Many important infectious diseases are associated with exposure to human and animal feces. In fact, most diarrheal diseases - the second leading cause of morbidity and mortality in children worldwide - result from exposure to infectious microorganisms in feces. To date, research has focused principally on exposures to human feces. Research on the significance of feces from animals to diarrheal diseases in humans is limited and not well understood. Yet, animal feces, replete with human enteric pathogens, are common contaminants in the human environment of poor communities. Further, the population of animals raised for food is rising due to increased demand for meat, poultry and dairy products in low and middle-income countries. In order to maximize our ability to prevent the spread of infectious diseases associated with feces we need to better understand the conditions that contribute to the transmission of enteric infections. Understanding the role that animals play in human enteric infections could lead to important and efficacious population-based strategies that improve the management of animal feces - breaking the fecal-oral route of zoonotic disease. This International Research Scientist Development Award (K01) will enable Dr. Jay Graham, a global environmental health researcher at the George Washington University School of Public Health and Health Science (SPHHS), to establish himself as an independent investigator through a combination of mentorship in advanced epidemiology, molecular microbiology and conducting international research. Dr. Graham's research focuses on diarrheal diseases and emerging infectious diseases associated with animals and livestock, with particular emphasis on childhood exposures to pathogenic enteric bacteria. The proposed K01 training and research will allow Dr. Graham to accomplish the following goals: 1) Improved ability to design studies that can quantitatively test disease transmission between humans and animals in diverse low-income semi-rural communities characterized by differing levels of interactions between humans and animals;2) Increased knowledge of special ethical issues in conducting research in low-income communities;3) Enhanced skills at working with community partners at all levels of research and implementation of interventions;4) Increased aptitude to build a broad network of mentors and colleagues who will serve as collaborators on future projects;and 5) Success at applying novel molecular microbiologic techniques to study the spread of zoonotic enteric infections. To become a successful independent global health researcher, Dr. Graham will engage in a four-year training program under the primary mentorship of Dr. Melissa Perry, the Chair and Professor of Environmental and Occupational Health at the GW SPHHS and Dr. Gabriel Trueba, a leading public health and veterinary microbiologist at The Universidad San Francisco de Quito. Dr. Graham has an experienced and collaborative mentoring team, which also includes Dr. Lance Price (GW SPHHS), an expert in genomics analysis of bacterial pathogens and Dr. Joseph Eisenberg, a leading epidemiologist in infectious enteric disease transmission.
Diarrhea is a leading cause of morbidity and mortality across all age groups and regions of the world. While it is known that diarrheal diseases mostly result from exposure to infectious microorganisms in the feces of humans and animals, there is a significant gap in our knowledge of the significance of enteric diseases that result from exposure to zoonotic enteropathogens. Livestock production is growing at an extraordinary rate in LMICs and animal feces are common contaminants in children's environments, especially those living in poor communities. This study will apply epidemiologic and next-generation DNA sequencing to refine our understanding of the transmission of zoonotic enteropathogens to children living in low-income semi-rural communities near Quito, Ecuador.