Early treatment with the FDA-approved antiparasitic drug nitazoxanide prevents mild or moderate COVID-19 symptoms from progressing to severe illness and hospitalization, a clinical study co-led by USF Health’s Christian Bréchot, MD, PhD, indicates.

The Phase 3 randomized, double-blind, controlled clinical trial, conducted at 36 centers in the U.S. and Puerto Rico, was led by Jean-Francois Rossignol, MD, PhD, executive chairman of Tampa-based Romark LLC, and Christian Brechot, MD, PhD, president of the Global Virus Network; associate vice president for International Partnerships and Innovation at USF; and professor, Division of Infectious Disease, Department of Internal Medicine at the USF Health Morsani College of Medicine.

The findings posted April 20 to medRxiv, a preprint server for health sciences.

USF Health’s Christian Brechot, MD, PhD, co-led the multicenter clinical study.

“Combining safe, potent therapies with vaccination programs will be critical to controlling this pandemic,” study principal investigator Dr. Brechot said. “Despite the remarkable advances in developing effective COVID-19 vaccines, we still urgently need new treatments to help prevent severe disease and hospitalizations.”

This is particularly the case earlier in the disease – before the COVID-19 virus replicates extensively and infection spreads from the lungs, potentially triggering an immune system-induced “cytokine storm” that damages other organs. Monoclonal antibodies, while achieving promising results when infused early enough, are costly, prone to resistance by viral mutations, and must be administered in a hospital or clinic, Dr. Brechot added.

Nitazoxanide, an existing drug widely prescribed to treat intestinal parasites, has a proven safety record in children and adults. In cell culture studies, it has been shown to inhibit replication of several different respiratory viruses, including the human coronavirus MERS, influenza viruses, and rhinoviruses. Researchers attribute the drug’s broad-spectrum antiviral activity to its interference with cell pathways that the virus exploits to multiply. Recently, nitazoxanide was identified as a promising candidate for early treatment of SARS-CoV-2.

With this in mind, the team led by Dr. Rossignol and Dr Brechot investigated whether nitazoxanide, could be repurposed to stop mild or moderate COVID-19 from worsening.

In the latest clinical trial, the researchers tested the effectiveness of nitazoxanide in 379 outpatients, ages 12 to 83, with laboratory-confirmed mild or moderate COVID-19. Study participants (whose COVID respiratory symptoms began no more than 72 hours before entering the trial) were randomized into one of two groups, both treated for five days. One group received 300 mg. extended release nitazoxanide tablets twice daily (a 600 mg dose); the second group received placebo tablets matching the real drug’s appearance twice daily.

Monoclonal antibodies, which have shown promise for early COVID-19 treatment, are costly, administered at a hospital or clinic, and prone to resistance by viral mutations.

Among the findings of the efficacy analysis:

• Time to sustained response (a measure of how long COVID mild or moderate symptoms lasted) was not reduced by nitazoxanide.

• Nitazoxanide treatment was associated with an 85% decrease in progression to severe illness, compared to placebo. Only one of all 184 outpatients in the nitazoxanide group progressed to severe disease (a rate of 0.5%), while seven out of 195 (3.6%) in the placebo group did.

• A subgroup of 238 study participants (63% of the total 379) were at high risk of developing severe COVID illness based on Centers for Disease Control and Prevention (CDC) criteria (age, underlying medical conditions, etc.). Of these higher-risk individuals the rate of progression to severe disease was significantly lower for the nitazoxanide-treated group (0.9%), than for the placebo group (5.6%).

• Treatment reduced the rate of hospitalization by 79% in the nitazoxanide group (0.5%), compared to the placebo group (2.6%).

The researchers emphasize that larger studies are needed to confirm their results.

New, easily accessible antiviral treatments are still urgently needed to prevent the progression of mild or moderate COVID-19 to severe illness and hospitalizations.

“The availability of a safe, oral, scalable, host-directed antiviral for the early treatment of COVID-19 in persons at high risk of severe illness could play an important role in reducing the number of severe illnesses and hospitalizations during this ongoing major public health crisis,” they concluded.

The study was funded by the Romark Institute for Medical Research.

A single virus, SARS-CoV-2, has plunged the entire planet into a health, socioeconomic and political crisis. The short, medium, and long-term effects are potentially devastating.

A relatively low direct mortality rate (approximately 0.3 to 0.8% depending on the population) facilitated the spread of this highly contagious respiratory virus. However, the elderly and those with chronic diseases, especially diabetes, suffer substantially higher death rates. Moreover, contagiousness seems to have risen since the beginning of the epidemic due to mutations. Beyond the numbers describing direct mortality, the overall health impact (including COVID-19’s negative knock-on effect on the treatment of other diseases) will undoubtedly be high.

