Virus detective: VCU alumnus stands at the forefront of flu research

Emergency hospital during 1918 influenza epidemic, Camp Funston, Kansas
Courtesy of the National Museum of Health and Medicine, Armed Forces Institute of Pathology, Washington, D.C., Image NCP 1603

By Julie Young

A pioneering virologist with medical and doctoral degrees from the Virginia Commonwealth University School of Medicine has unlocked secrets to a deadly flu virus through plots and twists befitting an Indiana Jones movie.

Jeffery Taubenberger, M.D., Ph.D.

As a med student in the mid-1980s, Jeffery Taubenberger, M.D., Ph.D. (M.D.’86/M; Ph.D.’87/M) couldn’t have imagined that his chief interest, basic immunology, would catapult him into scientific stardom.

The 1918 Spanish flu epidemic that killed more than 40 million people worldwide was barely a blip in his medical education but turned into a hobby and eventually his life work. Today, Taubenberger serves as deputy chief of the laboratory of infectious diseases at the National Institute of Allergy and Infectious Diseases. He’ll be at VCU Monday, Feb. 19, for a special VCU Libraries lecture, “On the Centenary of the 1918 Flu: Remembering the Past and Planning for the Future.”

The flu pandemic that fascinated Taubenberger led him to crack the 1918 strain’s genetic code and discover why it was so deadly. Mapping the genome unlocked the secret to pathogens responsible for the Spanish virus and revealed key behaviors of strains such as this year’s widespread flu.

After graduation in 1987, Taubenberger completed a pathology residency and worked as a staff pathologist at the National Cancer Institute. In 1993, he joined the Armed Forces Institute of Pathology in Rockville, Maryland.

“I set up a new group to use what, at that time in the early ’90s, was really kind of very cutting-edge, ‘Star Trek’-type medicine,” Taubenberger says. The strategy was to use molecular biology tools and new information about DNA mutations to diagnose diseases. “Traditionally, you make a diagnosis by looking at tissues under the microscope,” he says.

Taubenberger and his team worked in a Washington, D.C., building that housed the largest archive of pathology material in the world, which sparked his memory of that passing reference at VCU to the 1918 flu. “I was thinking that if we could find material from people who died of the 1918 flu, perhaps we could apply molecular biology tools to learn something about this huge, really virulent influenza virus,” he says.

After years of painstaking research, the team identified one positive flu case from a soldier who died in South Carolina in 1918. “We had a little tiny bit of lung tissue from that soldier’s autopsy, about the size of a fingernail,” Taubenberger says. It was enough to generate a partial sequence of the virus. The breakthrough was reported in 1997 in the journal Science.

Across the country in San Francisco, a freewheeling adventurer and retired pathologist named Johan Hultin read the Science article and wrote to Taubenberger. Hultin had traveled to Alaska’s Seaward Peninsula twice in the 1950s to extract DNA from flu victims under the permafrost in the village of Brevig Mission. He had tried unsuccessfully to culture the virus.

Hultin told Taubenberger that he could unearth larger samples of the virus. Using $3,200 of his savings, Hultin returned to the Seward Peninsula, where he exhumed and autopsied a flu victim nicknamed “Lucy.” He shipped her lung tissue to Taubenberger’s lab. The material tested positive for the virus.

Taubenberger used Lucy’s tissue and fragments from autopsies of other victims worldwide to sequence the entire genome of the virus. Using molecular biology techniques, a multi-institutional project was able to produce infectious copies of the deadly virus by 2005. Virologists hailed it as a lifesaving discovery, the largest-ever breakthrough in flu research.

“We’ve learned a lot,” Taubenberger says. “The concern that I have is that something like this could happen again. We would hope, obviously, that it never would, but we are concerned; therefore, what could we do to try to prevent that?”

Vaccination is the answer, he adds. But flu shots have proven to be only partially effective because “influenza is never standing still,” Taubenberger says. That’s what makes flu such a frustrating public health challenge.

“The reason the vaccine has to be remade every year is to try to keep up with this really rapid mutation of the virus,” he says. “It would be bad enough if it were just a human virus, but influenza viruses are present in hundreds of species of animals, including wild birds, domestic birds, pigs … and they have the ability to jump from one species to another.”

