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The ecology of disease

Medicine@Yale, 2016 - Sept Oct


From the flu to Ebola, predicting and then stifling pathogens’ spread

Alison P. Galvani, Ph.D., the Burnett and Stender Families Professor of Epidemiology, has devoted her research career to tracking diseases, and to transforming data into predictive maps and practical policy recommendations. So distinguished is her body of work that in 2015, at age 38, Galvani became the youngest-ever appointee to an endowed professorship at the School of Medicine.

When Galvani was just 5 years old, growing up in San Francisco, her mother—a clinical psychologist—died. According to Galvani, her grief instilled in her an abiding passion for helping the downtrodden and orphaned.

When she was in high school, a copy of Richard Dawkins’ book The Blind Watchmaker sparked her interest in evolutionary biology. Galvani took it upon herself to write a letter to Dawkins challenging some of his premises and outlining some of her own ideas about evolutionary processes. Dawkins praised Galvani in his reply and encouraged her to apply to the University of Oxford for an undergraduate degree in biology.

Galvani not only took his advice, but remained at Oxford to pursue a doctorate under theoretical biologist Robert May. Following a postdoctoral fellowship at the University of California, Berkeley, she came to Yale as a junior faculty member. By that time her pioneering work in behavioral epidemiology—how human behavior leads to and affects disease transmission—was well underway. “I’m fascinated by the power of mathematics to contribute in very practical ways to the benefit of society,” she says.

Galvani’s team at Yale has conducted international investigations into the transmission of HIV, influenza, Ebola, and Zika, among other pathogens. “We are most interested in projects that have the potential to improve policy and save lives,” she says. Her work on influenza and rotavirus has led to concrete policy changes and made vaccination programs in Israel and the United Kingdom more cost effective.

Galvani established the Center for Infectious Disease Modeling and Analysis (CIDMA) within the School of Public Health in 2014, shortly before the Ebola epidemic hit western Africa. When it did, she offered her team’s help in understanding the disease’s dynamics to Liberia’s health ministry, which welcomed the aid. Galvani and her colleagues worked tirelessly to generate models to capture the level of virus in patients, the patients’ survival outcomes, and the social behavior of affected families, all of which formed the basis for effective ways to stem the epidemic. Their predictions of the impact of combined interventions—published in the journal Science—forecast trajectories of the epidemic in Liberia with remarkable accuracy.

Galvani’s team also developed a smartphone app to track the location of symptomatic patients. Previously, with only pencil and paper to do that job, the arrival of ambulances had been delayed by as much as several days. With resources in Liberia severely limited, CIDMA contributed more than 30 computers and phones to the Ebola response team so that the mobile application could function. Patients received hospital care far more rapidly, improving recovery rates and curtailing further transmission.

Galvani has received numerous honors including the Blavatnik Award for Young Scientists from the New York Academy of Sciences, the Bellman Prize, and a Guggenheim Fellowship.

Throughout her career, as she has managed students and postdocs, and raised three children in a home that also includes a dog and a full chicken coop, Galvani has continued to apply the lessons of evolutionary biology that she first learned from Dawkins. “The same principles of ecology and species conservation apply, but in reverse,” she says. “In disease systems, we want to drive the parasite species extinct.”

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