 The complexity of infectious disease epidemiology, and the interdisciplinary advances in disease control observed in the 20th century in this country, suggest that a multidisciplinary approach is essential to the study of future emerging and reemerging infectious agents. The Harvard School of Public Health has a long history of research in infectious disease epidemiology, in a variety of academic departments.
The program in Infectious Disease Epidemiology is enhanced by a growing body of research activity. Research based in the Epidemiology department currently is focused in the following key areas:
- Epidemiology of pediatric HIV infection, including the impact of ART on long-term survival and other outcomes
- The behavioral and biological aspects of HIV transmission and natural history, including vaccine trial design
- Transmission dynamics and within-host population biology of infectious disease, combining in vivo (murine) experimental studies with statistical and computationally-complex mathematical modeling (population-dynamical) approaches
- Exhaled particles and their relationship to infectivity of influenza
- Identifying risk factors for the transmission of drug sensitive and resistant M. tuberculosis, using molecular and conventional epidemiologic methods
- Comparative genomics of M. tuberculosis strains, elucidating the genetic basis of transmissibility in drug resistant strains
Funded Research
Mechanisms of Capsular Diversity in Streptococcus Pneumoniae
This competitive continuation of “Vaccination and the Evolutionary Dynamics of Pneumococci” aims to increase understanding of the mechanisms maintaining capsular serotype diversity in S. pneumoniae. This project involves mathematical modeling, epidemiological data analysis, and animal experiments to identify biological differences (besides antibody reactivity) between capsular serotypes and understand whether such differences can account for the maintenance of capsular diversity in S. pneumoniae. (Lipsitch)
Methodological Approaches to Planning and Analysis of New Infectious Diseases (MIDAS Pilot Project)
This project aims to develop mathematical models for use in preventing, detecting, and/or controlling emerging infections, to aid in understanding and generalizing the output of computationally complex models of disease transmission. (Lipsitch)
Pediatric HIV/AIDS Cohort Study (PHACS) Data and Operations Center, and Strategic Leadership Group
This center serves as the collaborative nexus for analysis of perinatally-acquired HIV infection among adolescents and pre-adolescents, and the consequences of fetal and neonatal exposure to HIV and antiretroviral chemotherapy. The SLG
will serve as the scientific leadership for the PHACS study. (Seage)
Epidemiology and Transmission Dynamics of MDR/XDR Tuberculosis
The aim of this project is to conduct a series of linked interdisciplinary research projects focused on the emergence and transmission of multidrug and extensively drug resistant tuberculosis: a cohort study of host and microbial factors associated with MDR and XDR TB in Lima, Peru; a study characterizing M. tuberculosis strain diversity and its contribution to the emergence and spread of MDR; and a study using epidemic and individual predictive models to support public health policy and clinical decision-making for MDR and XDR TB. (Murray)
Macrophage Iron Metabolism and Tuberculosis Infection
We intend to elucidate the role of host iron status on the growth of M. tuberculosis, helping to identify those at high risk for disease progression and leading to therapeutic interventions aimed at reducing macrophage iron stores. This will be achieved through the measurement of mycobacterial growth in cells overexpressing Ferroportin 1, and in cells that have been stimulated by hepcidin. (Murray)
Curriculum in emerging infectious diseases
This project aims to develop and implement a core course in transmission dynamics of emerging infectious diseases, taking an interdisciplinary approach that incorporates case-based seminars and short courses. (Murray)
Comparative genomics and molecular epidemiology of tuberculosis
This project aims to develop tools for high-through-put molecular epidemiology to elucidate basis of strain-specific epidemiologic and clinical phenotypes and identify polymorphic proteins under immune selection. (Murray)
Optimizing HIV care in less developed countries
This study will assess the clinical impact, cost, and cost-effectiveness of alternative strategies for HIV management in South Africa, India, and Cote d’Ivoire. (Lipsitch, Seage, PI: Sue Goldie)
Post-PCV pneumococcal population genetics and resistance
This study aims to assess changes in patterns of colonization and serotype-specific antimicrobial resistance among pneumococcal isolates; to enhance our understanding of the biological processes which underlie apparent shifts in community carriage and resistance; and to re-assess risk factors for colonization and transmission of S. pneumoniae in the decades following universal PCV7 immunization. (Lipsitch, PI: Jonathan Finkelstein)
Evaluating the link between HIV prevention and treatment
This project aims to evaluate the cost-effectiveness of HIV screening on treatment and prevention. (Seage, PI: David Paltiel)
Statistical/Data Management Center-Pediatric AIDS Clinical Trials Group
This project is provides epidemiologic design and analytic support for pediatric HIV trials in the PACTG. (Seage, PI: Terry Fenton)
Cost-effectiveness of Preventing HIV complications (CEPAC)
This is a study to evaluate the cost-effectiveness of preventing HIV complications in the era of highly effective antiretroviral therapies (ART). (Seage, PI: Kenneth Freedberg)
Epidemiology of Multidrug-Resistant Tuberculosis in Peru
The goal of this project is to provide new knowledge about the transmission dynamics of multidrug-resistant tuberculosis in a high TB-burden area in Peru. This includes measurement of within-household transmission of various strains of TB, assessment of the impact of socio-demographic and clinical confounders and risk modifiers, and measurement of associations between specific resistance mutations and phenotypes. (Murray, PI: Mercedes Becerra)
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