Warmer weather across the globe is reshaping the landscape of human health. Case in point:��Dengue fever incidence could rise as much as 76% by 2050 due to climate warming across a large swath of Asia and the Americas, according to a new study led by , a researcher at the 91̽��.��

Dengue fever, a mosquito-borne disease once confined largely to the tropics, often brings flu-like symptoms. Without proper medical care, it can escalate to severe bleeding, organ failure, and even death. ��

The study,, is the most comprehensive estimate yet of how temperature shifts affect dengue’s spread. It provides the first direct evidence that a warming climate has already increased the disease’s toll.����

“The effects of temperature were much larger than I expected,” said Childs, a 91̽��assistant professor of environmental and occupational health sciences who conducted much of the research as a doctoral student at Stanford University. “Even small shifts in temperature can have a big impact for dengue transmission, and we’re already seeing the fingerprint of climate warming.”��

The study analyzed over 1.4 million observations of local dengue incidence across 21 countries in Central and South America and Southeast and South Asia, capturing both epidemic spikes and background levels of infection.����

Dengue thrives in a “Goldilocks zone” of temperatures — incidence peaks at about 27.8 degrees Celsius, or 82 degrees Fahrenheit, rising sharply as cooler regions warm but dropping slightly when already-hot areas exceed the optimal range. As a result, some of the largest increases are projected for cooler, high-population regions in countries such as Mexico, Peru and Brazil. Many other endemic regions will continue to experience larger, warming-fueled dengue burdens. By contrast, a few of the hottest lowland areas may see slight declines.����

Still, the net global effect is a steep rise in disease.��

The findings suggest that higher temperatures from climate change were responsible for an average 18% increase of dengue incidence across 21 countries in Asia and the Americas from 1995 to 2014 — translating to more than 4.6 million extra infections annually, based on current incidence estimates. Cases could climb another 49% to 76% by 2050 depending on greenhouse gas emissions levels, according to the study. At the higher end of the projections, incidence of dengue would more than double in many cooler locations, including areas in the study countries that are already home to over 260 million people.����

“Many studies have linked temperature and dengue transmission,” said senior author, a professor of biology in the. “What’s unique about this work is that we are able to separate warming from all the other factors that influence dengue — mobility, land use change, population dynamics — to estimate its effect on the real-world dengue burden. This is not just hypothetical future change but a large amount of human suffering that has already happened because of warming-driven dengue transmission.”��

The researchers cautioned that their estimates are likely conservative. They do not account for regions where dengue transmission is sporadic or poorly reported, nor do they include large endemic areas such as India or Africa where detailed data is lacking or not publicly available. The researchers also highlighted recent locally acquired cases in California, Texas, Hawaii, Florida, and in Europe — a signal of the expanding range of dengue. Urbanization, human migration and the evolution of the virus could amplify risks, while medical advances may help blunt them, making projections uncertain.��

Aggressive climate mitigation would significantly reduce the dengue disease burden, according to the study. At the same time, adaptation will be essential. This includes better mosquito control, stronger health systems and potential widespread use of new dengue vaccines.��

In the meantime, the findings could help guide public health planning and strengthen efforts to hold governments and fossil fuel companies accountable for climate change damages. Attribution studies are increasingly entering courtrooms and policy debates, used to assign responsibility for climate damages and to support funds compensating countries most affected.����

“Climate change is not just affecting the weather — it has cascading consequences for human health, including fueling disease transmission by mosquitoes,” Mordecai said. “Even as the U.S. federal government moves away from investing in climate mitigation and climate and health research, this work is more crucial than ever for anticipating and mitigating the human suffering caused by fossil fuel emissions.”��

Co-authors of the study include of Arizona State University, of the University of Maryland, and of Stanford. Lyberger and Harris completed much of their work while at Stanford.������

The research was funded by the Illich-Sadowsky Fellowship through the Interdisciplinary Graduate Fellowship program at Stanford University; an Environmental Fellowship at the Harvard University Center for the Environment; the National Institutes of Health; the National Science Foundation (with the Fogarty International Center); �ٳ��  �ٳ��  and the Stanford Woods Institute for the Environment.��

Adapted from a. For more information or to contact the researchers, email Alden Woods at acwoods@uw.edu.

The 91̽�� is No. 8 on the 2025-26 U.S. News & World Report’s Best Global Universities rankings, ��on Tuesday. The 91̽��maintained its No. 2 ranking among U.S. public institutions.

The 91̽��also placed in the top 10 in eight subject areas ranked by U.S. News.

