It used to be smallpox, polio and rabies. Today, a whole new class of 21st-century plagues – bird flu, mad cow, West Nile, and even some old threats like tuberculosis – keeps UC Davis infectious disease specialists working 24/7 in laboratories, classrooms, clinics, in the field, and most of all, in coordinated teams.
Scientists Kathryn DeRiemer, Christian Sandrock and Jerry Gillespie are just a few of the researchers at UC Davis committed to keeping even the possibility of a major outbreak in the only place it belongs – between the covers of a Michael Crichton bestseller.
Old enemy, new weapons
Once a disease that spawned countless sanatoriums, tuberculosis (TB) today continues to rage throughout communities. Indeed, California has the highest rate of TB in the nation, seven times the national public health objective, according to the California Department of Health Services.
Calling for more intense efforts to reduce TB, the California Tuberculosis Controllers Association assert that California also leads the nation in childhood incidence, mortality and a more severe threat: 30 to 40 new multidrug-resistant cases every year that do not respond to the two strongest TB drugs available.
Today, the epidemic is driven by homelessness, HIV infection, substance abuse and migration. Indeed, individuals migrating from other countries brought 77 percent of TB cases to California in 2006, reminding us that tuberculosis is a global health problem that inactively infects "some 2 billion people," says UC Davis infectious disease epidemiologist Kathryn DeRiemer.
One in 10 – that translates to 200 million people – will eventually become sick with active TB, adds DeRiemer, who has made it her life's work to address the epidemic. Last year, active TB killed 1.6 million people worldwide, a staggering number she converts to "4,400 deaths per day."
Transmitted through the air, most TB is treatable, DeRiemer explains. However, "prevention and control uses old tools" like the century-old tuberculin skin test, which can give false positive results while failing to detect the disease in infected people.
"We need new tools," DeRiemer emphasizes, "if we're going to have a significant impact."
Through the California Research Center for the Biology of HIV in Minorities and the UC Davis Department of Public Health Sciences, DeRiemer's research team has dispatched with ancient assays in favor of new immunoassay techniques to detect the bacterium that causes the disease, Mycobacterium tuberculosis, even when it's hiding and not active.
Novel assay tests, DeRiemer hopes, will answer some of TB's most troubling questions: Why do some people become infected but others do not? What determines whether TB is symptomatic or if it lies dormant for decades? How does the latent infection reactivate?
Working with colleagues "to identify bacterial components that might better indicate TB in its different stages," DeRiemer wants to "move these findings into the public health arena in the near future."
No two words define public health better than "be prepared."
Preparing California – the nation's most diverse state – for the public health impact from floods, mudslides and earthquakes has been Christian Sandrock's longtime responsibility.
An infectious disease expert and UC Davis assistant professor of clinical medicine, Sandrock sees California as "quite different than any other state," where public health threats tend to be "more one dimensional."
The medical director of the California Preparedness Education Network, Sandrock says he stays connected with "just-in-time public health education experts at all the UC campuses."
Together, they track the potential for public health catastrophes such as bird flu.
"Many public health experts think California will see the first case of avian influenza in the U.S.," Sandrock explains.
An infectious disease of birds that can infect humans, avian influenza – bird flu – comes in various strains including so-called "H5N1," an especially virulent variety the World Health Organization calls "the most serious known health threat facing the world."
Sandrock says, "we will have an influenza pandemic at some point, just like another earthquake," adding that reducing human and poultry exposure to wild, migratory birds can greatly mitigate the threat.
To that end, Sandrock joined UC Davis veterinary researchers Walter Boyce and Carol Cardona, and community physician Warner Hudson to get the word out about a flu train they all see "heading down the same track."
Together, they've educated dozens of officials, health-care providers and community groups. Reporters have quoted the team in the New York Times, Los Angeles Times, Washington Post, USA Today, network news, National Public Radio and Forbes.
Affectionately termed the gang of four, Sandrock and his colleagues recently formed the "Flu School," a grass roots education project with new classrooms in Uganda and Kenya.
"We're going to teach all the high-level human and vet medicine specialists, and it will be one of the rare times they are all together," Sandrock explains.
Rare abroad but commonplace at UC Davis, veterinary and medical public health collaborations, he says, are one reason the National Institute of Allergy and Infectious Diseases selected the university as a partner on the new $18.5 million Center for Rapid Influenza Surveillance and Research.
The collaborative center's mission, Sandrock says, mirrors his own – to catch flu early through research and education.
Uniquely UC Davis
"Think globally and act locally" may be a mantra of the business world. It's also a dictum of public health professionals protecting "an increasingly complex food system," says Western Institute for Food Safety and Security (WIFSS) founder Jerry Gillespie.
Officially retiring as the institute's first director, on July 1, the UC Davis veterinary medicine professor cites the globalization of the food supply as "the greatest challenge to safe and secure food."
Gillespie finds the U.S. food safety net woefully inadequate, noting that "none of the approximately 20 federal food safety regulatory agencies are equipped, staffed or funded in a manner that will enable them to monitor and regulate the global food continua."
Thirty years of inadequate funding for food safety research has left the U.S. vulnerable to a food-targeted bioterror attack, Gillespie says, a frightening situation that WIFSS and UC Davis are addressing through "the only Department of Homeland Security certified, comprehensive agro-terrorism preparedness curriculum."
Six daylong courses offered in more than 100 communities nationwide "assist communities and companies to build capable response and recovery teams in case of agroterrorism or a major natural foodsystem disaster," Gillespie explains.
Another WIFSS mainstay basic research – has focused on two issues: what factors sustain food-borne pathogens and what mechanisms cause specific pathogen strains to become more harmful.
In the process, "one of our researchers devised ways to eliminate harmful Salmonella bacteria from almond products," Gillespie says.
Citing a "core value of WIFSS – building and sustaining partnerships," Gillespie credits a uniquely UC Davis interdisciplinary approach with an even more significant success: ruling out migratory birds as a source of contamination during the recent lettuce and spinach disease outbreaks.
"To the extent that we have achieved success," Gillespie says, "it is no doubt due to interdisciplinary research."