Tag Archive | "Department of Public Health Sciences"

Zika Won’t Be Last Threat to Emerge

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Zika Won’t Be Last Threat to Emerge

Globalization, increased travel, and climate change are all contributing to the spread of vector-borne diseases.

By Robert C. Jones Jr.
UM News

zika2A plane flies over Miami’s Wynwood neighborhood, spraying pesticides. A pregnant woman decides to work full-time from home, secluding herself to her Miami apartment—whenever she does venture outside, she dons long pants and a hooded sweatshirt, even with daily temperatures in the 90s. And Miami Police officers give away cans of mosquito repellent to the homeless.

Such are the measures being taken to contain the spread of the Zika virus in Miami. Eventually such tactics, combined with education, counseling, and vaccine development, could very well prove successful in wiping out the disease.

But as sure as death and taxes, another virus, spread by a mosquito or other vector, will emerge and begin to spread, prompting health professionals to take action to contain and eradicate it. A group of experts at the University of Miami, which will host a special panel discussion on the Zika virus this Thursday on its Miller School of Medicine campus, are in agreement on that.

“Throughout human history pathogens have always co-evolved with us, and despite our best efforts to suppress either the pathogens themselves or the vectors that transmit them, most bugs have been very successful at evading control,” explains Justin Stoler, an assistant professor of geography and regional studies in UM’s College of Arts and Sciences, whose research explores the geographic patterns of urban health disparities, particularly in the developing world.

Could climate change, or more specifically warming temperatures, fuel the spread of disease-carrying vectors? The conditions must be right.

“Mosquitoes don’t like extreme weather either. If it just gets warmer and precipitation declines, things will dry out, and that’s not good for mosquitoes,” said Larry Kalkstein, a bioclimatololgist in the Miller School of Medicine’s Department of Public Health Sciences, who studies the impact of weather on all things living. “Basically what we’re talking about is a potential shifting of the range [of vectors], rather than just an expansion.”

Globalization of travel and trade coupled with unplanned urbanization quite probably plays a much larger role in the proliferation of vector-borne diseases.

“Anything that’s anywhere can easily get everywhere,” said Chris Cosner, a professor of mathematics who has investigated outbreaks of Rift Valley fever in Egypt. “When there was much less global travel, Zika was an isolated, obscure disease in an African forest. But once everybody can get anywhere, it [the disease] is out there trying to be pandemic. And it’s not the only disease out there waiting to do that.”

Cosner states a sobering fact, one with which other experts agree.

“There are many arboviruses (any of a group of viruses that are transmitted by mosquitoes, ticks, or other arthropods) and other pathogens that are obscure in the tropics, but with increased global connectivity and travel, it is likely that these neglected pathogens will potentially move from isolated areas to more populated places outside their restricted ranges,” said Doug Fuller, a professor of geography and regional studies who examines the distribution patterns of mosquitoes around the world.

“Zika is not currently in Wynwood and Miami Beach because of climate change. Zika is here because of globalization and increased air travel and because lower-resource countries are now rapidly developing,” said Stoler. “There are all these other pathogens lurking in tropical forests waiting to emerge, and there are additional superbugs emerging out of livestock populations. But climate change will, to varying degrees, shape how long some of these pathogens disperse and persist.”

It is likely that in the not-too-distant future, physicians and health officials, much like they are doing now with Zika, will be forced to react to a new outbreak of an unheard of virus, searching to find ways to wipe it out. Their efforts could be hampered by a system that merely reacts to crises rather than investigate their root causes and form action plans that can be implemented whenever there’s an outbreak.

“Zika, Ebola, Chikungunya—these are not new pathogens. The clinical community has known about these viruses for decades, but our knowledge of each is still limited. This is because there has not been a great effort to really understand what is making people sick in the Global South (those regions of the world made up of Africa, Latin America, and developing Asia including the Middle East) beyond the major diseases of malaria, HIV/AIDS, and tuberculosis—all of which have been on the decline,” explains Stoler.

“High-income countries, for all their best intentions in fighting emerging pathogens, haven’t really done their due diligence to find out what exactly is circulating, and where,” said Stoler, who is collaborating with the University of Ghana’s West African Centre for Cell Biology of Infectious Pathogens on a project to improve diagnosis, prevention, and control of febrile illnesses in sub-Saharan Africa.

