Infectious Disease

Towards Sustainable Antibiotic Stewardship in Arizona Nursing Homes

The objectives of this project were to analyze pilot data to evaluate the impact of a locally-developed antibiotic stewardship protocol developed for Arizona Nursing Homes, and to understand perspectives on antibiotic use, prescribing and stewardship among nursing home personnel. Funding Source: University of Arizona
Start Year
2017
End Year
2018
Researchers
Katherine (Kate) Ellingson

Antibiotic Resistance Patterns in Arizona Healthcare Facilities along the US-Mexico Border: Harnessing Data for Action and Advocacy

Our objectives are to identify all healthcare facilities serving Arizona residents within 25 miles of the US-Mexico border, create a database describing each facility’s procedure for clinical microbiology and antimicrobial resistance investigations, and to enter into data sharing agreements allowing the de-identified extraction of data to share with providers for regional education on resistance profiles. Funding Source: Arizona Health Education Center
Start Year
2019
End Year
2020
Researchers
Katherine (Kate) Ellingson

Antibiotic Resistance and Use Patterns in Arizona’s Border Region and in Sonora, Mexico

This project will enable us to strengthen collaboration with research partners in Sonora, Mexico in a binational effort to compare antibiotic resistance data from clinical laboratories serving healthcare facilities along the Arizona/Sonora border. We will also execute a binational survey on antibiotic knowledge and behaviors. Funding Source:University of Arizona International Research Program Development
Start Year
2019
End Year
2021
Researchers
Katherine (Kate) Ellingson

Rapid Lateral Flow Assay for Rapid Diagnosis of Coccidioidomycosis to Reduce the Unnecessary Use of Antibacterial Drugs.

This is a contract awarded by the CDC in response to a Broad Agency Announcement requesting tools to implement improved testing for Valley fever and reduce delays in diagnosis. This proposal addresses the gap in prompt diagnosis of Valley fever that results from the turnaround time for current diagnostic tests of at least one and usually three or more days. John N. Galgiani (PI) Funding Source:Centers for Disease Control and Prevention
Start Year
2018
End Year
2020
Researchers
Katherine (Kate) Ellingson

Prospective Cohort to Assess Novel and Repeated SARS-CoV-2 Infection and COVID-19 Illness within a US State or Region

We enroll and actively survey a longitudinal cohort of SARS-CoV-2 seropositive and seronegative frontline workers to study the incidence, predictors, and consequences of infection and reinfection. Funding Source:Centers for Disease Control and Prevention
Start Year
2020
End Year
2021
Researchers
Jeff Burgess
Katherine (Kate) Ellingson

Building Local Operational Capacity for Prevention of COVID-19 (BLOC-COVID)

We work with high-risk congregate care settings in Pima County and in neighboring border counties to identify optimal strategies for implementing infection prevention practices in these unique and resource limited settings. Funding Source:National Association of City and County Health Officials (NACCHO)
Start Year
2020
End Year
2021
Researchers
Katherine (Kate) Ellingson

Antibiotic Stewardship in Arizona Skilled Nursing Facilities

This goal of this project is to develop an antibiotic stewardship program, or “playbook,” for prescribing antibiotics to treat infectious diseases in skilled nursing facilities in Arizona. This playbook will be developed by implementing an antibiotic stewardship protocol across 16 Arizona skilled nursing facilities. This grant award is the result of an academic-community research partnership between Dr. Ellingson, community partners, and Peter Patterson, MD, MBA, a subject-matter expert in antibiotic stewardship with Patterson LTC Consults. This project is funded through an Arizona Biomedical Commission Investigator Grant.  Funding Source: Arizona Biomedical Research Commission
Start Year
2018
End Year
2021
Researchers
Katherine (Kate) Ellingson

Non-Pharmaceutical Interventions Public Health Emergency Program

Non-pharmaceutical interventions (NPI) are a critical set of actions that public health takes to mitigate the effects of infectious diseases in a population.  These actions can vary widely from isolation and quarantine, closure of public venues, environmental clean-up or decontamination, and hand hygiene.  However, studies have shown that the public’s compliance to NPI recommendations can be limited.  In order to better engage the public during an outbreak of an emerging or reemerging disease, such as Ebola, public health agencies could benefit from additional information on (1) ways to make NPIs more acceptable, (2) the best ways to disseminate the information to the general public and key target groups, particularly through social media, and (3) content that is more likely to motivate action.  The main objective of this project was to determine current engagement and successful messaging of NPI activities to across Arizona and determine acceptability of messaging by target groups; i.e. do they see the importance of the message being conveyed. This project received support from the Arizona Department of Health Services. 
Start Year
2016
End Year
2016
Researchers
Kristen Pogreba-Brown
Kacey Ernst
Erika Austhof

