Infectious Disease Epidemiology Research

Introduction

Infectious diseases (ID) remain key public health problems. In the developing world, diarrheal infections, respiratory infections, AIDS, malaria and tuberculosis are the principal causes of morbidity and mortality. Globally, pneumonia, meningitis, and nosocomial infections remain serious and costly health problems. Global travel and migration increase everyone’s susceptibility to epidemic and emerging diseases, from both natural (e.g., bird flu) and deliberate (terrorism) causes. The emergence and dissemination of drug resistant microorganisms represent an expanding threat. At the same time, our abilities to develop and deliver new drugs and vaccines to control these diseases have also increased. Infectious disease epidemiologists are needed to improve surveillance, identify newly emerging infections, understand transmission dynamics, and develop and evaluate prevention and control strategies.

In addition, we have many collaborative ties with other institutions in the Triangle involved in ID work, including:

 

Learning Objectives

  1. Understand the pathogenesis of infectious diseases including:
    • Route of pathogen entry
    • Host responses, including innate and acquired immunity
    • Relationship between disease and virulence factors, immune avoidance mechanisms, and pathogen host interactions
    • Host and microbial genetic factors
  2. Be familiar with the natural history of major infectious diseases;
  3. Understand the social, economic, behavioral, demographic and environmental determinants of infections, particularly emerging infections;
  4. Understand the causes for the enormous disproportion in infectious disease burden between resource poor and resource rich countries;
  5. Understand the special status in infectious disease prevention and control in marginalized populations such as prisoners, homeless, uneducated and persons of color;
  6. Be familiar with key surveillance systems and other sources of data relevant to the problem;
  7. Understand strategies for early detection and control of episodes of bioterrorism;
  8. Understand the principles and practices of outbreak investigation;
  9. Be familiar with the broad principles of infectious disease prevention including strategic use of prophylactic vaccines and vector control;
  10. Be familiar with the basic strategies for treatment of infectious diseases including use of antimicrobials;
  11. Understand the principles associated with infectious disease elimination;
  12. Be familiar with the broad principles of infectious disease modeling;
  13. Apply epidemiologic methods in the design, conduct and analysis of infectious disease epidemiologic studies;
  14. Communicate epidemiology concepts, methods and findings to community groups, state and local health departments, heath professionals and at-risk populations.

 

Courses

Required courses

EPID 751 EMERGING AND RE-EMERGING INFECTIOUS DISEASES (3 credits) Dr. Stamm. (Can be waived if equivalent coursework or experience is demonstrated).
EPID 755 INTRODUCTION TO INFECTIOUS DISEASE EPIDEMIOLOGY (3 credits) Drs. Pettifor and Meshnick.
EPID 894 INFECTIOUS DISEASE SEMINAR (1 credit) Dr. Meshnick.

Recommended courses

EPID 750 FUNDAMENTALS OF PUBLIC HEALTH SURVEILLANCE. (3 credits) Drs. Irwin, Horney and Alexander
EPID 753 PREVENTION AND CONTROL OF INFECTIOUS DISEASES AT THE LEVEL OF THE COMMUNITY (3 credits) Dr. Leone.
EPID 754 MATHEMATICAL MODELING OF INFECTIOUS DISEASES (3 credits) Dr. Van Rie.
EPID 756 CONTROL OF INFECTIOUS DISEASES IN DEVELOPING COUNTRIES (3 credits) Drs. Pettifor and Meshnick.
EPID 757 EPIDEMIOLOGY OF HIV/AIDS IN DEVELOPING COUNTRIES (3 credits) Drs. Behets and Weir
EPID 758 METHODS AND PRINCIPLES OF APPLIED INFECTIOUS DISEASE EPIDEMIOLOGY (3 credits) Dr. Nelson.
EPID 759 METHODS IN FIELD EPIDEMIOLOGY (3 credits) Drs Yeatts, Horney, and Alexander)
EPID 764 EPIDEMIOLOGY OF HEALTHCARE ASSOCIATED INFECTIONS (1-2 credits) Dr. Weber.

Dr. Allison Aiello, Professor of Epidemiology and Social Epidemiology Program Leader. Her research investigates socioeconomic and race/ethnic disparities in infectious diseases, the relationship between infection and chronic diseases, and prevention of respiratory infections in the community setting.

Dr. Ralph Baric , Professor of Epidemiology and Microbiology & Immunology, is an internationally recognized expert on Noroviruses and SARS coronavirus. His group has been interested in aspects of both host and viral genetics and how they relate to understanding pathogenesis and developing control tools. His research also focuses on identifying the molecular mechanisms governing emerging virus cross species transmission and pathogenesis in humans and seeks to identify the viral and host determinants which influence susceptibility to infectious diseases.