In recent years, his lab has pushed to develop a universal flu vaccine that would protect against all strains.

“This is a pretty tall order, but our hope is to develop a vaccine that would prevent the serious complications of influenza so that if you were exposed to a virus like 1918, perhaps you would feel ill for a couple of days but you would not develop pneumonia or need to be hospitalized. That’s the goal we would like to pursue,” Taubenberger says. “And having worked on the 1918 virus has really given us insights into how we could perhaps do that. We hope to have some of our initial candidate vaccines in clinical trials by next year, so we’re excited about that.”

Sanger Series: Going Viral with Jeffery Taubenberger, M.D., Ph.D.
“On the Centenary of the 1918 Flu: Remembering the Past and Planning for the Future”

Monday, Feb. 19
5-7 p.m.
Hermes A. Kontos Medical Sciences Building Auditorium, 1217 E. Marshall St.
Reception to follow

The lecture is free and open to the public, but registration is required.

VCU researchers receive $4.2M NIH grant to study treatment for chemical attacks

With the backing of a five-year award of approximately $4.2 million in total costs from the National Institutes of Health, Robert DeLorenzo and a team of Virginia Commonwealth University researchers are studying and developing ways to treat and prevent human fatalities and morbidity that could result from chemical attacks on U.S. soil.

DeLorenzo, M.D., Ph.D., the George Bliley Professor of Neurology in the VCU School of Medicine, is the principal investigator on the team that received the grant from the NIH Countermeasures Against Chemical Threats program. CounterACT supports basic and translational research aimed at identifying medical countermeasures against chemical threats.

DeLorenzo said public safety is the key goal behind the research. He is working with Robert Blair, Ph.D. (Ph.D.’98/M), and Laxmikant Deshpande, Ph.D. (Ph.D.’06/M), assistant professors in the VCU School of Medicine Department of Neurology, as well as Rakesh Kukreja, Ph.D., the Eric Lipman Professor of Medicine in the Department of Internal Medicine, and Matthew Halquist, Ph.D., assistant professor and laboratory director in the Department of Pharmaceutics in the School of Pharmacy.

Medical school alumna is a voice for all children

Colleen Kraft, M.D.

If it takes a village to raise a child, then Colleen Kraft, M.D. (M.D.’86/M; H.S.’89/M), might say it takes a pediatrician who knows that village to heal one.

Kraft, who earned her medical degree from the Virginia Commonwealth University School of Medicine in 1986, believes spending time in the community is what opened her eyes to the daily issues and concerns facing the children and families she cared for in the office. Nothing, Kraft says, can replace the education you receive when you observe a child’s everyday environment. Some of her greatest insights came during conversations at the park, visits to the local library, school nurse’s office, daycare centers and church nurseries.

“Kids spend 15 minutes in the [doctor’s] office but they live in the community,” she said. “Your investment in the community is what really makes a difference.”

Read more.

Devanand Sarkar’s quest to cure liver cancer

When Devanand Sarkar, Ph.D., came to VCU Massey Cancer Center in 2008, he wanted to pursue a new direction in his research. Driven by the loss of a close friend and colleague, Sarkar was on a mission to better understand the processes that drive the development of liver cancer. Nearly a decade later, his research is close to bringing about new treatments for the disease while redefining how obesity is connected to cancer.

In America, one of the biggest drivers of liver cancer is fatty liver disease due to obesity. Obesity leads to the deposition of fat in the liver, which causes chronic inflammation and eventually develops into cancer. The mechanisms behind this transformation were once a mystery, and then Sarkar unraveled them.

“It started with this gene, AEG-1,” said Sarkar, the associate director for education and training at Massey who also holds the Harrison Foundation Distinguished Professorship in Cancer Research and is a member of Massey’s Cancer Molecular Genetics research program.

Sarkar and his colleagues had originally discovered and cloned AEG-1 at Columbia University in the laboratory of Paul Fisher, Ph.D., now professor and chair of the Department of Human and Molecular Genetics at VCU School of Medicine.

Read more.

