Professors Receive Pilot Award for Infectious Disease Project.
Antimicrobial resistance is a significant threat to global public health, and two School of Public Health professors are one step closer to tackling the worldwide problem.
Jean van Seventer, clinical associate professor of environmental health, and Davidson Hamer, professor of global health and medicine at SPH and the School of Medicine, are recipients of the Established Investigator Innovation Award, which will fund the first stages of a research project that aims to identify antimicrobial risks among humans, animals, and the environment in Bangladesh.
The award is part of the SPH Pilot Awards Program, which offers funding opportunities to support faculty needs and research. Funding from the award is meant to prepare recipients for competitive applications for future extramural awards.
The professors’ pilot project, “Identifying Zoonotic Pathways of Antimicrobial Resistance (AMR) in Humans in Southwest Coastal Bangladesh,” encompasses the frame of One Health—a worldwide, trans-disciplinary strategy of achieving optimal health for people, animals, and the environment by recognizing that the health of each are inextricably connected.
“Our project is truly a One Health project, because it involves not only antibiotic resistance issues that can negatively affect the health of both humans and animals, but also tracking the movement of antibiotics and antibiotic-resistant microbes through the environment,” says van Seventer, who is also the faculty advisor for the school’s One Health Student Association. “This is about the health of the ecosystem.”
Van Seventer and Hamer will travel to Bangladesh in December to begin their project during the dry season. The ponds in Bangladesh are an ideal place to conduct antimicrobial resistance research because they are a prime setting for human, animal, and environmental activity. Poultry, livestock, and shrimp farming—all major sources of sustenance and income in the region—involve the heavy use of antibiotics which can promote the evolution of antibiotic-resistant bacteria in the farmed animals. Storm runoff and flooding during the wet season results in ponds receiving surface water that could be contaminated with animal feces containing antibiotics and multi-drug resistant (MDR) bacteria. When communities use ponds for water consumption, this creates an opportunity for increased microbial resistance among humans.
“During the dry season when the rivers recede, the well water becomes very salty and people use standing water on the ground as their water source for drinking, cleaning clothes, and washing utensils,” Hamer says. “But animals walking by may also use them. This can lead to the ponds becoming contaminated by animal waste, human waste, and nearby animal husbandry operations and shrimp aquaculture.”
As a result, he says, humans who rely on pond water during the dry season can develop bacterial diseases such as typhoid fever, non-typhoidal salmonellosis, and cholera.
The professors’ long-term research goal is to show that Bangladesh residents develop diseases and are exposed to antibiotics and antibiotic resistant bacteria as a result of professional and personal use of pond water contaminated by animals. However, before they examine the human risk, Hamer and van Seventer will conduct an exposure assessment to confirm that people who use and ingest the pond water are, in fact, exposed to antibiotics and MDR bacteria in the ponds.
To examine this exposure, Hamer and van Seventer will administer surveys about farming practices and domestic reliance on pond water among residents who live near ponds. They will also collect surface water samples to identify which antibiotics and MDR bacteria are present.
If they receive additional funding, they will be able to incorporate microbial source tracking, a form of genetics testing that would be able to determine the exact sources, down to the specific animal species, from which bacteria spread.
“This is why the surveys are so important; we need to know how people are interacting with different types of animals,” van Seventer says.
Hamer says their ultimate goal for their work in Bangladesh is to develop interventions and change practices that fuel the cycle of bacterial contamination and exposure, which leads to increased antimicrobial resistance.
“Once we know whether bacteria are being transferred from animals to humans, or animals to ponds to humans, we will be able to develop more effective interventions,” he says.
Van Seventer and Hamer are co-instructors of Analysis of Emerging Infections Using the One Health Approach. Van Seventer is trained as a veterinarian and has conducted extensive basic research in human immunology. She is also the director of the Infectious Disease context certificate program.
Hamer is a practicing physician at Boston Medical Center with a special interest in travel and tropical medicine. He runs the travel clinic at BMC as well as GeoSentinel, a global surveillance network that that collects demographic and diagnostic information from migrants and other international travelers. He is also an adjunct professor of nutrition at the Tufts University Friedman School of Nutrition Science and Policy.