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The Role of Arboviruses as a Cause of Undifferentiated Febrile Illness in Sind, Pakistan

The Role of Arboviruses as a Cause of Undifferentiated Febrile Illness in Sind, Pakistan. Topic No. 6.C Topic Title: Characterize pathogens endemic to Pakistan Proposal Number. FRBAA09-6C-2-0047. Dr. Greg Gray. Head PI Professor, Department of Environment and Global Health at UF

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The Role of Arboviruses as a Cause of Undifferentiated Febrile Illness in Sind, Pakistan

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  1. The Role of Arboviruses as a Cause of Undifferentiated Febrile Illness in Sind, Pakistan Topic No. 6.C Topic Title: Characterize pathogens endemic to Pakistan Proposal Number. FRBAA09-6C-2-0047

  2. Dr. Greg Gray • Head PI • Professor, Department of Environment and Global Health at UF • Director, One Health Center of Excellence • 20 years in the Navy, awarded Legion of Merit Medal for epidemiology work • Created and leads Certificate in Emerging Infectious Diseases Research Program that has trained more than 140 public health professionals from numerous countries. • Authored more than 210 peer-reviewed publications • Served on national expert advisory committees for US Armed Forces Epidemiological Board, Infectious Disease Society of American, and the Institute of Medicine.

  3. Outline • Intro to University of Florida • Review training program

  4. The University of Florida • The state’s largest university (and one of the nation’s largest) enrolls more than 50,000 students per year. • 16 colleges • 150 research centers/institutes • Since 1985, a member of the Association of American Universities (AAU) - the top 62 public and private U.S. institutions.

  5. The University of Florida • 5,500 international students from 130 different countries • Nearly 2,000 international scholars and faculty • Home base for over 2,000 study abroad students who study in over 50 countries

  6. Educational Excellence • Consistently ranked among the nation’s top universities… • No. 17, U.S. News & World Report “Top Public Universities” (2012) • No. 7, Princeton Review “Best Values in Public Colleges” (2011) • No. 6,The Center “Top Public Research Universities” (2006) • No. 8,The Scientist magazine’s “Best Places to Work in Academia” (2006) • No. 2, Kiplinger’s “Best Values in Public Colleges” (2012)

  7. Educational Excellence • 5,434 faculty members with distinguished records in teaching, research and service; • More than 52 Eminent Scholar chairs; • Nearly 35 faculty elections to the National Academy of Sciences, Engineering, or Arts and Science, the Institute of Medicine or a counterpart in a foreign nation.

  8. Educational Excellence • Awards include a Fields Medal, two Pulitzer Prizes, NASA’s top award for research and Smithsonian Institution’s conservation award.

  9. Academic Excellence Selective Student Admission • The fall 2011 incoming freshman class had an average GPA of 4.23 and an average SAT score of 1920. • The freshman retention rate of 96 percent is among the highest in the country.

  10. Research & Discoveries • UF received $619 million in research awards in 2010-’11; • Diverse areas include health care and citrus production. • Milken Institute named UF one of the top-5 in the country for the transfer of biotechnology to the marketplace (2006).

  11. Research Resources Emerging Pathogen Institute Institute on Aging Cancer & Genetics Research Complex McKnight Brain Institute

  12. Research Resources Journalism & Communications Building Biomedical Sciences Building Nanoscale Research Facility Proton Therapy Institute

  13. Research Resources Veterinary Education & Clinical Research Public Health & Health Professions, Nursing & Pharmacy Clinical & Translational Science Building Jacksonville Medical Campus Cancer Hospital Complex

  14. Department of Environmental and Global Health Primary Faculty Department of Environmental and Global Health Faculty Pathogens Afsar Ali Greg Gray Gary Heil Human & animal effects John Lednicky Richard Rheingans Zoonotic disease researcher Toxicology • Stephen Roberts • Tara Sabo-Attwood Aquatic • Andy Kane Environmental health • Bernard Okech • Song Liang

  15. EGH International Research Collaborations

  16. Emerging Pathogens Institute http://www.epi.ufl.edu/

  17. Center for Environmental and Human Toxicology

  18. Infectious Disease Field Laboratory & Guest House Haiti is reported to have many endemic infectious diseases but diagnostic capabilities are even more sparse than before the earthquakeCommission surveillance and research studies run by University of Florida faculty, AFHSC-GEIS, and other partners leveraging existing infectious disease assets.

  19. The University of Florida is in Gainesville.The Gator Nation is Everywhere. • The Gator Nation includes millions of people throughout the world: students, alumni, faculty, staff and administrators, as well as sports fans and anyone who wishes to affiliate with the values and spirit of the University of Florida. • For more information about UF, visit www.ufl.edu.