Harvard University, Massachusetts Institute of Technology and Stanford University topped the list in that order. The University of Oxford is No. 4, followed by University of Cambridge, the University of California, Berkeley, University College London and the UW. Yale University and Columbia University rounded out the top 10.

“Unquestionably, the 91̽��is advancing discovery that saves and improves lives, promotes prosperity, makes our nation stronger and expands human knowledge for the good of all,” said 91̽��President Ana Mari Cauce. “I’m very proud to see this extraordinary impact recognized through this latest ranking.”

The U.S. News ranking����—��based on data and metrics provided by Clarivate — weighs factors that measure a university’s global and regional research reputation and academic research performance. For the overall rankings, this includes bibliometric indicators such as the number of publications, citations and international collaboration.

The overall Best Global Universities ranking encompasses 2,250 institutions spread across 105 countries, according to U.S. News.

Here are the 91̽��fields of study that are in the top 10 in U.S. News’ subject rankings:

Molecular biology and genetics — No. 6

Clinical medicine — No. 6

Public, environmental and occupational health — No. 6

Microbiology — No. 7

Biology and biochemistry — No. 8 (up from 9)

Infectious diseases — No. 9

Marine and freshwater biology — No. 9

Social sciences and public health – No. 9

Four years ago, as attention locked onto COVID-19, another virus began circling the globe. A major outbreak of a new strain of bird flu — formally named — has since killed millions of wild birds and infected poultry, dairy cattle, and a small number of humans.����

In the United States, four people have contracted the virus. The most recently confirmed , a dairy worker in Michigan, was the first to experience flu-like respiratory symptoms. For now, federal health officials have deemed the virus a low risk to public health, while and monitoring the virus’s spread.��

But what exactly are public health officials looking for? How is this virus different from previous H5N1 outbreaks? And how can a bird flu become humanity’s problem, anyway?����

91̽��News brought these questions and more to 91̽�� experts Peter Rabinowitz, a professor of environmental and occupational health sciences and of family medicine, and , an assistant professor of epidemiology and of global health. They are director and deputy director, respectively, of UW’s , which studies the connections between the health of people, animals and our shared environment.

Peter, you recently . What makes this outbreak different, and why is it drawing so much attention from health officials?����

Peter Rabinowitz: Thirty years ago, outbreaks of highly pathogenic avian influenza were rare in birds. Beginning around 2003, a deadly strain of H5N1 avian influenza started spreading widely, but mostly impacted domestic poultry. Now this recent strain of H5N1 that has been circulating worldwide for the past two years is unprecedented in its ability to affect mammals.��

The H5N1 virus started with birds before “jumping” to dairy cattle and now a handful of humans. How does a virus “jump” between species like that, and what makes certain species vulnerable while others seem to resist the virus?��

PR: As they circulate, influenza viruses are continually changing some of their genetic material, acquiring new mutations in a process known as “” Sometimes when two different strains of a virus are present in the same host human (or animal), they can “recombine” to create a quite different strain.����

Health officials have said the chances of H5N1 becoming a major threat to humans are minimal, but that they’re monitoring the situation for any changes. What are they looking for?����

PR: Health officials are looking for evidence of mammal-to-mammal transmission in non-human mammals, and any evidence of person-to-person transmission, which could be a definite warning about H5N1’s potential to become an epidemic.����

The earliest cases of H5N1 in humans were mild — two dairy workers with eye infections — but the most recent case appears to be . That’s triggered alarm, of course, but what does that say about how the virus is evolving?����

Julianne Meisner: The location of symptoms can sometimes — though not always — tell us something about transmission. When symptoms are restricted to just the eye, it’s likely that transmission would require contact with the tissues around or fluids from the eye, similar to how pink eye (conjunctivitis) is transmitted.��

When health professionals see respiratory symptoms, we get concerned about transmission through droplets or aerosols. Because breathing is something every one of us needs to do, all of the time, respiratory transmission is incredibly efficient, and difficult to avoid. Also, some respiratory symptoms, such as coughing, can propel virus particles further, increasing the efficiency of transmission.����

Much has been made of H5N1 as the next possible pandemic. Should that happen, are there lessons we’ve learned from the COVID-19 pandemic that could help us navigate this one?����

PR: Yes, the lessons learned from COVID-19 in terms of rapid development of vaccines and the effectiveness of control measures such as masks would allow us to respond quickly. Unfortunately, everyone is quite tired of hearing about pandemics, so a challenge would be to capitalize on the helpful lessons learned and find a way to avoid misinformation and public backlash to a public health response.����

