Infectious Disease Mission

Challenges

Enhance surveillance and epidemiological predictions for Infectious Disease control

Infectious diseases are evolving rapidly, making timely detection and critical responses essential for informed policy decisions for public health. It is vitally important that policy decisions for public health are based on robust projections using the latest epidemiological data. There is an essential requirement to utilise data science (including mathematical and statistical modelling), genomic tools, syndromic surveillance, and evidence synthesis to predict, monitor, and control outbreaks.

Breakthroughs:

Surveillance and Data Science: We are developing novel methods to provide unique insights on a range of key infectious diseases, to support surveillance systems such as near-real time syndromic surveillance to understand which infectious agents are causing changes in healthcare presentations. Our data and evidence synthesis aim to deliver the best available insights and evidence to decision makers on a range of infectious disease threats; ranging from antimicrobial resistance, surveillance of neglected tropical diseases or vaccination strategies to health protection parameters of infectious diseases. We investigate the use of new methodologies such as machine learning to identify changes in levels of infectious diseases from what is expected, enabling rapid public health interventions, or predict winter health care pressures.

Epidemiological Predictions for Policy: Throughout the COVID-19 pandemic, Warwick researchers provided a range of projections and analyses to the UK government including: short- and medium-term projections such as the Roadmap to reopening documents in 2021; the role of schools in the spread of infection; the risks associated with universities and other closed setting; and the spread of novel variants (from Alpha to Omicron). We are currently working closely with UKHSA and DEFRA on analysis zoonotic spillover potential of highly pathogenic avian influenza (HPAI). Our work has international reach as we have worked closely with researchers at the KEMRI-Wellcome Trust Centre to provide similar assistance to the Kenyan Ministry of Health, with the Department of Health in the Philippines on the development of integrated bite case management protocols to support the elimination of canine rabies and on strategies to minimise zoonotic transmission of HPAI in Bangladesh and Thailand. We also work on the control of Neglected Tropical Diseases. Of particular note is the HATMEPP (Human African Trypanosomiasis Modelling and Economic Predictions for Policy) project, funded by the Bill & Melinda Gates Foundation, which supports ongoing global interventions to eliminate gambiense human African trypanosomiasis (gHAT or sleeping sickness).

Genomics for outbreak investigation: We have been developing a toolbox made of several methods for the analysis of pathogen genomic data. This includes methods to reconstruct phylogenies, estimate ancestral dates, detect outbreaks, reconstruct transmission trees, identify imports, analyse antibiotic resistance dynamics.

Challenge Lead

Dan Todkill

Challenges

Combat Antimicrobial Resistance

Antimicrobial resistance (AMR) poses a significant threat to global health, as it makes infections more difficult to treat and increases the risk of disease spread, severe illness, and death. Drug resistant microbes have caused a significant increase in the number of infection-related deaths and have severely impacted healthcare systems worldwide.

AMR is a complex problem that spans across disciplines. Better surveillance and tracking of infections, discovering new effective drugs, developing sensitive diagnostics and efficacious vaccines, along with policy development and social education are all essential in combatting AMR. Interdisciplinary solutions are hence crucial in successfully addressing this threat.

We have a community of researchers across different disciplines at UoW active in the area of AMR research. The Warwick Antimicrobial Interdisciplinary Centre (WAMIC)brings expertise from across the University together to develop cross-disciplinary solutions to AMR. The Sir Howard Dalton Centre conducts interdisciplinary, cross-scale mechanistic enzymology with a focus upon translation and science policy to help tackle AMR. The Warwick Antimicrobial Screening Facility is primed to aid in the discovery of new antimicrobial and anti-fungal treatments.

Breakthroughs:

Drug discovery: Our research encompassing cutting edge enzymology in vitro, and in vivo, structural approaches in silico has led to several discoveries of new drug targets and novel drugs. We are also exploring innovative approaches like phage therapy and nanoparticles for effective delivery of available drugs to intracellular bacteria and biofilms.

