By Lt. Cmdr. Gabriel Defang
I’d like to discuss NAMRU-3’s Viral and Zoonotic Disease Research Program, aka the Virology Program. Our mission is to study, monitor and detect emerging and reemerging disease threats of importance to the U.S. military and public health.
My department focuses on viral infectious tropical diseases. We are well placed in Egypt to conduct studies in West Africa, Horn of Africa (AFRICOM), and the Middle East (CENTCOM).
The U.S. military has been engaged in tropical diseases research since WWII because our Soldiers, Sailors, Marines and Airmen often operated in tropical clines. Our role is to study these endemic infectious diseases and develop new drugs and vaccines. Our scientific research has a great public health upside. By executing our mission, our host nations also benefit. Many of the nasty disease threats we face are viral in nature, and most of these emerging viruses arise from the interface between animals and humans (zoonotic diseases) – hence, the “Viral” and “Zoonotic” in the department’s name.
Viruses that we study include Middle Eastern Coronavirus (MERS-CoV), Rift Valley Fever (RVF), Crimean-Congo Hemorrhagic Fever Virus (CCHF), influenza – including avian influenza and more recently, Ebola virus. The last four are considered dangerous pathogens and must be handled in a biosafety level 3 enhanced containment laboratory such as the one we operate in Cairo. Dengue, RVF and CCHF are vector borne diseases, therefore, we work closely with NAMRU-3’s Vector Biology Research Program, to track these viruses in mosquitoes and ticks in endemic environments and animal populations.
So how do we go about studying these pathogens? Well, first we must identify and isolate the disease agent. To do this, we have set up surveillance networks in several partner countries including Burkina Faso, Togo, Cote d’Ivoire, Ghana, Yemen, Jordan and Egypt. We work closely with military and civilian medical personnel in these countries. Important disease incidence and prevalence data that is captured, allows for the testing of new vaccines and drugs.
A surveillance that we manage is the influenza surveillance, which became critically important after the 2009 pandemic flu event. Through this year-round exploration, we identify and isolate circulating flu strains, and monitor changes in their genetic composition that may allow escape or resistance from current vaccines or available drugs such as oseltamivir. We provide this information twice a year to the Department of Defense (DoD), Centers for Disease Control and Prevention (CDC), and the World Health Organization (WHO). They in turn use information from DoD to select flu vaccines and drugs for the upcoming year. Our activities in this domain and our regional reach has allowed us to serve as a WHO collaborating center and Avian Influenza (A/H5N1) reference laboratory.
Currently, we are experiencing a significant spike in A/H5N1 cases in Egypt. It is worse than “swine” flu. One in three infected people will die from it, but it’s generally thought to be difficult for humans to be infected. You have to be in close contact with poultry to get it. We do have a lot of poultry here. However, Egypt normally experiences 4 -40 cases a year, but get this: in the first three months of 2015, we’ve had 116 cases. This is an anomaly that has drawn global attention. We’ve been working in collaboration with the WHO and CDC to explain the current surge in cases. We’ve sequenced a few of the viruses from recent cases, but need to do more studies to understand what factors are driving the current outbreak. As you can see, there is always an emerging or reemerging disease threat that the virology program staff members have to tackle. In my next blog, I’ll tell you more about what we do, including our work on another relatively new respiratory virus that emerged in the Arabian Peninsula a few years ago. Stay tuned.