Tag: Epidemiology

Pandora Report 6.24.2016

by spopescu, posted in Pandora Report

Welcome back to your weekly biodefense roundup! To start things off on a light note and since it’s official summer, enjoy this satirical piece on the existence of public pools. In truth, public pools are a mixture of fun and risk for waterborne diarrheal diseases, so remember to stay safe. The NIH has given the green light for CRISPR-Cas9 clinical trials for cell therapies related to cancer treatment. Japan is currently on alert for a possible North Korean ballistic missile launch. Lastly, even though the outbreak appears over, many are discussing the aftermath of Ebola and if it’s really behind us

Tales from the Front Lines of Disease Detective Cases
Foreign Policy‘s Laurie Garrett discusses epidemic fighters, especially the work of Ali Khan, and his quest to speak the truth about epidemics. Khan’s work as an EIS officer and former Director of the Office of Public Health Preparedness and Response (PHPR) has given him a wealth of knowledge from being in the trenches of global outbreaks. Khan’s new book, The Next Pandemic: On the Front Lines Against Humankind’s Gravest Dangers, discusses his experiences from the Amerithrax attacks to the debate on smallpox sample destruction. “Khan writes, the most vital problem-solving exercise has little to do with science, and everything to do with social customs. In 2015, Khan was involved in an out-of-control moment in the Ebola epidemic of Sierra Leone. Long after neighboring Liberia had its outbreak down to a handful of cases, the military-run campaign in Sierra Leone was losing the support of the people by imposing mass quarantines, shutting down entire regions of the country for long periods. Out of the discontent over loss of business, food, and trade arose false leaders claiming witchcraft practiced by the foreigners and magic were spreading the Ebola — not intangible things few could comprehend, like ‘viruses.'” The blend of public health preparedness and front-line outbreak response gives Khan a unique and appreciated perspective into the world of global health security.

Why Hasn’t Disease Wiped Out the Human Race?
University of Pittsburgh’s infectious disease physician, Amesh Adalja, discusses why an infectious disease event with the magnitude of the Andromeda Strain is a bit more unlikely than people realize. He notes that an “apocalyptic pathogen” needs to be in the right place at the right time – more specifically, a combination of having no existing treatment or vaccine and high transmissibility prior to the start of symptoms. “The three infectious diseases most likely to be considered extinction-level threats in the world today—influenza, HIV, and Ebola—don’t meet these two requirements. Influenza, for instance, despite its well-established ability to kill on a large scale, its contagiousness, and its unrivaled ability to shift and drift away from our vaccines, is still what I would call a ‘known unknown.’ While there are many mysteries about how new flu strains emerge, from at least the time of Hippocrates, humans have been attuned to its risk.” Adalja notes that beyond these three (I’ll call them the Big Three), all the other infectious diseases out there fall short of meeting the global extinction sweet spot. Perhaps one of the most crucial lessons to take away from Adalja’s comments isn’t that we should ignore or diminish the impact of infectious diseases, but that institutional failure and infrastructure instability can often do more damage during an outbreak than the disease. With the growing concern related to antibiotic resistance Dr. Adalja notes that “to me, antibiotic resistance represents the most pressing challenge in the realm of infectious disease and, if it is not overcome, we face the very real prospect of being dragged back to the pre-penicillin era in which even routine surgery was a gamble.”

Iceland, Horses, and Hendra
GMU Biodefense MS student, Greg Mercer, can’t even go on vacation without thinking about global health security, but lucky for us, that means we get to learn about Icelandic horses and Hendra! Fueling our fascination with all things related to One Health and spillover, Greg discusses the exportation of Icelandic horses (look at them, wouldn’t you want one?) but also that importation of horses is banned in Iceland. Even an Icelandic horse that was sent abroad for a short period of time can’t return home. Greg notes that its been this way for a hundreds of years and while the import rules maintain purebred status, the ban also protects against disease. “Iceland has few natural horse diseases, and the breeder I spoke to said that Icelandic horses are frequently unvaccinated, which would be very unusual in the rest of the world. When they’re exported, they have to be treated as if they don’t have any immune protection. The import ban prevents foreign diseases from entering the country (via other horses, anyway).” Check out Greg’s Icelandic experience and why horse diseases struck a cord during his travels.