JM: While COVID has been very divisive in many ways, it has also familiarized many people with public health: People now know how to navigate dashboards on the health department’s website, and we have muscle memory regarding social distancing, mask wearing, handwashing, etc. Basic epidemiology principles such as quarantine, isolation, transmission rate, etc. are familiar to the general public now. But there is also a lot of fatigue, as Peter mentions, which may make it harder to implement public health countermeasures if they become necessary.����

You both study the connection between human and animal health. It’s easy for people to understand that animal diseases can spread to humans, but how else should we consider that relationship?��

PR: We should raise awareness about the terrible impact of the current avian influenza outbreak on wild and domestic animal populations: millions of poultry dying because of spreading infections, also hundreds of thousands of wild birds and mammals, including sea mammals such as sea lions and seals. An event like this represents a threat to biodiversity and the health of ecosystems, which we have learned is extremely important for human health. The concept of “One Health” stresses these vital connections between the health of humans, other species, and our shared ecosystems.����

To reach Rabinowitz or Meisner, contact Alden Woods of 91̽��News at acwoods@uw.edu.����

The 91̽�� rose from No. 7 to No. 6 on the��, released on Tuesday. The 91̽��maintained its No. 2 ranking among U.S. public institutions.

U.S. News also ranked several subjects, and the 91̽��placed in the top 10 in 10 subject areas, including immunology (No. 4), molecular biology and genetics (No. 5) and clinical medicine (No. 6).

In another ranking out this week, Times Higher Education World University Rankings 2023 by Subject, six subject areas at the 91̽��placed in the top 25.

“As a global public research university, the UW’s mission is to create and accelerate change for the public good,” 91̽��President Ana Mari Cauce said. “I’m proud that these rankings reflect the outstanding and wide-ranging work of our faculty, staff and students to expand knowledge and discovery that is changing people’s lives for the better, particularly in the health sciences.”

The U.S. News ranking —�� based on Web of Science data and metrics provided by Clarivate Analytics InCites — weighs factors that measure a university’s global and regional research reputation and academic research performance. For the overall rankings, this includes bibliometric indicators such as publications, citations and international collaboration.

The overall Best Global Universities ranking, now in its ninth year, encompasses the top 2,000 institutions spread across 90 countries, according to U.S. News.��American universities make up eight of the top 10 spots.

Here are all the top 10 91̽��rankings in U.S. News’ subject rankings:

• Immunology – No. 4
• Molecular biology and genetics – No. 5
• Clinical medicine – No. 6
• Geosciences – No. 7
• Infectious diseases – No. 7
• Public, environmental and occupational health – No. 7
• Social sciences and public health – No. 7
• Biology and biochemistry – No. 8
• Microbiology – No. 10

In the rankings, UW’s programs in these areas placed in the top 25:

• : No. 15
• (includes agriculture and forestry, biological sciences, veterinary science and sport science): No. 16
• (includes medicine, dentistry and other health subjects): No. 17
• (includes communication and media studies, politics and international studies — including development studies, sociology and geography): No. 18
• (includes mathematics and statistics, physics and astronomy, chemistry, geology, environmental sciences, and Earth and marine sciences): No. 19
• (includes education, teacher training, and academic studies in education): No. 23

The subject tables employ the same used in the overall��; however, the methodology is recalibrated for each subject, with the weightings changed to suit the individual fields.

The National Institutes of Health has renewed a major grant that funds a 91̽��-led research center to understand malaria in India.

The initiative — , which was first funded in 2010 — is one of 10 NIH-supported International Centers of Excellence for Malaria Research, or ICEMRs. The National Institute of Allergy and Infectious Diseases that it would provide $9.3 million in funds to the South Asia ICEMR over the next seven years, beginning July 1, 2017.

South Asia sits in the middle of the malaria corridor that cuts from Southeast Asia to Africa.

“India is a country of critical importance for understanding the spread of virulent malaria globally,” said , a 91̽��professor of chemistry and the director of the Malaria Evolution in South Asia ICEMR. “While most deaths caused by drug-resistant strains of malaria have occurred in Africa, most drug-resistant parasites arise first in Asia.”

Malaria in India remains underappreciated. The country has 1.3 billion people and more than 90 percent of the population live in areas where there is risk of malaria transmission. India had an estimated 13 million cases of malaria in 2015, according to the World Health Organization. Beyond that, the picture of malaria in India is one of diversity.

“There is enormous variation in the prevalence of malaria around the country — variation in levels of immunity and variation in the species of mosquitoes that spread the disease,” said Laura Chery, the South Asia ICEMR’s associate director. “Most importantly, there is unexpectedly high genetic diversity in malaria parasites that are circulating in India.”

