While students at the University of Hawaiʻi John A. Burns School of Medicine are on spring break this week, Dr. Albert To will be in Africa, more than 9,000 miles away from home, researching ways to help Liberia determine where insect-borne viruses are present.
In October, Dr. To received the American Society of Tropical Medicine and Hygiene (ASTMH) Robert E. Shope International Fellowship in Infectious Diseases. Dr. To will live in Liberia through early May, and supplement the work started by Principal Investigators (PI) Dr. Vivek R. Nerurkar, Ph.D., chair of the Department of Tropical Medicine, Medical Microbiology and Pharmacology, and Dr. rer. nat. Axel Lehrer, associate professor in the same department. This is in collaboration with Co-PI, Dr. Peter Humphrey, at the T.J.R. Faulkner College of Science & Technology, University of Liberia.
Drs. Nerukar and Lehrerʻs existing project in Liberia looks at the epidemiology of Lassa virus and filoviruses, like Ebola, Marburg, and Sudan ebolavirus, which recently swept through Uganda. Dr. To will research the natural history of West Nile virus, Dengue virus, Usutu virus, Yellow Fever virus, Zika virus, Crimean-Congo Hemorrhagic Fever virus, Rift Valley Fever virus, O’nyong nyong virus and Chikungunya virus.
“The staff at the UL are collecting human and animal samples to check their blood to see if they have any antibodies,” Dr. To said, discussing the current work in Liberia. “What the antibodies do is kind of give them a clue about the viruses circulating in that area or have circulated in that area,” he said.
When Dr. To arrives in Africa, he will conduct a type of surveillance known as “seroepidemiology.” Using blood samples, seroepidemiology is a tool that allows scientists to determine previous exposure to certain viruses. Dr. To will conduct this surveillance in Liberia and inform health officials of the results. The information Dr. To will provide will be critical for Liberian officials. It will allow them to target their outreach about specific viruses more strategically and precisely. This study will also provide a glimpse of the circulating insect-borne viruses in the country which has previously been scarcely documented.
“The Liberians are appreciative of our efforts because there’s not much of this type of research going on,” To said. “There’s few people in Liberia that can do this research. They are actively developing their infrastructure and communication networks, so it’s helpful that we’ll be providing them with important information that they can use to come up with healthcare policies or even containment strategies.”
The Shope Fellowship is for international research and encourages more research in low and middle-income countries. When Dr. To arrives in Liberia, he’ll stay for two months. With temperatures in the 70s and 80s, To, who grew up in Palolo and Makiki, will be accustomed to Liberia’s climate. The research will be grueling. It’ll take the Roosevelt High grad into the country’s most rural and remote parts.
“The project I proposed is called ʻEstablishing a Spatial Distribution of Arboviruses in Urban and Rural Liberia.ʻ We will go out there and collect samples from different counties, and we can get an idea of what type of viruses are in a particular area. We can share the information we generate with The National Public Health Laboratories or the Liberian CDC, and they can use the information we generated to create public health policy,” To said.
Dr. Toʻs Liberian trip will be another chapter in The University of Hawaiʻi’s relationship with the University of Liberia. Students from Liberia have been enrolled at the John A. Burns School of Medicine. At the same time, the Department of Tropical Medicine, Medical Microbiology, and Pharmacology continue to have a presence in the country on the West African coast.
Dr. Lehrer, JABSOMʻs Dr. Brien Haun, Kapiolani Community Collegeʻs Dr. John Berestecky, and Trop Med PhD student Varney Kamara, have all previously worked in Liberia. This will be Dr. Toʻs first trip and will require specific vaccinations.
“There’s some pathogens, like yellow fever, that can be pretty lethal, so I had to get the yellow fever vaccine,” To said, listing the required vaccinations. “I needed to get a polio booster because the last time I had it was more than 10 years ago. I need to get a meningitis vaccine and a typhoid vaccine. Malaria is a problem, too, so I have to take doxycycline as a prophylaxis before I go and four weeks after I arrive.”
Dr. To is going to great lengths to ensure his safety and is making a personal sacrifice to conduct this research. He says he is proud to put the John A. Burns School of Medicine on the map with this fellowship.
“The previous recipients of this award are from like Stanford, M.I.T., and Harvard. JABSOM is a smaller school, and Tropical medicine is a small department, so it’s nice to show that we’re up there with those large, well-funded universities.”
More on the Robert E. Shope International Fellowship: The Fellowship provides $25,000 in support for international training opportunities in arbovirology and emerging diseases for those with an MD, DVM, PhD or the equivalent. Recipients inspired by Dr. Shope will involve themselves in studies of arbovirology and/ or emerging diseases from clinical to field to laboratory studies. This award provides support for a short-term research experience in the tropics in the area of arbovirology and/or emerging diseases. Dr. To will use the money to offset the cost of travel, living expenses and research. Learn more here.