Day 1 :
Michigan State University
Time : 09:20-09:50
Reza Nassiri is a former Associate Dean of Global Health at the Michigan State University (MSU). He also served as MSU director of Institute of International Health. He is currently Professor of Pharmacology and Toxicology, Professor of Family and Community Medicine, and, lecturer in Global Health, Infectious Diseases and Tropical Medicine. He currently works on international public health issues relating to chronic diseases and has expertise in global health. He has made contributions in various fields of medical sciences including clinical investigation and health education. On the basis of his extensive experience and expertise in chronic infectious diseases including HIV/AIDS, TB as well as antimicrobial resistance and human gut microbiome, he developed clinical research programs in Brazil, South Africa, Haiti, Dominican Republic and Mexico.
Global consumption of antibiotics has increased nearly 40% in the last decade. The incredible rapid resistance of antibiotic resistance which is taking place worldwide is not only a serious threat to the practice of modern medicine, but equally important, a threat to global public health. This urgent issue is so alarming that it caught the attention of G-20 Summit in both China (2016) and Germany (2017), let alone the U.N. Assembly in 2016 had called for a special meeting of “superbugs” which focused on the escalating drug resistance with respect to the sexually transmitted disease gonorrhea and carbapenem resistant Enterobacteriaceae. While
the causes of antibiotic resistance are complex, certainly human behavior play a significant role in the spread of antibiotic resistant genes. In addition to the human behavior, the drivers of resistance include agriculture sector, animal husbandry, household and industry – these factors contribute significantly to the spread of the resistant genes within the ecosystem. Such resistant mechanisms are continuously emerging globally, which threatens our ability to treat common infections, resulting in increased death, disability and costs. Since the development and clinical use of penicillins, nearly 1000 resistant-related beta-lactamases that inactivate various types of antibiotics have been identified. There is also a global concern about the emergence of antibiotic resistant carried by the healthy individuals, the commensal bacteria. The CDC and WHO surveillance data shows that the resistance in E. coli is generally and consistently the highest for antibacterial agents in both human and veterinary medicine. Within communities, resistant bacteria circulate from person to person or from animals and environment to person, or vice versa. With 1 billion people travelling each year, bacteria is becoming more mobile. The bacterial resistance can kill 700,000 worldwide each year and it’s been estimated to kill 10 million by 2050. The WHO estimates 78 million people a year get gonorrhea, an STD that can infect the genitals, rectum and throat - there is a widespread resistance to the first-line medicine ciprofloxacin as well as increasing resistance to azithromycin.
The emergence of resistance to last-resort treatments known as extended-spectrum cephalosporins (ESCs) is now eminent. The five riskiest superbugs are recognized as (1) the original one: Staphylococcus Aureus (MRSA), (2) the hospital lurkers: Clostridium Difficile and Acinetobacter, (3) the food borne pathogens: Escherichia Coli and Salmonella, (4) The sexually-transmitted infections: Gonorrhea and Chlamydia, and (5) TB. India is a typical example of encountering the deadly bacterial resistance. The discovery of the New Delhi metallo-beta-lactamase-1 (NDM-1) which disables almost all antibiotics directed against it, was turning point in the rapid emergence of blaNDM-1 gene which was first identified in 2008 in people who had traveled in India or sought medical care in South Asia. The gene for NDM-1 travels on a plasmid, an extra-chromosomal loop of DNA that can be traded freely among bacteria. So far, it has been found a variety of bacterial species that carry NDM-1 particularly in the gut bacteria, can cause serious infections in vulnerable hospital patients in India, South Asia, South Africa and the UK. There are two major routes of spread for the bacteria; hospital and the community. In hospital infections, bacteria carrying NDM-1 move from person to person when patients who have received many antibiotics, develop diarrhea and traces of feces contaminate surfaces, equipment and healthcare workers' hands. In community infections, the bacteria carrying the enzyme passes from person to person when traces of feces contaminate municipal water supplies – and with a large percentage of the population lacking any access to sanitation. Public Health Foundation
of India believes that 60,000 infants per year are dying of drug-resistant infections due to NDM-1. In addition, tourists can pick up antibiotic-resistance genes in just 2-3 days. Currently, India is facing with two antibiotic resistant genes what carry NDM-1; E. coli and Klebsiella. The discovery mrc-1 gene in China which is being transferred between Klesbsiella pneumoniae and E. Coli further compounded the global burden of antibiotic resistance, which has already spread to the neighboring countries. In the animal husbandry and agricultural sectors of China, the demand for the antibiotics to reach almost 12,000 tons per year. The high prevalence
of the mrc-1 gene in E. Coli samples both in animals and raw meat, with the number of positive-testing samples are increasing each year in China. On average, more than 20 percent of bacteria in the animal samples and 15 percent of the raw meat samples carried the mrc-1 gene. Numerous European countries have reported the existence of mrc-1 gene in the isolates from human, isolates from animals used for food, isolates from food, and isolated from the environment. In conclusion, pathogens rapidly develop mutations that render current treatments ineffective – resistance to carbapenems, one of the ‘last lines’ of antibiotics, is widespread and has been observed in numerous countries. Therefore, there is an urgent need between research universities and industry aimed at developing novel antimicrobial agents to save the practice of modern medicine.
