Seventeen million people in the UK get diarrhoeal disease each year, and current surveillance systems miss many cases because fewer patients visit their GP. This project builds a single, real-time system that links human and animal health data, replacing slow lab tests with rapid genome sequencing to identify the exact pathogen behind a cluster of illness. The system also tracks how new strains evolve and whether they jumped from animals to humans. If it works, Health Protection teams and Environmental Health Officers will spot community outbreaks days or weeks earlier than they do now, allowing them to shut down contaminated food sources, issue public warnings, or treat water supplies before the outbreak spreads. The research is applied and practical—it directly redesigns how the UK detects and responds to diarrhoeal disease, from the patient’s first symptoms to the final lab confirmation.
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Seventeen million people suffer from diarrhoeal disease in the UK annually. It commonly causes outbreaks - norovirus outbreaks alone are the third most costly healthcare-associated infection in the NHS. Recent severe outbreaks of Escherichia coli O104 in Germany and O157 at Godstone Farm in Surrey are timely reminders that rapid detection, through surveillance, is key to control. We need to identify the nature, distribution and scale of outbreaks quickly enough to lessen impact. The hidden burden of undiagnosed disease is growing as fewer people consult their General Practitioner, reducing outbreak detection sensitivity. We will use syndromic surveillance for cluster detection in the community and targeted sampling, replacing traditional diagnostics with rapid modern technologies, to identify and characterise responsible pathogens rapidly. We will apply targeted microbial metagenomics, using latest-generation genome sequencing for pathogen discovery, and determine phylogeny and evolutionary trends to understand how new agents have arisen. Many diarrhoeal diseases are zoonotic yet medical and veterinary surveillance systems are poorly integrated so we will incorporate and develop veterinary surveillance. An interdisciplinary, integrated, real-time, surveillance/diagnosis/investigation system, placing the patient at its centre, will enable earlier detection of community outbreaks, lessening harm because Health Protection professionals and Environmental Health Officers can intervene faster.
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