VCU awarded $1.2 million grant to study transition to employment for military dependents with autism spectrum disorder

Paul H. Wehman, Ph.D.

Researchers at Virginia Commonwealth University have received a $1.2 million grant to investigate the impact of an evidence-based program that supports military dependents with autism spectrum disorder who are seeking employment after graduating high school.

The Congressionally Directed Medical Research Program grant is funding a study measuring the impact of “Project SEARCH plus ASD Supports” on employment outcomes for military dependents with autism between the ages of 18 and 22.

This is the first known intervention study that specifically targets transition aged military dependents with autism, a group frequently described as doubly disadvantaged by their disability and their family member’s service.

The principal investigator is Paul Wehman, Ph.D., a professor in the Department of Physical Medicine and Rehabilitation in the VCU School of Medicine and in the Department of Counseling and Special Education in the VCU School of Education.

Read more.

VCU researcher develops Lyme disease diagnostic and comes closer to creating a human vaccine

The Ixodes scapularis tick (deer tick) is a known Lyme disease vector.

A Virginia Commonwealth University researcher has developed a test to more effectively detect Lyme disease in humans. And after successfully developing a Lyme disease vaccine for canines last year, VCU researchers are now closing in on a human vaccine for the disease.

Next week, Richard T. Marconi, Ph.D., professor in the School of Medicine’s Department of Microbiology and Immunology, will be awarded a $510,000 one-year grant from the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, to advance the development of a human Lyme disease vaccine. In addition to NIH support, this effort is supported by the Stephen & Alexandra Cohen Foundation.

Read more.

Pharmacy professor named first da Vinci Center Faculty Fellow

Dayanjan “Shanaka” Wijesinghe, Ph.D.

Dayanjan “Shanaka” Wijesinghe, Ph.D. (Ph.D.’08/M),  wants to go beyond standard science.

“People like to say, ‘I’m doing arts, I’m doing science.’ No, no, no,” he said. “You are both doing art. It’s creating something brand new with the tools that you have. It’s art that’s based on a logical process, that’s true. But it’s creativity at its heart.”

The assistant professor in the Department of Pharmacotherapy and Outcomes Sciences at Virginia Commonwealth University’s School of Pharmacy is the first da Vinci Center Faculty Fellow. Wijesinghe’s commitment to collaboration across disciplines brought him to Garret Westlake, the center’s director.

“He actually reached out to me,” said Westlake. “I think it was my first week at VCU, and he said, ‘I would like to be more involved with the da Vinci Center, I wanted to get your ideas about where you see the center going in the future.’”

The faculty fellowship’s purpose is to highlight VCU faculty who champion cross disciplinary collaboration and innovation. Wijesinghe saw an opportunity to bring pharmacy and da Vinci students together to inspire entrepreneurship and creative thinking. He sees collaboration between the two as a ripe opportunity for student startups.

“Thinking outside the box, bringing the right people together and getting things done. That’s pretty much what we are trying to do here,” Wijesinghe said.

Wijesinghe recently sat down for an interview to discuss his roots as a scientist, and what intrigues him about the future.

Read more.

School of Medicine alumnus treats the neediest patients in some of the world’s most dangerous countries

Adrian J. Holloway, M.D. (M.D.’06/M) has traveled the world — to some of the most dangerous countries, by State Department reckoning — as an educator and cardiac intensivist. He is treated children fleeing ISIS in Northern Iraq, malaria victims in Malawi and earthquake survivors in Haiti.

What has he learned?

“No matter where you go, mothers are the same,” said Holloway, a 2006 graduate of Virginia Commonwealth University School of Medicine. “They know when their child is sick, and they know when their child is healthy.”

Holloway, assistant professor of pediatrics at the University of Maryland School of Medicine, plans to make sure more of them stay healthy. It’s part of his work as program director of the Global Health Pediatric Critical Care Fellowship, the first of its kind, and it’s given him the chance to assist in coordinating efforts to develop the first pediatric intensive care unit in Malawi.

Read more.

Globe-trotter: Esther Johnston travels the world to provide health care to underserved populations

By Anthony Langley (B.S.’16/MC)

Esther Johnston, M.D. (M.D.’11/M), has spent more than a decade traveling across continents providing health care for underserved populations.