Finally, we tend to overlook the severity of infection that leads to high numbers of intensive care admissions, including among young people, and leaves many with persistent symptoms. Approximately 30-40% of infected individuals continue to suffer from exhaustion, respiratory difficulties, and a loss of smell and taste three months after recovery. COVID-19’s broad impact unfortunately makes it very clear that infectious diseases, especially viral diseases, continue to be a constant threat to humans.

Key questions remain about our lack of preparedness. We must address the challenges of coordinating large-scale international institutions, especially recognizing that a reformed World Health Organization (WHO) – with the support of its member states – has a central role to play in this coordination process. The lack of a “scenario,” in the military sense, to anticipate the overall health effects of a viral pandemic, and its accompanying psychological, social, economic, and political consequences, has been painfully evident. In this context, I would like to emphasize the following three points:

1. The importance of diagnosis in controlling infectious diseases is generally underestimated.

We need to develop quicker, more effective approaches so that people can genuinely benefit from technological advances in identifying infections. Diagnostic tests play a key role in controlling any infectious disease, particularly COVID-19.

Despite tangible progress in developing treatments and vaccines, we will live with this virus for many months to come. That means we need to completely rethink the way we organize our professional, family and personal lives. Rapid, wide-spread use of diagnostic tests will be crucial for monitoring infections in schools, workplaces, restaurants and elsewhere, serving as a vital pillar for a comprehensive public health policy that carefully considers the socioeconomic impact of health measures. Yet, the gulf between the significant technical advances in diagnostics and the slow pace of their application among populations worldwide remains striking.

For example, a recent Global Virus Network (GVN) conference clearly demonstrated that rapid tests using both antigen and molecular techniques are available and would help considerably in containing infection. New approaches based on rapid sequencing or pooling (performing initial tests on pooled samples) are also being developed.

Sampling techniques need to be better suited for rapid screening. Why are we still only working with nasopharyngeal swabs? These devices are unpleasant and therefore impossible to use repeatedly on adults as well as children. Furthermore, swabs sometimes give rise to false negative results because of the wide range of sample collection techniques. Conversely, saliva tests performed under controlled conditions could form the basis of an effective, large-scale rapid testing strategy, with repeated testing compensating for any potential lack of sensitivity.

Finally, the massive growth in digital applications has paved the way for a new approach to monitor infection (beyond mere tracking), with educational and entertaining “apps” being developed for children and adults. Controlling pandemics will rely largely on our ability to monitor contamination in near real time, to inform, and to educate. Is this a utopian scenario, or a pipe dream? No, and it is up to us to create these tools. With that in mind, the GVN and USF Health have begun working with the research group of Dr. Pardis Sabeti at the Broad Institute in Boston and Sarasota Military Academy to develop such rapid testing and digital-based communications. Tests must be approved and validated with extreme care, but the validation process cannot remain confined to the national level. Cooperation between academic institutions and industrial stakeholders can help drive new approaches for rapidly developing and approving new tests.

Clearly, we cannot produce a test if we don’t know what virus we are looking for; however, we can at least predict the technical problems we will likely encounter in devising novel tests. We must build upon current successes with vaccines. The U.S. has invested heavily in the development of new SARS-CoV-2 vaccines, and its Biomedical Advanced Research and Development Authority (BARDA) played a key role not only in funding, but in promoting interactions between academics and industry. Several countries have already secured access to vaccines by making deals with pharmaceutical companies, even though the vaccines were still under development. The Coalition for Epidemic Preparedness Innovations (CEPI), a partnership of academic institutions, industry stakeholders, governments, WHO and major foundations such as the Bill & Melinda Gates Foundation and the Wellcome Trust, was set up in 2015 following the Ebola virus crisis. This coalition has helped speed the production of large quantities of vaccines. We should draw inspiration from these vaccine investments and initiatives to make us more effective in the field of diagnostics.

2. Improving the training and recruitment of virologists is vital.

The importance of training and recruiting a new generation of virologists has been underestimated worldwide. Although many scientists demonstrate remarkable expertise in molecular virology, we lack virologists with both training in “conventional” virology, including virus culture, and a cross-disciplinary approach to research. Several institutions have partnered with industry to introduce outstanding training programs, with excellent teaching and supervision and tutoring for students. We need stronger investment in this field to organize cross-disciplinary virology training programs that meet real-world needs and support recruitment of the best and brightest students. This is what has been reinforced at USF Health, with the recent online course developed in partnership with GVN.

