To listen to the entire conversation, please follow the link to CBC Manitoba: Up to Speed.

To read the full article, please visit Nature. 

“We’re seeing evolutionary changes within the virus that’s suggestive of increased human transmission… and we’re seeing the changing demographics in this one specific region of Congo,” said Dr. Jason Kindrachuk, an associate professor in infectious disease at the University of Manitoba in Canada and co-author of the paper.

“This is very important, because it’s suggestive of a change in the epidemiology [distribution] of the disease,” he told the Telegraph. 

To read the full story with Dr. Kindrachuk, please visit The Telegraph.

“Once the mosquito habitat is established, it only takes one or two people to bring the virus into that habitat for the mosquito to [spread it],” said Dr. Amila Heendeniya, a clinical infectious diseases physician at the Winnipeg Regional Health Authority and an assistant professor at the University of Manitoba.

Read here

Cameron ended up being diagnosed with both meningitis and encephalitis, two dangerous forms of brain inflammation, and spent a month in a Toronto hospital. Medical teams didn’t know why her son got sick, until lab reports later revealed a culprit McKissock had never heard of before: Jamestown Canyon, a viral infection carried by mosquitoes.

McKissock was stunned. “They asked us if we traveled, if we had gone anywhere or did anything,” she said. “And we said the only place we have been is our backyard.”

In recent decades, scientists began seeing more urban transmission, outside the typical insect ranges, said Dr. Amila Heendeniya, a clinical infectious diseases physician at the Winnipeg Regional Health Authority and an assistant professor at University of Manitoba.

“Something is changing,” he said, “either [through] climate change, the environment, and the urban sprawl — how we’re getting closer and closer to the woods.”

Read here

The situation is much worse in other countries such as Ukraine, where there were more than 100 cases of botulism reported in 2017, with 11 deaths. Most of these fatalities were due to eating improperly cooked or stored food at home. In 2015, a victim in Slovakia fell ill after eating botulism-tainted hummus and went into a coma.

‘Emergent BioSolutions produces the botulism antitoxin for both public and government use’

Fortunately, if botulism is diagnosed early enough, it can be treated with antitoxin. In Ukraine, an international effort produced a supply of botulism antitoxin and rushed it to victims there. This antitoxin was produced in Winnipeg at Emergent BioSolutions, a global life sciences company physically located on the campus of the University of Manitoba.

Emergent comprises a huge set of buildings in SmartPark at the U of M. A highly-secure facility, its mandate is to “provide specialty products for civilian and military populations to address accidental, intentional, and naturally occurring public health threats.”

Although headquartered in Maryland, one of its largest footprints is here in Manitoba, employing more than 350 technicians, researchers, and professionals, and also training graduate students in fields related to biotechnology. Emergent partners with the university to provide real opportunities for new graduates seeking to gain experience in their fields of study.

Dr. Laura Saward is senior vice-president, antibody therapeutics business unit head for Emergent BioSolutions in Winnipeg.

At the U of M site, Dr. Laura Saward is Emergent’s senior vice-president, antibody therapeutics business unit head.

A U of M graduate (PhD/00), Saward is an adjunct professor in the Rady Faculty of Medicine department of microbiology and infectious diseases.

Before joining Emergent, Saward had been chief scientific officer and vice president of research and development for Cangene, where she developed and licensed products and oversaw government contracts for the U.S. Strategic National Stockpile that includes: Heptavalent botulism antitoxin, Vaccinia immune globulin, and Anthrax immune globulin.

Cangene was originally majority-owned by Canadian pharmaceutical company Apotex and was acquired by Emergent in 2014.

“It has long been an interest by the American government to have something that could be used against a bioterrorism attack, so we worked initially with the Centers for Disease Control and Prevention and then with the U.S. Department of Health and Human Services to license an antitoxin that would treat all types of botulism toxin. Emergent produces the botulism antitoxin for both public and government use,” says Saward.

In addition to botulism antitoxin, Emergent has developed a number of products that have been commercially produced, including some for military use.

One of these is a reactive skin decontamination lotion kit (RSDL) that can be applied to skin affected by chemical agents, to remove or neutralize chemical warfare agents and T-2 toxins such as Fusarium mold that can be absorbed through the skin.

