The goal of this project is to develop a sewage informatics-based surveillance platform for infectious disease outbreaks and antimicrobial resistance in Singapore. Currently, the bioinformatics aspects have been transferred from MIT and are being built up in Singapore in order to create a platform powered by genomics and metabolomics. These ‘omics data and basic platform in the AMR lab are complementary to and provide foundation for the Intra-CREATE Cities grant awarded for “Sewage-based surveillance for rapid outbreak detection and intervention in Singapore”.
Our goal is to enable mapping of disease and chemical signatures in Singapore’s sewage network. The work proposed herein combines novel methods-development for sewage-based surveillance of viruses that are of public health concern in Singapore. We will focus on Dengue fever but would also adapt and validate our state-of-the-art panel assay for detection of 11 other key human pathogenic RNA viruses including Norovirus, Enterovirus (including Poliovirus) and hepatitis A and E viruses. Sampling and analysis will be accomplished through implementation of an MIT-developed platform technology. This approach to sampling for disease agents that is agnostic to disease prevalence could be especially pertinent for early detection of impending outbreaks. In the case of Dengue and Zika, the occurrence of large number of cases may be preceded by introduction of new strains of Dengue or Zika virus. Such introduction may be missed due to a combination of factors, including asymptomatic/subclinical infections and lack of urgency in healthcare seeking behavior during non-epidemic periods. Consequently, detecting a build-up of Dengue or Zika virus in the sewage could be an early warning system that complements both case and mosquito surveillance in Singapore. If successful, such an approach could be rapidly expanded to survey for other emerging viruses.

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