She dreamt at an early age of becoming an investigative reporter, but as she entered high school, her passion shifted to medicine. She says she knew a career in health care would constantly challenge her and lead to a lifetime of learning.

“From the moment I realized it, I knew it was the right fit,” says Johnston, director of family medicine programs for the Boston-based nonprofit Seed Global Health and faculty member with the Wright Center Family Medicine Residency at HealthPoint in Auburn, Washington. “I wanted to do something where I would wake up feeling good every morning.”

Johnston attended the University of California, San Diego for her undergraduate degrees while working with the Flying Samaritans. The group works with a clinic in Ensenada, Mexico to improve access to health care in the community. It was there that she first witnessed the radical differences in health care outside of the U.S.

After graduating from UC San Diego with bachelor’s degrees in animal physiology and neuroscience and history, Johnston took a year off from school and traveled east to Charlottesville, Virginia. She split her time between working in the University of Virginia’s biomedical department and working as a coordinator for the Charlottesville Free Clinic before enrolling in Virginia Commonwealth University’s School of Medicine.

“I chose VCU because there weren’t a lot of schools in the country at the time with programs like the [International/Inner City/Rural Preceptorship program] focused on helping underserved populations,” she says. “Being a part of that laid the foundation for a lot of the work I’ve done since.”

In her first year, one of her lifelong mentors, Mark Ryan, M.D. (M.D.’00/M; H.S.’03/M), assistant professor in the Department of Family Medicine and Population Health and medical director of the I2CRP program, helped Johnston start a Spanish-language learning group, the Spanish Table, to encourage medical students to develop a working understanding of the language so they could better serve patients.

“When I first met her, I was worried that I wouldn’t be able to add much to her training because of all the experience she already had, but she was willing to share that knowledge to teach others and strengthen their abilities as well,” Ryan says. “There are some students where one can feel grateful for having been part of their learning, and that you develop lasting relationships, and I am very glad that I can count [Esther] among my friends and colleagues.”

For Johnston, the feeling is mutual.

“[Dr. Ryan] inspired me to work both internationally and domestically with underserved populations,” Johnston says. “I feel like there are so many people around the country who are grateful to have met him and just have him as a teacher.”

That same year, Johnston met Michel Aboutanos, M.D., M.P.H. (H.S.’00/M), the Fletcher Emory Ammons Professors in Surgery in the School of Medicine, chair of the Division of Acute Care Surgical Services and medical director of the VCU Trauma Center, who played a large role in her decision to pursue a career in public health.

After completing her second year of medical school, Johnston left VCU to earn a master’s in public health at John Hopkins University. Her degree focused primarily on international health and for most of that year, she worked on a water quality and safety project within the Mae La refugee camp in Thailand and the Kakuma refugee camp in Kenya.

With her M.P.H. in tow, Johnston returned to VCU, and by her fourth year, she was working with the Centers for Disease Control and Prevention under a CDC-Hubert Global Health Fellowship to develop a pandemic influenza surveillance program in Nairobi, Kenya.

“It turns out, within a few days of arriving, there was an outbreak of measles within the refugee population we worked with, and I had to switch focus to figure out what the barriers to immunization were for those refugees in the capital,” Johnston says. “I was extremely grateful for the strong support I had from VCU to work on this project while I was still finishing school. They did everything possible to make sure I had everything I needed to complete my degree and still finish my work with the CDC.”

Johnston earned her M.D. in 2011 and completed her residency at the University of Arizona’s Continuity Clinic less than 60 miles from the U.S.-Mexico border, where she served a large refugee population in a hospital-based training environment. Afterward, she joined the Global Health Service Partnership, run by Seed Global Health and the Peace Corps, to teach pediatrics and child health at Hubert Kairuki Memorial University in Dar es Salaam, Tanzania.

“It was challenging at times, but it was an incredibly fulfilling experience,” she says. “When I finished the trip, I was given the opportunity to continue my involvement with Seed Global Health, and I love it.”