3.COVID-19 has intensified the need for international and independent scientific collaboration, incorporating new ways of organizing research.

Research organizations, agencies, universities, and hospitals play a vital role in research, especially when it comes to viral diseases. Moreover, WHO can and must play a central role in coordinating efforts to tackle viral pandemics. Restructuring WHO is crucial to this process, but realistically we must focus on two areas in particular to help strengthen the work of all these institutions.

First, and particularly relevant in a health crisis, we must promote risk-taking and responsiveness beyond what can be achieved by traditional review procedures. At USF Health, as well as within the GVN, I have witnessed how we can generate truly innovative ideas. International calls for proposals need to target projects that take risks and are reviewed based on the quality of the project proponents. The Grand Challenges initiative, coordinated by the Bill & Melinda Gates Foundation, the Wellcome Trust and others, is a step in the right direction — but it does not go far enough.

Secondly, research networks can complement the effective operation of institutions in responding to pandemics. They embody flexibility, avoid placing scientists in burdensome institutional positions, do not need a return on intellectual property, and distinctly focus on dialog and collaboration – all of which allows them to support meaningful responses to health crises. Research networks also embrace changes in interpersonal communication and interaction brought about by the emergence of social media.

Several such networks already exist. The Global Outbreak Alert and Response (GOARN) network set up by WHO is a step forward but for obvious reasons linked with the size and workings of WHO, it cannot perform with optimal flexibility and efficiency. The concept of research networks, therefore, requires greater recognition, and the independence of these networks must be guaranteed by support from a variety of private and public partners. The National Science Foundation (NSF) in the U.S. recently launched a call for proposals for “networks of networks,” reflecting the importance of the research network as a means of organization to accelerate scientific discovery and highlighting the need for individual networks to coordinate their efforts.

By now it is clear that we are not just dealing with a serious health crisis; we are witnessing the dawn of a new era. The recently announced effectiveness of the first vaccines against COVID-19 is a breakthrough, lifting global hope. But, we still need to learn lessons from this pandemic including fostering international cooperation and adapting our research efforts so that we are better aligned to tackle future pandemics.

Christian Brèchot, MD, PhD
Senior Associate Dean for Research in Global Affairs,
USF Health Morsani College of Medicine
Associate Vice President for International Partnerships and Innovation,
USF Professor, Department of Internal Medicine
President, Global Virus Network

University of South Florida-led research identifies individual hosts more or less likely to escalate outbreaks

Tampa, FL (Jan. 29, 2019) – The 2014-16 Ebola virus epidemic that ravaged Western Africa, killing thousands, was the largest in history. An analysis of the epidemic found that not all individuals played an equal role in spreading the deadly infectious disease – just 3 percent of patients caused more than 60 percent of infections in other people. “Superspreaders” have also been implicated in other outbreaks, including severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).

Now, an international study led by a University of South Florida professor provides a new model to help identify and understand superspreaders and other forms of extreme competence, including less studied “superdiluters” that may protect individuals against infection risk.  The research is published today in the journal Trends in Ecology and Evolution.

Lynn Martin, PhD, a professor in the USF College of Public Health,  says a deeper investigation of the relationship between physiology and behavior in individual hosts and how infectious disease emerges and spreads in the community can help better target control of epidemics.

“The relationship between physiology and behavior in individual hosts determines the dynamics of how infectious disease emerges and spreads in the community,” said lead author Lynn Martin, PhD, a professor at the USF Health College of Public Health who studies disease ecology. “Individuals are not the same – and distinguishing how they differ within the context of host-parasite interactions is critical.  This new framework might help us better target vaccinations, hygiene and other measures to those individuals most likely to influence the spread of infections during epidemics.”

Simple epidemiological models for infectious diseases have been unable to explain or predict the behavior of some outbreaks, often because they don’t account for variation in individual host competence.  Competence represents the capacity for one human or animal host to cause new infections either in other hosts, or in vectors – biting insects and other carriers that can transmit viral, bacterial, and other infections. (For instance, Culex mosquitoes are the vectors that transmit West Nile and other viruses to humans.)

The model developed by Martin and his Australian colleagues elucidates various aspects of host competence that may increase or decrease the risk of effectively spreading disease. It breaks down host competence into four key stages – exposure to, susceptibility for, suitability for, and transmissibility of infectious organisms – and proposes that various combinations of these factors among individual hosts will determine how a disease circulates and evolves within a community.

