Joint program with CDC trains physicians in infectious diseases

The emergence of viral diseases such as AIDS, the evolution of multidrug resistant bacterial strains, and recent outbreaks of Hanta Virus and Ebola Virus all have served to refocus attention on infectious diseases, according to David Stephens, director of the Emory/CDC Postdoctoral Fellowship Training Program.

The development of antibiotics and vaccines, and the eradication of diseases such as smallpox, had caused the medical community to become quite confident in its ability to deal with disease agents such as bacteria and viruses, and consequently fewer resources have been devoted to infectious disease research and training. The Postdoctoral Fellowship Training Program was established in July 1994 through the Division of Infectious Diseases in the Department of Medicine to address the predicted shortages of physicians and scientists trained to conduct basic and applied research on infectious diseases.

The three-year joint fellowship training program is designed to produce individuals eligible for board certification in infectious diseases. According to Stephens, the goal of the program is to train individuals to better understand the biology of infectious diseases and the organisms that cause them, as well as the sociological issues associated with the spread and transmission of disease.

Physicians selected for the program may either pursue a three-year fellowship in epidemiology and clinical infectious diseases, or they may choose a fellowship in basic laboratory research and clinical infectious diseases. Epidemiology is the branch of research that involves determining how diseases spread, what types of factors put people at risk for developing a certain disease, and what preventive measures can be taken to protect a population from infection. Program fellows who choose this track spend 18 months in clinical rotations at Emory-affiliated hospitals and 18 months of epidemiological research at the U.S. Centers for Disease Control and Prevention (CDC,) with an emphasis on current CDC/Emory joint projects going on in Atlanta.

Fellows choosing the basic research track also spend 18 months in clinical infectious diseases training, but they will focus their remaining fellowship work on basic lab research in a CDC laboratory under the direction of an investigator who holds a joint Emory faculty appointment. These fellows will study problems such as how infectious organisms invade the hosts and what types of immune responses are generated against infection.

Rick Hengel, the first fellow admitted into the training program, has chosen the basic research track. Working with J. S. McDougal, chief of the Immunology Branch in the Division of HIV/AIDS at the CDC, he currently is investigating the transmission of HIV from infected mothers to their children. Only one-third of the children born to mothers who have HIV test positive for the presence of HIV in their blood, and Hengel is interested in the fact that the other two-thirds of the children seem to be protected from infection by the virus. He is studying the antibodies from infected mothers to determine if those antibodies can neutralize the virus in the lab, and to determine if there is a correlation between children who are seronegative (no HIV detectable in their blood) and the ability of maternal antibodies to neutralize the virus.

Hengel also is interested in populations of people around the world who are at a high risk for developing AIDS, yet never test positive for the presence of the virus. He is studying blood group types to see if there is a correlation between the HLA blood type and these people.

Currently the fellowship training program has four physicians, each attacking different problems posed by emerging infectious diseases.

-- Michele Arduengo

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