Incorporating More One Health Into the Global Health Security Diet
Some may say we need more cowbell, but in the world of global health security, we need more One Health. The One Health Commission and the One Health Initiative are teaming up to help create and promote a global education plan that will focus on the “unifying interconnected health of humans, animals, and the environment that sustains all life on earth.” A recent paper looks to accumulate interested parties and help drive the project forward. The drive behind this partnership is to capture the younger generations and lay a strong foundation of One Health education and support. “The overall intent of the concept paper is to raise awareness about the urgent need for the development  and to explore the concept further through a small pre-project proposal conference (possibly off and/or on-line) with a view to fleshing out a strong plan to fund the envisioned global learning program.” The group is currently organizing the pre-project proposal conference, but in the mean time, if you’ve already got some great ideas or are interested in participating in spreading the One Health message, check out their website here.

Zika Weekly Updates
Inovio Pharmaceuticals announced on 6/20 that it received FDA clearance for the phase 1 clinical trials for its Zika vaccine. Clinical trials are set to begin by the end of this year for the DNA-based vaccine. A new study finds that the Zika epidemic can be fielded by climate variations on multiple timescales.  Researchers utilized a novel timescale-decomposition methodology and found that “the increasingly probable 2016-2017 La Nina suggests that ZIKV response strategies adapted for a drought context in Brazil may need to be revised to accommodate the likely return of heavy rainfall.” The CDC has also recently issued guidance for travelers visiting friends in areas with ongoing transmission of Chikungunya, Dengue, or Zika. The NIH is launching a large study in efforts to answer questions about Zika virus and pregnancy. Hoping to enroll 10,000 pregnant girls and women (ages 15 and older) in their  first trimesters, the study will look to long-term impacts on babies and the role that previous dengue infections play in birth defect frequency. You can find the recently published article regarding the history of a newly emerging arbovirus here, which summarizes “the history of Zika virus from its first detection to its current worldwide distribution.” In the early hours of Thursday morning, the House passed the $1.1 billion Zika funding bill. The White House threatened to veto the bill though. “The threat from deputy White House with press secretary Eric Schultz came as the Senate prepared for a vote next week, likely Tuesday, even though there’s no guarantee that the Senate can round up the 60 votes necessary to break a filibuster as Democrats call the bill partisan and inadequate.” Several studies have pointed to the linkage between earlier dengue infection and worsened Zika infections, however there is also a potential for a certain antibody against dengue being a target for a vaccine. The CDC has confirmed, as of June 22nd, there have been 820 cases within the U.S. and DC.

One Step Closer to the Zombie Apocalypse 
Researchers from the University of Washington recently reported that several hundred genes actually increase in expression after death. Scientists found that “the transcriptional abundance of some 500 genes was significantly changed after death in healthy zebrafish and in healthy mice. While gene expression overall declined after death, the expression of some genes increased shortly after death and others increased 24 hours or 48 hours later. These genes, the researchers note, were commonly involved in stress, immunity, inflammation, apoptosis, and cancer.” It’s believed that this post-mortem gene expression is a result of residual energy and this may happen in humans as well. This new discovery leaves many asking about the definition of death if a person’s genes are still active for up to 48 hours after they die.

Listeria Troubles Dozens of Schools  large-epi-curve-6-2-2016
Pre-prepared sandwiches are being recalled across 38 school districts as a result of a possible Listeria contamination. “The potentially contaminated food was produced at a facility where the U.S. Food and Drug Administration found Listeria monocytogenes ‘on multiple food contact surfaces where the products were produced on several different occasions’ during routine FDA environmental sampling, according to the recall notice.” While students have been let out on summer break, the concern is that Listeria can take 70 days for symptoms to appear. This latest food safety issue comes after Molly & Drew recalled some of its beer bread mix due to concerns over E. coli contamination.  E. coli outbreaks been plaguing the news lately as a result of the General Mills flour outbreak that sickened 38 people across 20 states.