“I like the metaphor of the United States healthcare system where we don’t emphasize preventive care and take a more reactive approach to medicine in our fee-for-service system,” Stoler said. “Our Zika control efforts are a similar band-aid, as they do not address the root causes of infectious outbreaks. We need to diagnose and study emerging diseases in their place of origin, and learn about how they transmit so that when something like Zika inevitably jumps across the continent, we can say, ‘Hey, we’ve seen that before. We know what it does. Here’s what we need to do.’ ”

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Zika Forum Spotlights the Epidemic

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Zika Forum Spotlights the Epidemic

By Robert C. Jones Jr.
UM News

John Beier of the Department of Public Health Sciences discusses the importance of effective mosquito-control efforts to help prevent the spread of Zika and other vector-borne diseases.

John Beier of the Department of Public Health Sciences discusses the importance of effective mosquito-control efforts to help prevent the spread of Zika and other vector-borne diseases. Seated are, from left, Jose Szapocznik, chair of the Department of Public Health Sciences; Anna Marie Likos, director of the Division of Disease Control and Health Protection for the Florida Department of Health; and Lillian Rivera, administrator of the Florida Department of Health in Miami-Dade County.

CORAL GABLES, Fla. (March 24, 2016) – Here’s the tally, though by the time you read this, the number will have probably changed: 907.

That is the number of confirmed cases of microcephaly in Brazil. The birth defect, in which a baby is born with an abnormally small head and often incomplete brain development, has been linked to an explosion of the mosquito-transmitted Zika virus in that country.

The virus, which is transmitted to people primarily through the bite of an infected Aedes aegypti mosquito, has dominated the headlines for months. While no local mosquito-borne cases have been reported in the U.S., there have been travel-associated cases. In Florida alone, Zika cases now stand at 72.

And it was that number, as well as other startling statistics, such as how Zika has hit more than three dozen countries and territories in the Americas, that drew more than 300 people to a forum at the University of Miami’s Shalala Student Center on Wednesday that addressed recent developments on the virus.

The four-hour forum, which was presented by the Miller School of Medicine; UHealth – the University of Miami Health System; the Department of Public Health Sciences; the Institute for Bioethics and Health Policy, whose founder and director, Kenneth W. Goodman, Ph.D., served as the forum’s facilitator; the Department of Medicine; and the Division of Infectious Diseases, included panel discussions and remarks from several researchers and physicians from UM and elsewhere.

“We’re very concerned about the Zika virus,” said John Beier, professor and director of the Division of Environmental and Public Health in the Miller School’s Department of Public Health Sciences. “It causes microcephaly, but it is also the first sexually transmitted vector-borne disease.”

He called the virus an Aedes problem, referring to the mosquito that spreads it.

Aedes aegypti, which can also transmit dengue fever and the chikungunya virus, is proving to be “a little bit more fierce than we’re used to seeing,” said Esper G. Kallas, an infectious disease specialist and professor of medicine at the University of São Paulo, Brazil, who delivered the forum’s keynote address.

While females are known to lay their eggs in stagnant freshwater, Aedes aegypti are now showing an ability to multiply in polluted water sources as well, said Kallas. And rising temperatures that are the result of global warming are helping the mosquito to adapt to northern locations, where in the past, the insect would never have been found.

Beier called the Aedes aegypti a challenge for vector biologists to control, noting that the mosquito has even demonstrated an ability to go underground and find suitable habitats during winter.

“We have tools for controlling mosquitoes,” said Beier, who also studies mosquito ecology and behavior in West Africa, “and we have newer methods, but they haven’t been validated yet.”

Florida has some of the world’s most effective mosquito control practices, Beier said. But in developing countries, mosquito infestations can be difficult to control, allowing vector-borne diseases to spread easily. Giving people better access to safe drinking water and improving sewage treatment practices could help, he said.



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Alumnus Appointed Dean of the Graduate School

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Alumnus Appointed Dean of the Graduate School

UM News

Prado photo

Guillermo “Willy” Prado

CORAL GABLES, Fla. (February 1, 2016)—The University of Miami has appointed UM alumnus Guillermo “Willy” Prado, the Leonard M. Miller Professor of Public Health Sciences and the director of the Division of Prevention Science and Community Health at the Miller School of Medicine, as the new dean of the Graduate School, effective immediately.

“Dr. Prado is well positioned to raise the Graduate School at UM to a new level of excellence, thanks to his passion as a researcher and educator,” said Executive Vice President and Provost Thomas J. LeBlanc.

As dean of the Graduate School, Prado will work in partnership with the deans of the schools and colleges to support and develop strategies for attracting the next generation of scientists and researchers to graduate education at the University of Miami.