For example, a single human genetic mutation, linked with increased ingestion of malaria parasites by white blood cells, might make some humans who are otherwise exceptionally susceptible to infection incapable of attaining a high enough volume of parasites in their circulating blood to transmit the parasites to mosquito vectors.  Human hosts with this particular mutation may act as superdiluters, significantly weakening the risk of malaria in their communities. By contrast, human (or animal) hosts very attractive to malaria-infected mosquitos and also highly able to replicate parasites might act as superspreaders.

Panel A depicts existing information on competence for human and avian (bird) malaria (Plasmodium and Haemoproteus). Red and blue circles denote traits of two different individuals in all four stages of the host-vector-parasite interaction. Graphic courtesy of Trends in Ecology and Evolution.

Panel B depicts: Hosts that are super-attractors to vectors (in this case mosquitoes) could have either super-diluting or super-spreading consequences depending on relationships between traits within hosts. White-filled symbols depict uninfected hosts, dark green-filled symbols depict infected hosts, blue and red symbols reflect alternate forms of competence, and green-shaded circles reflect host impacts on local malaria transmission. Graphic courtesy of Trends in Ecology and Evolution.

The interplay between host behavior and physiology in individual hosts is very important, Martin said. For instance, traditional funeral practices emphasizing washing and dressing a body that retains the blood, sweat and other bodily fluids of the Ebola virus prolonged West Africa’s deadly epidemic.  Differences among individuals in these behaviors probably influenced that Ebola epidemic, Martin said. For several infections, research indicates that asymptomatic people who do not feel sick yet travel great distances or remain socially active in their communities may be more effective spreaders of infections than infected individuals who stay home because they feel lethargic and sick.

In a second paper published the same day in Trends in Parasitology. Dr. Martin (senior author) and co-investigators used the new framework to investigate how host body size effects on competence might influence disease risk for others.  The researchers revealed that large species appear to be disproportionately better at generating infections like West Nile virus and Lyme disease than smaller species based on how effects of body size on host traits combine to impact competence.  However, they emphasized that the lower population density of large hosts may sometimes diminish amplifying effects of body size on disease risk.

-Photo by Torie M. Doll, USF Health Communications and Marketing

Dr. Christian Bréchot will help elevate biomedical and health-related areas of research excellence to the international level

The former head of the world-renowned Pasteur Institute in Paris has joined USF Health to help university leaders strengthen biomedical and health-related areas of research excellence – and to elevate interdisciplinary signature programs to the international level.

Christian Bréchot, MD, PhD

Preeminent virologist Christian Bréchot, MD, PhD, joined the USF Health Morsani College of Medicine part time in October as senior associate dean for research in global affairs, associate vice president for international partnerships and innovation, and a professor in the Division of Infectious Disease, Department of Internal Medicine.  Dr. Bréchot is also executive director of the Tampa-based Romark Laboratories Institute for Medical Research. Since 2017, he has served as president of the Global Virus Network, a coalition of the world’s foremost medical virologists.

“Dr. Bréchot has been at the forefront of catalyzing teams of top scientists to work together effectively on global solutions for emerging pathogens, malaria and microbial infections,” said Charles Lockwood, MD, senior vice president for USF Health and dean of the Morsani College of Medicine. “He is the ideal person to work with leadership across USF Health and USF in strategically identifying opportunities to take our infectious diseases, cardiovascular, neuroscience, and maternal-child health translational research to the next level, and to build upon the international networks he helped create at the Pasteur Institute and elsewhere to make that happen.”

Before serving as president of the Pasteur Institute from 2013 to 2017, Dr. Bréchot was vice president of medical and scientific affairs at Institut-Merieux, a company that develops new approaches to fight infectious diseases and cancers.  He also served as the general director of Inserm, the French national agency for biomedical research (analogous to the National Institutes of Health in the U.S.) from 2002 to 2007. As professor of hepatology and cell biology at Necker School of Medicine, Paris Descartes University, he headed the clinical department of liver diseases at Necker-Enfants Maldes Hospital from 1997 to 2001.

Dr. Bréchot has authored more than 400 articles in medical and scientific journals, and in 2005 was ranked by the Institute for Scientific Information as the 4^th most cited author on the topic hepatitis C. He has been recognized as an inventor on 18 patents, and helped to create three biotechnology companies.

With a prestigious career bridging basic science and medicine, Dr. Bréchot has combined research, clinical service and teaching with top administrative posts to enhance scientific understanding and better public health. His scholarly endeavors have included cultivating productive public-private partnerships between academia and industry.