Stories You May Have Missed:

  • CRISPR vs. Flaviviruses – researchers at the Washington University School of Medicine have found a “single-gene pathway that is vital for viruses like Zika to spread infection between cells”. Even better, the team found that when they shut down a gene in this pathway, flaviviruses aren’t able to leave the infected cell and thus replicate. Using CRISPR technology to selectively shut down a single gene in the pathway, they were able to shut down flavivirus infection without negatively affecting the cells.
  • DRC Declares Yellow Fever Outbreak– The DRC Heath Minister recently declared a localized epidemic of yellow fever after reporting 67 cases. 58 of these cases were considered imported as they were from Angola, where the outbreak has grown beyond 3,100 cases and 345 fatalities. The outbreak has crept across Angola, Uganda, and now the DRA as a result of vaccine shortages.
  • MER-CoV Outbreak in Riyadh Hospital –  the WHO released information regarding the outbreak that begin with a woman whose illness wasn’t detected until after her stay in a surgery ward. Her hospitalization exposed 49 healthcare workers and all but 2 of the 22 MERS cases reported in Saudi Arabia (June 16-18) are related to this outbreak.

 

Pandora Report 4.15.2016

by spopescu, posted in Pandora Report

It’s been a big week in the world of biodefense – today is International Biomedical Laboratory Science Day! Biomedical Laboratory Scientists work hard to ensure procedures and patient care happens in a safe environment and that patient safety comes first! April 10th marked the anniversary of the Biological Weapons Convention opening for signature in London, Moscow, and Washington in 1972. The U.S. Geological Society also just released evidence that Alaska remains a “hot spot” for avian influenza to enter North America.

GMU Participation in UNSCR 1540 Civil Society Forum
IMG_3260This week our GMU Biodefense Professor and Graduate Program Director, Dr. Koblentz, participated in the UN’s 1540 Civil Society Forum – A Dialogue with Academia and Civil Society. Dr. Koblentz presented a paper on the role of academia in implementing and strengthening Resolution 1540, as well as moderating a panel regarding academic outreach. Resolution 1540 (2004) “imposes binding obligations on all States to adopt legislation to prevent the proliferation of nuclear, chemical and biological weapons, and their means of delivery, and  establish appropriate domestic controls over related materials to prevent their illicit trafficking. It also encourages enhanced international cooperation on such efforts.” Dr. Koblentz’s  work with the UNSCR 1540 Civil Society Forum addresses the evolution of WMD proliferation threats related to non-state actors, 1540 obligations that pertain to the academic community, and the importance of academia in these efforts. The forum also focussed on how to enhance review and analysis of 1540 implementation via communication between civil society, national governments, and the 1540 Committee.

Written Testimony for April 14 Senate Committee on Homeland Security & Governmental Affairs Hearing – “The Federal Perspective on the State of Our Nation’s Biodefense”
You can now catch up on the written testimony from this hearing on biodefense within the U.S. Pointing to the evolution of threats to include more emerging infectious diseases and the role of DHS in biodefense, this overview gives insight into the current biodefense situation within the U.S. The hearing addressed the National Biosurveillance Integration Center (NBIC), BioWatch Program, Public Health Emergency Medical Countermeasures Enterprise, and state and local responder engagement. “In the wake of these growing threats, the Department of Homeland Security (DHS) remains fully engaged and proactive in attempting to characterize the threat, providing warning of emerging and imminent threats, and coordinating whole of government response. During the most recent Ebola Virus Disease outbreak in West Africa, DHS provided intelligence analysis to the interagency, state and local governments, and first responders, and it directed research to better characterize the threat and fill gaps in public health and operational responses.” You can read the testimony before the Committee on Homeland Security and Governmental Affairs, “The Nation Faces Multiple Challenges Building and Maintaining Biodefense and Biosurveillance” here.