He will specifically manage the process of external program reviews and new program proposals, oversee the selection process for University of Miami graduate fellowships, chair the Graduate Council meetings, and meet regularly with graduate program directors, among other duties.

“This appointment is particularly meaningful to me because the University of Miami has been my academic home for 15 years, inclusive of my graduate training,” said Prado, who earned his Ph.D. in epidemiology and public health in 2005 and his Master of Science in statistics in 2000. “My plan is to work collaboratively with University leadership, graduate program directors, and the rest of the University community to continue to increase the quality of graduate education for our students.”

Prado joined the UM faculty in 2007. In the areas of research, he has served as principal investigator of approximately $10 million of National Institutes of Health (NIH) funding. He also has served in the roles of mentor and co-investigator of approximately $60 million of NIH and Centers for Disease Control and Prevention (CDC) funding, including a leadership role on two NIH-funded center grants.

His research has appeared in more than 100 peer-reviewed publications, including The Journal of the American Medical Association, Pediatrics, American Journal of Public Health, and American Journal of Preventive Medicine.

During his tenure, Prado has led the development of the Ph.D. program in Prevention Science and Community Health, as well as redesigned the epidemiology doctoral program. Having taught more than 10 graduate courses in prevention science, epidemiology, and biostatistics at UM, Prado has mentored many junior faculty, post-doctoral students, and graduate students.

As chief of the Division of Prevention Science and Community Health since 2013, Prado has overseen a research program endowment of $375,000. Before that, he led the Ph.D. in Epidemiology Doctoral Program and served as acting chief of the Division of Epidemiology.

John L. Bixby, vice provost for research and professor of pharmacology and neurological surgery, chaired the search committee for the Graduate School dean and describes Prado as the “best of the best.” Noting that Prado will play a key role in UM’s progress in education and research, Bixby said, “Even among a number of highly impressive applicants who interacted with the Search Committee, Willy’s personality, accomplishments, and insight stood out. I am personally delighted that he will be our next dean.”

“Willy is an extraordinarily bright, dedicated public health researcher whose enthusiasm for his work is infectious,” said José Szapocznik, chairman of the Department of Public Health Sciences, who recruited Prado to the faculty after he completed his doctoral degree. “His work in prevention science has made him a superstar at UM and in the national scientific community.”

Prado replaces M. Brian Blake, who was named provost and executive vice president for Academic Affairs at Drexel University last spring. In the interim, Angel Kaifer, professor of chemistry and senior associate dean for research and graduate education in the UM College of Arts and Sciences, served as dean.

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Faculty and Staff Support the U: Julie Kornfeld Fuels Passion for Public Health by Removing Barriers

Julie Kornfeld

Julie Kornfeld

Julie Kornfeld is so inspired by the graduate students she guides in the master’s in public health (M.P.H.) and the combined M.D./M.P.H programs at the Miller School of Medicine that she is compelled to help them succeed. “They are passionate about transforming the health of our communities,” says the assistant dean for public health in the Department of Public Health Sciences. “But graduate education is expensive, and I want to help remove the financial barriers for our students.”

Kornfeld has been contributing to the University for more than 20 years through the United Way and Momentum2 campaigns. “My donations have primarily been focused on providing scholarships for our public health students,” she says. “My dream is for every qualified student to be able to afford the training they need to address our nation’s public health problems.”

Kornfeld grew up in Philadelphia and worked in television and the nonprofit sector before joining the University 21 years ago. A double UM alumna, she earned a master’s degree in public health in 1997 and a doctoral degree in 2009. Her husband, Fred Silverman, a TV producer and communications consultant who also has taught at UM, is now enrolled at the University as a graduate film student. They have three children, Dylan, Morgan, and Ely.

“We all volunteer our time and raise funds for nonprofit organizations,” she says. “There are so many needs in our community, and we believe it’s important to give something back.”

At the University, Kornfeld plays a critical role in the development and implementation of the Miller School’s public health curriculum. Since 2010, she has served as the co-principal investigator on an educational development grant to accelerate the M.D./M.P.H. program so students can obtain both degrees in four years rather than five. She is also an active instructor for a wide variety of public health courses, including special seminars for dual degree programs at the law and medical schools.

Reflecting on the importance of donations, Kornfeld says, “I believe that all faculty and staff members should support UM. It’s important for our University’s future and it demonstrates to our students and co-workers that we truly believe in what we do every day.”