  20. The Role of Arboviruses as a Cause of Undifferentiated Febrile Illness in Sind, Pakistan Topic No. 6.C Topic Title: Characterize pathogens endemic to Pakistan Proposal Number. FRBAA09-6C-2-0047

  21. ABSTRACT Arboviralinfections have a global distribution; however viral agents vary in different geographical regions. The true burden and epidemiology of arboviruses in Pakistan is not known as many of these infections present as a febrile illness of unknown etiology. Due to the lack of diagnostic testing capability, febrile viral infections are often misclassified. In one month, WHO reported 4,731 cases of undifferentiated fever from 12 districts of Sind province of Pakistan, and recently dengue virus emerged in Karachi and surrounding regions of Sind, Pakistan. According to press reports, more than 3,640 patients were affected with an estimated 40 deaths, of which 37 were from Karachi. Lack of diagnosis and inappropriate management may have contributed to many of these deaths. Pakistan is at risk of suffering large epidemics of vector-borne diseases for a variety of reasons, and the goal of this project is to improve Pakistani capabilities to detect, characterize and report severe West Nile, Japanese encephalitis, dengue and chikungunya virus infections and aid in the sustained monitoring and reporting of these infections which have weapons of mass destruction (WMD) potential. This will be accomplished by development of surveillance methodology and training programs between the United States and Pakistan. This work will create a sustainable dynamic of communication and infrastructure development with Pakistan that can be applied to other medical or veterinary pathogens that may be potential WMD.

  22. Pathogen Focus • Dengue virus • West Nile virus • Japanese encephalitis virus • Chikungunyavirus

  23. Dr. Bernard Okech • Entomologist • Extensive experience conducting entomological field studies and molecular parasitology • US-DoD funded to study malaria in Haiti • Will lead entomological training and field mosquito collection techniques

  24. Dr. Gary Heil • Manages Global Pathogens Laboratory • Extensive experience in virology, immunology, and protein chemistry • Teaches PHC 6561“Introduction to Public Health Laboratory Techniques” • Will lead laboratory diagnostics training

  25. Dr. John Lednicky • Aerosol Biologist & Virologist • Extensive experience with experimental transmission studies with aerosols • Development of human and animal virus detection, isolation, and identification methodologies • Will lead laboratory diagnostic training for JEV as well as training in virology techniques

  26. Dr. Maureen Long • Department of Infectious Diseases and Pathology at UF’s College of Veterinary Medicine • Done research in zoonotic diseases, including WNV • Last 10 years focused on mosquito-borne viruses • Part of the State of Florida Arboviruses Partner Surveillance Plan • Will lead laboratory analysis and training in BSL-3 lab as well as WNV diagnostics

  27. Year #1 (FY13-14)Work Plan • Task 1: Provide Pakistani collaborators with training for virus surveillance and diagnostics • 1.1 Assay development for ELISAs, qRT-PCR and virus culture • 1.2 Handbooks, Manuals and SOPs developed and translated to Urdu • 1.3 Curriculum Development • 1.4 Training Dr. Khan and 2 senior research scientists for three months at UF • 1.5 Course work for the 9 credit hour Certificate in One Health • 1.6 Training workshop for 6 Medical Officers for 1 week in Pakistan • Task 2: Assess the prevalence of arboviruses in Sind province Pakistan • 2.1 Acquire IRB approval for research involving human subjects • 2.2 Patient recruitment and sample collection from 300 individuals within Sind province, Pakistan.

  28. Year #2 (FY14-15)Work Plan • Task 1: Provide Pakistani collaborators with training for virus surveillance and diagnostics • 1.1 Employment of diagnostic assays which includes ELISA, qRT-PCR, entomological and virological assays at AKU • 1.2 Training workshop for Medical Officers • Task 2: Assess the prevalence of arboviruses in Sind province Pakistan • 2.1 Patient recruitment and sample collection from 300 individuals within Sind province, Pakistan • 2.2 Employment of insect surveillance programs in Sind province, Pakistan.

  29. Year #3 (FY15-16) Work Plan • Task 3: Validation and dissemination of data • 3.1 Laboratory-based diagnostics and data entry at AKU of patient and insect samples • 3.2 Validation of serological and entomological results by the UF research team • 3.3 Sequence analysis of viral isolates obtained from study participants

  30. Year #4 (FY16-17) Work Plan • Task 3: Validation and dissemination of data • 3.1 Analysis of results, dissemination and final report • Task 4: Pakistan-based training workshop for public health practitioners • 4.1 Training workshop for 30 public health practitioners in Pakistan to learn viral diagnostics and surveillance for 1 week.

  31. Review Schedule

  32. DTRA Overview • Defense Threat Reduction Agency (DTRA) • Formed (as DTRA) in 1998 • Department of Defense combat support • Headquartered in Fort Belvoir, Virginia • ~2,000 military and civilian personnel • 12 locations worldwide “The Defense Threat Reduction Agency safeguards America and its allies from Weapons of Mass Destruction (chemical, biological, radiological, nuclear, and high explosives) by providing capabilities to reduce, eliminate, and counter the threat, and mitigate its effects.”

