Infectious Diseases

  1. Issues of Contraception and Abortion in the Zika Outbreak

    February 17, 2016 by Allison Park

    Director General Margaret Chan of the World Health Organization (WHO) officially declared the Zika virus a global health emergency Monday, February 1. Given the intense backlash from their delayed response to the Ebola crisis, it comes as no surprise that the international agency would take little time in declaring the Zika outbreak an international emergency.

    CDC_map_of_Zika_virus_distribution_in_January_2016Though the disease has been seen in Africa, Southeast Asia, and the Pacific Islands for years, it was only introduced to the Americas within the last year. The first cases were seen in Brazil last May, and it has since spread rapidly to 20 Latin American countries. The lack of immunity in Latin American populations has fostered rapid transmission, while experts anticipate heavy rain from El Niño weather patterns to further catalyze the spread of this mosquito-borne illness.

    Little attention has been paid to the virus in the past, as the symptoms, only experienced by a fifth of those infected, are relatively mild and rarely fatal. The main concern lies in the perceived link between prenatal infection and microcephaly, a condition that causes infants to be born with abnormally small heads and brain damage. The Director General stated that, “The experts agreed that a causal relationship between Zika infection during pregnancy and microcephaly is strongly suspected, though not yet scientifically proven. All agreed on the urgent need to coordinate international efforts to investigate and understand this relationship better.”

    Brazil, Colombia, El Salvador and Ecuador have all responded to the crisis by asking the women of their countries to avoid getting pregnant. Beyond broad issues of population management and economic development for these countries, such requests carry serious threats to the health of these women.

    Latin American women are faced with limited access to viable resources to manage their pregnancies, and must frequently resort to life-threatening options to do so. It is estimated that over half (56%) of all pregnancies in the region are unintended—a direct symptom of the 23 million women who lack access to contraception and wide spread gender based violence.
    Screen Shot 2016-02-16 at 10.02.36 PMFurthermore, Latin American countries have some of the most prohibitive abortion laws in the world. El Salvador is one of only six countries worldwide with a complete ban on abortions. Of the four countries currently advising against pregnancies, only Columbia allows for abortion in the case of fetal impairment (check out this interactive to learn more about abortion laws worldwide). But the fact of the matter is that, rather than stopping abortion services, these laws only push women towards unsafe abortions. Unsafe abortions represent 95 percent of the 4.4 million abortions performed in Latin America and the Caribbean each year. Women continue to seek out these risky procedures, despite that fact that roughly a quarter result in hospitalization. Worldwide, abortion remains among the top five causes of maternal mortality.

    With Latin American governments pushing women towards these life-threatening operations, it remains unclear whether the WHO’s announcement will mediate or exacerbate the situation. On one hand, it seems probable that their emergency designation will incite public panic and further encourage the use of unsafe abortion services. However, on the other hand, this classification will serve to stimulate funding and action from the international community, position the organization as a global coordinator, and allow for more standardized surveillance of the virus’ spread. Additionally, the Emergency Committee has not supported the calls to avoid pregnancy, instead stating that “attention should be given to ensuring women of childbearing age and particularly pregnant women have the necessary information and materials to reduce risk of exposure.”

    The United Nations High Commissioner for Human Rights has stepped in as well, asking Latin American governments to improve access to contraception and abortions. Though this request is both obvious and necessary, it has yet to be seen whether it is culturally feasible. The current lack of contraceptive use results not just from medication shortages but prominent religious aversion as well. As discussed during the recent cultural competency event, culturally appropriate interventions take bottom-up approaches and years of research and development. However, the current rate of transmission does not provide such a time frame.



  2. Mabie Fellowship Sends GlobeMed Team To Uganda

    October 30, 2015 by Drew Gerber

    This summer, the Northwestern GlobeMed GROW team traveled to Namugoga, Uganda and worked with the Adonai Medical Centre to learn more about the community’s perception of malaria and bed nets as part of the John & Martha Mabie Fellowship for Public Health, which helps fund student research. The GlobeMed team comprised Weinberg seniors Victoria Zapater-Charette and Carol Feng, Weinberg junior Marilyn Janisch, and SESP freshman Neil Thivalapill. Members of the team study a range of fields, including: biological sciences, philosophy, Spanish, human development and psychological services, anthropology, and cognitive science — and of course, global health.

    How did your experience on the ground vary from your expectations?


    This year, the GlobeMed team worked to help the Adonai clinic address mosquito net use and treatment practices.

