INSTITUTE OF INFECTION AND GLOBAL HEALTH ANNUAL 2019 REPORT INTRODUCTION CONTENTS It gives me great pleasure to introduce this infection and global health threats, and we annual report, as I complete one year as will continue to develop internal and external Dean of Institute. The past 12 months has partnerships to achieve this. 4 Global Change seen the Institute make strong progress Over the past year, the Institute has made against each of its five research challenges, several strategic appointments to support and this report describes some of those 6 Food Security its research challenges, including of both achievements. established and early career researchers. This year’s report also contains a special The Institute has also supported several 8 Antimicrobial Resistance feature to mark the 70th Anniversary of successful Fellowship applications. Career the NHS; several case histories detail the development of all staff and students will 10 NHS at 70 Institute’s contribution to tackling the continue to represent a vital part of our burden of infectious diseases in Merseyside. strategy. 12 Diagnostics Veterinary infection research in Liverpool Finally, I would like to thank all staff, both also has a notably long and distinguished academic and professional services, for history, and a distinctive feature of the 14 Vaccines their continued hard work and exceptional Institute’s strategy is to address its contributions. I hope you enjoy reading challenges by bringing together Liverpool’s 16 Our People this report and I look forward to another medical and veterinary researchers in exciting year ahead. a “One Health” approach to infection. 18 Public Engagement Multidisciplinary working is essential to Professor Nigel Cunliffe comprehensively tackle the world’s major 2017/18 Research Income £10.6M INSTITUTE OF INFECTION AND GLOBAL HEALTH (IGH) MAJOR CHALLENGES Department Department of Clinical Department of 2016/17 of Infection Infection, Microbiology Epidemiology and Biology and Immunology Population Health 2015/16 £10M 1 GLOBAL CHANGE £9.9M Theme 1 Understanding how pathogens cause disease FOOD SECURITY Theme 2 Pioneering diagnostics, treatments and vaccines 2 ANTIMICROBIAL 2014/15 Theme 3 Enhancing food safety and security 3 RESISTANCE £9.3M RCUK Theme 4 Tracking emerging and zoonotic infections £1,977,227 Research Themes Research 4 DIAGNOSTICS Theme 5 Improving the health of pets, working animals and their owners 5 VACCINES Non-UK & other Research The Institute is organised into three departments with cross-cutting research themes. Through them £2,828,748 Awards we are addressing the five major research challenges identified in our strategic plan. 2017/18 Image on cover shows mammalian cells infected with Zika virus. Infected cells appear round Total: £9.1M and slightly detached in comparison with elongated healthy cells. Gaps show where cells have UK Industry been destroyed due to viral infection. Credit: Shona Moore, Postdoctoral Researcher £90,363 UK Charities £2,325,666 UK Govt & Health £1,889,393 MAJOR CHALLENGE 1 Zoonoses in Livestock in Kenya (ZooLinK) Parts of East Africa are currently experiencing cases of Rift Valley Fever, an GLOBAL CHANGE acute, fever-causing viral disease that is transmitted by insects and usually seen in livestock but can also infect humans. The current cases are thought to result in part from unusual weather patterns that allowed proliferation of the mosquito vector. ZooLinK is a collaborative project that aims to enable Kenya to develop an effective surveillance programme for such zoonotic diseases Rapid climatic, environmental and societal changes are (diseases transmitted between animals and humans). Recent research from the team, led by Professor Eric Fèvre, measured antibodies to the disease in leading to the emergence of new diseases and the spread people in western Kenya, a tropical region where transmission was assumed not of existing ones. The Institute is providing evidence to help to occur. The research showed that while low, there was a risk of local infection and that in particular, certain occupational animal exposures such as working in a predict and mitigate the impacts of climate, environmental, slaughterhouse in this region were particularly risky. During this year’s outbreak and societal change on human and animal health. of Rift Valley Fever in Kenya, at least one slaughterhouse worker contracted the disease and died. The results highlight the need to expand existing climate based risk models to account for occupational risks and animal movement networks, and recommendations have been fed in to national decision making processes in Kenya. Further zoonotic disease surveillance activities are essential to enable early detection of such transmission events. Cook E, et al. PLoS Negl Trop Dis. 2017;11:e0005731 Epidemic of bloodstream infections currently killing around First case of oriental eye Single DNA change 400,000 people worm reported in UK in Salmonella linked each year Researchers have diagnosed the UK’s first to deadly African known