Head of UNESCO Chair Sexual Health & Human Rights
Paris Diderot University
Keynote: Why it is important to integrate the SDGs in a sexual and reproductive health education to improve the HIV and STIs results and to achieve the SDGs?
Time : 09:50-10:20
Thierry Troussier is currently working at the Health Directorate General of the French Ministry of Health. Since 2018, in charge of sexual health promotion strategies, 2001– 2017 Coordinator of the national program for HIV-AIDS and STIs prevention for Metropolitan France and the five French Overseas Territories.
Background: The UNESCO Chair for sexual health & human rights is engaged in the implementation of the sustainable developmentgoals (SDGs). Strategically, she uses a global perspective them to advance her advocacy on sexual reproductive health and rights(SRHR).Methods: For increase understanding and exchange experiences on sexual reproductive health and rights, the UNESCO Chair proposes a chart developing targets for 17 SDGs, in relation with SRHR. This chart on “Sexual Health and Rights” in the 2030 Agenda NU, is presented for this symposium. Results: The aim of this chart is to describe the relation between the SDGs, human rights and sexual health in order to: facilitatepeople’s access to information and lifelong learning on their sexual heath and reproductive health; promote health and sexual wellbeingfor living better and longer; ensuring universal access to sexual and reproductive health-care services and ending the HIV and
STIs epidemics; include a focus on the general population and specific population groups like migrants, LGBTI, handicapped andelderly people; challenge pervasive stigmatization and discrimination and; to promote a people-centered approach, gender equalityand health equity. The final objective of this chart is to strengthen and advance our advocacy on sexual and reproductive health andsexual rights on the ground, among healthcare professionals, social and legal professionals, as well as with the decision makers.Conclusion & Discussion: To achieve in 2030, the sustainable development goals 3.3 (end the HIV and STIs epidemics) as well asthe targets of goal 2 (zero hunger), goal 6 (clean water and sanitation) and goal 7 (clean and affordable energy), this requires thatgoal 17 be fully realized indeed the partnerships between the countries, the regions of the world and between the private and public organizations is essential to solve financial and human needs.
Baylor College of Medicine Texas
Keynote: Zika virus tissue sampling protocol’s purpose defined through algorithm in anatomic pathology for trainees
Time : 10:35-11:05
Kristine McCluskey is lead PA and both a pathology residency and a pathologists’ Assistant Program Instructor with expertise in acroscopic pathology. She received the Baylor College of Medicine’s Fulbright and Jaworksi, LLP Faculty Excellence Award in Teaching and Evaluation. She conducts monthly workshops and directed her first symposium for continuing medical education credit accredited by the American Society for Clinical Pathology pertaining to macroscopic disease at a local and national level. She has spoken at national conferences regarding her field in academic medicine and surgical specimen processing. Her educational tools have been published andshe plans to pursue a doctorate in health science education. Her research interests include medical education curriculum development and breast cancer.
Dr. Ram Manohar Lohia Hospital
Keynote: Profile of opportunistic infections in patients with HIV/AIDS started on ART & its correlation with CD4 cell counts
Time : 11:05-11:35
Sharwani Vijayshree Lal is currently working as a Medical Officer at a Central Government Hospital in the capital of India. She has developed sharp acumen and insight ineffective clinical judgement. Her passion for meticulous and comprehensive management of a case has matured during her rewarding exposure to healthcare in hospitals and educational institutions over the years. This study, capturing profile of opportunistic infections in patients with HIV, effectively demonstrates the significance of sound assessment and diligent handling of a case.
