UM Experts Join Forces to Investigate Mosquito-Borne Illnesses

College of Arts & Sciences Sponsors Cross-Disciplinary Seminar to Mark World Health Day

More than one billion people in the world are suffering from mosquito-borne diseases, and about one million of these individuals will die from these illnesses this year. Mosquito-borne viruses, such as malaria and dengue fever, are becoming a more widespread threat as globalization makes the world smaller – and people, goods, and germs travel around the globe with increasing speed and ease.

Scholars from across the University of Miami came together on World Health Day to address the threat of mosquito-borne illnesses and the actions necessary to prevent and protect individuals from these “small bites, and big threats,” during a cross-disciplinary seminar aimed at educating UM students, faculty, and the community.

The seminar marked World Health Day – the annual observance of the founding of the World Health Organization (WHO) on April 7, 1948. It was sponsored by the Department of International Studies in the UM College of Arts & Sciences, along with student groups United Against Infectious Disease and Miller School of Medicine Public Health Student Association.

Dr. Sherri Porcelain, senior lecturer of global health in the College of Arts & Sciences, who was instrumental in organizing the event, said the theme (selected by the WHO) provides an excellent opportunity to showcase expertise at UM. “We have so many great scientist-scholars who could contribute to this important event. The issues and policies are very complex, and no discipline alone can tackle the problems related to vector-borne disease,” she said, adding that important issues to consider include globalization, climate change, environmental management, biology, ecology, urbanization, geography, health disparities, epidemiology, surveillance, and cross-border collaboration.

Dr. John Beier, professor and director of the Division of Environment and Public Health in the Miller School, kicked off the seminar with a presentation on the possibility of eliminating malaria completely by controlling mosquito populations. He presented the Roll Back Malaria Partnership’s goal to reduce deaths from malaria to “near zero” and decrease cases of malaria by 75% by the end of 2015.

Beier said preventing transmission of malaria from mosquitoes to humans is the key. “Unless we eliminate transmission, we will not have an impact on eliminating deaths,” he said, adding that most people who now contract malaria are bitten in outdoor environments, making bed nets and spraying inside buildings ineffective.

Dr. Justin Stoler, assistant professor of geography in the College of Arts & Sciences, said that, while malaria is an important health risk, his research in Ghana is showing that dengue fever is a hidden health threat in Africa.

Stoler, who is working with an interdisciplinary team at the University of Ghana Legon, is testing blood samples of patients who come to clinics with symptoms such as fever, headache, and nausea – ailments that could be caused by malaria, but also a host of other viral, bacterial, or fungal diseases. Because clinics do not have the resources to perform blood tests on patients who come in with these generalized ailments, they are often presumptively diagnosed with malaria and given anti-malarial medications. Stoler and his colleagues have found significant evidence of dengue fever among these individuals.

He said, “While dengue doesn’t kill very many people, it is a tremendous bane on productivity during an epidemic.”

Stoler added that the mosquitoes that transmit dengue breed in water-holding containers such as plant saucers, buckets, and tires – making them ideal “urban mosquitoes” that flourish in cities where waste collection can be unreliable and families collect rain water for their household usage (like Accra, Ghana).

Mosquitoes also like plants that contain water, such as the bromeliads which are common throughout South Florida, and on the UM campus.

Dengue fever has become the fastest-spreading mosquito-borne viral disease, with 2.3 million cases reported in the Americas in 2013.

Dr. Whitney Qualls, a postdoctoral fellow with the Vector Biology Team in the Miller School Department of Public Health Sciences, is an expert on mosquito management. She has overseen various vector control programs in the United States and Haiti, and her remarks focused on strategies to prevent mosquito-borne illnesses in America. She noted the importance of planning interventions that are targeted to the specific species of mosquito in the affected area, and that address the appropriate stage of the vector’s development (for example, larva or adult).

Dr. Aileen Chang, general medicine fellow and clinical instructor in the Department of Internal Medicine at the Miller School of Medicine, gave the clinical perspective. She presented a case study on diagnosis and treatment of dengue fever, prepared in response to the 2009-2010 outbreak of the disease in Florida (specifically Key West). It was a rare appearance of dengue in America transmitted by local mosquitoes, and not “imported” by a traveler who had recently been to a region where dengue is prevalent.

Chang detailed the importance of treating dengue at the “critical phase,” when patients no longer have fever but are at risk for serious complications – but noted that 75% of dengue cases are asymptomatic, and only 5% of patients become severely ill.

Next, the developers of DengueWEB presented their product – a unique software application that integrates data collection, analysis, and reporting in one platform, which can be accessed on mobile devices. DengueWEB will allow health workers to more easily detect, track, and predict emerging epidemics.

The event ended with a rousing game of Humans vs. Mosquitoes: A Game-Based Intervention created by Assistant Professor of Interactive Media Clayton Ewing, from the UM School of Communication.

This innovative tool pits “Team Mosquito” against “Team Human.” Humans use tarps, tents, and other tools to eliminate mosquito “eggs,” while mosquitoes tried to take humans’ “blood.”

Ewing is a recognized game designer who has worked with numerous non-profit organizations including the Red Cross and the World Bank, to create interactive public health applications. Humans vs. Mosquitoes is being adapted for use in Panama this summer by a group of UM students who will be providing health educational interventions to the Guna Indians.

Porcelain said that the threat of mosquito-borne diseases must be tackled from three key areas: globalization, health diplomacy, and health security.

“Engaging countries to minimize the risk of cross-border threats, encouraging cooperation and sharing data in a timely fashion” are critically important, she said, adding, “Protecting health within and across borders requires a more rational approach that addresses the intersection of health and security today.”

April 10, 2014