With her time split between Seed Global Health and the Wright Center at HealthPoint, Johnston still keeps VCU close to her heart as the place where she found her calling with the help of her two mentors, Ryan and Aboutanos.

“It was exhilarating to be surrounded by people who were passionate about the same things I was,” Johnston says. “I’ll never forget my time at VCU.”

For the greater good: Alumnus Tim Ford is bringing changes to palliative care

By Anthony Langley

“I didn’t even know that [chaplaincy] was an option for me,” says Tim Ford (M.S.’02/AHP), staff chaplain for the Thomas Palliative Care Unit at the Virginia Commonwealth University Massey Cancer Center. “One day in [graduate school], a professor said, ‘Some of your classmates are thinking about becoming chaplains,’ and I said, ‘We can do that?’ It was eye-opening.”

Ford, a Buddhist chaplain, began to study the teachings of Buddhism after graduating with a bachelor’s degree in philosophy from St. John’s College in Annapolis, Maryland. Realizing he wanted to study the practice academically, he enrolled in a graduate program Naropa University in Colorado, founded by a Buddhist teacher in 1974. It was during the latter half of his studies there that he first experienced chaplaincy.

“A friend and I decided to intern as hospice chaplains that semester,” he says. “If I hadn’t, I would have never discovered how much I loved the work.”

He completed a master’s degree in religious studies focused on engaged Buddhism at Naropa, but opted not to follow the traditional Buddhist studies path, which would take him next to a doctorate degree. Instead, Ford decided he wanted to train as a chaplain and enrolled at the VCU School of Allied Health Professions to earn a master’s in patient counseling with a chaplain certification concentration.

During his studies, he worked with Massey, home to one of the nation’s flagship programs for palliative care, a specialized type of medical care for people with life-limiting illnesses. Palliative care providers focus on providing relief from the symptoms and stress of the illness to improve quality of life for patients and their families. Ford’s experiences in hospice care and the one-on-one connection he could have with his patients drew him to the field. When he graduated from VCU in 2002, he initially returned to hospice care in the Richmond, Virginia, community because there wasn’t a palliative care chaplain position at the university at the time.

“Even though I went off to do hospice, I still kept in touch with the friends I had in the palliative unit,” Ford says. “When they finally did create the chaplain position, I was first in line.”

In 2006, Ford joined Massey’s Thomas Palliative Care Unit, becoming the nation’s first full-time palliative care chaplain. In addition to counseling patients, Ford is an instructor in the School of Allied Health Professions’ patient counseling department and works, as part of Massey’s research team, to push the profession forward.

“If we found barriers that stopped us from helping a patient, we’d publish our materials to gain insight from others, and likewise, when we found something that worked, we wanted other universities to be able to try it out as well,” Ford says. “It wasn’t enough to be bedside with one patient. We had to work empirically, objectively and consistently.”

As the palliative care field has evolved and adopted a more clinical approach, Ford briefly considered focusing on performance improvement at the unit but changed his mind after realizing he’d only be helping one system. By broadening his focus, he could alter his entire field and bring advances to the palliative care units across the country.

To achieve that goal, Ford applied for and received one of eight prestigious Chaplaincy Research Fellowships in 2016 through the Transforming Chaplaincy Program supported by the John Templeton Foundation and coordinated through Rush University. The fellowship allows him to complete a two-year, research-focused Master of Public Health, which he is earning at VCU’s School of Medicine.

While his overall research focuses on clinical spirituality and how it can affect health outcomes, Ford is working alongside Brian Cassel, Ph.D., director of analytic services at Massey, to study advanced care planning and the financial impact palliative care can have on families.

“The great thing about working with Tim is that he already has the characteristics necessary to become a successful researcher: innovative thinking, attention to detail, persistence and the desire to work collaboratively on multidisciplinary projects,” Cassel says.

This semester, the pair plan to publish several articles about the issues at the intersection of public health and end-of-life care, as well as about public knowledge and attitudes toward advance care planning.

“By providing the public with resources about advanced planning, they’ll be better informed about the choices they have available and have autonomy over the care they’ll receive,” Ford says. “I’m glad to be a part of this, and I know great things will come from it.”