Statement of the Problem: India has 21.17 lakh people living with HIV/AIDS (PLHIV) in 2015. Although mortality has decreased substantially but the course of HIV is still frequently complicated by various opportunistic infections which are still the most common cause of death amongst these patients. Methodology: It was a cross sectional, observational study done over a span of one year at PGIMER, Dr. RML Hospital, New Delhi. Patients were evaluated for any pre-existing opportunistic infections by clinical, radiological and laboratory parameters. Results: A total of 651 patients were started on ART (64% males and 36% females). The most common route of transmission was heterosexual (95%) followed by intravenous drug abuse (3%) and 2% couldn’t elicit any cause. 32, 13 and 24 patients were positive for HBsAg, Anti-HCV and VDRL respectively. The mean CD4 counts of 651 patients were 264/μL. 130 (20%) patients amongst these 651 developed or had opportunistic infections at the time of initiation of ART and their mean CD4 counts were 95/μL. All of them were on 1st line ART as per NACO guidelines (2NRTI + 1NNRTI). 95% compliance was seen in >90% of these patients. 80% of these opportunistic infections manifested after ART was started (Immune Reconstitution Inflammatory Syndrome - IRIS). The most common opportunistic infection was tuberculosis (74%) out of which 61 (45%) patients had extra pulmonary TB and 39 (29%) had pulmonary TB. 16 (12%), 11 (8%), 3 (2%), 3 (2%) had candidiasis, diarrhea, herpes zoster, cryptococcal meningitis respectively,and 1 case each of toxoplasmosis, LRTI and molluscum contagiosum. 14 patients died of these infections, 6 were lost for follow up.Conclusion: Opportunistic infections especially TB is very common in PLHIV in India. Many of these infections occur as a part of IRIS, where a thorough clinical judgement and expert management is of utmost importance.
Natalie Borg has completed her PhD from the University of Melbourne and postdoctoral studies from Monash University Department of Biochemistry and Molecular Biology. She is an ARC Future Fellow and Heads the Immunity and Infection Laboratory at the leading Australian University, Monash University. She has published 29 papers in premier journals including Nature and Nature Structural and Molecular Biology.
Hendra virus (HeV) is a paramyxovirus that causes severe disease and a high incidence of fatality in infected humans. Despite recurrent outbreaks and potential for human lethality no vaccine or anti-viral agent is available to prevent or treat human HeV infection. Key to HeV pathogenicity is the viral phosphoprotein (P) gene, which also encodes the V and W proteins as distinct products. V modulates the host response to infection by targeting numerous host proteins. Here, we show nuclear transport receptors are amongst those targeted by HeV V. We characterize the interactions and identify key residues in V that mediate the interaction.Finally, we report specific inhibitors of nuclear transport prevent interaction with host transporters, and reduce HeV infection. These findings broaden our understanding of HeV-host interactions and have implications for the design of novel anti-HeV therapeutics.
Fisheries and Oceans
Kristina Miller holds a PhD from Stanford University (1992) and is currently the Head of Genetics and Genomics at Fisheries and Oceans Canada. She is also an adjunct professor at UBC. Dr. Miller is on the editorial board for Immuno genetics, Facets and Coastal Marine Fisheries Journal. She has over 120 primary publications in the fields of genetics, genomics, immune genetics, and disease.
Climate change enhances vulnerability of organisms to stress and disease, which can result in volatility in survival and ultimately population decline for many species. Emerging infectious diseases have been resolved in some cases, but understanding their disease etiology can be difficult in instances where morbidity and mortality are not readily observable. Sensitive technologies to detect early stages of disease development in live-sampled organisms, and the ability to differentiate pathogen carrier states from active disease states are required to demonstrate impacts of infectious diseases in wild populations. We present the discovery and validation of host transcriptional biomarkers capable of distinguishing the presence of an active viral disease state (VDD) from latent viral infections, and viral versus bacterial disease states in salmon. Biomarker discovery was conducted through meta-analysis of published and in-house microarray data, and validation performed on independent datasets including disease challenge studies and farmed diagnoses of various viral, bacterial, and parasitic diseases. We demonstrate that the VDD biomarker panel is predictive of disease development across RNA-viral species, salmon species, and salmon tissues, and can recognize a viral disease state in cultured and wild-migrating salmon. Application of this technology has led to the discovery of eight novel salmon viruses in British Columbia alone. Biomarkers resolved in our study on salmon were highly overlapping with those based on similar human viral influenza research, suggesting a highly conserved suite of host genes associated with viral disease that may be applicable across a broad range of vertebrate taxa.