case of canine oriental eyeworm in a dog that had been recently imported epidemic from Romania. The disease is caused by a A single genetic change has been The Institute’s Professor Melita Gordon vector-borne parasite (Thelazia callipaeda) identified in Salmonella that is playing a who was involved in the project, and who and is spread by the males of a species of Vapers are vulnerable to key role in the devastating epidemic of first described the epidemics of disease fruit fly Phortica( variegata) that is found in bloodstream infections currently killing caused by ST313 strains in Africa, said: the UK. Documented cases of the disease pneumococcal infection around 400,000 people each year in sub- “The ability of Salmonella strains to cause have been growing across several European Saharan Africa. The collaborative study, led such serious disease leads to devastating countries including France, Italy, Spain, Whilst the impact of tobacco smoking on by Professor Jay Hinton at the University’s and frequently fatal consequences for Greece, Croatia and Romania, but until now health has long been known, the impact of Institute of Integrative Biology, has very young children, and for adults who there have been no recorded cases in the using e-cigarettes is less clear. However, identified a single nucleotide difference may be the chief breadwinners in their UK. Lead author of the report, John Graham- new research by Professor Aras Kadioglu that is unique to the African ST313 strain homes and communities. It is now urgent Brown said: “This case raises awareness of and colleagues has shown that exposure and causes high expression of a virulence that a vaccine is developed to combat this a new imported disease and highlights the to inhaled e-cigarette vapour significantly factor called PgtE that prevents Salmonella dangerous infection.” ongoing risks associated with pet travel and increases colonisation of bacteria in the being killed in the bloodstream. Hammarlöf D, et al. PNAS. 2017;115:E2614-E2623 importation, and the need for vigilance when mouse nasopharynx, making them more examining these animals.” susceptible to invasive pneumococcal Graham-Brown J, et al. Vet Rec. 2017;181(13):346 disease. Increased bacterial adherence to airway lining cells is caused by e-cigarette consultations collected from UK veterinary vapour increasing the level of Platelet- Targeted advice for practices to identify the risk factors for Activating Factor Receptor (PAFR), a deadly rabbit disease flystrike across the nation. molecule which pneumococcal bacteria use it remains difficult for researchers to understand the circumstances One of the key findings was to precisely Assessing the burden of dog bites to stick to airway cells, and subsequently leading up to dog bites, with most studies relying on evidence Flystrike is a serious condition for pet define the impact of temperature on disease invade body tissues and cause disease. collected after bites happen. In a new study researchers have, for rabbits, and is caused by larvae of the green risk. For every 1°C rise in the average local Preventing dog bites is an increasingly recognised public health Professor Kadioglu said: “Our studies show the first time, used YouTube videos to directly observe and analyse bottle fly feeding on the surface of the skin. temperature, there was a 33% increase and political issue with implications for both human and animal health that vaping significantly increases PAFR This can lead to severe tissue damage, and welfare; it is of particular importance in Merseyside which has the dog bites in situ. expression in the mouse nasopharynx, in the risk of flystrike, with risk peaking secondary bacterial infections and may between June and August. Rabbits over highest number of dog-related injuries and deaths in the UK. Lead author of this study Sara Owczarczak-Garstecka said: “Online which is consequently associated with result in death of the animal. It is completely the age of five were also more likely to be Dog bite studies usually rely on hospital records, but research led videos present us with an unexplored opportunity to observe dog increased bacterial colonisation density. preventable and is treatable if identified affected.Professor Alan Radford, who leads by Dr Carri Westgarth has shown that the actual number of dog bites first-hand, something which is just not possible using other As pneumococcal disease is preceded early, however there is a lack of awareness SAVSNET, said: “These results can be used bites may be much higher than hospital records indicate, with only methods. Making more use of this type of shared content for by colonisation of the nasopharynx, vape amongst rabbit owners. induced expression of PAFR may be for targeted health messaging to reduce 0.6% of people in the study who had been bitten requiring hospital research could help us better understand how and why bites occur clinically significant and lead to increased The University’s Small Animal Veterinary the impact of this deadly disease for rabbits, admission.