of the infectious pathogen or its vector. The software tools for the correlations and comparative study would be developed as part of this exercise. Such type of studies using manual methods for pathogen identification have been done for mapping endemic areas of filariasis by Vector Control Research Centre, Pondichery and in identifying the locality-wise disease profile in a limited area by Christian Medical College. To exploit the powers of RS, it is also important that the tools developed should be compatible. Manual methods requiring skilled or semi skilled operations would not suit for this purpose. Therefore instrumentation based identification of pathogen would be an excellent platform for such purpose. Once RS based surveillance is established, control of infectious diseases could become much easier and straight forward. Though this could be an ambitious aim of this programme, we believe it could definitely help achieve the aim subsequently. 4) Biomarker identification for emerging pathogens and instrumentation for Multi-Drug-Resistant bacteria: Study of the proteins on the outer surface using Proteomics techniques (electrophoresis followed by mass analysis) is a powerful method to identify characteristic biomarkers accounting for the virulence traits. Such a study is being done in case of enteropathogenic E.coli isolated from the childhood diarrhoeal cases admitted to Children�s hospital, Egmore, Chennai revealing interesting variations. Such biomarker based tools will aid in effective surveillance. Multi-drug resistance is another virulence trait acquired from environment conducive for genetic exchange. In fact spread of such MDR strains, as in the case of TB, are dreaded and requires monitoring on priority. We are already developing an instrumentation method for identifying MDR phenotypes in a high-throughput format and it'll be used for surveillance. 5) Training of public health workers, NGOs, and NSS volunteers in instrumentation: Unlike in the case of non-communicable diseases like cardiovascular or diabetes, the awareness among the public health workers and NGOs on communicable diseases and ways to eradicate them is poor mainly because of lack of instrumentation based control measures. For example, public have much better knowledge of sugar and cholesterol effects rather than of bacteria. Therefore, we would target them in training through frequent workshops on the use of our tools. In fact in the immediate next phase we are keen to teach our NSS, NSC, and other student volunteers on such information and spread the message more effectively and with our community radio and micro satellite facility of Anna University. Expected major outcome Our efforts to develop infectious pathogen detection methods in a variety of environmental samples will continue throughout the 2nd phase. As the instrumentation tools are made ready from the end of the 1st year, training programmes and field studies will be started at frequent intervals of once in 3 months, throughout the programme. This could generate the much-needed awareness, acceptance and use of such methods in public health. Development of surveillance tools and integration with GIS and RS studies will begin from the start of the project and useful results may be expected only from the end of the 2nd year. The investigatory research in developing non-invasive remote sensors based tool development would take longer to yield significant results only towards the end of the programme. In all, we expect that with the availability of instrumentation tools, integration with the field level staff and volunteers, education of public and public health officials on such facilities would have initiated definitive steps towards technology based control of infectious diseases by monitoring environment. Our interactions and networking throughout the country through national programmes on instrumentation would bring in outside expertise to augment our capabilities to control infectious diseases. Such an integrated effort in the control of infectious diseases using new technology development is a unique attempt in the country, if not in the world.