Training Medical Warriors: Tropical Medicine Specialists Who Ward Off Bioterrorist and Global Health Threats Pass the Torch to the Next Generation

NORTHBROOK, Ill., Nov. 5 -- In 1963, when Karl Johnson, M.D., chose to set up a laboratory in Bolivia for the National Institutes of Health instead of taking a job working on a vaccine for the common cold, little did he know that his research would lay the foundation for the containment of numerous deadly infectious diseases around the world. With just a quick built laboratory, a few microscopes, mosquito nets and syringes, Dr. Johnson and his colleagues were able to identify Machupo virus, a hemorrhagic fever that had reached epidemic proportions in the South American country. More than 30 years later, that break through, along with groundbreaking research on several other viruses, continues to aid scientists to identify and contain life-threatening diseases such as Ebola and Sin Nombre, which have both reached American soil, but thanks to the pioneering research of Dr. Johnson and other global warriors, never reached their potential pandemic proportions.

While many Americans may not recognize these virus names, it is because, in many cases, they are stopped before they ever reached U.S. borders. But, with the spread of diseases such as West Nile virus in the U.S., the urgency to track down and contain infectious diseases at their origins has heightened. The rarely heard of but integral specialty of tropical medicine has for decades been home to key scientists whose work has helped find treatments for and alleviate the spread of infectious diseases around the world. Without these specialists, epidemics of yellow fever, cholera and SARS, may never have been contained or treated, altering the health and welfare of generations.

"We live in a global community with mass import and export of food supplies and extensive travel to foreign lands for both business and pleasure," explains Dr. Johnson. "Therefore, tropical medicine disease specialists are more important now than ever before, particularly to address health issues posed by potential bioterrorist threats."

With infectious diseases posing increased global health threats, ensuring that the "torch is passed" to specialists who can protect future generations is a main objective for the American Society of Tropical Medicine and Hygiene (ASTMH). A small, but mighty, society of nearly 4,000 members, the ASTMH provides opportunities, guidance and funds for students and future researchers to travel to the furthermost parts of the globe to track down and combat both emerging and neglected diseases, many of which take the largest toll on those living in poverty.

As the ASTMH prepares to gather this week at it's annual meeting to share information to further identify, prevent and treat continuous and newly emerging diseases, the goal of ensuring that the population continues to be protected against bioterrorist and global health threats remains at the top of their agenda. "Continuing the work on tropical and infectious diseases is key to the health of not only the country, but the world," explains Edward T. Ryan, M.D., scientific chair of the ASTMH meeting and director of the Tropical and Geographic Medicine Center at Massachusetts General Hospital.

Dr. Johnson, past president of the ASTMH, was himself infected with Machupo virus while working in Bolivia, but survived. While most tropical medicine specialists prepare themselves to be infected with diseases, all members of the Society firmly believe that working in the actual environment of the disease is necessary to gain otherwise inaccessible information.

Scott Heysell went to Vietnam as part of the Yale/Johnson&Johnson Physicians Scholars program. He helped train medical students there and drafted a textbook to help them learn medical English. After being in Vietnam for two months, Dr. Heysell knew that he wanted to include global health into his career. "At times the conditions are challenging, but one has the chance to make a huge impact in areas of significant poverty and social disparity," says Dr. Heysell, who is leaving his position as chief resident at Yale and returning to South Africa with his wife to continue studies on tuberculosis and HIV for the next year. "I'm so glad there is a group of mentors that have joined together to train young clinicians and researchers like myself, and to offer them opportunities not be available to them otherwise. With the assistance and guidance of the ASTMH, my eyes were opened to the amount of work I can contribute on a global level."

With so much sacrifice and little financial reward, what draws these researchers to put their lives in danger for the sake of science? Dan Milner's first trip to Africa working in a rural clinic in the Gambia did not deter him. Even though Dr. Milner lived with six other students in a tiny concrete building with a hole in the floor for a toilet, a bucket of water to bathe and food just once a day, as well as undergoing multiple vaccines before each trip, he realized that this was the work he was meant for as a physician. "As far as I'm concerned the field of tropical diseases has the biggest impact on disease transmission than any other medical specialty."

After a trip to Malawi to study why so many children were dying of malaria, Dr. Milner's idea of being a cancer pathologist in the U.S. quickly disappeared. "Once I saw how much I could do to treat and prevent diseases for people who literally had nothing, I knew that was where my services would be most important." As much as Dr. Milner wanted to help those with no health provisions, funds to travel and work in another country proved difficult to come by. "Through the ASTMH, I was able to secure grants that allowed me to travel to Malawi for several years to continue my research, while finishing his training at Brigham and Women's Hospital."

Also through the Yale program and ASTMH grants, Jesse Nussbaum spent time in a small hospital in Zambia. "I had heard stories, but nothing could have prepared me for what I saw. However, the interventions we brought, with larger, research-based changes, could make an enormous impact on underdeveloped areas." Dr. Nussbaum is next heading to Malawi to provide HIV care and conduct research on meningitis treatment in resource-limited settings.

When asked why not concentrate research and efforts to help people here in the U.S., Dr. Nussbaum explains, "Understanding when and why diseases begin is our only chance to improve health for both poor and wealthy populations - worldwide. And, we can only do this by conducting research at the disease setting."

For more information about the ASTMH meeting Nov. 5-8 in Philadelphia, please contact Rosalind D'Eugenio at the ASTMH press room, (215) 409-4053 or [email protected].