HackingEpidemics:UnlockingtheDriversofTransmissionSeasonalitytoBattleVaccine-Preventable Diseases TheUNestimatesthat94.4millionchildrenunder5willdiebetween2016and2030iftheunder-5 mortalityrateisnotdecreased.Currently,infectiousdiseasesthatarepreventableortreatablecause abouthalfofchildhooddeaths.Iworkonchildhoodinfectiousdiseasesbecausemajorimprovements canbeachievedbyoptimizingtheadministrationofexistingvaccinesandtreatments.Thereisa needforsmartervaccinationstrategiesthatareadaptabletochangingepidemiologyand groundedfromanunderstandinginhumanimmunobiology.Wehavethreestudiesthatseekto fulfillthisneed.First,wewilldevelopastatisticaltoolsettomeasurevaccineefficacyinreal-time usingbothtraditionalandnewdatastreams(internetquerydata).Byapplyingourtoolset,wewill evaluatetheimpactofthechickenpoxvaccineintheUS.Second,weaimtoquantifythetransmission andreactivationdynamicsofherpesvirusesinordertomakerecommendationsregardingvaccination effortsandtiming,whileanticipatingtreatmentneeds.Todoso,wewillusedataonhospitalized chickenpox,shingles,herpessimplex,andcytomegaloviruscasesfromCalifornia,spanning3 decades.Hospitaldata,vaccinecoverage,demographydata,anddynamicmathematicalmodelswill becombinedtoestimatetransmissionandreactivationratesforeachofvirus.Wewilldetermineif reactivationisseasonal,whichwehypothesizeisamanifestationofseasonalimmunity.Third,wewill conductahumanclinicalstudytodetermineifimmunityundergoesfunctionalchangesthroughoutthe yearthataffectsusceptibilitytoinfection.Wewillcharacterizebothcircadian(24-hr)andseasonal rhythmsintheimmunesystemandinteractionsamongrhythms.Weproposeaninnovativesampling schemeinvolvingmulti-dayclinicalsessionsinwinter,spring,summer,andfall,whichwouldprovide snapshotsofimmunecellactivityaroundthe24-hrcycle,andacrossseasons.Thisstudywould advanceourknowledgeoftheinseparableinterplaybetweenhumanimmunobiologyandinfectious diseasedynamics.
Thisprojectwillhaveamajorimpactonpublichealthbyachievingtwogoals.First,wewilldevelop statisticaltoolsandmathematicalmodelstoquantifythetransmissionimpactofnewvaccinesinreal- timeastheyarerolled-outintocommunities,leadingtoabetterunderstandingoflong-termprotective effectsofimmunization.Second,wewillconductaclinicalinvestigationtoadvancethefieldofhuman immunology,todetermineifseasonalchangesinimmunityinfluencesusceptibilitytodiseaseswhich wouldaidinthepreventionandtreatmentofdiseases.
| Winter, Amy K; Martinez, Micaela E; Cutts, Felicity T et al. (2018) Benefits and Challenges in Using Seroprevalence Data to Inform Models for Measles and Rubella Elimination. J Infect Dis 218:355-364 |
