Title: NIHR Health Protection Research Unit in Emerging and Zoonotic Infections (Lead: University of Liverpool)
Funder: Department of Health and Social Care

Abstract: The overarching aim of the Health Protection Research Unit (HPRU) is to support and strengthen Public Health England (PHE) in protecting England from emerging and zoonotic infections, whilst increasing research capacity. Emerging infections are those which have appeared recently, or are increasing rapidly in incidence or geographical range, e.g. Ebola, MERS (Middle East respiratory syndrome), Zika and monkey pox. Most are also zoonotic, meaning they spread from animals to humans. Other zoonoses are already established in the UK, e.g. Lyme disease. Many emerging and zoonotic infections are spread by bites from mosquitoes or ticks (arthropod vectors); others are classified as high consequence infectious diseases (HCIDs) because they spread from human to human directly, have high death rates, and lack effective vaccines or treatments Background: This HPRU builds on the first HPRU in Emerging and Zoonotic Infections (EZI; 2015-20), a partnership between the University of Liverpool, Liverpool School of Tropical Medicine, and PHE. It is enhanced by the addition of University of Oxford, and the considerable research strengths of all partners. The HPRU will address key emerging and zoonotic threats, through Three Major Programmes of interlinked projects on: I &ndash; High Consequence Infectious Diseases (HCIDs) II &ndash; Imported mosquito-borne infections, such as Zika and dengue, which can have severe neurological complications III &ndash; Tick-borne diseases in the UK such as Lyme. The research will examine crucial questions through Four Major Themes: 1. Patient Research for Public Health &ndash; can we improve the detection and management of patients with HCIDs and other imported infections? 2. Diagnostics and Host Response &ndash; can we strengthen our ability to diagnose infections with more effective innovative tests and through examining the body s immune reactions? 3. Pathogen and Vector Biology &ndash; how are the pathogens (viruses) changing and interacting with mosquitoes, ticks and humans? 4. Epidemiology and Risk Analysis &ndash; what are the risks of acquiring infection and can they be reduced? Our cross-cutting Knowledge Mobilisation and Patient and Public Involvement and Engagement Theme will ensure we address questions important to the public and maximise our research impacts. Outcome: At the end of five years we will understand better how to recognise HCIDs and minimise the risk from imported and endemic vector-borne diseases; have enhanced our diagnostic approaches; and improved understanding of infection and transmission risks. The overall outcome will be a stronger evidence base for PHE policies on management and control of emerging and zoonotic infections.

Lay abstract: The overarching aim of the Health Protection Research Unit (HPRU) is to support and strengthen Public Health England (PHE) in protecting England from emerging and zoonotic infections, whilst increasing research capacity. Emerging infections are those which have appeared recently, or are increasing rapidly in incidence or geographical range, e.g. Ebola, MERS (Middle East respiratory syndrome), Zika and monkey pox. Most are also zoonotic, meaning they spread from animals to humans. Other zoonoses are already established in the UK, e.g. Lyme disease. Many emerging and zoonotic infections are spread by bites from mosquitoes or ticks (arthropod vectors); others are classified as high consequence infectious diseases (HCIDs) because they spread from human to human directly, have high death rates, and lack effective vaccines or treatments Background: This HPRU builds on the first HPRU in Emerging and Zoonotic Infections (EZI; 2015-20), a partnership between the University of Liverpool, Liverpool School of Tropical Medicine, and PHE. It is enhanced by the addition of University of Oxford, and the considerable research strengths of all partners. The HPRU will address key emerging and zoonotic threats, through Three Major Programmes of interlinked projects on: I &ndash; High Consequence Infectious Diseases (HCIDs) II &ndash; Imported mosquito-borne infections, such as Zika and dengue, which can have severe neurological complications III &ndash; Tick-borne diseases in the UK such as Lyme. The research will examine crucial questions through Four Major Themes: 1. Patient Research for Public Health &ndash; can we improve the detection and management of patients with HCIDs and other imported infections? 2. Diagnostics and Host Response &ndash; can we strengthen our ability to diagnose infections with more effective innovative tests and through examining the body s immune reactions? 3. Pathogen and Vector Biology &ndash; how are the pathogens (viruses) changing and interacting with mosquitoes, ticks and humans? 4. Epidemiology and Risk Analysis &ndash; what are the risks of acquiring infection and can they be reduced? Our cross-cutting Knowledge Mobilisation and Patient and Public Involvement and Engagement Theme will ensure we address questions important to the public and maximise our research impacts. Outcome: At the end of five years we will understand better how to recognise HCIDs and minimise the risk from imported and endemic vector-borne diseases; have enhanced our diagnostic approaches; and improved understanding of infection and transmission risks. The overall outcome will be a stronger evidence base for PHE policies on management and control of emerging and zoonotic infections.

Research activity codes: 4.5 RESOURCES AND INFRASTRUCTURE (DETECTION)
Health categories: INFECTION