    Marilyn: As a person that had never been out of the country, I really didn’t have many expectations. I had no idea what to expect except, per the past GROW teams, how welcoming and friendly everyone at our partner, Adonai, was going to be. When I got to Namugoga, I was overwhelmed by the openhearted friends we would soon make. This experience was nothing like I was expecting. However, the first few weeks were more difficult than I would have been able to anticipate. I never knew what it felt like to be so out of my comfort zone, away from my culture and ripped from my usual lifestyle. As time went on, I learned to get past the unfamiliarity of a new place and just soak up the experience I was fortunate enough to have and take advantage of getting to know the wonderful people around me.

    What was your most challenging moment, and how did you cope?

    Marilyn: Throughout the stay, there were many different aspects that I had to adjust to. From shower accommodations to religious events, it was a lot to take in. However, coming from a very independent “self” culture to a very sharing and collaborative environment was one of the most difficult things to deal with. Having the need for alone time but the expectation to mingle and be social at nearly all hours of the day was very overwhelming and difficult to manage. I felt very misunderstood as being “quiet” or even “standoffish.” In order to express my true self while still being comfortable, I decided to be more present and active while I was outside and with the children, something that didn’t particularly come naturally to me. I gave myself a bit of a routine: a time to type the field notes of the day and a short time to even workout. This gave me a moment to myself and allowed me to reinstate the structure of my everyday life back at home.

    Tell us about your project. What inspired your work?

    Victoria: Each year, our ideas for the research projects begin with our partner. We are in contact throughout the year via Skype and email so when the team is decided, we discuss what we as students can do to best help the Namugoga community and the new clinic specifically. This year we studied the barriers to use of mosquito nets and the treatment seeking practices of community members to see how the Adonai clinic can best address these current issues.

    What was your most meaningful experience abroad, and what did it teach you?


    More than just collecting data, GlobeMed team members had the opportunity to hear community members’ stories.

    Victoria: With the nature of our qualitative and semi-structured research methods, we had the opportunity to hear community members’ stories without simply collecting survey data. We conducted most of the interviews inside or near community members’ homes and I was so grateful for how welcoming they were to students who they had never met. Both through the research and with our time living at the Adonai Centre, it was the process of learning personal stories, both about healthcare and not, that will stick with me for a very long time. This taught me to take advantage of every random encounter or free moment to chat because you never know whom you will meet and how their seemingly different experiences may relate to your own.

    Do you have any advice for students wishing to conduct research in an unfamiliar location?

    Victoria: The most important thing for me visiting a new community, even one I had heard so much about from my peers, was consistently keeping an open mind and open ears. No matter how well you prepare by speaking with other people or reading about the area, nothing will compare to the initial experience of arriving on the ground and absorbing everything you can. Our research questions and aims changed in just the first few interviews because there were challenges we hadn’t foreseen as well as simple solutions to what we as foreigners had perceived as problems. Finally, outside of whatever you are working on in the community, it is so important to participate in the social activities alongside community members. Some of our best memories are from the huge soccer tournament, long walks with Adonai workers, and meals shared with locals.

    Did you encounter any cultural differences?

    Neil: There were definitely many cultural differences that the GROW team had to get used to. What was probably most evident was the calling out of our ethnicities in public or in conversation. While we may think it’s rude to identify someone solely based on their race, it was something that happened almost every day and something that became part of our daily routine that we just had to understand. A religious affiliation is part of everyday culture in the area of our partner. For me, it was hard to reconcile my own lack of religious conviction with their religious conviction. The conservative nature of the clothing was also sometimes hard to work around simply because I saw my friends forcing themselves to put on skirts and dresses in order to be culturally sensitive even though it might have been uncomfortable to wear.

    Has your summer experience impacted your future goals and interests at Northwestern or after?

    Carol: Leaving Uganda this summer, I gained a sense of clarity about my goals and interests — professionally and otherwise. Our time spent in the field working with our partner organization and the Namugoga village has reaffirmed my commitment to pursuing a future in which I can contribute positively to the health outcomes of underserved communities. Being able to see for myself the immense burden that health can have in the lives of others in this particular setting further motivated me to work towards changing that reality. Fortunately though, working with Adonai’s growing medical center showed me the possibility and potential to lift that burden — revitalizing my interest in medicine. Through our research interviews, I found that I really enjoyed talking to people about their experiences, problems and hopes. Connecting with people — and then having the technical knowledge to empower them to take ownership over their health — is what informs my desire to pursue a medical degree as soon as I can.