It is the only decontaminant that neutralizes or removes known chemical warfare agents from skin. Emergent also has developed vaccines against anthrax and smallpox, as well as a Star-Trek-like auto-injector device containing an antidote for nerve agents.

Buffer preparation tanks in the Emergent BioSolutions facility in Winnipeg.

Saward explains: “Beyond the antibody therapeutics, we have vaccines and antivirals, as well as medical devices to address various kinds of chemical and biological threats, and emerging infectious diseases such as Zika and Ebola.”

Emergent is also working on fighting the common flu.

In fact, on Jan. 4, 2018, the company announced human trials of its anti-influenza immune globulin product being developed as an intravenous treatment for serious illness caused by influenza A infection in hospitalized patients.

“In our quest towards our mission – to protect and enhance life – Emergent has an opportunity to progress a novel therapeutic that could potentially address this unmet need and provide a treatment option for these patients where influenza can cause serious disease and even death,” says Saward.

Throughout her career, Saward has acquired a broad range of expertise in biology and medicine.

“I’ve had very different types of research focus,” she says. “I started in cancer research, worked for many years in cardiovascular, then moved into the field of infectious disease. They all have very common elements even though they seem diverse because they address cellular processes, and I’ve been able to translate my knowledge.”

She adds: “I’ve always had the overarching goal to have a career that would make a difference in human lives, and provided value for my research. I chose industry for those reasons and was less focused on a specific area of research and more involved in developing drugs and bringing them to market. It’s very rewarding to have been involved in several drugs that have made it to market in this way.”

Around the world, botulism continues to be a serious health threat. A 2017 report from the International Society for Infectious Disease described an outbreak of botulism in Slovakia, and in late 2017, the Canadian Food Inspection Agency (CFIA) issued warnings about some products made from lake trout and sold across Canada. One illness was reported and the CFIA was concerned that trout roe and some smoked fish may have had the botulism bacterium.

Fortunately, the antitoxin that could save the lives of people affected by the lethal disease is produced in Winnipeg, and can be rushed to the scene of outbreaks wherever it is needed.

“This is a good example of how the commercialization of research can benefit people around the world,” Saward says.

It was a surprising observation for a team of researchers studying sexually transmitted diseases among prostitutes in a Nairobi slum in the early 1990s: Despite being continuously exposed to HIV through unprotected intercourse with myriad partners, a small number of the women appeared to be resistant to the deadly virus.

For Keith Fowke, a University of Manitoba graduate student with the group who would later write his PhD thesis on the topic, it was the start of a journey that appears to be yielding a weapon in the fight to prevent AIDS. At root was the finding that those female sex workers in the Pumwani slum were apparently protected by inactive immune cells in the genital tract, preventing HIV infection.

Today, as head of the Department of Medical Microbiology and Infectious Diseases at the University of Manitoba and a visiting scientist at the University of Nairobi, much of Dr. Fowke’s research has focused on the interaction between HIV and the immune system. A key conclusion involves the importance of “immune quiescence,” the somewhat counterintuitive finding that “if you have immune cells in the genital tract that are resting and HIV comes into contact with them, it is not able to establish an infection in those cells.”

Dr. Fowke is currently studying a relatively safe, cheap and available anti-inflammatory substance that can have a quietening effect on these immune cells and reduce the risk of HIV transmission: Aspirin.

Read the full story here. 

“It goes one of two ways: Some people think it’s really cool and some stay away from me,” Wong says.

The unassuming 31-year-old scientist is part of the University of Manitoba contingent who works with Canada’s National Microbiology Laboratory and found a treatment for people infected with Ebola. During the summer of 2014, with all eyes on the outbreak in West Africa, the group announced an even more effective cocktail of antibodies than their headline-grabbing mixture from two years earlier. They showed all of their lab’s monkeys could be saved up to five days after infection, even if they were already severely ill.

Gary Wong, a doctoral student, part of a team led by Gary Kobinger which performed the experiments to reverse advanced Ebola infection.

