Recent EPI Publications

In this study, we investigated how each type of IFNλ (IFNλ1, IFNλ2, and IFNλ3) contributes to antiviral readiness in human intestinal epithelial cells. By selectively removing each IFNλ, we discovered that IFNλ2 and IFNλ3, but not IFNλ1, are essential for maintaining this built-in antiviral state. Cells lacking IFNλ2/3 became highly vulnerable to a wide range of viruses and lost the ability to activate key antiviral genes. Our findings reveal a previously unrecognized hierarchy among IFNλs and highlight IFNλ2/3 as critical guardians of gut antiviral defense, even before infection occurs.

Human norovirus (HuNoV) is the leading cause of foodborne illnesses in the United States, recognized for its environmental persistence and sanitizer resistance. However, limited data exist on its persistence in agricultural water. This study assessed the survival of HuNoV GII, its cultivable surrogate Tulane virus, and Escherichia coli TVS 353 in preharvest agricultural water collected from a Florida farm (treatment) compared with phosphate-buffered dilution water (BPDW, control). These findings demonstrate the long-term persistence of enteric pathogens in preharvest agricultural water and underscore the critical need for risk-based water safety strategies.

A widespread and underreported zoonosis, anthrax is a severe infectious disease of significant public health concern for humans, livestock, and wildlife. In this study, we used historical data from 1991 to 2020 from northern Vietnam and a simulation model to investigate the effects of different vaccination strategies on livestock outbreaks. Results showed that vaccination leads to a significant reduction in buffalo mortality, with reactive and increasing vaccination campaigns having the largest impact in reducing outbreak size. Our findings underscore the value of mathematical and simulation approaches to overcome data challenges and underreporting in global disease management for anthrax and other neglected diseases.

The introduction of the wMel strain of Wolbachia into Aedes aegypti mosquitoes significantly reduces dengue virus transmission. We evaluated the impact of large-scale releases of Wolbachia-infected Ae. aegypti on dengue incidence in Campo Grande, a large urban city in the Central-West region of Brazil, in the first deployment of Wolbachia as an official dengue-control strategy by the Brazilian federal government.

Livestock are recognized as major reservoirs for Campylobacter species and other enteric pathogens, posing infection risks to humans. High prevalence of Campylobacter during early childhood has been linked to environmental enteric dysfunction and stunting, particularly in low-resource settings.

While telemedicine has become an established component of healthcare delivery globally, challenges to scaling emerging initiatives persist across multiple levels. Over the last 5 years, our team has developed a pediatric telemedicine and medication delivery service (TMDS) in Haiti that integrates clinical guidance with rapid access to medications. Building on successful proof-of-concept studies, we are now well positioned to characterize both general challenges to telemedicine scale-up and those unique to the TMDS model.

Plant-based meat (PBM) products have rapidly grown in popularity due to increasing consumer demand for sustainable, ethical, and health-oriented food alternatives. However, these novel products may pose microbiological risks similar to traditional meats, including contamination by Salmonella spp. In this study, PBM samples (n = 63), including raw products (ground pork, mushroom, and burger) and cooked products (chicken tender, chicken breast, nugget, and beef), were collected from local retail markets in Bangkok, Thailand.

Fungal pathogens pose a global public health risk, driven by the alarming rise of antifungal resistance. The current antifungal pipeline remains limited to three main classes (azoles, polyene, and echinocandins). Additionally, fungal biofilms, with its extracellular matrix, further complicates the antifungal therapeutics.

Targeted indoor residual spraying focuses insecticide applications on common resting surfaces of Aedes aegypti mosquitoes (an arboviral disease vector) in houses, such as exposed lower sections of walls and under furniture. We conducted a two-group, parallel, unblinded, cluster-randomized trial in Merida, Mexico, to quantify the efficacy of targeted indoor residual spraying for preventing aedes-borne diseases (chikungunya, dengue, or Zika).

Federal Medicaid work requirements, recently enacted under national legislation, are expected to cause substantial disenrollment among low-income adults. However, the public health consequences of these policies remain poorly quantified. Medicaid work requirements are projected to increase mortality and chronic disease burden across the United States. These findings highlight the role of state administrative capacity and underscore the public health cost of restricting insurance access.