In addition to researchers from the UW, the South Asia ICEMR also includes U.S. scientists from Harvard University, the Fred Hutchinson Cancer Research Center, the Center for Infectious Disease Research and Stanford University. But by far the largest contingent of researchers that make up the center’s efforts are the dozens of scientists, clinicians and field workers at sites across India.

“We have formed wonderful, productive partnerships with hospitals, clinics, government agencies and community members,” said Chery. “Together, we have learned to do advanced science on the ground at clinically important sites.”

Through partnerships with local hospitals and research institutes, the center currently works out of six sites across India. The locations capture the diversity of this massive country: Four sites are in eastern and northeastern India, where malaria is endemic and cases can reach as high as 50 to 100 per 1,000 people. Two other sites are on the west coast, where the prevalence of malaria can be relatively low — fewer than 1 case per 1,000 people. But these sites include urban hospitals that attract and treat large numbers of malaria patients, including migrants from other parts of the country.

“We believe that movement of people within the country can partly explain the complexity of malaria in India,” said Rathod. “However, we do not fully understand the basis for such variations.”

At each site, staff enroll patients to obtain malaria parasite samples, as well as information on each patient’s health history. From on-site laboratories in India, center staff and partners pursue a number of research projects: analyzing parasite samples for signs of drug resistance, understanding the basis for variations in disease presentation, sequencing parasite genomes and determining their genetic relatedness to one another, and testing how well different mosquito species take up various malaria strains.

In addition to setting up complex research infrastructure, in its first seven years the center has made some surprising conclusions about malaria in India. Parasites in India show more genetic diversity than parasites in the rest of the world combined, according to Rathod. As a consequence, some standard laboratory tests for drug resistance, developed elsewhere in the world, do not accurately predict whether Indian parasites will show drug resistance.

Drug resistance is a major concern in malaria. Chloroquine was once an effective drug to fight malaria. But a generation ago, malaria parasites began to evolve resistance to it, rendering it largely ineffective. Today, the drug artemisinin is considered the best treatment against malaria. But artemisinin-resistant strains of malaria already have been identified in Southeast Asia. The Indian government and the South Asia ICEMR are on the lookout for artemisinin resistance among patients in northeastern and eastern India. Beyond that, the South Asia ICEMR is looking for parasites that mutate at extraordinary rates, as seen in Southeast Asia.

“By getting a clearer picture of malaria in India, we’re ‘closing the gap’ on how this complex parasite behaves globally,” Rathod said.

For the 2017-2024 cycle, other South Asia ICEMR project leaders are , director of the National Institute of Malaria Research in India, and at Harvard University. Additional U.S.-based senior contributors are at the Center for Infectious Disease Research, at Stanford University and and at the Fred Hutchinson Cancer Research Center. Additional India-based senior contributors are Anup Anvikar at National Institute of Malaria Research; Subrata Baidya at Agartala Government Medical College; D.R. Bhattacharrya and P.K. Mohapatra at Regional Medical Research Centre, NE Region; Edwin Gomes at Goa Medical College & Hospital; Sanjeeb Kakati at Assam Medical College; Ashwani Kumar at National Institute of Malaria Research, Goa Field Unit; Sanjib Mohanty and A.K. Singh at Ispat General Hospital; and Swati Patankar at Indian Institute of Technology Bombay.

###

For more information, contact Rathod at rathod@uw.edu or 206-384-9404 and Chery at lauraarn@uw.edu or 206-321-2409.

Grant number: U19AI089688

If human trials underway are successful, the compound — known by its acronym DSM265 — could give doctors a new tool to prevent and treat infection by the microscopic parasites that cause malaria, a mosquito-borne disease that kills more than 500,000 people annually.

The team’s efforts stem from new, streamlined processes to identify and optimize chemical compounds that show promise against malaria parasites. The scientists in this international partnership — spanning 20 institutions on three continents — pooled their collective expertise to accelerate the pace of discovery and validation. This novel anti-malarial drug is their first major breakthrough for use in humans.

“This is the first of a new class of molecules that’s going into humans,” said 91̽��chemistry professor , and leaders of this endeavor. “Until now, everything else in humans has been variations of drugs that have been developed in the distant past.”

DSM265 targets a cellular protein made by the malaria parasite. Malaria parasites rely on this protein — known by its acronym DHODH — to express their genes and copy those genes when it’s time to divide. Since DHODH provides a critical function, this drug could impair the parasite at multiple stages of its life cycle, including one elusive stage when it hides in the human host’s liver.

