Sydney Institute for Emerging Sydney Institute for Emerging Infectious Diseases and BiosecurityInfectious Diseases and Biosecurity

Tania SorrellTania Sorrell

SEIBSEIB

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What is an Emerging Infectious Disease?

Why establish an Institute of EID and Biosecurity?

Why at the University of Sydney?

What are our goals?

What is our structure?

What have we achieved since February 2010?

What do we aspire to now?

Epidemic and emerging infectious diseases

HighMorbidityMortality

MajorSocial

Disruption

Major Economic Hardship

Avian flu>US30 billion

~60%

Animal Human

Antibiotic-Resistant

Infections (US) ~$60 billion pa

~70% of these wildlife“One health”

Asia-PacificIncubator andBellweather

Outbreaksand

Antimicrobialresistance

Newly-recognised human infectious agents in the current era

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1980 1990 2000 2010

HIV 2 years

Hepatitis C 17 years

Multi drug RTB

V. cholerae 0139Bartonella

HantavirusT. whippelii

Hendra

Bat lyssa

H5N1Nipah

SARS

Chikungunya

XDR-TBArtemisinin RP. falciparum

H1N1 09

After Brown et al, Yung Text ID, 2010

~2 months

Origin of HIV

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Distribution of EID events (1940-2004)

K. Jones, Nature 2008

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Outbreaks, animals and severe consequences

GPC (Staph) & GNRTB

FungiMalaria

(Viruses)

Influenza, arboviruses, HIV

Avian fluH1N1 09

EncephalitisVirusesDengue

Salmonella, food- borne disease

Antimicrobial resistanceVaccines, drugs and diagnostics

(development and evaluation)

Modelling and Bioinformatics

Expertise in SEIBWhy Sydney?

through

Partnering in research, education and capacity building

communication and advocacy

Sydney Institute for EID and Biosecurity

A multidisciplinary institute devoted to

reducing risks from, and global impacts of,

emerging and re-emerging infectious diseases

Especially in the Asia-Pacific Region

seib@sydney.edu.au

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SEIB

Medicine&

affiliated institutions

Veterinary Science

Nursing & Midwifery

ScienceEngineering, IT

Pharmacy

Law

Economics & Business(Biosecurity)

Arts

Management BoardChair Bruce Robinson

SEPIAC(Advisory)

External alliances(Australia)

Government agencies

NGOsCollaborating

institutions

International alliances

WHO, CDCAsia-Pacific

partnersSwiss Tropical Inst

OtherWestmead

Camperdown

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Emerging infectious Diseases in our time –Research and translation in SEIB

Influenza

(HIV)(Malaria)

Tuberculosis

Cerebral infections

Hepatitis C

Transmissible antibiotic resistance in bacteria

(Resistant infections in closed environments)

New Diagnostics

DiagnosisSurveillance, Data transfer, Policy advice

Response capacity Building, Vietnam

Clinical networksInfection control, Vaccination

Livestock, poultry movement,Spatial charact-erisation, Avian flu Qualitative research

Perception of risk, Responses to media, political

& ethical challenges

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Multidisciplinary research: Influenza

SEIB

CIDMLSAHSLabs

ID/ICU

LawBasic

Science

VetScience

VaccinesSerosurveillanceVaccine uptake

Paed surveillanceEpidemiology

Public Health

Proteome analysisModelling

Int

Security

Studies

CVELIM

Legal, ethical preparedness (region)

ID I

CIDMPH

NCIRSCHW

AHSResistance

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Tuberculosis, 2008

WHO Weekly Epidemiological Record 19/3/2010

9.4 million cases world-wide (54% SE Asia/W Pacific); 1.8 million deaths (19%)1.4 million associated with HIV infection; 0.52 million deaths (37%)

0.5 million cases MDR-TB (INH & RIF); ≥0.15 million deaths (30%)50,000 cases XDR-TB (R to 1st & 2nd line drugs); ≥30,000 deaths (60%)

Mortality

HIV MDR XDRAll

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Group Leader: Dr Jamie Triccas

Areas of Research Development and testing of novel anti-tuberculosis vaccines

Elucidating strategies employed by Mycobacterium tuberculosis to survive within the host and promote virulence

Defining in detail the host immune response to chronic bacterial infection

Discovery of new agents to treat infections with M. tuberculosis

Microbial Pathogenesis and Immunity Group - Tuberculosis

M tuberculosis : Molecular epidemiology

Beijing family (24%) East African/Indian (12%)

Machine learning algorithms (spoligo and MIRU typing): no association genotype/R/clinical phenotypes

Low level transmission; temporo-spatial distribution => migration/residence

aggressive individual pathogenseg S. aureus

co-operative pathogens eg E. coli, P. aeruginosa

Rapid spread of antibiotic resistance in GNR:The shared transmissible gene pool

R plasmids with variable host

range

GPC

GNR

Rapid diagnostics applications through understanding genetics of resistance (high throughput “hyper”multiplex systems)

Iredell Lab, Westmead

Metabolic Complications of HCV

Steatosis (fatty liver) –

HCV Genotype 3

Insulin resistance (diabetes) –

HCV Genotype 1- Faster progression to liver fibrosis,

cirrhosis and liver cancer

- Predicts non-response to antiviral treatment (interferon, ribavirin)

Mechanisms are poorly understood – investigating - Pathways involved

- New drug development

180 million cases; 3-4 million new pa

Malaria - cellular & molecular mechanisms

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Pathogenesis of CNS infections

Cryptococcosis•Determinants of invasion of the CNS•Mechanism of crossing the blood brain barrier

•Immunopathology, cytokine networks•endothelial biology, blood-brain barrier, •microvascular pathology, microparticles

Grau, Hunt

King, Kesson

Sorrell, Djordjevic

Flaviviruses (encephalitis, retinal infection) •In vivo models of immunopathology (WNV) •Transcriptional regulation and role of Toll receptors in immune recognition molecules by WNV•Mathematical modelling of survival parameters

Professor Richard Russell laboratory

Vector Control: Dengue and filariasis

Dengue in Australia

Aedes aegypti

Aim: to reduce use of insecticides

Toxic cloth strip for killing adults

Lethal ovitraps

Sticky plastic strips trap adult mosquitoes to lay eggs

Biodegradable: do not need retrieval and do not become habitats

Existing & potential external networks and collaborations

Swiss TPH Institute

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-

Stage 1 Stage 2

Build profileSecure future

Ensure growthsustainability

Buildcollaborations

Integrate withmajor

UniversityInfrastructuredevelopments

Stage 3

SEIB – 5 year plan

Research

Education &Capacity building

Advocacy & Communication

STPH InstituteIndonesia

ABIN, WHO

Planning daySEIB launch May 19-20

Ed. Initiatives progressingLab twinning in Maldives &

Indonesia

Pandemic flu workshop20 May

Outcomes H1N1 09

Meetingswith key

constituencies

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Support

Sydney Medical School Foundation(to Dec 2010)

Sydney West Area Heath Service(office)

Sydney Medical School(office)

Deliotte (pro bono: Business Plan)

Current objectives

•Continuation of funds for Director & Program Mgr

•Secretarial support (P/T)

•Academic support (Lecturer)

•Scientific exchange support

•Student exchange support

•PhD student stipends

•Conference support

SEIB 2010SEIB 2010

SMH Magazine,15/16 May 2010