VOLUME 23
NUMBER 3
October 6, 1999
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Reprinted with permission of the Daily Gazette
Scientists in Role as Detectives, Epidemiologists Work to Solve E. Coli Case
By Katy Moeller

     When University at Albany graduate student Kevin Delaney tells people he's studying to become an epidemiologist, people are often befuddled by his chosen profession. Some think he's going to be working with skin, others expect him to become some kind of an expert on insects.
     But the Colonie native, a second-year master's student in the University's School of Public Health, plans to leave the skin business to trained dermatologists and the insect stuff to bug-eyed entomologists.
     As an epidemiologist, Delaney will be involved in the collection and analysis of public health data. He'll scour reams of data, keying in on statistical patterns that could offer new insight into the nature of diseases and other factors that affect public health.
     Sometimes, when people aren't able to visualize what all this really means, Delaney turns to popular culture to convey some sense of what epidemiologists - or at least those who specialize in infectious diseases - actually do.
     “If they have no idea what I’m talking about, I say, ‘Did you see the movie ‘Outbreak’?” he said, referring to the 1995 suspense thriller about the spread of a deadly virus from Africa to the United States.
      “Infectious disease is kind of the glamorous one (branch of epidemiology). It's ‘Outbreak.’ You're hunting down the monkey.”
     The outbreak of E. coli in the Capital Region this month - arriving on the heels of outbreaks of St. Louis encephalitis in New York City and malaria on Long Island - has sent state epidemiologists running in all directions trying to prevent new infections.
     About 50 of the state Department of Health's staff of 200 epidemiologists are working on the E. coli outbreak stemming from the Washington County Fair, which killed two people and is suspected of sickening more than 1,000 people.

Gathering clues

     Working as scientific sleuths of sorts, epidemiologists collect detailed information - clues - from disease victims and those who were unaffected. The data is critical in determining the source of the infection: it's also used for in-depth research of the outbreak and any number of other factors.
      “The process of conducting science does resemble detective work in the sense of solving mysteries,” said David Strogatz, chairman of the epidemiology department at the University at Albany's School of Public Health. “But what may be unique about epidemiology compared to some other sciences is that epidemiology is done outside a lab, in the real world, in a nonexperimental setting. We try to answer the question: Is X responsible for Y, based on observations from people’s lives rather than setting up experiments.”
     Students at the University’s School of Public Health have been involved in gathering data during the recent outbreaks in New York state, said Louise-Anne McNutt, professor of epidemiology.
“We've had students who have made calls for E. coli and malaria,” said McNutt of interviews conducted with victims and family members.
    “When something like this happens, people kind of drop things that are not as pressing and everybody helps out. There have been a lot of people at the health department - both students and faculty. It's an incredibly educational experience for our students.”
     When McNutt says that faculty at the School of Public Health are quick to respond when there's an infectious disease outbreak, she's not exaggerating.
     That's because about 25 of 30 professors in the school's epidemiology department are actually state health department employees who make time to teach. This assemblage of faculty - largely professionals who teach on a part-time basis - is very unusual. The school, which opened in 1985, has about 200 faculty members.
     “We're the only school of public health in this model,” Strogatz said. “A lot of schools are very interested, but it requires a large enough health department, with a significant number of individuals and a lot of training and energy.”
     Additionally, Strogatz said, the university has to be located near the state health department and the two must share a common vision for the School of Public Health. Very few places have all those ingredients, though Emory University and the U.S. Centers for Disease Control and Prevention in Atlanta do cooperate in somewhat similar fashion.
     Those who attend the University at Albany's School of Public Health for training in epidemiology come with varied educational backgrounds: about one third are physicians, and the rest have  master's degrees or have just completed a  bachelor's degree.
     Strogatz said those pursuing graduate degrees in epidemiology usually have undergraduate degrees in the biological sciences, but not uniformly. Some are admitted with degrees in psychology or sociology.
     “I like the sociological perspective, in terms of looking at populations and understanding populations,” said Strogatz, who studied sociology as an undergraduate. “I was also interested in health. I wanted to do research. I wanted to somehow combine the two.”
     When Strogatz began graduate school in the late 1970s, there weren't as many programs that offered graduate training in epidemiology. Today, the number of people entering epidemiological work without advanced degrees in the field is much less common.
     “I don't have a card that says I’m an epidemiologist, but I am because that's what I do,” said Richard Venezia, who directs the departments of epidemiology and clinical microbiology at Albany Medical Center and also teaches at Albany Medical College and the University at Albany. “I’m a clinical microbiologist with a Ph.D.”

