May 032020

Published in Hawai‘i Journal of Health & Social Welfare, May 2020, Volume 79, No. 5, ISSN 2641-5216.

Authors: Lauren Ching BS, Sandra P. Chang, PhD, and Vivek R. Nerurkar, PhD; Department of Tropical Medicine, Medical Microbiology, and Pharmacology and Pacific Center for Emerging Infectious Disease Research, John A. Burns School of Medicine, University of Hawai‘i at Manoa, Honolulu, HI


Nationwide shortages of tests that detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and diagnose coronavirus disease 2019 (CO- VID-19) have led the US Food and Drug Administration (FDA) to significantly relax regulations regarding COVID-19 diagnostic testing. To date the FDA has given emergency use authorization (EUA) to 48 COVID-19 in vitro diagnostic tests and 21 high complexity molecular-based laboratory developed tests, as well as implemented policies that give broad authority to clinical laboratories and commercial manufacturers in the development, distribution, and use of COVID-19 diagnostic tests. Currently, there are 2 types of diagnostic tests available for the detection of SARS-CoV-2: (1) molecular and (2) serological tests. Molecular detection of nucleic acid (RNA or DNA) sequences relating to the suspected pathogen is indicative of an active infection with the suspected pathogen. Serological tests detect antibodies against the suspected pathogen, which are produced by an individual’s immune system. A positive serological test result indicates recent exposure to the suspected pathogen but cannot be used to determine if the individual is actively infected with the pathogen or immune to reinfection. In this article, the SARS-CoV-2 diagnostic tests currently approved by the FDA under EUA are reviewed, and other diagnostic tests that researchers are developing to detect SARS-CoV-2 infection are discussed.

Mar 092020
  • Strengthening Collaborations in Liberia
  • Northern Pacific Global Health (NPGH) Program
  • Dr. Frederick DeWolfe Miller’s Retirement Celebration
  • Congratulations to the Award Winners
  • Vietnamese Scientist Visits Pacific Center for Emerging Infectious Diseases Research, JABSOM
  • MHRT 2020
  • New Faces at the Department of Tropical Medicine, Medical Microbiology and Pharmacology
  • One Health Interdisciplinary Undergraduate Certificate Program
Feb 072020

As Hawaiʻi is a hotspot for Non-Tuberculosis Mycobacteria (NTM) pulmonary disease, the Hawaiʻi NTM Education and Research Conference was hosted by the National Jewish Health (NJH) and ʻIolani School on Feb. 1-2, 2020 to help educate and spread awareness of NTM lung disease to Hawaiʻiʻs students, scientists, health care providers, and the general public.

Photo of participants in NTM conference

The National Jewish Health team, led by Dr. Jennifer Honda, an Associate Professor and TRMD graduate faculty, established one of the largest citizen scientist projects in NTM including an outreach network of Hawai’i high school students, undergraduates, and their mentors from 11 different schools and involving more than 400 local students. Their goal is to understand the environmental, host, and microbial factors driving the emergence of this lung disease in the Hawaiian Islands. Volunteers also included local adult volunteers and family members of NTM patients, who act as citizen scientists to help collect > 2,000 household and non-household environmental samples from Oahu, Kauai, Hawai’i Island, and Maui. NJH also partnered with local pulmonologists and infectious disease physicians to obtain matched respiratory NTM isolates and environmental samples from NTM patients. By understanding the diversity of NTM in these environmental and respiratory samples, potential source points of infection can be identified and mitigated.

The purpose of the two day conference was to share their findings with the students and mentors that have helped procure samples as well to explain to the Hawai’i community the step-by-step process of how NTM is sampled, processed and cultured, and genomically identified, and to show how this data relates back to what is observed clinically. The presentations also showcased the overwhelming scientific accomplishments that can be made when local communities, researchers, clinicians, and patients work together to understand this under-recognized lung disease of public health importance.

Sep 242019

Dr. Axel Lehrer, Assistant Professor in the Department of Tropical Medicine, Medical Microbiology, and Pharmacology, John A. Burns School of Medicine, has been awarded $2,500,000 from the Centers for Disease Control and Prevention (CDC U01GH002256-01-00) to support a global health collaboration between multiple colleges within the University of Hawaii system and institutions in Liberia. The title of the five-year project is “Epidemiology and Immunity to Ebola virus and Other Emerging Infections in Liberia”.

Faculty and Staff, RoleInstitution
Axel Lehrer, Principal InvestigatorUniversity of Hawaii at Manoa
Vivek R. Nerurkar, Co-InvestigatorUniversity of Hawaii at Manoa
John Berestecky, UH Project CoordinatorKapiolani Community College
Wei-Kung Wang, Viral ImmunologistUniversity of Hawaii at Manoa
Alan R. Katz, EpidemiologistUniversity of Hawaii at Manoa
Mosoka Fallah, NPHIL Principal InvestigatoryNational Public Health Institute of Liberia (NPHIL), Liberia
Fatorma Bolay, Senior Technical AdvisorNational Public Health Institute of Liberia (NPHIL), Liberia
John Dogba, Lead Laboratory DiagnosticsNational Public Health Institute of Liberia (NPHIL), Liberia
Thomas Nagabe, EpidemiologistNational Public Health Institute of Liberia (NPHIL), Liberia
Ophelia I. Weeks, UL Principal InvestigatorUniversity of Liberia (UL)
Peter Humphrey, UL Project CoordinatorUniversity of Liberia (UL)
James McClain, UL Technical Laboratory LeadUniversity of Liberia (UL)
Ilhem Messaoudi, UCI Principal InvestigatorUniversity of Califorinia, Irvine (UCI)