  3. Ebola and food security: local impacts of the outbreak

    October 22, 2014 by Arianna Yanes

    WFP response to EbolaEbola has been all over the news for the past few months. We’ve heard stories about American aid workers and journalists contracting the disease and being flown back to the U.S. for treatment. We’ve heard about the increasing numbers of deaths in West Africa. We’ve heard about the breach in infection control protocol at Texas Health Presbyterian Hospital in Dallas.

    What has been largely left out of the news is the effect of this Ebola outbreak on the lives of West Africans. Currently, food security is a major concern.

    The Ebola outbreak has profoundly affected food security in West Africa, causing prices to rise by an average of 24 percent.  The cost of food and accessibility pose barriers for individuals in Liberia, Sierra Leone, and Guinea, the countries in which the current outbreak is spreading.

    Fear and restrictions on movement have led to panic buying and food shortages. Additionally, labor shortages on farms have affected rice and maize production. Border crossing closures and reduction of trade has also profoundly impacted the food availability in these countries.

    Elisabeth Byrs, a WFP spokesperson, told Reuters that  “planting and harvesting [are] being disrupted.”

    The United Nations’ World Food Program (WFP) has approved plans for 65,000 tonnes of food to 1.3 million people; to patients, cases in isolation, and communities badly affected. Just this Saturday, food rations were delivered to 265,000 people in the Waterloo district outside of Freetown, the capital of Sierra Leone. The deliveries aim to prevent the spread of the virus, by stabilizing quarantined families and removing the necessity to leave their homes in search of food.

    The aim of the food deliveries is to “prevent this health crisis from becoming a food and nutrition crisis,” Gon Myers, the WFP Country Director in Sierra Leone told ABC News.

    Additionally, the World Food Program (WFP) is using mobile phones to carry out a food security survey in Liberia, Sierra Leone, and Guinea. The first round of the survey has reached 800 people in Sierra Leone.

    On Wednesday, October 15, international representatives gathered to the annual World Food Prize Award Ceremony. Though not initially scheduled as a topic, African leaders discussed the effects of Ebola on the food supplies in a press conference, with an available webcast online.

    “I think the impact on regional trade is going to be very, very serious,” said Dr. Kanayo Nwanze, President of the United Nations International Fund for Agricultural Development. “And so we believe that like in any other situation where you have a crisis, we should begin to plan for the aftermath of the crisis.”


  4. Feinberg Global Health Day gathers panel to discuss Ebola outbreak

    September 11, 2014 by Arianna Yanes

    Ebola has been on the global radar the past few months and the current outbreak in West Africa continues to spread rapidly. As a part of the Feinberg School of Medicine’s Global Health Day, hosted by the Center for Global Health, a panel of experts from the university came together for a presentation and panel on the current state of the Ebola outbreak.

    Chad Achenbach explains the basics of the ebola epidemic to attendees

    Chad Achenbach explains the basics of the Ebola epidemic to attendees

    Chad Achenbach, Assistant Professor in the Division of Infectious Diseases, started the presentation with foundational knowledge about the virus, describing how it started and how it continues to be transmitted. In 2004, he said, this particular strain of the Ebola virus, EBOV, was circulating around animals. It remains unclear how it was introduced into humans in this outbreak. This is the largest outbreak of Ebola in history, with 42% of the nearly 4,000 cases from the past month, he said.

    The virus strain of the Ebola outbreak doesn’t appear to be more virulent or have higher case fatality rates than other outbreaks- so, why does this outbreak have more cases than all other Ebola outbreaks combined? As Achenbach described, unlike past outbreaks in more rural areas, this virus has made its way into dense urban areas, as a result of increased mobility of populations to move within countries and across borders.

    The Center for Global Health at Feinberg is currently collaborating with a laboratory in Mali to test samples for the presence of the Ebola virus. Of twenty samples received thus far in Mali, all have been negative. Achenbach anticipates this lab will be “active and very involved” in the coming months.

    “It’s been done before. We can do it- it’s just going to be a massive effort,” Achenbach said in regards to controlling transmission.

    After Achenbach’s presentation, the discussion was opened up to the panel, moderated by Robert Murphy, director of the Center for Global Health. Panel member Juliet Sorensen, Clinical Associate Professor at Northwestern Law School, described the role of the World Health Organization as that of a “global coordinator” to control the virus in the short term. However, the WHO is only as strong as its member countries, she described.

    “Now is the time for the international community to step up,” Sorensen said.