Dr. Myron Cohen, J. Herbert Bate Distinguished Professor of Medicine, Microbiology and Immunology and Public Health at UNC. Dr. Cohen’s research focuses on the transmission and prevention of transmission of HIV, with emphasis on the role played by STD co-infections. In 2005, Dr. Cohen received an NIH MERIT Award for ongoing support of this work. Much of Dr. Cohen’s research has been conducted in resource constrained countries, especially in the African country of Malawi and in the People’s Republic of China. Dr. Cohen serves as the Chair of the Scientific Advisory Board of the China CIPRA (located at the China CDC), and as co-director of an NIH Ellison Fellowship Program at the National STD Center in Nanjing China.

Dr. Michael Emch , Associate Professor of Geography, Adjunct Associate Professor of Epidemiology, and Fellow at the Carolina Population Center. His specialty is in medical geography/ spatial epidemiology and his research uses geographic information systems (GIS), satellite remote sensing, and spatial modeling techniques. One of his ongoing research projects investigates how spatial analysis, environmental modeling, and social network analysis can be used to measure the effectiveness of vaccines. For the past decade he has conducted a series of research projects in Bangladesh on local level socio-environmental risk factors of diarrheal diseases including cholera, rotavirus, shigellosis, and E. coli. Another newly funded project looks at population and environmental drivers of avian influenza virus evolution.

Dr. Michele Jonsson-Funk, Research Assistant Professor of Epidemiology using secondary data to determine how initiation of HAART and other factors affect progression of HIV disease and patient survival.

Dr. Carla Cerami Hand is a Research Assistant Professor whose research primarily focuses on malaria. Project (1) Impact of host iron status on growth and viability of erythrocytic stages of Plasmodium falciparum. Project (2) Erythropoietin and Erythropoietin-mimetic Peptides for the Treatment of Cerebral Malaria. Project (3) Hemozoin breaker: a novel class of anti-malarial compounds with in vitro and in vivo activity.

Dr. David Margolis , Professor of Medicine, Microbiology & Immunology, and Epidemiology, is an expert on HIV molecular biology and is attempting to develop treatments targeted at HIV that evades the immune response and persists despite antiviral therapy. He is also involved in studies of acute HIV infection, and particularly compartments such as resting CD4+ cells, the GALT, and the CNS, where persistent virus infection is established.

Dr. Steven Meshnick , Professor of Epidemiology and Microbiology & Immunology, is the ID program leader. He has been working in Malawi, the DR Congo, Thailand and Cambodia. In Malawi and the Congo, his group has studied the pathogenesis of malaria in pregnancy, and on how malaria and other infectious agents affect mother-to-child transmission of HIV. In these sites, as well as Thailand and Cambodia, he has been using newly developed molecular assays to study the epidemiology and clinical significance of antimalarial drug resistance.

Other research by Dr. Steven Meshnick includes prevention of tick bites and tick-borne illness among North Carolina outdoor workers using long-lasting insecticide-impregnated clothing TICS (Tick-borne Illness and Clothing Study).

Dr. William Miller Associate Professor of Medicine and Epidemiology, is interested in mucosal sexually transmitted infections and HIV infection. He is involved in ongoing projects both domestically and internationally examining approaches to improve the identification of persons with acute HIV infection. He has ongoing research to apply spatial analytical techniques to the identification of infectious diseases outbreaks.

Dr. Sonia Napravnik, Research Assistant Professor of Epidemiology and Medicine, and an Epidemiologist with the UNC Center for AIDS Research and the AIDS Clinical Trials Unit. She has primary expertise in the treatment and prevention of HIV-infection both domestically and internationally, including work in Ethiopia, Malawi, South Africa and Puerto Rico. Her ongoing research focuses on both intended and unintended effects of antiretroviral therapy especially drug resistance, improving HIV testing and medical care access, and applying newer epidemiologic methodologies to the study of HIV.

Dr. Brian Wells Pence, Assistant Professor, focuses on the links between mental health and HIV-related behaviors and health outcomes in the Southeastern US and in Africa. He is PI or co-PI on three current or recent NIH grants, including a randomized clinical trial to assess whether depression treatment integrated into HIV clinical care in the US improves HIV medication adherence; a study to define the epidemiology of depression among HIV patients in Cameroon and pilot-test a nurse-delivered depression treatment intervention; and a study to define the impact of antidepressant treatment on HIV outcomes among HIV patients in the CNICS network of 8 large clinical sites across the US. With Kathryn Whetten, he recently co-authored the second edition of You’re the First One I’ve Told: The Faces of HIV in the Deep South (Rutgers University Press, 2013). This book presents the life histories of 25 individuals infected with HIV and living in the US Deep South, and highlights in particular the high prevalence and profound influence of traumatic life experiences. In the second edition, the original qualitative findings are substantiated with new quantitative research, primarily drawn from the Coping with HIV/AIDS in the Southeast (CHASE) longitudinal cohort study of over 600 HIV-infected individuals from across the Southeastern US.

Dr. Audrey Pettifor, Assistant Professor, prior to this she was Director of the Adolescent Health Division at the Reproductive Health Research Unit in Soweto, South Africa from 2002-2004. Dr. Pettifor is an epidemiologist who has conducted HIV prevention research in South Africa for close to 10 years; her research focuses on HIV prevention among young people, particularly young women, in South Africa. Other research includes HIV prevention interventions for young couples in South Africa; behaviors of individuals with Acute HIV Infection and behavioral interventions for the acute period; and prevention interventions for HIV infected youth in Kinshasa, DRC.