Abstract: Liberia, a resource rich but economically poor country, continues to struggle with growth and recovery following a 14-year civil war that destroyed its infrastructure. The 2014-16 Ebola Virus Disease (EVD) epidemic had a devastating impact in West Africa resulting in 10,678 suspected, probable and confirmed cases and 4,810 deaths in Liberia. As not all individuals infected with Ebola virus (EBOV) sought medical attention or received laboratory confirmation of EVD, the full magnitude of the outbreak is still unknown. While the West African outbreak permitted advancement of scientific inquiry into the natural history, sociobehaviorial context, and effectiveness of countermeasures for EVD, significant gaps in knowledge remain about post-Ebola sequelae, immune responses to Ebola virus infection and disease, and durability of immunity over time. Another subject of concern is the persistence of EBOV in immunologically protected sites of EVD survivors (and potentially undiagnosed Ebola virus infections). Persistent infection has resulted in sexual transmission of the virus and subsequent clusters of disease following the end of widespread transmission. This viral persistence combined with minimal available seroepidemiological surveillance data for Ebola and other viruses with epidemic potential in West Africa poses a continued risk for resurgence of Ebola virus infection or disease cases and the possibility of new clusters or large-scale outbreaks originating from previously reported or unrecognized infections.

In line with the mission of CDC, this project is aimed at establishing a serological baseline for a future surveillance platform, allowing the study of underlying etiologies, characteristics, and response to emerging infections. This will advance our combined knowledge on priority epidemic-prone viral diseases in Liberia, allowing development of strategies to prevent future outbreaks through a combination of conventional, targeted serosurveillance and disease and intervention modeling. We propose to address the overall research goals with the following four Specific Aims: (1) Develop and optimize virus-specific antibody-detection assays. Multiplex immunoassays for detection of antibody responses to relevant viral antigens will be further refined. (2) Establish assays to document cell-mediated immune responses in humans against emerging viral pathogens. Cell-mediated immunity in survivors of Ebola and Lassa virus infections will be documented using flow cytometry and transcriptome analysis to develop an immunological signature for these infections. (3) Determine a serological baseline of evidence of Ebola virus and other emerging viral infections throughout Liberia. Samples from all health districts in Liberia will be collected and analyzed for evidence of prior viral infections. (4) Conduct temporal assessment of the immune status and associated health outcomes in Ebola and Lassa virus symptomatic and asymptomatic survivors in comparison to the seronegative population. Following cohorts of persons previously infected with EBOV or Lassa virus will allow establishment of a time course for waning immunity to these priority pathogens.

Aug 092019

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A celebration of Dr. George Hui’s administration of the NIH NIDDK Pacific-STEP UP Program for the past 15 years was held on July 29th. Attending the celebration were Dr. Griffin Rogers and Dr. Lawrence Agodoa from the NIDDK, JABSOM Dean Jerris Hedges, representatives of the Office of US Representative Ed Case, Mrs. Hui, faculty and students.

The University of Hawaii at Manoa continues to develop the Pacific STEP-UP Program to provide research training and mentoring to underrepresented minority and disadvantaged high school students in the State of Hawaii, and the US Territories in the Pacific: American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau. For the past 5 years, Pacific STEP-UP has enrolled and trained 145 student interns in the NIDDK STEP-UP summer program, and exposed another 414 students to laboratory sciences during the school years. STEP-UP has helped build the capacity for laboratory research in the Pacific-based colleges (including personnel training) where little previously existed. Of 270 STEP-UP alumni tracked from as early as 2005, a great majority pursued college education with a science emphasis, and many also sought post-graduate training and terminal degrees. To date, Pacific STEP-UP remains the only formalized research training program for high school students in the greater US Pacific. A region with an urgent need to build and foster a pipeline of underrepresented individuals seeking health research and service careers and thus help combat health disparities.  With confidence that Pacific STEP-UP has established roots in the region, efforts continue to expand STEP-UP research training and mentoring.  STEP-UP continues to provide the NIDDK mandated research training/mentoring while raising community awareness of relevant health issues and the importance of “home-grown” healthcare researchers. Pacific STEP-UP has three Specific Aims. 1. Recruit the best qualified high school students (11th and 12th graders) from the seven US State and Territories in the Pacific into the STEP-UP Summer Research Program, and track the cohort’s academic progress for a minimum of 5 years. 2. Provide individualized summer research experience (and related education and training) that stresses local community or population relevance to the Pacific STEP-UP interns. Provide STEP-UP alumni with follow up, and research-focused mentoring extending for 9 months. 3. Seed and cultivate interests in laboratory sciences in the Pacific high schools while strengthening local colleges’ capacity to enable and sustain laboratory and community-based research in support of the Pacific STEP-UP training program.