  33. Basic and Applied Sciences (J9-BA) Mission: To foster and enable farsighted, high payoff research focused on the unique challenges related to countering the effects of weapons of mass destruction (WMD) by: • Attract next-generation workforce • Advancing the fundamental knowledge and understanding in the sciences • Facilitating the transition of research that enables new capabilities for the warfighter • Complementing the Agency applied research efforts with university research capabilities

  34. Research Programs • Basic Research (BR) Program • Discovery-based research without specific application • Primarily a U.S. university portfolio • Growing international component • Fundamental Research Program • Includes basic and early applied research • Translates basic research into broadly defined needs • Vehicle for cooperative research to support CBEP

  35. Research Thrust Areas Sensing and recognition: Detection, characterization, and quantification of materials or energy sources of significance Cognitive and information sciences: Convergence of computer, information, mathematical, natural, and social sciences for predictive modeling and threat analysis Protection sciences: Protection of life and life-sustaining resources through containment, decontamination, filtering, and systems shielding Defeat sciences: Improvements to success rate of defeat actions, accessing target WMDs, and weapons modeling Secure and handle WMD:Verification of treaty compliance, development of methods to monitor and secure nefarious materials, and disruption of proliferation pathways Cooperative Counter WMD Research with Global Partners: Exploratory research to confront global WMD threats through international collaborative efforts FUNDAMENTAL BASIC

  36. Promoting Global Partnerships • Global Security Engagement: A New Model for Cooperative Threat Reduction (2009) • Creative, flexible approach for new engagements • Partnership as a basic mechanism for cooperation • Focus on long-term relationships and capacity-building • Engagement benefits survive beyond programs / projects • Peer-to-peer scientific engagements • Engagement through the academic community 2010 Quadrennial Defense Review (QDR) 1. Defend the United States and support civil authorities at home 2. Succeed in counterinsurgency, stability, and counterterrorism operations 3. Build the security capacity of partner states 4. Deter and defeat aggression in anti-access environments 5. Prevent proliferation and counter weapons of mass destruction 6. Operate effectively in cyberspace

  37. Cooperative Research on a Global Scale U.S. / foreign university-centric cooperative fundamental research for enhancing global security: • Foster international science & technology capabilities • Advance sustainability of effort in partner nation • Foster accountability for conducting ethical research • Utilize science and technology (vice military) interface • Support NLGC strategic goals

  38. Thrust Area 6 Topic Description The goal is to improve international collaboration to detect, characterize, & report WMD, and to advance partner nation sustainment through a culture of long-term cooperation & scientific responsibility. • Detect, characterize, and report disease outbreaks • Prevent, diagnose, and treat illness • Train in the conduct of ethical research • Advance sustainment of global health security initiatives

  39. Engagement Process/Expectations • U.S. university as prime awardee • Pakistani universities/institutes as subawardees • Utilize existing DTRA BAA for fundamental research • U.S. university will be responsible for: • Transferring funds to foreign university via their funding vehicles • Monitoring for ITAR compliance with their foreign counterpart(s) • Grant monitoring will occur via interaction with prime

  40. Pathway to Success • Success requires publications and presentations • Funding Acknowledgment: “This work was supported (in part) by the Defense Threat Reduction Agency, Basic Research Award # HDTRA1-14-X-xxxx, to YYY institution” • Metrics showing ‘return on investment’ • Scientific accomplishments (publications and presentations) • Capacity-building efforts (training, workshops) • Number of students, degrees awarded • Honors and awards, including matching funds, new grants • Discoveries > Invention Reports > Innovation and Commercialization ***Option Yearsare not guaranteed. Decisions will be made internally by CBEP based on technical progress, success of partnership, CBEP priorities, and funding availability.***

  41. Technical Expectations: Summary *Terms and Conditions of Grant

  42. Technical and Quality of Relationship Reporting Metrics **Required reporting metric according to grant award terms and conditions

  43. Technical and Quality of Relationship Reporting Metrics **Required reporting metric according to grant award terms and conditions

  44. Summary We are enthusiastic about your participation in the DTRA fundamental research program. We want to maintain open communication. • Your success is our success. • We encourage you to develop positive collaborations with the GOR. We need your input on metrics for value added. • Scientific accomplishments • Number of students, theses, degrees, publications, & presentations • Others as indicated (see slides 15 & 16) We look forward to developing the partnership.

  45. Contact Information • Grants Officer (GO) Nadine Rafaels nadine.rafaels@dtra.mil • Grants specialist (GS) Nardia Collins nardia.collins@dtra.mil • Grants Officer’s Representative (GOR) Heather Meeks heather.meeks@dtra.mil

  46. Project Design • Goal for you to design and execute surveillance, training plan, etc. • Rough ideas regarding surveillance? • Flexible schedule but we want to see you engaged in research project development: proposal, IRB docs, IACUC, budgeting, ordering supplies, etc.

  47. Ground Rules • You are pioneers…if you do well we win more funding • Setting you up in the EPI, 4th floor • I am your coach but responsible to many that we use DTRA funding well • Follow UF rules & be safe • Keep Anne Buck and me informed of your plans. My cell 3522625786. • Weekends are yours – if you want to do something special just let us know

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