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School and Program Updates

School and Program Updates

Columbia Addresses the Issue of Preparedness

Dr. Steven D. Stellman, professor of Clinical Epidemiology at the Mailman School of Public Health, is co-author on several forthcoming studies by the NYC Department of Health and Mental Hygiene on health consequences of exposure to the World Trade Center terrorist attacks. Dr. Stellman was research director for the Department’s WTC Health Registry, a cohort of 71,000 exposed individuals that has resulted in over 70 publications to date.

A latest study of over 4,500 WTC Registry participants who were also affected by Superstorm Sandy offered an unusual opportunity to gauge the impact of a second disaster on individuals who had previously been strongly affected by the World Trade Center disaster. An analysis of 1,162 residents of the most heavily inundated evacuation zone reports that 51percent of study participants evacuated their homes. Those more likely to evacuate knew they resided in a danger zone, had previously evacuated during Hurricane Irene of 2011, and lived in a more cohesive community. Evacuation was less likely among those possessing at least 7 of 8 items indicative of “preparedness,” suggesting intention to shelter in place. The latter unexpected finding implies pre-disaster preparedness messaging needs to be stronger and more detailed.

A study of the impact of disasters on children and adolescents co-authored by Dr. Stellman, to be published in Pediatric Research, found that 25 percent of 9/11 exposed adolescents had been subsequently diagnosed with asthma, and in 23 percent of those their asthma was poorly or very poorly controlled. Poor asthma control was associated with lower income and having one or more mental health conditions, speaking to the need for comprehensive pediatric post-disaster physical and mental health management.

Finally, an issue of the American Journal of Industrial Medicine timed to coincide with the 15-year anniversary of 9/11 will include four papers co-authored by Dr. Stellman. These include a study of the impact of 9/11 on job loss and early retirement, one on inter-relationships among asthma, PTSD, and gastroesophageal reflux disease (GERD), the first comprehensive health study of the 15,000 workers at the Staten Island landfill which received the debris from the destroyed buildings, and a 10-year report on cancer incidence in the Registry population.

The Center for Infection and Immunity (CII) is one of the world’s most advanced academic centers for research in disease surveillance, diagnosis and discovery in acute and chronic illnesses. CII has established unique partnerships with academic and public health institutions and governmental agencies in over 40 countries to provide expertise in managing outbreaks and assistance with pathogen discovery, training and surveillance.

To this end, the CII invented the technology known as VirCapSeq-VERT, which represents a breakthrough in genetic testing that will give clinicians a fast, efficient way to broadly screen for viral infections. The new method can detect and characterize the genetic composition of every virus in blood, urine, saliva, tissue, spinal fluid, and environmental samples with sensitivity and accuracy. Scientific American hailed this breakthrough as one of ten “World Changing Ideas”.

CII is currently working to address the Zika virus outbreak both nationally and globally by partnering with the US, Brazilian and other governments on two fronts. First, they are developing tests to allow for rapid diagnosis to determine whether an individual is infected by the Zika virus or other mosquito-borne viruses like Dengue, Chikungunya, or West Nile. Second, they are working to understand the connections between infection and outcomes like microcephaly.

Forecast of Infectious Disease

Infectious disease modeling experts at the Mailman School, led by Dr. Jeffrey Shaman, continue development and dissemination of operational infectious disease forecasting systems.  These include real-time weekly predictions of influenza incidence in cities and states across the U.S. (presented operationally in real time at cpid.iri.columbia.edu), as well as West Nile virus, respiratory syncytial virus and dengue.

The forecasting systems adapt model-inference techniques used in modern weather prediction to create local forecasts of future incidence by locality.

Flu forecast website features include: an interactive map of the U.S. displaying the relative severity of seasonal flu in cities across the country with flu and incidence numbers for each; influenza incidence predictions by city for the coming weeks; a map illustrating the proportion of flu cases by region; and charts comparing the timing and severity of the four most recent flu seasons.

Dr. Shaman and colleagues are working to expand the number of infectious disease prediction systems and to improve existing forecasting methodologies.  To this end, they recently launched an intensive, active surveillance program for influenza and other respiratory pathogens in the urban Manhattan environment with the aims of significantly advancing understanding of transmission dynamics, documenting the genetic basis of immune response to respiratory virus infection, bettering now-casting capabilities, and improving respiratory disease model simulation and forecast.

Student Surge Capacity for Outbreak Investigation

The Student Surge Capacity for Outbreak Investigation (Team Epi) is an educational collaborative program between the Mailman School of Public Health, the National Center for Disaster Preparedness and the New York City Department of Health and Mental Hygiene (NYC DOHMH).

Team Epi, not limited to Epidemiology graduate students, recruits and trains student volunteers from Epidemiology, Environmental Health Sciences, and Biostatistics to provide surge capacity support of epidemiological investigations at the NYC DOHMH in the event of an outbreak in New York City.

The course is offered each semester as an on-going request from the NYC Department of Health. Dr. Stephen Morse is a co-founder of the program and presents to the students throughout the year on outbreak investigation interviewing strategies.