Infectious Disease
Global experience for a global problem
In an age of ever-expanding air travel and international trade, it takes mere hours for an infectious disease to circle the globe.
When an epidemic gets out of hand, it’s called a pandemic. And chances are that pandemic will cross national and continental boundaries.
H1N1 is the most visible new example of the rapid spread of a pandemic, but other infectious diseases, though slower moving, can be just as or more deadly. Thirty years ago HIV/AIDS was contained to a remote part of Africa. Today it is one of the world’s top killers with 40 million people living with the disease and no end in sight.
SPH faculty members have been working at home and abroad for decades to confront infectious diseases head-on and at all levels. They work to stop them before they start and to prepare countries, including our own, to handle them if they do.
For example, SPH professor Randall Singer has led an ecological study in southern Chile for the past several years to determine how environmental factors are affecting the water quality of a system of rivers. His team, including many students, is looking at how wastewater treatment plants, population density, runoff from the land, and hospital waste may be contributing to antibiotic resistance in the people who live there, lowering the capacity for them to fight infectious diseases.
SPH faculty, too, have long recognized that health care varies tremendously around the world and not all countries are equally equipped to handle the rapid spread of infectious diseases. The United States Agency for International Development (USAID) recently made SPH faculty part of a team, funded with $185 million, that will work toward better response times to emerging zoonotic pandemics— diseases that can spread between animals and humans such as SARS, avian flu, or the Ebola virus.
U experts will travel to global hot spots—likely located in Southeast Asia, South America, and Africa—to participate in classroom and web-based education programs with in-country partners.
Managing the spread of infectious diseases also involves having a clear picture of the prevalence of the disease and the characteristics that lead to severe cases.
INSIGHT: The world’s largest HIV trial
Eight years ago, SPH professor Jim Neaton pulled researchers together into a group called INSIGHT (International Network for Strategic Initiatives in Global HIV Trials) that has enrolled more than 10,000 patients in the world’s largest HIV clinical trials.
This year, with the emergence of H1N1, INSIGHT is engaging in two international studies of the H1N1 virus, the first time the network has investigated an infectious disease other than HIV.
Over the next several months, up to 5,000 patients with H1N1 who seek medical care will be tracked for two weeks. And 1,000 patients who are hospitalized with severe cases will be followed for two months.
By tracking the medical histories and treatments of patients worldwide, new patterns of risk factors for treatment complications may emerge. The studies were designed in less than a month, and findings are expected to start rolling out just as the flu season is hitting the southern hemisphere.
The INSIGHT team will also create a central repository of patient specimens for virus characterization. This will allow researchers to study viral mutations and antiviral resistance that may occur with treatments for influenza.
The information gleaned from the studies will help guide policymakers worldwide to respond to the pandemic and plan for future influenza seasons.