Rathod’s partners include with the University of Texas Southwestern Medical Center at Dallas and at Monash University in Melbourne. The three research groups and their recent partners in Europe, Australia and the U.S. shared information and divided tasks openly, playing to the strengths of each group. Rathod’s lab at the 91̽��was involved from the start.

“All the enabling chemistry work was done here first, and all the tests on malaria parasite cells and human cells started and have continued here,” said Rathod.

Since DHODH performs such a critical role in malaria cells, scientists had long sought drugs that would inactivate it. The Texas researchers studied the malaria DHODH protein, working to identify a chemical compound that would cripple it. Once they found a chemical that showed promise, Rathod’s lab undertook validation, modification, and fine-tuning. With additional guidance and collaboration from advisors at the , Rathod’s group altered the chemical compound to increase its potency against DHODH.

They also had to ensure that the compound would not target the human version of the DHODH protein, which performs an important role in our cells. In all, Rathod’s group made more than 500 versions of the initial compound and tested how well it inhibited malaria parasites in the lab. The 265^th version — DSM265 — showed the most promise.

“‘DSM’ actually stands for ‘Dallas-Seattle-Melbourne,’ our three cities,” said Rathod. “We wanted to name it after our founding teams that are working really hard at each site.”

Rathod and his group passed DSM265 and related compounds to their collaborators at Monash University, who tested how our human cells might modify or metabolize the compound. These experiments ensured that a drug based on DSM265 would last for a long time in our bodies — an ideal feature for a single-dose anti-malarial treatment — and would not produce toxic byproducts. They also determined what doses of the compound might be the most effective in humans.

Rathod’s lab also developed and performed experiments to test how well the malaria parasite might evolve to become resistant against DSM265.

“We developed methods to watch the malaria parasites mutate and try to generate solutions against DSM265 in real time,” said Rathod. “And with whole genome sequencing, we can really look at the whole scene as it’s unfolding in front of us.”

If doctors know the conditions that permit the malaria parasite to develop resistance to DSM265, they can tailor the drug’s use in a clinical setting to lower that risk.

Rathod hopes that the development and discovery pipeline for DSM265 will pave the way for a faster and more collaborative drug development process in what he calls “the long war against malaria.” The project benefited from an open process, Rathod said. Researchers also transferred their patent rights for DSM265 to the , a Bill & Melinda Gates Foundation-supported nonprofit public-private partnership that is leading some of the clinical and field trials, in the hopes of accelerating the drug’s clinical development.

Other authors from the 91̽��include John White and Sreekanth Kokkonda, senior scientists with the 91̽��Department of Chemistry and researchers in Rathod’s lab.

The DHODH research projects in Rathod’s and Phillips’s labs were funded by the U.S. National Institutes of Health grants AI075594 and AI103947.

###

For more information, contact Rathod at 206-384-9404 or rathod@chem.washington.edu.

91̽�� is examining its readiness plans and advising employees and students on Ebola. Experts believe the threat of Ebola to the general U.S. public is very slim, but also that agencies should take well-informed precautions and be prepared to initiate a response if needed. The 91̽��is working closely with Public Health-Seattle & King County and the Washington State Department of Health on preparedness planning.

As long as the Ebola epidemic remains uncontained in West Africa, untold lives will be lost in that region. Other parts of the world will remain on alert for new cases cropping up in their countries. The Centers for Disease Control and Prevention, an arm of the U.S. Department of Health and Human Services, leads U.S. efforts in this matter, in conjunction with many organizations ranging from port authorities to state and county public health services.

“Universities and colleges across the country also are among those being called upon to be part of Ebola preparedness,” said Lynn Sorensen, nurse manager for Hall Health Center, the 91̽��campus health service. “This is largely due to the global programs and multinational population of faculty, staff and students at many universities.”

Additionally, some major universities, as is true of the 91̽��, also run teaching hospitals and other medical services to care for patients in conjunction with education and research missions. Like health institutions everywhere, 91̽��Medicine has to prepare for the possibility of an Ebola diagnosis in a patient coming to them for treatment.

The 91̽��campus as a whole, and 91̽��Medicine as a health-care system, have done extensive work on readiness plans that align with national guidance from the Centers for Disease Control and Prevention and with localized advisories from city, county and state health departments.

“Plans are constantly updated to stay abreast of the latest information and guidelines on Ebola, and to incorporate lessons learned from institutions and individuals who have managed cases,” said hospital infection control expert Dr. John Lynch, who is working with Dr. Timothy Dellit on overseeing 91̽��Medicine Ebola preparedness. Both physicians are associate professors in the Division of Allergy and Infectious Diseases, 91̽��Department of Medicine.