Preparing for the Next Zika
Kendall Hoyt and Richard Hatchett are tackling the struggle of U.S. preparedness efforts for future infectious disease outbreaks. “The development of new biomedical countermeasures—vaccines, therapies and diagnostic—requires the coordination of a wide number of institutional and industry actors to succeed. We argue here that international efforts to develop countermeasures for emerging infectious diseases should build on lessons learned from US programs to develop closely related biodefense products.” While the WHO declaration of Zika virus as a public health emergency has pushed for the rapid development of a vaccine, Hoyt and Hatchett highlight the empirical delay that comes with vaccine development. Overall, they emphasize that lessons from the U.S. biodefense program should inform international efforts to build and strengthen medical countermeasures for emerging infectious diseases. If you enjoyed their article, you can also hear from the experts, in person, at GMU’s Pandemics, Bioterrorism, and Global Health Security summer program. Dr. Hoyt will be one of the instructors for our professional education course this summer (information will be made available shortly), so don’t miss out on getting to chat with experts in the field about all things biodefense.

GMU SPGIA PhD Information Session
Considering a PhD? Check out GMU’S School of Policy, Government, and International Affairs PhD Informational Session on Thursday, April 21, 7-8:30pm at our Arlington Campus, Founders Hall, Room 126. Dr. Koblentz will be discussing the Biodefense program and available to answer questions!

Lab Safety Tracking Website – Improving Select Agent Lab Oversight
In response to ongoing scrutiny and biosafety failures, federal regulators have launched a new website that will allow them to track their progress “improving oversight of safety and security at facilities working with bioterror pathogens such as anthrax and Ebola.” While still a work in progress, many are pointing to this site being a step in the right direction towards transparency. The CDC released their Federal Select Agent Program (FSAP) report card to look more closely at biosafety and security issues surrounding this work. Unfortunately, some note that the report card still fails to meet the requested details on labs violations and incidents at specific labs. The increased scrutiny and attention to lab safety failures has brought attention from the White House, initiating a push for more transparency regarding the research and incidents in labs working with bioterror agents.

HIV Fights Off CRISPR
Just when you thought CRISPR-Cas9 could do just about anything, HIV brings its A-game. Since its creation, many researchers have attempted to use CRISPR to combat HIV. Unfortunately, the virus has been skilled at fending off these efforts. “The very act of editing—involving snipping at the virus’s genome—may introduce mutations that help it to resist attack.” There are a handful of strategies for using CRISPR gene editing technologies against HIV – editing the T helper cells to avoid the virus from getting in or aiding the T cells with the capabilities to seek out and destroy any HIV that infects them. “When HIV infects a T cell, its genome is inserted into the cell’s DNA and hijacks its DNA-replicating machinery to churn out more copies of the virus. But a T cell equipped with a DNA-shearing enzyme called Cas9, together with customized pieces of RNA that guide the enzyme to a particular sequence in the HIV genome, could find, cut and cripple the invader’s genome.” Sounds like a good plan, right? Unfortunately, a team from McGill University found that the newly equipped T cells were, within two weeks, churning out virus particle copies that had avoided the CRISPR attack. The team performed DNA sequencing to get a closer look at what exactly what going on – they found that the virus had actually “developed mutations near the sequence that the CRISPR-Cas9 enzyme that been programmed to cut.” The team believes that it’s not actually the copying error-caused mutations that helped beat CRISPR, but rather that things went wrong when Cas9 cut the viral DNA. A team at the University of Amsterdam experienced similar results and both groups agree that this problem can be overcome and there is still a possibility for a CRISPR-Cas9-based HIV treatment.