Making inroads

     The roots of modern epidemiology date back at least to the mid-19th century, when John Snow studied the pattern of deaths caused by cholera in London. Snow mapped the occurrence of cholera cases in the city and correctly concluded that the Broad Street water pump was the source of the infection.
     By the 1950s, infectious diseases had been reigned in by improved sanitation, vaccines and antibiotics. Epidemiologists began to apply their methodology to chronic diseases, such as cancer and heart disease.
     After documenting and publicizing in 1964 the numerous health risks found to be associated with smoking, public health officials focused their effort on changing people's behavior - diet, exercise and alcohol consumption.
     Today, epidemiologists study a very wide range of infectious and chronic diseases, as well as other factors that may affect public health, including domestic violence.
     The master's in epidemiology at the University at Albany is a two-year program, though many of those who are working full time take several years to complete the coursework.
     Graduates are hired into public health jobs - city, county, state, national (National Institutes of Health and CDC) and international (World Health Organization). In the private sector, they're snapped up by think tanks, HMOs and pharmaceutical companies.
     “When you have master's level training, you are prepared to be a real key team player in conducting epidemiological research,” Strogatz said. “With doctoral training, you're prepared to: lead the team, identify the question to be addressed, understand the significance of the question and know how to collect, analyze and interpret the data.”

Tracking disease

     Delaney, who earned his bachelor's degree in biology from George Washington University, had a fellowship with the CDC this summer. It was an eye-opening experience for the Colonie native, who already had a year of graduate school under his belt.
     He spent part of the summer in Chicago, collecting information from the families who lost loved ones in the sweltering heat wave that claimed the lives of more than 185 nationwide. The data is being analyzed to determine the significant factors affecting those who survived and those who died.
     “We interviewed both relatives of the deceased and controls - people who didn't die but were from the same area,” he said. “It's hard when you start. The point of epidemiology is you try to ask the questions the same way to everybody. You ask it and move on. You have to be really impartial about it.”
     Delaney also spent time at the CDC in Atlanta analyzing mortality data of children listed as having died of sudden infant death syndrome.
     “SIDS is tricky. They don’t know what causes it. They have certain associations,” he said. “What I was doing was a technical definition (relating it) to the levels of iron absorbed in the infants' lungs.”
     Delaney also got a chance to learn more about what county public health workers do on a day-to-day basis. For example, some were dispatched into the community to observe people with tuberculosis take their medication.
     Dr. Terry Briggs, infectious disease specialist for Albany County, said her office primarily collects data on “reportable diseases” - the diseases physicians are required to report to the health department - such as E. coli, salmonella and girardia. She's always keeping an eye out for unusual clusters or trends in the data.
     In 1998, Albany County had 377 reported cases, not including sexually transmitted diseases and rabies. The county typically gets one or two reported cases of E. coli a year.
     From time to time, Briggs, who is a private practice internist when she's not working at the county, must do some detective work to figure out why unrelated people are exhibiting similar symptoms of an undiagnosed disease.

A case in point

     Several years ago, Briggs saw two patients experiencing mental grogginess and abdominal pains. Briggs learned from the family of the second patient that a friend of his had also been admitted to the hospital - and both had attended a golf tournament in Vermont. All of the dozen men who attended the golf tournament were contacted to find out if there were others with similar symptoms.
     “As it turned out, there were three people who were home ill,” Briggs said. “Going over their 48 hours of activity, we found that they all happened to be smokers and happened to be hot tub users, all of whom complained of it being on the cool side.”
     The men were suffering from Legionnaire's disease, caused by the moisture-loving Legionella bacteria. The hot tub that the golfing buddies were using was tested and disinfected so that others would not contract the disease.
     “Our interest is in protecting the community,” Briggs said. “Your doctor is your advocate. We, on the other hand, in public health, are overwhelmingly the advocates of the healthy population. Our interest is in interrupting the transmission of that disease.” 
Editor’s Note: Katy Moeller is a reporter with the Daily Gazette.
 UAlbany Initiatives For Women Dinner Features Area Women Presidents
by Lisa James Goldsberry