If the need arises, the integrated response system that scores of people have been refining and testing for the past several months will be activated at short notice.

The precautions include, but are not limited to, helping those with exposure risks check for symptoms during a 21-day watch period, screening for and managing potential cases of Ebola Virus Disease, safeguarding health workers and others who care for any possible Ebola patients, and preventing the spread of infection to others.

The 91̽��is also reviewing its policies to advise employees or students who might be affected by other public health measures to avert or control outbreaks, such as contact monitoring or household quarantines.

“Practicing good infection control practices at a university is always important even outside of the present concerns about Ebola,” Sorensen said. Ebola adds another dimension of prudence, according to Sorensen, but should not be a cause for alarm.

While the chance of Ebola exposure within the United States is extremely low, people who have very recently lived in or traveled to West Africa, however, could have been exposed, depending on their activities while there. The disease is spread when virus-infected body fluids of the sick or dead enter through a break in the skin or through a mucus membrane, such as those lining the eyes, mouth, nose and anal/genital area. Body fluids refer to blood, saliva, semen, urine, vomit, sweat, nasal discharge, diarrhea, breast milk and the like.

People with symptoms can pass the infection to others. Reactions to the virus vary: some resist it completely, some suffer and recover, but some succumb to the disease. Early symptoms resemble many other sicknesses going around: fever, muscle aches, diarrhea, vomiting and cough. If the disease progresses, bleeding, organ failure and shock can occur.

91̽��travelers to Africa should realize that butchering or eating bush meat can transmit the disease. In Africa fruit bats and some monkeys and apes may carry the virus, according to the 91̽��School of Public Health’s Peter Rabinowitz, who studies zoonotic diseases – illnesses that are transmissible between animals and humans.

On Sept. 17 the 91̽��community received an e-mail notice that the 91̽��was restricting any non-essential travel to Sierra Leone, Liberia, Nigeria and Guinea. Mali is now under review, 91̽��Global Emergency manager Pascal Schuback noted. For details on 91̽��travel restrictions, contact Schuback at 206-616-7927.

91̽��travelers abroad to any part of the world are encouraged to register with the 91̽��Travel Registry. Members of the 91̽��community who have been in one of the affected African countries within the past 21 days being asked to notify Hall Health (206-221-2517) or the Employee Health Clinic (206-685-1026), said a representative from 91̽��Environmental Health and Safety.

Anyone at the 91̽��with a risk of exposure who does become ill with symptoms resembling Ebola should phone for medical assistance before going to Hall Health or a hospital, Sorensen advised.

She explained that, “Voluntary quarantine of anyone who has symptoms of Ebola and a recent travel history to an affected region will help protect others. It is very important for a person with these risk factors to call the clinic for advice to allow time for a plan to be set in place by the clinic or hospital response team.”

Hall Health, like other of the nation’s walk-in clinics, is preparing for unexpected cases. Designated response teams are being formed. Staff members are checking patients travel history, other risk factors, and symptoms, Sorensen said. Suspected Ebola cases will be taken to an isolated, closed-off area for evaluation and first line of care. Other treatment and infection control guidelines, including the use of personal protective gear, health department notification, and decontamination procedures, will be followed.

“Ambulatory clinics have guidelines for Ebola detection and initial management tailored to being a walk-in source of medical care,” Sorensen said. Clinics are expected to arrange with their local health department concerning the transport of suspected cases to hospitals ready to receive them.

“Communication among the various agencies that are part of the Ebola response is essential,” Sorensen said. “There are so many pieces, and we’re just one of the pieces.”

“At 91̽��Medicine’s hospitals and clinics, physicians and staff from a wide range of units are receiving training and are actively involved in Ebola preparedness,” said Johnese Spisso, chief health system officer, 91̽��Medicine, and 91̽��vice president for medical affairs. Daily huddles by leadership team members are being completed. Information is cascaded to staff daily through information lines and intranet sites.

Town-hall meetings have also been occurring to present general information, while educational sessions are held to teach 91̽��Medicine staff about specific Ebola response measures. Importantly, the information is put into practice in training sessions and drills. A staged drill might begin with the unannounced presence of an actor in the role of a patient with a fever and raging gut. If the intake reveals a travel history and other risk factors for Ebola, the plan is set in motion.

While all the details are too numerous to mention here, they would include: reassuring the patient, donning the proper protective care, isolating the patient in a specialized room, assigning a care team, reporting to public health agencies, providing supportive treatment and nursing care, ordering an Ebola test, handling lab specimens safely, removing gear in a manner that eliminates exposure, having observers confirm that nothing is amiss, performing decontamination procedures, and following many other guidelines recently established.