PetAirapy Pathogen Chamber Study

Each year, an estimated 8-10 million animals will be housed in animal shelter. These animals are susceptible to infectious diseases during their confinement. Many organisms have been discovered in animal shelters including feline noroviruses, sapovirus, canine circoviruses, canine influenza, feline calicivirus, and many others. Sheltered animals are at increased exposure and infection risk due to dense housing conditions and community transmissions of pathogens. The goal of this study is to evaluate the efficacy of a passive air purification technology developed by PetAirapy, LLC. Under controlled conditions of air flow, humidity, and containment, the PetAirapy unit will be evaluated for efficacy of seeded aerosolized virus (bacteriophage MS2) removal from the air.
Start Year
2017
End Year
2017
Researchers
Marc Verhougstraete

Kidenga Fever: Viral Social Marketing for a Participatory App to Track Emerging Pathogens

The goal of this project was to develop a community-based participatory surveillance application and educational platform for arboviral diseases in the United States. Financial support from the Skoll Global Threats Fund (STGF) was used to support a University of Arizona developer migrate to a new push notification platform and convene 3-4 meetings of key stakeholders. These funds supplemented the CDC grant funding for the development of Kidenga and previous SGTF funding used for marketing of the tool.
Start Year
2016
End Year
2017
Researchers
Kacey Ernst

XStream: Controlled Laboratory Chamber Study of Antimicrobial Efficacy Over Long-Term Use

The goal of this study is to evaluate the efficacy of the XStream Infection Control system against viruses, bacteria and spores from the air, surfaces and human hand transfers. Microbial surrogates will be used to represent human enteric and respiratory viruses (i.e. influenza and norovirus), MRSA and other bacterial pathogens, and C. difficile spores. The resulting data can be used for the development of exposure and risk assessment models for determining the relative risk reduction in human populations following XStream Infection Control system use.
Start Year
2015
End Year
2017
Researchers
Kelly Reynolds
Marc Verhougstraete

Vulnerability of Climate and Vector-Borne Diseases

The CDC initiative “Building Resilience Against Climate Effects (BRACE)” is a 5 step framework to facilitate developing plans to communicate and prepare for health effects of climate. Our support to the Arizona Department of Health Services is to provide the scientific background behind climate associated infectious disease concerns in Arizona, in particular, West Nile virus disease and valley fever. Using climate models, we are developing projections of future risk.
Start Year
2015
End Year
2018
Researchers
Heidi Brown

Feasibility of Latent TB screening among migrant farmworkers on the border

The goal of this project is to 1) to demonstrate utility and feasibility of detection of LTBI among migrant farmworkers, and to compare outcomes in the US and Mexico and; 2)To assess follow-up of workers detected with LTBI and ability to link individuals to care. Through additional funding, we have been able to expand the work to include further care for participating migrant farmworkers in conjunction with the Migrant clinicians Network.
Start Year
2014
End Year
2017

Stress and Asthma in public schools

The goal of this project is to examine the association between stress and asthma morbidity, using our preliminary work from the Children’s Respiratory Study, and within the context of an ongoing school-base randomized clinical trial, to determine to what degree variations in asthma control and morbidity are associated with chronic school stressors. Eyal Oren was a contributor on this project but has since left the University of Arizona. 
Start Year
2015
End Year
2017
Researchers
Lynn Gerald

Adherence to latent TB infection among at-risk populations (TXT4MED)

The goal of this project is to determine whether texting can serve as a low cost technology for improving low LTBI adherence rates. This work is being completed in partnership with the Pima County Health Department TB Clinic in Tucson, AZ. Specifically, the project will focus on these aims: Aim 1. To determine the effectiveness of text reminders for improving adherence in latent TB patients using a randomized controlled single blinded trial. Aim 2. To establish the costs associated with text messaging. Aim 3. To determine patient experiences with the texting intervention. You can learn more about TXT4MED and its progress at http://txt4med.arl.arizona.edu  
Start Year
2015
End Year
2017
Researchers
Melanie Bell
Lynn Gerald

Assessing the rate of dengue virus development in the mosquito Aedes aegypti supported by the UA Center for Insect Science

The goal of this project is to generate pilot data on the extrinsic incubation period for an important dengue vector. We used this to translate a mathematical model into MATLAB. This model is being used to investigate weather-related vector abundance for dengue, chikungunya, and West Nile virus vectors. Support for this project came from the University of Arizona Center for Insect Science. 
Start Year
2013
End Year
2014
Researchers
Heidi Brown
Kacey Ernst

