Infectious Disease 2019

Over the past 25 years many advances in techniques have been incorporated into infectious disease research. From genetically modified animals to advances in basic techniques that improve results much has changed. However, many other core principles are just as critical now as they were then and tend to be forgotten in the rush to incorporate new technologies. This presentation will discuss what has changed in the last quarter century for in vivo research including new technologies and techniques as well as point out some critical concepts that deserve to remain in consideration.  

Learning Objectives: 

1. Demonstrate the need for a high level of technical skill and understanding to generate high quality data while maintaining the appropriate welfare of our animals
2. Identify key components for high level study execution

Tuberculosis has killed more than one billion people in the last 200 years. It is the oldest and the deadliest human pathogen, recently surpassing HIV. Its adaptation to host and drug pressures is remarkable given its slow rate of growth and provides a moving target in molecular epidemiology of the disease. In this talk we will discuss the epidemiology of the disease, the challenges that the pathogen offers in its adaptation, and the challenges faced in the diagnosis and treatment of the disease. We will discuss the advantages and disadvantages of various diagnostics platforms and outline some exciting new developments on the diagnostics and prognostics fronts. 

Learning Objectives: 

1. Epidemiology of tuberculosis
2. Diagnostic approaches for detection of antibiotic resistance

Recent evidence indicates that the immunoglobulin (IG) gene loci reside within the most complex and variable regions of the human genome, characterized by elevated levels of single nucleotide and gene copy number variants. This unique locus architecture has hindered the comprehensive characterization of polymorphisms in these regions, particularly using standard, short-read and array-based high-throughput genomic methods. As a result, our appreciation of the extent of haplotype variation across human populations, and the role of IG polymorphism in the immune response remains limited. This presentation will discuss efforts currently underway to establish improved genomic resources and tools that will facilitate large-scale characterization of IG genetic diversity as a means to leverage this information to improve our understanding of the functional antibody response in disease and relevant clinical phenotypes.

Learning Objectives: 

1. Appreciate the complexity of the human immunoglobulin gene regions and the need for improved genomic resources and tools.
2. Understand the importance of immunoglobulin genetic variation in the antibody response and antibody-related phenotypes.

“Emerging infections” are those that appear suddenly or are rapidly increasing in incidence or geographic range (e.g., HIV/AIDS, Ebola, SARS, Middle East Respiratory Syndrome [MERS], H5N1 avian influenza, pandemic influenza, Zika).  Most are pathogens from other species that acquire opportunities to come in contact with humans and spread (often as a result of such factors as changes in ecology and land use, increasing urbanization, and human movement).  A pandemic is an epidemic that spreads to cover a broad geographic range.  Despite progress in identifying the underlying factors (or “drivers”) and improvements in early warning, no emerging infection or pandemic to date has been correctly predicted before its appearance in humans.  In two of the most recent epidemics, Ebola in West Africa and Zika in the Americas, the first outbreaks were initially discounted.  Before the recent reports of neurological effects, Zika, a mosquito-borne virus that came to Brazil from the Pacific Islands only two years ago and had been circulating in Africa far longer, was considered a mild disease and little cause for concern.  By contrast, Ebola's lethality has been legendary since its first identification in 1976, but an epidemic with over 11,000 fatalities seemed inconceivable.  Such surprises demonstrate that population density, and host social and biological factors, likely play as important a role in the development of pandemics as characteristics of the pathogen, and should serve to warn against complacency.  Our current approach is reactive.  Although we have the capability to develop more effective systems to anticipate and prevent emerging infections and pandemics, much more needs to be done.  Many effective public health measures, such as immunization and mosquito control, often become victims of their own success and are not sustained.  As urbanization increases worldwide, effective and sustainable early warning and response remain ever more essential.

Learning Objectives:

1. Define and distinguish an emerging infection and a pandemic
2. Assess probable future pandemic risks and how they might be prevented
 

The Ebola virus disease outbreak in West Africa in 2014-2016 was the largest of its kind in history.  This was the first outbreak that involved a randomized clinical trial for therapeutics, and the first where affected individuals were repatriated to other countries. Knowledge regarding Ebola virus disease dramatically increased during this outbreak, and more was learned clinically, epidemiologically and scientifically.  This lecture describes the advances from this outbreak in the context of the current outbreak that is occurring in the Democratic Republic of the Congo.  

Learning Objectives: 

1. Know the current status of the Ebola outbreak in the Democratic Republic of the Congo
2. Understand the current state of therapeutics for Ebola virus disease

Despite over 60+ years of research, the etiology of bacterial vaginosis (BV), the most common vaginal infection, remains controversial. Epidemiological data strongly suggest that BV is acquired via sexual transmission. This presentation will review pertinent epidemiological data regarding BV, particularly as it relates to sexual transmission. It will also discuss current hypotheses regarding the etiology of BV. 

Learning Objectives: 

1. Review the epidemiology of bacterial vaginosis (BV), particularly as it relates to sexual transmission
2. Discuss current hypotheses regarding the etiology of BV

To reduce the global burden diseases causes by infectious disease, including parasites and bacteria, scientists need better information about mechanisms of virulence, immune evasion, and drug resistance, as well as new insights into parasite and pathogen vector biology and life cycles.  One of the longstanding challenges in infectious disease has been the lack of high-quality reference genomes.  Parasite genomes in particular have been highly fragmented, as the telomeric regions of their chromosomes are dense with highly homologous genes that cannot be resolved with short read sequencing.  Recent developments in genome sequencing, however, are helping researchers overcome this barrier.  Recently, highly contiguous genome assemblies of Plasmodium falciparum, Aedes aegypti, and multiple trypanosomes have become available.  The number of reference genomes for bacteria that cause infectious disease is similarly expanding rapidly. Join Dr. Ashby as she discusses now these new resources are already yielding new biological insights into critical questions in infectious disease research, including how parasites evade the immune system add how pathogens are adapting to evolutionary pressures.

Learning Objectives:

1. Understand how the structure of parasite genomes facilitates immune evasion and rapid adaptation while at the same time creating challenges for high-quality genome assembly.
2. Discuss how long-read sequencing and high-quality references facilitate the identification of genomic changes linked to selective pressure, either directly or in conjunction with short read data.