“It was very exciting, considering that for the longest time people have been saying that you can’t use antibodies to treat Ebola, that you need more than just antibodies. So it was very satisfying to show that, yes, they can be used,” says Wong, who grew up in Vancouver.

He did the research as part of his PhD, under medical microbiology associate professor Gary Kobinger.

“It was kind of like, ‘Wow, this works,’” says Wong. “We might have something significant on our hands. It kind of builds up and then you realize the implication of it all.”

Doses of the life-saving treatment, derived from the tobacco plant and dubbed ZMapp, have since been shipped to hard-hit West Africa and used to help save infected patients returning to developed countries—including the first faces to make the news, American doctor and missionary Kent Brantly and nurse Nancy Writebol.

The vaccine to prevent Ebola infection is also a U of M discovery, dating back to 2005.

Eight hundred vials have been shipped overseas to help curb the outbreak, which has already killed 5,000 and infected more than twice that number. Kobinger and his group run a mobile diagnostic unit on the frontlines in Kailahun, Sierra Leone, testing patients’ blood. They’re among the few worldwide who know how to work safely with the virus. Back in the lab, they’re focused on finding ways of maximizing lives saved with a limited number of antibodies, which are expensive to produce. “It is difficult to produce a sufficient amount to combat the outbreak,” says Wong. “The supply hasn’t caught up with the demand yet. It takes a little bit of time because it’s still a very new technology.”

U of M infectious disease researchers first tackled Ebola more than a decade ago. They must work ahead of the curve, securing funding for potential threats most people have yet to hear about, says Keith Fowke, department head of medical microbiology.

Keith Fowke, department head of medical microbiology.

“We don’t have a crystal ball so we don’t know what it’s going to be next,” he says. “One of the biggest challenges is that some of the pathogens that we’re trying to work with mutate so quickly that they are always evading the drugs we develop.”

Could Ebola, spread through contact with bodily fluids, become airborne? “It’s not impossible, but it’s not probable,” says Fowke.

The quickly mutating HIV has never gone airborne despite having been around for decades, he notes.

Wong and Fowke don’t anticipate Ebola becoming an epidemic in North America, but the outbreak serves as a bold reminder of the importance of having good medical systems worldwide.

What concerns Distinguished Professor Emeritus Allan Ronald, a pioneer in HIV/AIDS research, is that no one knows exactly how precaution-taking health care workers are becoming infected with Ebola. One of Ronald’s good friends—an American doctor in his 40s who he worked with in Uganda—contracted Ebola in Sierra Leone and is fighting the illness from an Atlanta hospital bed. “He was not someone who took unnecessary risks,” said Ronald in a phone interview from Cape Town, South Africa. “It’s terrible seeing your colleagues dying of something.”

The ongoing battle against HIV/AIDS

Colleagues credit Ronald with helping to create the discipline of infectious disease at the U of M and across Canada. He is on his 85th visit to Africa. His first was in 1979. Having dealt successfully with an outbreak of genital ulcers in Winnipeg, Ronald was asked by the University of Nairobi to help out with similar symptoms they were seeing in their patients.

Allan Ronald, a pioneer in HIV/AIDS research. Credited with helping to create the discipline of infectious diseases at the U of M and across Canada.

Ronald and his student, Frank Plummer—who would go on to become the scientific director general of the National Microbiology Lab—were among the first researchers to uncover HIV in Kenya in the early 1980s. In the beginning, there were so many unknowns. Ronald recalls an airline attendant, likely an AIDS victim, coming to the hospital with a horrible neck tumour blocking his trachea and within three days he was dead. “It was difficult because we didn’t know what caused it and there were all kinds of myths and hypotheses that weren’t true. People were afraid to provide care,” Ronald recalls.

Their studies were the beginning of an international collaboration that spans more than three decades and involves a growing number of researchers. The U of M-Nairobi partnership, which has received millions in funding from the Bill and Melinda Gates Foundation, has produced findings that changed the way the world thought about HIV, revealing it can be spread heterosexually and from mother to child through breastfeeding; and determining that sexually transmitted diseases like gonorrhea and chlamydia make it easier to be infected.