In addition, similar dress-rehearsals in infection control have been held for health sciences students, along with education on Ebola and its treatment. Lectures are also being offered by experts in various aspects of the epidemic, not the least of which is how to teach about it as the situation quickly changes.

This past Saturday, for example, veterinarians and physicians in the region learned about Ebola preparedness in relation to household pets at a breaking news session of a local medical conference. In a country where many consider dogs and cats family, Rabinowitz said, public health officials are concerned about the need for evidence on how best to manage an exposed pet.

“Developing effective guidelines for how exposed domestic animals will be handled during the epidemic is part of public health preparedness,” Rabinowitz.

The Ebola readiness underway strengthens the overall ability of 91̽��health services to recognize and manage new disease agents.

“We may never have a case of Ebola, but other types of emerging infectious diseases could find their way here,” said Sorensen. “We need to be just plain prepared. This takes away the fear factor. Groups like Doctors Without Borders have been dealing with Ebola in austere conditions in countries that have sparse resources. They use simple measures – tents, cots, buckets, protective gear and bleach spray – with very few instances of provider infections. We can learn from their skill and their courage.”

“We should be able to do this.”

Read the 91̽��Medicine on Ebola.

Although modern roundworms, fruit flies and humans are separated by hundreds of millions of years of evolution, all three species use many similar molecular strategies to control cell growth, development and function, according to research conducted by a collaboration of scientists from around the world, including several from the UW.

“If features of the genomes of these disparate organisms are the same, it is likely those features are important and fundamental to cell function,” said , 91̽��professor and chair of genome sciences, and a co-author on several papers on this research in the Aug. 28 Nature. The work is part of a federally funded effort to understand the genomes of two organisms common in biomedical research, Drosophila melanogaster, the fruit fly, and Caenorhabditis elegans, a 1 millimeter-long, soil-dwelling roundworm, and to correlate findings with those of the human genome.

Read about the research at:

91̽��Medicine outpatients will be able to see doctor’s notes in their medical records

Patients become more involved in their medical care when they can read their doctors’ full clinical notes in their online medical record. So says research accumulated over the past several years at three U.S. clinical sites, one of them Harborview Medical Center.

That finding, and the realization among most participating doctors that their initial misgivings about the open notes concept were unfounded, is leading 91̽��Medicine to make that same access available in late October to outpatients at all of its clinics and hospitals.

See how open notes work:

Teaching about rapidly changing health topics like Ebola

Dr. Doug Black, an infectious-disease specialist and 91̽��associate professor of pharmacy practice, describes how he teaches students about Ebola, a fast-changing health topic, by appealing to their curiosity, sense of discovery, and desire for accurate, up-to-date information.

Follow the Q & A:

Insight into successful depression care for women

In America, about a fourth of women will experience a major depressive episode in their lifetimes. 91̽��research has shown that collaborative care from a primary-care provider and a mental health professional is an effective model for treating women’s depression. The�� newest report, Aug. 26 in the online American Journal of Psychiatry, found that women with publicly funded health insurance or without insurance coverage experienced greater improvement in depression symptoms, with collaborative care, than did women with commercial insurance. The method the researchers used, called DAWN for Depression Attention for Women Now, will be offered at Harborview Medical Center in Seattle.

Learn more:

While the Ebola outbreak in West Africa has captured the world’s attention, it’s just one of many emerging infections that we must confront in the coming years, said , 91̽��professor of microbiology. He leads Ebola research at a high-level biocontainment facility at the Rocky Mountain Laboratories in Montana.

“Ebola is not the only emerging virus; it’s just the most famous one,” Katze said. “There’s West Nile, which was never in North America before and now is everywhere. There’s Chikungunya virus, which had never been in the Americas, but now has spread through the Caribbean and has reached the southern United States. There’s SARS (Severe acute respiratory syndrome), which spread from Asia to Toronto and Vancouver, and there’s MERS (Middle Eastern Respiratory Syndrome) that still ongoing in Saudi Arabia and the Middle East. That epidemic isn’t over.

To be more agile in responding to emerging pathogens, Katze advocates for accelerated development of new drugs and vaccines.

Read more:��

Study helps explain why HIV causes lifelong infection

The persistence of HIV infection despite antiretroviral treatment depends partly on which human genes the virus integrates, according to a ��by researchers at the 91̽��schools of Public Health and Medicine, Seattle Children’s Research Institute, and Fred Hutchinson Cancer Research Center.