All Things Zika
On 4/13, the CDC formally concluded that Zika virus causes microcephaly and other birth defects. Zika virus may now also be tied to another brain disease. The American Academy of Neurology published a report regarding a study that was released on April 10th, in which “Zika virus may be associated with an autoimmune disorder that attacks the brain’s myelin similar to multiple sclerosis”. While it’s a small study, these findings point to the neurological effects Zika virus is capable of causing and the need for further research. Experts are warning governments in Latin American to “fill a shortfall of investment to prevent further human tragedies” despite economists denying that there will be major impact from the virus. These experts are pointing to the already weakened economies that are plagued with “chronic underinvestment in water and sanitation”, which can aid in the spread of such diseases. On Monday, April 11th, the White House said that the released funds for Zika virus won’t be enough to combat the growing threat. Dr. Fauci of the National Institute of Allergy and Infectious Diseases highlighted that the more information that is gathered on Zika virus, the more worrisome it becomes. “One big problem, Fauci said, is that pharmaceutical companies could be reluctant to work with the federal government if they don’t have confidence that there will be a stable source of money.” A recent study published in PLOS Neglected Tropical Diseases, suggests that the virus may have been brought to Latin America via the 6th World Sprint Championship Canoe Race in August 2014.  USAID has put out a call for problem solvers to share groundbreaking ideas to help combat Zika virus. The Combating Zika and Future Threats Grand Challenge will invest up to $30 million in solutions. As of April 13th, the CDC has reported 358 travel-associated and 7 sexually transmitted cases of Zika in the U.S. You can also get the full WHO Zika situation report here.

Predicting and Evaluating the Epidemic Trend of Ebola in the 2014/2015 Outbreak and the Effects of Intervention Measures Screen Shot 2016-04-11 at 9.41.51 AM
Researchers developed several transmission models for Ebola to predict epidemic trends and evaluate just how efficient and effective the intervention methods were following the 2014 outbreak. Accounting for effective vaccination rates, a basic reproductive number as an intermediate variable, and fluctuations of diseases transmission based on a SIR model, this study evaluates the effects of control and prevention measures. “Measures that reduced the spread of EVD included: early diagnosis, treatment in isolation, isolating/monitoring close contacts, timely corpse removal, post-recovery condom use, and preventing or quarantining imported cases. EVD may re-emerge within two decades without control and prevention measures.”

Stories You May Have Missed:

  • National Science Advisory Board for Biosecurity (NSAAB) Meeting – Don’t miss out on the NSAAB meeting on May 24, 2016! Agenda items include: (1) Finalization of NSABB findings and recommendations on a conceptual approach to evaluating proposed gain-of-function (GOF) studies; (2) discussion of next steps for U.S. government policy development regarding GOF studies; and (3) other business of the Board. The meeting will also be webcast here at the time of the event!
  • BMBL Virtual Town Hall and Workshop – The National Academies of Science, Engineering, and Medicine presents an opportunity for stakeholders to provide input for a revision of “Biosafety in Microbiological and Biomedical Laboratories”. This is a virtual town hall that is open for comments from April 4-May 13th. There will also be a workshop on May 12th in Washington, DC that you can register for here.
  • DARPA INTERCEPT Program for Biodefense Countermeasures – The Defense Advanced Research Project Agency (DARPA)’s Biological Technologies Office (BTO) is hosting a Proposers Day for the INTERfering and Co-Evolving Prevention and Therapy (INTERCEPT) program. “The goal of the INTERCEPT program is to explore and develop a new therapeutic platform to outpace fast-evolving viral pathogens, based upon virus-based therapeutic particles that interfere with viral infection and co-evolve with viral targets.”
  • Angola Yellow Fever Outbreak – The WHO has reported that as of April 10th, there have been 1,751 suspected cases and 242 deaths associated with the yellow fever outbreak. 582 of the cases were laboratory confirmed, of which 406 were from the Luanda province.

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Pandora Report: 12.18.2015

by spopescu, posted in Pandora Report

Hungry, hungry anthrax hippos? If there’s one thing we love about the science community, it’s when a gem pops up in your inbox like this (thanks ProMed!). In Ebola news, public health officials are exploring the possibility that survivors may be a potential source of case surges. Fun history fact Friday: On December 18, 1620, the Mayflower docked at Plymouth Harbor and passengers began settlement and on December 14, 1980, the CIA issued a warning about Soviet arms sales to Third World nations. Take a break from holiday preparations with this week’s Pandora Report – we’re discussing everything from zombies to Bob Dylan lyrics!