    The panel had Baldwin Auditorium at capacity with members of the Northwestern communit

    The panel had Baldwin Auditorium at capacity with members of the Northwestern community

    Jennifer Chan, Assistant Professor of Emergency Medicine at Feinberg, identified communication as one of the greatest challenges in this outbreak. Difficulties arise not only in getting messages to local communities about what to do, but also in getting the communities to trust the messages they receive.

    Mike Schmidt, also an Assistant Professor of Emergency Medicine at Feinberg, addressed the protocol of Northwestern Memorial Hospital’s Emergency Department in regards to Ebola. Each patient is screened for travel history and potential exposure to the virus as part of the initial evaluation. Though no patients have presented at the hospital with the virus, Murphy described Chicago as a city with many travelers to and from West Africa.

    “If the person had a travel history that was concerning, those patients would be placed in particular areas of the emergency department where we can isolate them,” Schmidt described.

    Following the panel, a poster session showcased student research and projects in global health. In the evening, the Global Health Social Hour gave students and residents the opportunity to share abroad experiences and discuss project successes and challenges. On the Center for Global Health’s Facebook page, images capturing these travels are displayed as a part of a photo contest. Take a look at what the medical students have been doing and “like” your favorites to vote.

    Feinberg students presented global health projects and research from all across the world

    Feinberg students presented global health projects and research from across the globe

  5. The Ebola Outbreak: Fast Facts and Resources

    August 4, 2014 by Emily Drewry

    The global health world is abuzz this summer with the frightening spread of Ebola, a deadly virus that has emerged in frightening force over the past few months in West Africa. Officials are labeling the outbreak responsible for 826 deaths as of August 4, as organizations across the globe are stepping in to try and contain the spread before the count grows.  As the media coverage continues to escalate, so does the challenge of keeping up with it, especially the quick facts. Read on to get a quick overview, then follow the links under each question for further information.

    Ebola Virus

    Ebola Virus. Source: Associated Press

    What is Ebola? Ebola is a group of viruses that cause deadly hemorrhagic fevers. According to the WHO, the virus has a case fatality rate of 90%. It can be transmitted by direct contact with blood, body fluids, and tissues of infected people or animals, and is known to be one of the world’s most virulent diseases. The current strain is considered to be the most lethal strain of the group, but in many cases, can be treated if identified.


    Background information: Ebola is named after the river in Zaire where it first emerged in 1976. The virus produces a protein called ebolavirus glycoprotein that attacks the body’s cells and creates the hemorrhagic symptoms that often appear in patients. However, not all cases of Ebola are identified with extreme hemorrhaging – instead, the cases generally begin with flu-like symptoms. Therefore, much of the danger of the outbreak lies in the challenge of containing those who carry the virus and avoiding exposure, which often takes place in funeral circumstances or through the work of health care providers.


    Where is the outbreak? The cases of this summer’s outbreak have been located along the shared borders of the West African countries of Sierra Leone, Liberia, and Guinea. There is fear of the virus spreading after an infected man flew on a commercial airliner from Liberia to Nigeria last week, but as of now, officials have yet to report any cases. On July 31 the CDC issued a travel advisory for the three countries where Ebola has been identified, urging a temporary halt to nonessential travel.


    How does this outbreak compare? This year’s outbreak is now officially the largest in history, with over 1,300 infected this year. Past outbreaks have been reported across the world since the first recognition of the disease in 1976. An outbreak in 2000-2001 in Uganda infected 425 individuals, with a 53% death rate reported.  Ebola has been identified in three continents since 1976, and has been a collaborative research project for the CDC and various national health departments for years.


    What is happening in the US? Two Americans, who were infected with the Ebola virus while working in Liberia, are being transported to Emory University Hospital in Atlanta for treatment this week. A 33-year old American doctor arrived in Atlanta on Saturday and a 59-year old aid worker is scheduled to arrive in the US tomorrow. The news created a stir of responses from individuals afraid of the healthcare system’s abilities to keep the virus contained. A Pentagon spokesman confirmed the move, acknowledging that specially trained teams will be handling the cases. This is the first time an Ebola patient has been brought to the US, according to the CDC.


    What does the WHO have to say? The WHO has kept their updates quite frequent, updating their website with response plans and resources as the outbreak has progressed.  Most recently, they informed the public of an intensified Ebola outbreak response plan to be put in place by Dr. Margaret Chen, Director-General of the WHO and the presidents of the West African nations affected.  The $100 million response plan will “require increased resources, in-country medical expertise, regional preparedness and coordination,” says Dr. Chen.


    Where can I get more information? All the links above will bring you to articles with coverage of the current outbreak. In addition, the CDC ( and WHO ( websites contain valuable background and updated information.

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