Because there’s no real winter in Africa, influenza threatens much of the continent year-round. Yet researchers don’t fully understand how the disease works in Africa. They don’t know how sick it makes people, for example, or how much it contributes to pneumonia, which kills more than two million children a year in the developing world. Nor do scientists have firm data on the effectiveness of seasonal-flu vaccines in Africa.
But that’s changing, says John “Chris” Victor, MPH ’97, PhD ’04, an advisor for epidemiologic science and clinical trials at PATH, an international health nonprofit based in Seattle. Through a three-year, $4 million cooperative agreement between the U.S. Centers for Disease Control and Prevention and PATH, Victor is directing a study aimed at determining the rates of influenza illness in an African population, and at measuring the effectiveness of seasonal influenza vaccine to reduce those rates. It’s the largest influenza vaccine study ever done in Africa and among the first of its kind.
The study involves approximately 32,000 people in 20 villages in rural Senegal and is designed in part to resemble research conducted in 1968 by Victor’s mentor, Arnold Monto, SPH professor of epidemiology, as part of the famed Tecumseh (Michigan) Study. In that trial, Monto found that vaccinating children in one part of a community reduced transmission rates throughout the entire community.
While working with Monto as a student at SPH, Victor collaborated on trials of hepatitis A vaccine and seasonal influenza vaccine. The skills he learned led directly to his job at PATH, where he has also studied Japanese encephalitis and rotovirus. In part as a result of Victor’s recent work on rotovirus—a disease that is estimated to kill more than half a million children a year worldwide—the World Health Organization has changed its immunization guidelines to recommend that infants in every country in the world be vaccinated against rotovirus. Victor says it’s a public health dream come true—“to have generated data that helped change global policy for one of the most important infectious diseases in the world.” <
Cardiovascular Disease
Most people think of cardiovascular disease as something that happens in old age, but it actually starts in childhood, says Trudy Burns, MPH ’76, PhD ’82. A professor of epidemiology at the University of Iowa College of Public Health, Burns studies the links between childhood risk factors and subclinical cardiovascular disease.
Burns has been interested in cardiovascular disease ever since she was a doctoral student in biostatistics at SPH. Early in her career, she coauthored a study with SPH epidemiologist Pat Peyser showing that BMI, or body-mass index, has a significant genetic basis.
At Iowa, Burns has been using data from The Muscatine Study—including CT scans and ultrasounds of the heart and blood vessels—to further her understanding of the links between childhood risk factors and cardiovascular disease. The Muscatine Study is a longitudinal study that’s been tracking a cohort of children from Muscatine, Iowa, since 1970.
“Many kids who have high risk factors already show evidence of the atherosclerotic process,” says Burns. “And we know from looking at the cause of death of their adult relatives, that those kids also have a higher probability of dying from cardiovascular causes. So it really is a lifelong process.”
Indeed, she adds, “this may be the first generation where kids don’t live as long as their parents—and a primary reason is because of the increase in obesity. And that’s exactly what we’re studying.”
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