During a recent interview in his office at USF Health, Dr. Bréchot talked about leading the Pasteur Institute, a preeminent global network of 33 institutes in 26 countries; his diverse background; and his new role at USF Health.  The interview has been edited for length.

What has been your area of research focus?

As an MD-PhD, I’ve always been convinced of the need to combine basic research with clinical practice — long before translational medicine became fashionable. My basic science research has combined cell biology and molecular virology, mostly focusing on hepatitis B (HBV) and hepatitis C (HCV) and how these viruses can induce liver cancer. I’ve also been very involved in developing diagnostic tests of HBV and HCV and evaluating new drugs to treat chronic forms of the infection.  More recently, I’ve worked on the mechanisms of liver regeneration and based on longstanding research activity in my laboratory, we discovered a new molecule (HIP/PAP, or hepatocarcinoma-intestine-pancreas/pancreatic associated protein), now being tested in clinical trials as a drug that may be useful for patients with a severe form of acute and chronic hepatitis. We’re contemplating organizing new phase 2 clinical trials in China, because China has so many people with chronic hepatitis B infection.

What were some major accomplishments at the Pasteur Institute under your leadership?

First, both at Inserm and the Pasteur Institute, I was very much focused on attracting and supporting young investigators. We created programs and special funding mechanisms to really give scientists at the early stages of their careers the means to develop interdisciplinary research and then get a grant. Second, at Pasteur, we reinforced research activities, especially in the fields of bioinformatics and integrative biology. We created a Center for Bioinformatics, Biostatistics and Integrative Biology (an international multidisciplinary center for processing, analyzing and modeling biological data) that included recruiting 40 high-level engineers and opening a new building.  Third, we merged the activities of different departments focused on the microbiota. For instance, we had a program called Brain and Microbes in which scientists working on infectious agents and those working in the neurosciences looked at how the bacteria of the intestine can modulate brain function, including disorders such as anxiety and depression.

What is the microbiome, and why is it such a hot area of research interest?

The microbiota is made up of populations of bacteria, fungi, certain viruses and other microorganisms present throughout the body.  It’s actually a very old topic:  The first microbiota intervention (to treat diarrhea) was done by a Chinese doctor 3,000 years before Christ (the ancient equivalent of a fecal microbiota transplant). What’s new is our technological progress – with the capacity for genome sequencing and advances in bioinformatics, we now have the possibility to investigate the human microbiota like never before… As a result, we’ve discovered very significant connections between dysbiosis — modifications of how microbe populations are distributed in the gut, the lungs, the skin — and metabolic disorders such as obesity and diabetes, cardiovascular diseases, neurological diseases like Parkinson’s and perhaps also Alzheimer’s, and some infectious diseases where disease severity correlates with what happens to intestinal bacteria. It’s a fascinating, challenging field with applications for cross-disciplinary research and translational medicine, and where international cooperation can be extremely interesting because the link between, say for example, the microbiota and diabetes may be very different in the U.S. and Africa due to the strong influence of environmental factors such as nutrition, as well as genetic variations… So, the science of microbiota as it affects certain diseases is a very good example of a collaboration which, if organized with centers in Africa, Southeast Asia and South America, could create a unique USF program very competitive with other universities.

What attracted you to the University of South Florida?

USF already has a lot of excellent ongoing research activities and in my discussions with senior leadership I found there’s real international ambition here, a desire and commitment to go further. I liked that.

What is your vision for helping advance research at USF Health?

I’m still in the stage where I need to listen and learn more about the research activities to see how I can best contribute. But, initially I want to work with Drs. Lockwood, (Paul) Sanberg, (Stephen) Liggett, (John) Sinnott and other leaders to delineate which strategic research areas need to be reinforced and then contribute to the high-level recruitment of scientists. Second, we’ll increase coordination among different departments working in research areas such as the intestinal microbiota and its impact on cardiovascular, neurodegenerative and infectious diseases. Third, I hope to contribute to the international expansion of USF, building upon the networks from my previous activities including work with industry partners.

I absolutely appreciate that I will only be efficient in helping to advance research activities at USF if I integrate into the team. It’s not always easy, but it works.

Dr. Bréchot will build on global networks from his previous activities, including work with industry partners.

You have said talent is key to research excellence. Is there one predominant quality you seek in selecting top talent?

You start by looking for bright minds. But, when you must choose among five scientists all with very bright minds, enthusiasm and the capacity to integrate are critically important. I’m a fan of soccer where you need to have very talented players, but you also very much need players with team spirit. Modern science needs researchers with an interdisciplinary mode of thinking who interact well with those from other disciplines.