     “A Celebration of Four Women Presidents,” a conversation among New York Capital Region's groundbreaking female higher educational leaders, will highlight the Sixth Annual Initiatives For Women Awards Dinner on Tuesday, Oct, 26, beginning at 5:30 p.m., in the atrium of UAlbany's new library. Tickets for this fundraiser are $65 for individuals, or tables for $1,000.
     Karen R. Hitchcock, president of UAlbany; Shirley Ann Jackson, president of Rensselaer Polytechnic Institute; Jamienne Studley, president of Skidmore College; and Jeanne Neff, president of The Sage Colleges, will discuss their careers, current work and philosophies of leadership at a fundraising event for Initiatives For Women, a University at Albany program that seeks to enhance educational and career opportunities for women. A champagne reception at 5:30 p.m. in the Helderberg Room of the new library will precede the 6:30 p.m. dinner.

     Hitchcock is the first female president in the 152-year history of the University. One of the nation's leading scholars in the field of pulmonary cell biology and development, she came to UAlbany as vice president for Academic Affairs in 1991. Hitchcock gained a national reputation for her research on Respiratory Distress Syndrome. She earned her Ph.D. in anatomy from the University of Rochester School of Medicine and Dentistry.

     Jackson became the 18th president of RPI on July 1, 1999. A theoretical physicist, she is the first female African American president of a national research university. She was also the first African American woman to receive a doctorate from M.I.T. in any subject and is one of the first two African American women to receive a doctorate in physics in the U.S. Prior to coming to Rensselaer, Jackson was chairman of the U.S. Nuclear Regulatory Commission.

     Studley is the first female president of Skidmore College. Before her appointment in June 1999, she was general counsel and a senior officer of the U.S. Department of Education and a former associate dean of Yale Law School. She was a key advisor to Secretary Richard Riley on all aspects of education, including civil rights and legislation. Studley earned her law degree from Harvard Law School. 

     Neff became the eighth president of The Sage Colleges in July 1995. In recent years, she has helped to launch a national initiative to enhance the visibility and stature of independent colleges. Her background includes leadership in several national higher education groups, including membership on the Board of Directors of the Association of American Colleges and Universities. Neff earned her doctor of arts from Carnegie-Mellon University. 
     Initiatives For Women supports endowed scholarships, fellowships, excellence awards for students, internships and training programs, career planning and advisement, research on women and women's issues, academic and career advancement for women of color, and educational and professional initiatives for physically challenged women and others in particular need.
     Award winners this year include a Ph.D. student who wanted to attend the third International Women's Studies workshops at the University of Havana for her study of gender and education in Cuba, a secretary in the Department of Public Administration and Policy who is returning to school to earn a master’s degree, and a Ph.D. student in anthropology for a course in Guatemala on the K'iche Maya language in preparation for her dissertation work. 
     At the fundraising event, tables for corporations and groups are also available. The price of the ticket, which includes the tax deductible contribution, will help provide funds for the next round of awards. For more information or for an invitation, please call (518) 442-5415.
    “In times of tight resources, an award from Initiatives For Women can make a dream a reality for the woman researcher, the student who is a single parent, the artist who needs support to present her thesis exhibit,” said Gloria DeSole, senior advisor to the President for Affirmative Action and Employment Planning and chair of the Initiatives For Women Steering Committee. “The opportunity to make a significant difference in the lives of women whose dreams need support is a privilege. And the chance to hear from these four extraordinary women who are the leaders in education in this area will be a delight, as well.”

UAlbany to Host Meeting About National Summit on Africa
     The University at Albany will host the upstate New York meeting on the National Summit on Africa on Saturday, Oct. 9, from 9:30 a.m. to 3 p.m. in the Campus Center Ballroom on the University's main campus. The event is free and open to the public. Students are encouraged to attend. The National Summit on Africa is a nationwide effort to guide U.S. relations with the countries of Africa, educate the American public about Africa, and broaden the network of Africa's supporters in the U.S. This meeting will provide information about the National Summit on Africa, which will be held in Washington D.C. from February 16-20, 2000.
     Attendees at the meeting will also have the opportunity to be elected as one of the delegates to the National Summit on Africa.
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