Helicobacter pylori and Stomach Cancer supported by the Chapa Foundation

The goal of this project is to evaluate the role of Helicobacter pylori infection and gastric diseases in the southwestern United States to identify interventions to reduce disease. This private foundation-sponsored work has resulted manuscripts and multiple poster presentations, as well as numerous engaged students and faculty. In addition we are using this work as a springboard to apply for additional funding to investigate infectious causes of chronic diseases.
Start Year
2013
End Year
2017
Researchers
Heidi Brown
Robin Harris

Simulation Modeling of Public Health Interventions on Dengue Vector Abundance: Current and Future Estimates

COPH Research Area
Two and a half billion people around the world are at risk from the mosquito-borne viral disease, dengue. Reducing risk by eliminating the mosquitoes that carry the virus is the only way to prevent disease. For this project we are modeling a novel intervention strategy developed by the Centers for Disease Control and Prevention in Puerto Rico using ‘field’ data collected at the UA’s Biosphere-2. Modeling this public health intervention its effectiveness can be model compared to other strategies, in other locations, and under alternative climate scenarios.
Start Year
2013
End Year
2018
Researchers
Heidi Brown

On the Edge: Dengue and Climate

COPH Research Area
Aedes aegypti mosquitoes are the primary vector for dengue, yellow fever and chikungunya.  The vector is present in most urban communities stretching along the U.S.-Mexico border yet dengue transmission has only been noted in two U.S. border communities in Texas, notably Brownsville and Laredo, TX.  While many argue that this is a result of different social factors across the border, this fails to explain the lack of transmission in some communities in northern Mexico, notably Nogales, Sonora.  Nogales is a large urban area on the Mexican side of the border with large vector populations and a constant influx of people from dengue endemic areas yet no local cases have been recorded.  Vector presence alone is not sufficient to cause disease transmission; vectors must also survive long enough to blood feed and become infected, have the parasite develop and feed again, transmitting the virus.  Climatic influences on the lifespan and behavior of Ae. aegypti may also influence the risk of dengue transmission in this region which lies at the boundary of both virus and vector. Geographic areas such as this, at the edge of the range of disease and vector, are at greatest risk of emergence and reemergence of infectious diseases. We will assess the relative age structure of Ae. aegypti populations in nine cities with varying climates in the southern United States and Sonora, MX by trapping and molecularly determining the ages of adult Ae. aegypti during four mosquito seasons. We expect that cities with extremely dry and hot conditions will have younger Ae. aegypti populations. Cities with reported dengue transmission we expect to have Ae. aegypti that are on average younger when taking their first blood meal than cities without transmission. To determine how the age of Ae. aegypti population vary over a finer spatial scale, we will sample adults in 150 households in Hermosillo, Mexico; a city with a history of dengue outbreaks. Additionally, we will survey the households for potential social and environmental factors that mediate the relationship between climate and longevity.  We expect to find significant variability across households.  Residences with older mosquitoes will have more vegetation, fewer barriers to mosquito access and indoor resting sites, no competing vector species and no control measures. From the information gathered in the first two objectives, we will construct a model to predict the likelihood of the expansion of Ae. Aegypti populations that survive long enough to transmit dengue and thus changes in risk of dengue transmission. We expect that models of risk of dengue under climate change scenarios will decrease in areas that surpass a heat and dryness threshold and will increase in populations with increasing moisture.  Service: During our survey process we went door to door. After the survey was completed we emptied all standing water and taught community members how to identify breeding sources and provided information on dengue and West Nile virus.
Start Year
2011
End Year
2013
Researchers
Kacey Ernst

Developing direct plating method for Coccidioides spp.

COPH Research Area
Faculty seed grant (FTE is on my own time), funding ended December 2011 Research: developed isolation techniques for the select agent Coccidioides spp. that requires BSL3 laboratory and procedures. Results and methods will be maintained as a trade secret and used to fund additional work and the Keating BSL3 laboratory. Service: Method of isolation will provide research, government and private sectors a less expensive alternative for exposure and ecological investigations. Training: I achieved sufficient training and experience to be given unrestricted access to conduct studies in the Keating BSL3 laboratory. Joe Tabor was a contributor on this project but has since left the University of Arizona.
Start Year
2010
End Year
2011

Hepatitis A epidemiology in Arizona

COPH Research Area
This project examines ADHS immunization and case data for trends over past 20 years. One paper has been published in connection with this project. A draft of another will be submitted soon.
Start Year
2010
End Year
2011
Researchers
Kacey Ernst