Dr. Kimberly Powers, Assistant Professor of Epidemiology, uses epidemiological, statistical, and mathematical modeling methods to study HIV transmission, with the overarching goal of informing HIV prevention strategies. Her work focuses on improving understanding of the behavioral and biological determinants of HIV transmission, developing efficient methods for detecting acute HIV infection, and using mathematical models to predict the impact of HIV transmission prevention strategies. Ongoing projects aim to inform measurement of HIV incidence and prevalence, as well as HIV treatment coverage and impact.

Dr. Victor Schoenbach, Associate Professor, has a long-time collaboration with Dr. Adaora Adimora in the Division of Infectious Diseases, focusing on sexual networks and heterosexual dissemination of HIV especially among African Americans. He also teaches the School-wide introductory epidemiology course (two classroom and two Internet courses/year) and leads two annual broadcasts on health disparities topics.

Dr. Jennifer Smith, Research Assistant Professor, works on on human papillomavirus (HPV) and cervical cancer worldwide. She is studying the effect of male circumision on the natural history of penile HPV infection in Kisumu, Kenya. She is works on CDC-UNC collaborative project that investigates the acceptability of HPV vaccination in communities with high cervical cancer mortality in North Carolina. Dr. Smith is also involved in systematic reviews of global literature, and in studies of herpes simplex virus type-2 seroprevalence worldwide, and on the prevalence of type-specific HPV infection and cervical cancer in China.

Dr. Lola Stamm , Associate Professor, is an expert on emerging and re-emerging bacterial pathogens. Her current research focuses on determining the role of the Toll-like receptor (TLR)-mediated innate immune response during bacterial infection and identifying immunomodulatory strategies to promote pathogen clearance and prevent disease.

Dr. James Thomas, Associate Professor, studies social forces affecting the distribution of HIV and STDs. His research includes the effects of high rates of incarceration on STD rates in North Carolina counties, and on census tracts in two particular counties of the state; the relationship between community characteristics and STD rates in Chicago neighborhoods; and the effects of HIV prevention agency networks on HIV prevention in North Carolina.

Dr. Annelies Van Rie, Associate Professor in the Department of Epidemiology, UNC. Dr Van Rie is a pediatrician with clinical and international research experience in infectious disease epidemiology. Her research focuses on clinical, immunological and health services aspects of HIV related tuberculosis in both adults and children, social aspects of tuberculosis and pediatric HIV care, pediatric HIV care and pediatric neuro-AIDS. Dr Van Rie has active research projects in Kinshasa, Democratic Republic of Congo; Yala, Thailand; Blantyre, Malawi; and Johannesburg, South Africa.

Dr. David Weber, Professor of Medicine, Pediatrics, and Epidemiology serves as the Epidemiologist and Research Subject Officer for the NIH supported UNC General Clinical Research Center. He also serves as the Medical Director of the UNC Health Care Department of Hospital Epidemiology and Associate Director of the NC Statewide Program in Infection Control and Epidemiology. His research interests include environmental pathogens (long standing collaboration with Dr. Mark Sobsey, Environmental Health and Sciences), infections in child care (long standing collaboration with Dr. Jonathan Kotch, Vice-Chair Maternal and Child Health), and healthcare-associated infections (long standing collaboration with Dr. William Rutala, Department of Medicine).

Dr. Sharon Weir, Research Assistant Professor of Epidemiology, is a Carolina Population Fellow at the Carolina Population Center and a Senior Monitoring and Evaluation Specialist on the USAID funded MEASURE Evaluation Project. Her focus is HIV surveillance and the monitoring and evaluation of HIV prevention programs in developing countries. Her current work is in Malawi, Zimbabwe, Jamaica, Swaziland, and China.

Dr. Daniel Westreich, Assistant Professor of Epidemiology, studies the intersection of women’s reproductive health and HIV. Projects including assessing the impact of pregnancy on response to antiretroviral therapy, outcomes of pregnancy in HIV-positive women, and the impact of hormonal contraception on risk of HIV acquisition. Additional work examines the impact of HIV-related tuberculosis in adults, HPV-HIV co-infection, outcomes of antiretroviral therapy general, and methods for causal inference in observational data. He has research in both the United States and South Africa.

Students are supported by a variety of means. Many students are supported by research assistantships existing from grants from the NIH or other sources.

In addition, the Department has an NIH T32 training grant entitled “Training in Infectious Disease Epidemiology”, which provides 2-years of support for graduate students, after finishing one year of the MSPH or PhD program.

Students also receive support from other training grants including a Sexually Transmitted Infection Training Grant, a Virology Training Grant, and two Fogarty training grants.

Students interested in applying for Training Grant funding should contact the Epidemiology Department Student Services.

Nancy Colvin
Carmen Woody