Refining Surveillance for Zoonotic Respiratory Viruses in Sarawak, Malaysia (2018-2019)

Background

Zoonotic diseases, caused by pathogens transmitted from animals to humans, account for approximately three out of five new human illnesses. The multidisciplinary One Health approach is gaining traction as the way forward in solving the problem of emerging diseases plaguing human, animal and environmental health.

Southeast Asia has been identified as a hotspot for infectious diseases due to the tropical climate and anthropogenic factors that have led to increased contact between humans, wildlife and the ecosystem. In recent years, novel respiratory viruses such as avian and swine influenza viruses, enteroviruses and adenoviruses have caused significant outbreaks that have devastated human and animal populations. Stakeholders acknowledge the importance of increasing surveillance and epidemiological research to understand the emergence of zoonotic diseases to prevent potential future pandemics; however, major gaps in surveillance remain in Malaysia, particularly at the interface of human and animal health.  

Project Description

Building on the work of the 2017-18 Bass Connections project team, this project aims to refine surveillance efforts for emerging respiratory viruses in Malaysia; leverage a One Health approach to understand the etiology of respiratory viruses; and build the surveillance and diagnostic capacity of local collaborators.

Bioaerosol specimens collected during a pilot sampling at an abattoir were positive for several novel respiratory viruses, including enteroviruses, porcine circovirus 2 (PCV2) and porcine reproductive and respiratory syndrome virus (PRRSv). Given the abundance of human and nonhuman respiratory pathogens detected in the air, this project will implement increased surveillance of respiratory pathogens in environments where there is frequent contact between animals and humans. Team members will conduct repeat sampling in night abattoirs and introduce several new and high-priority environments in Sarawak to include poultry farms and live poultry markets. In addition, the team will introduce surveillance in school environments. Children are known sentinels for disease in the greater community, and given the noninvasive methodology of bioaerosol sampling, monitoring schools for the presence of respiratory viruses is an appropriate mechanism to potentially predict community illness.

The team will collect 75 aerosol samples over 10 weeks in Sarawak and examine these samples for influenza viruses A, B, C and D, adenoviruses, enteroviruses, coronaviruses, PCV2 and 3 and PRRSv.

Anticipated Outcomes

Several publications; data for future grant applications; participation in domestic and international conferences; increased laboratory and diagnostic capacity at Sibu Hospital’s Clinical Research Centre

Student Opportunities

Students will have unique opportunities to conduct their fieldwork in multiple settings across Sibu and Kapit, to include night abattoirs, poultry farms, schools, Sibu Hospital and the Clinical Research Centre laboratory. In addition to collecting field specimens, students will gain hands-on experience conducting molecular work, such as RNA and DNA extractions and real-time polymerase chain reaction. Students may have the opportunity to engage in workshops held by the Clinical Research Centre while conducting their fieldwork.

Malay and Mandarin are the two most commonly spoken languages in Sibu, though all on-the-ground collaborators speak English. Master’s students will gain skills in cross-cultural and cross-disciplinary collaboration, as well as competence in team management. Components of the project will potentially be developed into individual research undertakings for the master’s students to submit for publication in peer-reviewed scientific literature.

The team will highlight a collaborative relationship between six students of different education levels and academic backgrounds from both Duke University and Duke Kunshan University. In addition to engaging two Duke University master’s students in global health (to be named), one or two global health master’s students from Duke Kunshan University will be recruited. One Duke University master’s student will be selected at the outset of the study to serve as project manager/study facilitator. S/he will be responsible for documenting the team’s progress toward project milestones, leading team meetings and directing communications among team members and leaders. Two undergraduate students will be recruited from Duke University, with an emphasis on students with a background in global health, biology, chemistry, environmental science or engineering. While previous laboratory experience is recommended, it is not required.

To prepare for the Summer 2018 field data collection in Malaysia, team members will begin to work together and develop molecular laboratory skills in Spring 2018. The team based at Duke University will meet on a weekly basis to establish a team charter, discuss research methods and prepare for field departure. The team will conduct Skype calls with the Kunshan-based team members on a bimonthly basis. The project manager will lead the IRB and IACUC review process in collaboration with contributors from Sibu Hospital.

Upon completion of two weeks of the One Health Training Program in Summer 2018, the team will travel to Sibu, Sarawak to complete 10 weeks of fieldwork and laboratory work. Returning to their respective Duke campuses, students will collaboratively analyze the data, complete any outstanding lab work and work toward publication of a manuscript.

Students will be evaluated with course grades during the One Health Training Program. Students will collectively evaluate how effectively they have performed during weekly meetings in the Spring and Fall 2018 semesters.

This project is pre-approved to meet the Global Health major’s Experiential Learning Activity requirement.

Timing

Spring 2018 – Fall 2018  

  • Spring 2018: March: begin weekly meetings; undergraduates begin training in One Health lab; project manager finalizes IRB and IACUC approval with Malaysia’s National Medical Research Register and Duke; April: continue trainings, meet weekly and prepare laboratory materials
  • Summer 2018: May 17 - June 1, Duke One Health Training Program; June 2, depart for Sarawak for 10 weeks of fieldwork
  • Fall 2018: Continue analysis of collected data during weekly meetings; work on deliverables, including posters, manuscripts and oral presentations

Crediting

Independent study credit available for fall and spring semesters; summer funding

See earlier related team, Building Capacity for Surveillance and Diagnosis of Respiratory Viruses in Sarawak, Malaysia (2017-2018).

Themes

Faculty/Staff Team Members

Kristen Coleman, Duke-NUS Medical School, Singapore
Jane Fieldhouse, Duke Global Health Institute
Gregory Gray, School of Medicine-Medicine: Infectious Diseases*
Nathan Thielman, School of Medicine-Medicine: Infectious Diseases*

Graduate Team Members

Karen Lin, Medicine-MD

Community Team Members

King Ching Hii, Kapit Hospital
Teck Hock Toh, Sibu Hospital, Malaysia

* denotes team leader

Status

Active, New