Some things you may not know about Dr. Bréchot:

-Each generation of Dr. Bréchot’s family, dating back to King Louis XIV of France, had at least one medical doctor.

– As a student at Pasteur Institute, he helped set up the first diagnostic test to detect hepatitis B virus in blood; he also taught the first course in molecular biology in China in 1981.

-He met his wife Patrizia Paterlini Bréchot, MD, PhD, a professor of medicine at Necker School of Medicine and founder of a biotech company, when she came from Italy for a postdoctoral fellowship at Necker and Pasteur Institute in Paris. His five grown children include two MD-PhDs: a daughter who is a cancer immunologist at Pennsylvania State University, and a son who directs an intensive care unit at Pitié–Salpêtrière Hospital in Paris, one of Europe’s largest teaching hospitals. There are also six grandchildren, ranging from ages 1 to 11.

-Dr. Bréchot enjoys jogging, playing tennis and snow skiing. Currently, he’s reading about U.S. history, including biographies of George Washington and Abraham Lincoln.

-Photos by Eric Younghans, USF Health Communications and Marketing

By Douglas A. Holt, MD
Andor Szentivanyi Professor of Medicine
Director, Division of Infectious Diseases and International Medicine
USF Health Morsani College of Medicine

(As of 8/04/2016)

What is known about the Zika outbreak in Miami?

• Mosquitoes in Miami have infected at least 14 people with Zika virus.
• A specific Miami neighborhood referred to as Wynwood has now been declared an area with active Zika virus transmission.
• This means that everyone who resides in or travels frequently to this area is at ongoing risk for being infected with Zika.
• The following steps are being taken to prevent Zika from spreading.
  1. Mosquito control is taking aggressive mosquito control measures within a minimum of an expanded 200 yards around the residence where a case of Zika infection has been reported.
  2. Mosquito control is testing mosquitoes for Zika.
  3. A medical advisory for the area has been issued through media, targeted outreach, health care provider notification and guidance targeted to OB/GYNs, midwives, Healthy Start, and others caring for pregnant women.
  4. Voluntary isolation will be recommended for infected individuals for 7 to 10 days from the onset of symptoms.
  5. The Florida Department of Health (FDOH) is going door-to-door to offer testing to identify more people infected, which will help determine the extent of the outbreak.
  6. FDOH will provide Zika Prevention Kits to pregnant women living in the area.

• Based on past experiences with dengue virus, also spread by the same mosquitoes, it is hoped that the outbreak will remain contained to this small area.
• However, Zika virus has proven to be very unpredictable, so we expect additional areas across the state to be identified as having active Zika virus transmission.

What does this all mean for Tampa Bay?

• Pregnant women are advised to avoid travel to the Wynwood neighborhood of Miami. If they have recently traveled to, or lived in, this area they should consult their obstetrician about being tested for Zika virus.
• Everyone should continue to take steps to prevent mosquito bites.
  1. Remove standing water from inside and outside your home or workplace. Check containers such as flowerpots, buckets, animal water bowls, and children’s pools. Scrub them clean and turn them over or cover them so they don’t collect water.
  2. Use an insect repellant, like bug spray or lotion, that’s registered with the Environmental Protection Agency (EPA). All EPA-registered bug sprays and lotions are checked to make sure they are safe and work well. If you use sunscreen, apply it first before bug spray or lotion.
  3. Wear a hat, a long-sleeved shirt, long pants, shoes and socks when outdoors. Treat clothes, shoes and other gear with bug spray called permethrin or wear treated clothes if you’re hiking, camping, or doing other outdoor activities.
  4. Use air conditioning and screens on windows and doors to keep mosquitoes out. Make sure screens on doors and windows don’t have holes or tears in them.

• Health care providers are being asked to remain alert for any patient with an illness that might be Zika fever and to notify the Health Department at 813-307-8010. Any two of the following clinical manifestations should suggest Zika fever: Fever, rash, joint aches and conjunctivitis or pink eye.

• Any pregnant woman should also now be asked about travel to the Wynwood neighborhood in addition to all the other countries outside the United States identified as having active Zika virus transmission. Additional areas will be included as they are identified by the FDOH. 

What is USF Health doing to respond if mosquitoes in Tampa Bay also spread Zika virus?