Epidemiology of a Zombie Outbreak
Tara C Smith and the writers of The BMJ certainly know how to hook a biodefense nerd – epidemiology of zombie infections? Don’t mind if we do! Using historical tales and movie outbreaks, Smith takes us through several hypothetical zombie outbreaks we’ve experienced as viewers or readers for the past few decades. Tracing the origins of certain outbreaks and the transmission patterns via bite, this scientific approach to one of our favorite topics is fascinating.  Potential etiological considerations included weaponized Yersinia pestis, a mutation of bovine spongiform encephalopathy, or a genetically modified form of the Ebola virus that was tested on chimpanzees (that later escaped!). Last but not least, we can’t forget to consider the ethical implications of such an outbreak. How do we handle resource depletion or quarantine? All things to consider before the zombie apocalypse!

Risk & Benefit Analysis of Gain of Function Research 
With the National Science Advisory Board for Biosecurity (NSABB) meeting fast approaching (January 7-8, 2016!), we’re recapping the role of gain-of-function (GoF) research in biodefense. Earlier this year, Gryphon Scientific was awarded a NIH contract related to assessment of GoF research and the risk-versus-benefits that may impact future federal funding. With the intent to make future recommendations, the assessment had three major tasks: a risk analysis (RA) of accidents and natural disasters, a biosecurity RA, and a benefit assessment. Extensive review and analysis of data from the intelligence and law enforcement community reviewed potential gaps within security practices. “The biosecurity RA is delivered in two parts because risks posed by malicious acts targeting laboratories that conduct GoF required a different analytical approach than the assessment of the risk generated by the misuse of published GoF research.” GMU Biodefense alum and previous Pandora Report editor, Julia Homstad, is also the lead author on Chapter 11 (Risk of Loss of Trust in Science). Perhaps one of my favorite points from the report was that “this assessment requires the identification of scientific and non-scientific barriers to the realization of these benefits.” You can also find Michael Selgelid’s White Paper regarding the ethical implications of GoF research. While the 1,001 pages may seem a daunting task, this is not only a highly relevant report, but approaches GoF concerns and risks in an engaging and holistic manner.

Bob Dylan Lyrics in Medical Literature?
Have you ever read a scientific article and felt a complete unknown, like a rolling stone? Scientists at the Karolinska Institute in Sweden have been sneaking Bob Dylan song lyrics into their papers as part of a long-standing bet since 1997. “It all started in 1997 with a review in Nature Medicine entitled ‘Nitric oxide and inflammation: the answer is blowing in the wind.'” Carl Gornitzki and colleagues from The BMJ decided to do some additional digging in Medline and found that 213 of 727 found references were unequivocally citing Bob Dylan. Starting a few years after his musical debut, research papers included a variety of biomedical topics, like those of Hermanson et al., who managed to work “like a rolling stone” into their paper on epigenetics. The variety of lyrics found throughout the literature is certainly more than a simple twist of fate.

Outbreak Preparedness 2015 Report
Ever wonder how your state ranks in terms of emerging infectious disease preparedness? Trust for America’s Health and the Robert Wood Johnson Foundation recently published their 2015 report regarding state capabilities to protect against new infectious disease threats (MERS-CoV, multi-drug resistant organisms, etc.) and “resurging illnesses like whooping cough, tuberculosis, and gonorrhea.” The report found that over half of US states ranked at five or lower on a scale of ten. The five all-star states (scoring eight) were Delaware, Kentucky, Main, New York, and Virginia (go Virigina!). The report findings noted that “the nation must redouble efforts to protect Americans” and included points on healthcare-associated infections, flu vaccination rates, food safety, and superbugs. Check out the report to find where your state ranked!

