RAPID: Investigating risk for environmentally acquired nontuberculous mycobacterial lung infections in the wake of the Lahaina, Maui wildfires

The objective of this Rapid Response Research (RAPID) project is to study the risk for naturally occurring nontuberculous mycobacteria (NTM) exposure after the 2023 Maui wildfire. Exposure to NTM can cause chronic and difficult to treat lung disease in people globally that is acquired through inhalation of these bacteria or ingestion through contaminated tap water.

In the United States, Hawai’i is a widely recognized hot spot for NTM infections. On August 8-9 a deadly wildfire of yet unknown cause completely burned grasslands and destroyed hundreds of buildings and homes in the historic town of Lāhainā. There are many concerns including toxic ash exposure and compromised water systems.

The acute and long-term repercussions on this community are uncertain but may include negative effects on lung health for Lāhainā residents and because wildfire pollutants can travel over long distances, the fire may also have affected neighboring islands. Recognition of respiratory bacterial infections in the aftermath of wildfires is a challenge that needs a much clearer understanding particularly in the wake of the ever-increasing frequency of fires and other similar natural disasters.

Project results will be combined with previously collected data on environmental NTM diversity and volcanic exposures in the State of Hawai’i collected before the Lāhainā inferno to learn significantly more about environmental factors that increase NTM risk in the community.

Extreme, deadly wildfires are increasing in occurrence on a global scale particularly in the context of exacerbating climate change, elevating fires as a significant public health threat. Yet wildfire microbiology with pulmonary implications is an understudied field. In the current proposal, researchers will apply quantitative microbiological, molecular, ecological, and genomic analyses to study the possibility for a “one-two punch” that is, “wildfire-NTM” punch in the context of the Lāhainā inferno.

Study objectives include performing timely sampling of the environment as close to the event as possible to include wildfire ash, smoke, water, soil, and dust to elucidate NTM diversity, compare Lāhainā wildfire NTM to pre-existing NTM species diversity in Maui and other neighboring islands before the wildfire, and study fire pollutants as a possible carrier of NTM organisms. By capturing new information regarding NTM within the immediate fire aftermath and by comparing results to before fire data, broader impacts to society include identification of key areas of exposures that increase vulnerability for residents, first responders, and those who choose to rebuild, not only in the context of NTM lung disease but other similar environmentally acquired lung pathogens influenced by growing climate changes.

This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.