Research led by U of M professor Stephen Moses showed circumcision reduces men’s risk of infection by a whopping 60 per cent. This captured headlines—Time magazine heralded it as the most important medical breakthrough of the year in 2007—and helped kick start programs to expand male circumcision services throughout eastern and southern Africa. “It’s having a huge impact,” says Fowke.

In the late 1980s, Fowke was Plummer’s graduate student when the pair discovered that some Kenyan women, all of them sex workers, were naturally immune to HIV infection. Fast forward to 2014, and Fowke and his team have findings that suggest the women’s cells were in a resting state and that the virus prefers infecting highly active immune cells. They have used this insight to identify what could be the next major weapon in the war on HIV, found in an unlikely source: Hydroxychloroquine, an anti-malaria pill, and everyday Aspirin. Preliminary data, funded by Grand Challenges Canada and the Canadian Institutes of Health Research, shows the two anti-inflammatory drugs—both inexpensive and safe candidates for widespread use in developing countries—encourage a resting state, reducing the number of cells for the virus to target in the blood. Fowke wants to create a drug-delivering, internal vaginal ring which women would insert monthly to limit the number of target cells in their genital tract. “It’s a brand new prevention strategy,” Fowke says. “It’s something that people could do on their own, and that’s been proven safe and can be a brand new mechanism of trying to reduce the risk of HIV infections.”

“There will always be new micro-organisms, viruses, bacteria, fungi, parasites, so we’ve always got to be prepared for the unknown.”

Historically, prevention strategies developed in Kenya have been unrolled on an even larger scale in other parts of the world, including India and Pakistan. (Some of which are led by James Blanchard, the director of the university’s Centre for Global Public Health).

But there’s no one-size-fits-all solution, cautions Fowke. It’s vital that safe-sex messaging is modified to what works in a specific region and delivered by local experts. One way of educating locals is bringing them to the Bannaytne campus as medical microbiology PhD students. When they return, they’re better equipped to take on the plights of their countries and teach the generations that follow. “We’re really building up capacity,” Fowke says.

People are under the false impression that the HIV global pandemic is under control—it’s not. There are two million new infections annually, with 5,000 dying daily, he notes.

Predicting what’s coming next

Health workers screen people for the deadly Ebola virus in Sierra Leone. Photo by Michael Duff, Associated Press

Fowke first heard of the latest Ebola outbreak while tying up his skates for a game of shinny at a Winnipeg rink with some colleagues from the National Microbiology Lab. At the time, no one yet knew its true scale.

What other threats lurk below our radar? It’s hard to say when a virus could transfer from animal or insect to human at any given moment. (There is speculation that the first casualty of the latest Ebola outbreak—a two-year-old boy in Guinea—contracted the virus from a fruit bat.) Marburg hemorrhagic fever, a killer as ruthless as Ebola with two of its largest outbreaks in Germany and Serbia, has no vaccine or treatment available. Recently, two American backpackers contracted Marburg while backpacking in Uganda and brought it home to Colorado and the Netherlands. Wong suspects they caught it from an animal by doing something as simple a scraping themselves on a rock. Scientists are also monitoring the tropical, mosquito-born chikungunya virus that has reared its head in Africa, Asia, Europe, India and the United States, causing fever and severe joint pain. One of the newest and most worrisome viruses is D-68, a cold-like illness that has caused paralysis in some and killed more than a handful of people across North America.

Fowke admits science still doesn’t fully understand why the common flu sometimes kills perfectly healthy kids or adults. “We don’t know if it’s something unique about the virus or something unique about their immune system. I believe it’s a combination of the two.”

The only virus successfully eliminated to date is smallpox. Tuberculosis goes back to Egyptian times yet still runs rampant in First Nations communities in Manitoba. Polio still pops up in parts of Africa and there is even the occasional report of the flea-born plague, which wiped out one third of Europe and is now easily treated with antibiotics. A misuse of the latter will make our fight against illnesses going forward increasingly difficult, notes Ronald.

“There will always be new micro-organisms, viruses, bacteria, fungi, parasites,” he says. “So we’ve always got to be prepared for the unknown.”

Story originally appeared in the Winter 2015 issue of Research Life.