Working With Young Clinicians to Identify, Treat Vector-Borne Diseases

We are continuing our new series, Media Day, where we spotlight individual medical institutions and their infectious disease (ID) programs. This episode profiles New York University (NYU).

With New York City being a transportation hub, international flights into the city happen daily. And the larger New York metro area has over 19 million people. With global influxes of people and a large local population comes the potential for viruses and pathogens to come from anywhere in the world. Another facet of this is not only international travel bringing in vector-borne illnesses, but the possibility of local transmission that can now happen in the US. Although extremely rare, there has been cases of these diseases popping up including malaria, West Nile disease, and others.

With the potential for any type of disease state to be seen in New York, clinicians need to be prepared to identify and treat patients when these situations arise.

“We see patients with infections from everywhere. And so for us, being aware of outbreaks in Asia, South America, Africa is extremely important, because we know those patients are going to be here at some point. So, being prepared to see anything that you may imagine in the world,” said Angelica Cifuentes Kottkamp, MD, associate director for Research and Diversity, NYU Vaccine Center.

There are global outbreak alerts provided to the NYU staff so they can be aware of them when they are seeing patients. For example, Cifuentes Kottkamp says there has been an ongoing Mpox outbreak in a few countries in Africa, and when they see people from that region it is something that they take into account during the workup and possibly beyond if a clinician has a patient with a highly infectious disease.

“If you have someone that is traveling from this region, you have to think about these diseases,” Cifuentes Kottkamp said. “There is always a team that is checking globally what's going on in terms of infections, and being aware and putting in place isolation protocols, alerting the emergency room teams. They have to know what's going on and how to react very fast, in case one of these patients shows up to the emergency department."

Working alongside young clinicians, NYU’s medical staff does think about vector-borne diseases employing differential diagnosis, especially when a patient is presenting with a headache and is febrile.

“We like to think about the different categories—viruses, bacteria, fungi, parasites—that can give you a fever with a headache, and so that's how you start probing the students and teaching them to think in an organized manner, ensuring that they're not going to miss any of those potential pathogens,” Cifuentes Kottkamp said.

In addition to the clinical component, NYU Langone’s Department of Microbiology has 2 labs with specific study focuses around vector-borne diseases. The Rodriguez Lab focuses on 2 parasites: Plasmodium, which causes malaria, and Trypanosoma cruzi, which causes Chagas disease. And the Stapleford lab focuses on the La Crosse virus and chikungunya virus.

In the next NYU Media Day episode, Margaret Aldrich, MD, discusses NYU’s pediatric infectious clinical care.