Understanding pathogen biology and host interactions: Our current research utilises cutting-edge molecular and cellular technologies including advanced microscopy to study bacterial physiology and drug targets, and mechanisms of drug resistance. We employ novel in vitro and in vivo models of infection to study complex host-pathogen and microbiome interactions.

Challenge Lead(s)

Dr. Meera Unnikrishnan

Prof. David Roper

Challenges

Accelerate Vaccine Development and Immunotherapy

The development and implementation of vaccines is essential to prevent infectious diseases and control new outbreaks. Immunotherapeutics holds immense promise in the treatment of other intractable diseases such as cancer.

Currently vaccine and immunotherapy development can be costly and time consuming. Accelerating the development and implementation of broadly protective vaccines will allow for improved intervention to target variable and hard to treat pathogens and protect populations worldwide. The development of novel immunotherapeutics promises to provide treatments for current intractable diseases.

Breakthroughs:

We currently have research on going in the areas of (1) nucleic acid and drug delivery system development spanning polymer technology of molecular syringes, and (2) the next generation broadly protective vaccines RNA viruses.

For the last decade we have provided advice to the Department of Health and the Joint Committee on Vaccination and Immunisation (JCVI) on the cost-effectiveness of vaccination policies. Our work was instrumental in the introduction of gender-neutral vaccination against Human Papillomavirus, and in the targeting and deployment of COVID-19 vaccines.

Challenge Lead

Craig Thompson

Challenges

Development of unique diagnostics for early detection, prevention and monitoring of infectious diseases

Appropriate patient care, disease surveillance and effective public health responses all hinge on accurate and timely diagnosis of infection or disease. As a major driver of health and economic outcomes, diagnostics therefore represent a core pillar of global health security and universal health coverage, as well as being a fundamental component of functioning health systems.

Breakthroughs:

At Warwick, in partnership with UCHW, we have a programme of work which aims to develop novel diagnostics tests to improve the early and accurate detection of pathogens and diseases. Examples include the use of bacteriophages, E-Nose technology, genomics, waste-water surveillance, as well as the development of new lateral flow and PCR-based tests.

Challenge Lead

Nicole Robb

Challenges

Develop practical solutions for prevention and control of infectious disease using one health approaches to improve global health

Infectious diseases disproportionately affect low- and middle-income countries, exacerbated by limited healthcare infrastructure and resources and infrastructure are limited. The challenge is to reduce these health disparities by using research to inform policy and improve access to prevention, diagnosis, and treatment.

Understanding the risk to global health posed by these infections requires a holistic approach that considers all the involved populations and the potential routes of transmission. A one health approach encourages working across human, animal and environmental health to improve global health. We have researchers involved in supporting disease elimination and eradication goals, combatting neglected tropical disease and conducting field studies across the world.

Breakthroughs:

Healthcare in low resource settings: We have developed REmote Consulting in Healthcare (REaCH) training to optimise healthcare delivery the limited digital/telecoms infrastructure in Africa to deliver a safe and trustworthy healthcare equivalent of face-to-face consultations in low resource settings, allowing for continued care during the COVID-19 pandemic. We have also worked with international partners to shorten multidrug resistant tuberculosis treatments providing cost-effective alternatives in low resource settings.

Neglected Tropical Diseases: We have supported disease elimination efforts through modelling methodologies and analysis of elimination programmes against Gambiense Human African Trypanosomiasis, and Yaws. We have also supported the WHOs goals for eradication of Lymphatic filariasis through modelling which has led to discovery for enhanced drug administration methods.

Animal Disease and Zoonosis: We have developed novel approaches to prevent disease which have been used in field studies internationally. Our tools are able to capture and model the spread of livestock diseases and has ultimately aided efforts to control of Avian influenza (Bangladesh and Thailand) and Foot and Mouth disease (Denmark and USA) in rural and farming communities. Field studies in collaboration with the Brazilian Ministry of Health have disrupted zoonotic transfer of the parasite Leishmania infantum through its vectors, which is expected to lower the infectious transfer to dogs and humans thus reducing the incidence of visceral leishmaniasis.

Challenge Lead

Mike Tildesley