Summer 2001 Issue
International Fellowship Focuses on Hepatitis
Globally, 170 million people are infected with hepatitis C virus, and 350 million people are chronic carriers of hepatitis B. Hepatitis is clearly a threat to public health around the world. To broaden the expertise and resources of foreign scientists dedicated to fighting this menacing disease, Eli Lilly and Company, in partnership with the Association of Public Health Laboratories (APHL), CDC, and the CDC Foundation, has funded two International Emerging Infectious Diseases Laboratory Fellowships that focus solely on viral hepatitis and liver disease.
Established in 1998, the International EID Laboratory Fellowship program is designed for non-U.S. citizen doctoral-level scientists to gain professional training in laboratory-related aspects of infectious diseases. The research conducted in the U.S. host laboratory under these fellowships is intended to promote enhanced laboratory practices in the fellows’ home countries. This one-year program is also intended to train a network of laboratory leaders throughout the globe to provide rapid, multinational responses to infectious disease threats. With the addition of the two hepatitis fellowships, a total of six foreign scientists - five funded by Eli Lilly - will now benefit from the International EID Laboratory Fellowship program this year.
“Eli Lilly supports the fellowship program because of our concern with the growing, worldwide problem of new, reemerging, and drug-resistant infections,” says Gail Cassell, M.D., vice president for infectious disease research at Eli Lilly. Bo Shu, M.D., of China, and Do Tuan Dat, M.D., of Vietnam, are the first two fellows to focus specifically on hepatitis.
Hepatitis A, B and C are the three most familiar forms. CDC scientists estimate that approximately three percent of community-acquired cases of acute hepatitis in the United States are of unknown etiology. Because some hepatitis viruses are blood-borne, they pose a threat to the blood supply and to people who are exposed to infected blood, such as through blood transfusion, sexual contact or injection drug use.
Howard Fields, Ph.D., chief of CDC’s Molecular and Immunodiagnostic Section, who heads the research team with which Drs. Shu and Dat are working, says that the International EID Laboratory fellows are engaged in the transfer of laboratory technology for the improvement of public health. “They are learning all about the operation of a diagnostic laboratory - serologic assays, antibody and antigen detection, and molecular diagnostics - as well as how to manage a laboratory,” he says. “The fellowship furnishes them with the essential skills to go back to their countries and set up their own labs.”
Past fellowship recipients from China and Vietnam have helped implement the manufacture of vaccines against hepatitis B in their countries. Hepatitis B is highly endemic throughout Asia, particularly in China where up to 80 percent of the population is infected at some point in their lives. Fellows have also taken back the skills and tools to perform enzyme immunoassays for detection of hepatitis B surface antigens to permit accurate screening of blood supplies for the presence of the virus. And they have returned to their countries with anti-HCV technology for use within the blood transfusion services.
Dat, of the National Institute of Hygiene and Epidemiology of Vietnam in Hanoi, has been working in the area of hepatitis for seven years. He says the knowledge he is gaining in his work on the CDC team is giving him the tools to develop a hepatitis C diagnostic kit for manufacture in Vietnam. “Right now, we have to import hepatitis C test kits for blood screening,” Dat says. “If we can manufacture our own testing materials, it will make widespread screening more economically feasible.”
Shu, of China Medical University in Shenyang, China (Manchuria), has been studying hepatitis since 1989. His work with the CDC team focuses on the development of novel techniques to isolate previously unidentified hepatitis viruses.
“Preventing the disease is the most effective approach,” Shu says. “I hope through my work, to identify these new hepatitis virus strains so that we can develop vaccines against them. I am very grateful to CDC and to Eli Lilly for this opportunity to participate in the fellowship program.”
Harold Margolis, M.D., acting director of the Division of Viral Hepatitis of the National Center for Infectious Diseases, says that hepatitis, like other infectious diseases, needs to be viewed in its global context. “Borders are largely irrelevant in terms of infectious disease,” he says. “Training is vitally important to permit sharing of knowledge and technology, and cooperative programs such as the International EID Laboratory Fellowship permit scientists to take critical knowledge back to their countries, implement the technologies, and train others.”
The International EID Laboratory Fellowship is administered by APHL, which is a professional association dedicated to protecting and preserving the health of the nation and to promoting technology transfer in laboratory practices in order to foster better health globally. Co-sponsored by CDC and the CDC Foundation, the fellowship program places participants in federal (CDC) and state public health laboratories that best match the training and research needs of individual fellows and demonstrate a commitment and capacity to host an international scientist.
- Rosemarie Perrin