Read more:

Back-to-school tips to reset kids sleep routines

As the new school year approaches, School of Nursing sleep expert Teresa Ward, professor of parent and child nursing, offers advice on helping your children arrive rested each day and ready to learn and play.

Learn how kids establish good sleep habits:

These findings are reported Dec. 16 in the advanced online edition of the journal Nature. The research was a collaboration between the 91̽�� and the Seattle Biomedical Research Institute.

Dr. Lalita Ramakrishan, who studies how TB evades the body’s immune system and manipulates the body’s defenses for its own ends, is the senior author. She is a 91̽��professor of microbiology, medicine and immunology. The lead author is C.J. Cambier of the 91̽��Department of Immunology.

Ramakrishnan noted that the recent study suggests an explanation for the longstanding observation that tuberculosis infections begin in the comparatively sterile lower lungs. In the upper respiratory tract, resident microbes and inhaled microbes of a variety of species signal their presence.

These tip-offs alert and attract many infection-fighting cells to the upper airways. The presence of other microbes in the upper airway may thereby help to keep TB infections at bay by creating a hostile environment.

Their presence may explain why TB is less contagious than diseases caused by several other respiratory pathogens.

To produce an illness, TB bacteria must sneak through this well-patrolled area and head for parts of the lungs where fewer microbiocidal cells are policing.

Like most other bacteria, TB pathogens have telltale molecular patterns that should activate an immune response. However, TB pathogens have evolved mechanisms to circumvent tripping the alarm. Almost like home intruders wearing a stocking over their faces, the TB pathogens produce particular types of fatty substances, or lipids, on their cell surfaces.

These lipids, abbreviated as PDIM, are already known to be associated with bacterial virulence. The researchers showed that PDIM lipids function by masking the underlying molecular patterns that would reveal their dangerous nature to infection-fighting cells.

At the same time, a related lipid – called PGL – on the bacterium’s cell surface promotes the recruitment of clean-up cells that engulf but don’t kill the TB pathogens. Instead, they take them across the lung lining, deep into the lung tissue where the bacteria can establish an infection.

The TB pathogens then use the other lipid molecule, PGL, to co-opt a host chemical pathway that triggers the recruitment of the permissive macrophages.

The present study expands on earlier work in the Ramakrishan and collaborative labs, which helped describe the strategies by which TB pathogens manipulate host pathways for their own purposes after they enter certain host cells.

These include the secretion of proteins that expand the niche for TB by recruiting macrophages to the early lung tubercles characteristic of the disease. The present study describes earlier stages in infection, when the pathogens first come in contact with their potential host at the surface of the lung lining.

“The current study suggests the manner in which the TB pathogens manipulate recruitment of the first responding macrophages to gain access to their preferred niche,” the researchers noted.

“The choreographed entry involves two related TB cell lipids acting in concert to avoid one host pathway while inducing another,” they wrote. The findings link the previously known, absolutely essential virulence factor on the surface of TB cells, PDIM, to the evasion of immune cell detection. On the other hand, PGL is not required on the surface of TB cells for them to infect the body.

Ramakrishnan noted that globally, a lot of samples of TB taken from infected patients do not have PGL. “However,” she and her research team noted, “the importance of PGL in mediating TB virulence or transmission is underscored by its presence in many of the W-Beijing strains” of TB which are starting to appear in more patient samples, and which have predominated in outbreaks in North America.

Ramakrishnan explains that their findings suggest how PGL may be important in increasing TB’s infectivity.

“The presence of PGL in ancestral strains of TB suggest it played an integral role in the evolution of TB infectivity,” the researchers noted. “TB is an ancient disease and the enhanced infectivity conferred by PGL may have been essential for most of its history before human crowding, with its increased opportunity for transmission, made it dispensable.”

The study findings, and previous work on TB, might also explain why smaller droplets of TB are more infectious than larger ones. Only the smaller droplets can make their way down into the lower airways. All it takes is 3 or fewer TB mycobacteria with PGL-producing ability to enter the lower lungs and start an infection.

###

The other researchers on the study, in addition to Cambier and Ramkrishnan, were Kevin K. Takaki, David M. Tobin, and Christina L. Cosma, all of the 91̽��Department of Microbiology; Ryan Larson and Kevin N. Urdahl of the of the 91̽��Department of Immunology and the Seattle Biomedical Research Institute. Urdahl also is from the 91̽��Department of Pediatrics.

The research was supported by training and research grants from the National Science Foundation, American Lung Association, National Institutes of Health, and American Cancer Society. Tobin is an NIH New Innovator and Ramakrishnan is an NIH Pioneer.