• Our physicians and medical providers have already begun screening our patients for symptoms suggesting Zika fever and all pregnant women for potential exposure to Zika virus.
• The Wynwood area of Miami has been added to the areas of concern and additional areas will be included as they are identified by the Florida DOH.
• We are working closely with the Department of Health-Hillsborough County to test patients who meet the criteria for Zika infection.
• Medical providers are following the recently released Centers for Disease Control and Prevention (CDC) guidelines on Caring for Pregnant Women with Possible Zika Virus Exposure.

Where can I get more information?

• CDC Health Alert Network (HAN) Health Advisory: CDC Guidance for Travel and Testing of Pregnant Women and Women of Reproductive Age for Zika Virus Infection Related to the Investigation for Local Mosquito-borne Zika Virus Transmission in Miami-Dade and Broward Counties, Florida https://content.govdelivery.com/accounts/USCDC/bulletins/15a36d4
• Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure — United States, July 2016  http://www.cdc.gov/mmwr/volumes/65/wr/mm6529e1.htm

• CDC Zika Page: http://www.cdc.gov/zika/index.html/

• CDC Travel Notices: http://wwwnc.cdc.gov/travel/notices

• FDOH Zika Page: http://www.floridahealth.gov/diseases-and-conditions/zika-virus/

• CDC Microcephaly: http://www.cdc.gov/ncbddd/birthdefects/microcephaly.html

• CDC: Questions and Answers: Zika virus infection (Zika) and Pregnancy: http://www.cdc.gov/zika/pregnancy/question-answers.html

• Zika Virus Infection with Prolonged Maternal Viremia and Fetal Brain Abnormalities: http://www.nejm.org/doi/full/10.1056/NEJMoa1601824

• Zika Virus: http://www.nejm.org/doi/full/10.1056/NEJMra1602113
• Association between Zika virus and microcephaly in French Polynesia, 2013–15: a retrospective study. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)00651-6/abstract

• Update: Interim Guidance for Health Care Providers Caring for Women of Reproductive Age with Possible Zika Virus Exposure — United States, 2016. http://www.cdc.gov/mmwr/volumes/65/wr/mm6512e2.htm?s_cid=mm6512e2_w

Yu Chen, PhD, an associate professor in the Morsani College of Medicine’s Department of Molecular Medicine, was among five USF faculty members who recently received the university’s Excellence in Innovation Awards for their exceptional research and innovation.

Each winner received a $2,000 award and plaque presented at the annual luncheon of the USF Chapter of the National Academy of Inventors on Aug. 31.

Yu Chen, PhD

The award recognizes Dr. Chen for his patented technology of novel beta-lactamase inhibitors licensed by Gordian Biotechnologies to tackle the growing problem of antibiotic resistance, for the development of collaborations with Achaogen Inc., and for his publications last year in the Journal of Medicinal Chemistry and Future Medicinal Chemistry.

Dr. Chen’s structure-based drug design approach has led to the development of novel small molecule inhibitors against multiple proteins involved in antibiotic resistance, metastatic cancer and Alzheimer’s disease. Using an interdisciplinary approach, he combines both computational and experimental techniques to investigate the function and inhibition of enzymes related to bacterial cell wall synthesis, the biological process targeted by antibiotics such as penicillin.

Dr. Chen has extensive experience in biochemistry, X-ray crystallography and molecular docking. He has characterized the catalytic mechanisms of three enzymes and determined about 40 crystal structures including protein complexes with DNA or small molecules.

The crystal of a protein used to help design better beta-lactamase inhibitors.

A team of USF Health researchers is celebrating World Immunization Week by kicking off a campaign that focuses on the connection between vaccines and prevention of infectious diseases.  The researchers join health advocates in 180 countries around the globe who unite to mark this occasion during the last week of April.

Sponsored by the World Health Organization, World Immunization Week promotes the message that vaccinations are one of the most effective public health interventions in modern history.

According to the Centers for Disease Control and Prevention’s latest Morbidity and Mortality Weekly Report, vaccines will prevent 322 million illnesses, 21 million hospitalizations, and 732,000 deaths in the United States.  Recent outbreaks across the United States and Europe of measles and whooping cough, which are vaccine-preventable, have been attributed to non-vaccination or under-vaccination.

The USF multidisciplinary research group, comprised of infectious diseases, health disparities, biology, and public health specialists, is partnering with local communities to bring high-quality vaccination information and services to adults in Hillsborough and Polk counties.  The project, called VaccineLink-Conexión de Salud, has three goals:

• Create long-lasting partnerships with low-income and minority communities,
• Provide  high-quality, accurate and sustainable information about vaccines and vaccine preventable diseases, and
• Increase access to vaccines

 
Dawood Sultan, PhD, and Jamie Morano, MD, MPH, are among the project leaders.