Fighting Antibiotic Resistance in the United States18170_lores
On Thursday, the House Appropriations Committee presented the 2016 Omnibus Appropriations bill, which revealed discretionary funding plans for the federal government. Buried in new legislation, the FDA and NIH will receive part of this discretionary funding to help fight antibiotic resistant bacteria and “advance prevision medicine initiatives”. The FDA is set to receive $2.7 billion, which was over a $10 million increase from FY2015. Within the bill, there is “funding for the Combating Antibiotic Resistance Bacteria (CARB) initiative ($8,732,000), the precision medicine initiative ($2,392,000), and the Orphan Product Development Grants Program ($2,500,000). The NIH will receive an extra $2 billion for FY2016, which supported projects specially for Alzheimer’s diseases research, brain research, antibiotic resistance, the Precision Medicine Initiative, etc. Given last week’s report on the phantom menace CRE and growing cases of multi-drug resistant organisms, it’s extremely important antibiotic resistance be given more attention.

Stories You May Have Missed:

  • CDC Establishing Flu Vaccine Efficacy Lab Network – The CDC has provided funding for a network of US institutions to collect and analyze information related to annual flu vaccine effectiveness. “Participating institutions will coordinate enrollment of patients with acute respiratory illness, confirm influenza infection using a standardized reverse-transcription PCR (RT-PCR) assay, and estimate vaccine effectiveness.” The 30 million dollar funded project will run from July 2016-2021.
  • Avian Influenza in France – France has reported 30 outbreaks of avian influenza, specifically one of the highly pathogenic influenza. Unfortunately the strain in the most recent cases hasn’t been identified, but these outbreaks been attributed to one of the H5 strains.
  • Hawaiian Dengue Outbreak Update – Cases of dengue virus on Hawaii Island have now reached 157. There are 7 individuals considered still infectious and the Hawaii Department of Health (HDOH) continues their efforts to identify cases and reduce transmission. 140 of the cases are Hawaii Island residents, and 34 of the overall cases have been children under the age of 18.

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The Epidemiologist: Dark Horse of Public Health

by juliadhomstad, posted in Media Notes, News

By Chris Healey

Many identify physicians as the preeminent professional in the health field – followed by dentists, physical therapists, pharmacists, and nurses – to name a few. However, one of the most important cogs in the health infrastructure mechanization is publicly obscure, yet works almost exclusively with the public. The epidemiologist is the most important health professional you may never meet.

An epidemiologist is not intentionally obscure. The occupation simply does not require as much face-to-face interaction as other health professionals. Instead, epidemiologists analyze data collected by healthcare providers to discern patterns overlooked on a patient-by-patient basis. That data is often analyzed offsite, away from patients. While physicians are treating the individual, epidemiologists are looking at the big picture.

State and federal regulations require physicians and other health professionals to report pertinent diagnosis and patient information to local health departments. That data is collected and analyzed by regional and district epidemiologists to detect unusual disease instances or patterns in their respective regions and districts. Data from local health departments is collected and further consolidated on the state and federal level by state health departments and the Centers for Disease Control respectively.

Epidemiologists serve as the vanguard in outbreak and bioterrorism detection. A clandestine bioterrorism event will likely be detected first by epidemiologists. For example, while several physicians may treat several different E. coli casesin the same day, they are unlikely to communicate mutual diagnoses among themselves. However, an epidemiologist whom analyzes all E. coli diagnoses that day may be able to discern unusual incidence. A physician can identify a single illness, but epidemiologists identify outbreaks and epidemics.

Incidence and pattern detection is only one function of the typical epidemiologist. Once pathogens of interest are detected, epidemiologists investigate patients to determine how they became infected with the respective agent. While physicians can serve in an investigative capacity, diagnosis and treatment of the patient at hand is often their focus. Epidemiologic investigations typically include patient interviews and environmental sample collection. In instances of foodborne illnesses, those investigations are critical to identify the tainted food and water sources. Product recalls and water treatment advisories are often the result of epidemiologic investigations.

Epidemiologists are often marginalized in popular culture and cinema. They are conflated, and often completely replaced, with physicians. However, the 2011 film Contagion portrayed epidemiologists as discrete health professionals with accurate—though dramatized—job functions.

Epidemiology is a growing field. According to the Bureau of Labor Statistics, epidemiologist employment is projected to grow 10 percent from 2012 to 2022, which is about as fast as the average for all occupations.

 

(Image Credit: Contagion)