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Interactive Media’s ‘Zoo Rush’ Wins Good Gaming Award for Raising Sickle Cell Awareness

By Nancy M. Molina
Special to UM News


Designer Fan “Franklin” Zhang, a second-year MFA student in the Interactive Media program, works on the award-winning Zoo Rush game.

CORAL GABLES, Fla. (July 25, 2014) – Collaborating with the Miller School of Medicine’s Department of Public Health Sciences, student game developers in the School of Communication have created Zoo Rush, an award-winning adventure game that aims to increase awareness about sickle cell disease and reduce the stigma often associated with the painful inherited blood disorder that slows blood flow.

Representing the UM team, Zoo Rush developers Ebtissam “Ebby” Wahman and Fan “Franklin” Zhang brought the Silver Award in the Games for Good category back from the 2014 International Serious Play Awards held July 24 at the University of Southern California.

In the game, which can be played on the Web or by download to any Android or iOS device, players take on the role of a zookeeper with sickle cell disease who, on his or her first day on the job, faces a monumental challenge: All the animals escape.

The goal is for the player to capture each escaped animal before time runs out. Due to the zookeeper’s medical condition, the player must avoid infections, hydrate often, check in with their physician, and take their medication, such as hydroxyurea, the only FDA-approved medication for sickle cell disease.

Assistant Professor Clay Ewing, Zoo Rush’s project manager and game designer, said the Serious Play award validates the work of students and faculty in the School of Communication’s new Interactive Media program, who collaborated with Lanetta Jordan, M.D., M.P.H., M.S.P.H., associate professor of Public Health Sciences and president of the Foundation for Sickle Cell Disease Research, to build awareness about the disease that largely affects people who come from or whose ancestors came from parts of the world where malaria is or was common.

As Ewing notes, new programs must establish credibility, and the Serious Play Association’s recognition is a sign that the program is on the right path. He and the Zoo Rush team are particularly proud that the game is proving successful at increasing awareness of sickle cell disease, the most common genetic disorder of newborns in the U.S.

“My friend’s daughter downloaded the game and couldn’t stop playing,” Ewing said. “Later that night, she asked her dad about sickle cell disease. He didn’t know anything about it, so they spent the night finding out about it online. That’s exactly what we’re trying to do: Get a person engaged in an experience to the point where they begin seeking new knowledge on the topic and spreading the word.”

Wahman, who graduated from the UM College of Engineering’s electrical engineering program in 2012, had limited knowledge of sickle cell before taking part in the project. She said Zoo Rush was the first full game she developed and the experience helped her grow both as a developer and a person. “I feel honored that I was a part of such a project where I not only made a fun game, but also raised awareness about a disease that doesn’t get enough attention and affects millions of people around the world,” Wahman said.

Added Zoo Rush’s sound designer, Isabella Douzoglou, a motion picture and computer science major, “Increasing awareness through a fun medium is brilliant, especially when it’s for a good cause. It was a pleasure to be involved.”

Students from all majors at the School of Communication had the opportunity to test the game on various devices in an open playtest. They said the game gave them some insight on sickle cell disease and left them curious to learn more. The developers used this feedback to make adjustments to the game.

In sickle cell disease, red blood cells take on a sickle or crescent shape. Normal red blood cells are round and move through the blood vessels with ease, carrying oxygen to all parts of the body. Sickle-shaped blood cells often get stuck in blood vessel passageways, slowing down blood flow and preventing oxygen from reaching certain parts of the body. This can cause severe pain and other serious problems, such as infection, anemia, and stroke.

As Jordan notes, the transition from pediatric to adult care in young adults with sickle cell disease is becoming a major public health issue. Studies show that young adults transitioning to adult medical care are at a much higher risk for early death, especially shortly after leaving pediatric care. For some, the shift away from pediatric services results in the loss of an established primary medical home or access to health insurance.

In addition, Jordan said, these young adults are especially at risk of suffering from complex psychosocial issues due to stigmatization, the process of identifying an attribute and associating it with a stereotype that negatively labels a person or group.

Children and adolescents with sickle cell often experience low self-esteem or embarrassment. Pain is one of the most stigmatizing aspects of the disease, which often requires treatment with opioids.  As a result, Jordan said, up to 80 percent of young adults and adults with sickle cell disease choose to manage their pain at home. Zoo Rush developers hope to reduce this number by targeting young adults in the sickle cell community and influencing the way people perceive the disease.

For more information, visit Zoo Rush and the Foundation for Sickle Cell Disease Research.

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