USF Health investigators leading the project include Jamie Morano, MD, MPH, assistant professor of medicine, Division of Infectious Disease & International Medicine; Dawood Sultan, PhD, assistant professor of public health, Department of Health Policy and Management (HPM); Meghan Borysova, PhD, Health Equity Leadership Institute Scholar and research associate in HPM, and April Schenck, MBA, grant coordinator.The team is joined by trained public health professionals and Spanish language experts/translators Arturo Rebollon, MD, MPH, Viviana Delgado, and Veronica Estrella, MS.  Community member health liaisons and web-platform skilled technology experts are expected to join the project to help extend its outreach.

Those in Hillsborough and Polk counties interested in learning more about VaccineLink-Conexión de Salud can contact April Schenck at aschenck@health.usf.edu.

Campaign video:
//www.youtube.com/watch?v=Bs1ePbkuND4

Story by Drs. Meghan Borysova and Arturo Rebollon, USF College of Public Health 

RELATED STORY:
Pfizer awards $475,000 grant to Drs. David Sultan, Jamie Morano, and Meghan Borysova for vaccine uptake

Tampa, FL (Dec. 5, 2012) – Douglas A. Holt, MD, FACP, the Andor Szentivanyi Professor of Medicine, has been named director of  the Division of Infectious Disease and International Medicine in the USF Health Morsani College of Medicine Department of Internal Medicine.  His appointment began Dec. 1.

Dr. Holt, who joined the USF medical faculty in 1989, has been the associate director of the Division he will now lead since 2006.   He succeeds John T. Sinnott, MD, as Division Director.  Dr. Sinnott stepped up to become the new chair of USF’s Department of Internal Medicine.

Dr. Holt will continue to serve as director of the Hillsborough County Department of Health, responsible for assessing, maintaining and improving health and safety within Florida’s fourth most populous county. 

He is also vice chief of internal medicine and hospital epidemiologist at Tampa General Hospital, a major teaching affiliate of USF Health.

Dr. Douglas Holt

“We are lucky to have a leader like Dr. Holt,” said Dr. Sinnott, the James P. Cullison Professor of Medicine and chair of the Department of Internal Medicine.  “He is a thoughtful, effective and learned physician who inspires all of us to excel.”

“I have been blessed with a career that I love, and am fortunate to be part of an academic community with enthusiasm for learning and an appreciation for meaningful growth,” Dr. Holt said. “As Division Director, I am committed to inspiring and supporting every member of the team as we seize the opportunities that lie ahead.”

Dr. Holt earned his medical degree from the University of South Alabama in 1984. After completing a residency in internal medicine and a fellowship in infectious diseases and tropical medicine at USF, he joined the faculty of the USF College of Medicine as an assistant professor.

He was a member of the inaugural class of the USF Leadership Institute and served as secretary of the College of Medicine Faculty Council and the college’s Financial Oversight Committee.

Dr. Holt twice served as the acting deputy state health officer, from Sept. 2001 to Feb. 2002, and again from May to Sept. 2011.  This fall his outstanding record of public service and leadership was recognized by Gov. Rick Scott with a Distinguished Service to the State of Florida award.

Long recognized for his teaching excellence by students, residents and fellows, Dr. Holt has been the principal or co-principal investigator for more than 60 clinical research studies and authored 21 peer-reviewed publications and several textbook chapters.

A fellow of the American College of Physicians, he is an active member of many state and local organizations.  These include the Hillsborough County Medical Association, American Medical Association, Florida Public Health Association (past president), Public Health Leadership Society, Florida Medical Association, School Readiness Coalition, Hillsborough Community College Foundation Board of Directors, National Association of County & City Health Officials, Children’s Board Advocacy Committee, and the Healthy Start Coalition Board of Directors.

Dr. Holt led an initiative throughout the Hillsborough County Health Department to incorporate quality management and a co-creating philosophy that encourages more active involvement of the department’s customers in the development and improvement of its services. He recently chaired a statewide effort to redesign Florida’s system of care for tuberculosis.

 -USF Health-

USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Biomedical Sciences and the School of Physical Therapy and Rehabilitation Sciences; and the USF Physician’s Group. The University of South Florida is a global research university ranked 50^th in the nation by the National Science Foundation for both federal and total research expenditures among all U.S. universities.

Media contact:
Anne DeLotto Baier, USF Health Communications
(813) 974-3303 or abaier@health.usf.edu