Year 14 Pilot: Designing Community-Led Public Health Surveillance in Rural Areas

PI: Marlene Wolfe

Public health and local leaders have begun to use samples from wastewater as a way to understand community health. We can use sewage to detect the presence of bacteria and viruses (shed in urine, stool, and saliva) in the broader community, , including infectious diseases outbreaks. However, rural and remote areas have largely been left out of these programs, which are mostly used in cities with large sewer systems. Remote communities already have limited access to public health support during outbreaks. They are located far from medical systems that would diagnose and report disease, so cases of infectious diseases, such as tuberculosis and the flu, are often underestimated. Alaska Native communities are especially at risk. They experience higher rates of infectious disease than the rest of the U.S. and are extremely remote and disconnected from medical services. Monitoring wastewater with low-cost, efficient methods in these communities can help us understand how illnesses are spreading and support public health response. We will partner with Alaska Native communities to explore their needs for infectious disease monitoring and to co-design sampling and data handling methods for portable, low-cost wastewater monitoring technologies. We will do this through interviews, focus groups, and workshops with the communities. This project will empower communities to lead their own surveillance efforts and improve local access to public health data, while we learn how to best design and scale environmental public health surveillance in rural and remote settings.

How this study advances exposome science: This research will help determine the best ways to introduce wastewater surveillance into rural communities, enabling us to collect high quality information on community exposures while establishing community data ownership and management.