01/27/2021
By Katharine Webster

Global infectious diseases like the COVID-19 pandemic need global as well as local solutions, says Prof. Timothy Ford, the new chair of the Department of Biomedical and Nutritional Sciences.

Ford, whose career bridges microbiology and public health, researches waterborne infectious diseases and the conditions that make them more virulent and widespread, as well as ways to predict possible outbreaks and prevent them.

Born and educated in the United Kingdom, he came to Harvard University as a post-doctoral fellow and then faculty member in the 1980s and ’90s. There, he joined a working group that was among the first in the world to study new and emerging infectious diseases, including AIDS and Ebola. Since then, his research has taken him to Mexico, India, Russia, Bermuda, China and Haiti, as well as Native American lands in the U.S.

Ford joined the Zuckerberg College of Health Sciences last summer, drawn by the opportunity to collaborate with other faculty on community-based research and training, both regionally and internationally. He recently sat down to talk about his research and emerging epidemics.

Q: Which diseases are your main focus?

A: I’m very interested in waterborne diseases, especially cholera and E. coli 0157, a newer strain of E. coli that’s highly toxigenic and has a high fatality rate.

My research group at Montana State University was the first to identify the presence of E. coli 0157 in the Ganges River in Varanasi, India, in 2004. For millions of people, the Ganges is their sole source of water for bathing and washing clothes and dishes, despite raw sewage discharges upstream.

In Montana, we also found E. coli 0157 in a swimming hole near the site of the annual Crow Fair, along the Little Bighorn River. The Crow Fair is a big Native American gathering that’s held in August, the hottest time of year, and of course all the kids want to jump in the swimming hole. We worked with the Crow Agency to set up a community advisory board and train local people to monitor the water. We also helped set up a network among all of the tribal communities in Montana to deal with environmental health issues. That’s where I learned the importance of community-based participatory research.

Q: What are you researching now?

A: We’ve been looking at ways to do better surveillance of the deadly strain of cholera that arrived In Haiti with U.N. peacekeepers, after the 2010 earthquake. It has killed close to 10,000 people there and sickened hundreds of thousands more.

Under a $200,000 annual grant from the Alliance for Global Health Innovation, we’ve been working with the University of Notre Dame of Haiti in Hinche as well as the group Midwives for Haiti for the past three years to improve early detection and prevention. We’re helping them to train thousands of women and traditional birth attendants in hygiene techniques, as well as how to recognize symptoms and start treatment.

We’re also working with the university’s faculty and health care students to optimize an ingenious, handheld device for measuring multiple genomes in contaminated water supplies so that it can compare those samples to a database of pathogens. Our hope is that these devices, which require only a cellphone signal to work, will be able to identify the cause or causes of a disease outbreak on the spot so that appropriate treatment can begin quickly.

We’re looking at ways to create financial incentives for people to improve community health. We’re hoping to empower women to be “water stewards” by linking them with microfinancing and business opportunities. And we’re helping them now with the COVID-19 pandemic.

Q: You have written recently for The Conversation about issues involving COVID-19 vaccines, based on your work in global health. Why are more deadly diseases breaking out around the world, and how can we prevent or contain them?

A: No matter how diseases are transmitted – whether airborne, waterborne, by direct contact or through vectors such as ticks and mosquitoes – the same trends worldwide are leading to the emergence of new pathogens or more dangerous versions of existing diseases.

Global warming and environmental degradation encourage certain parasites, microbes and vectors to multiply and spread into new areas. As populations move into previously unpopulated areas due to wars or climate change, they are exposed to different diseases and vectors of disease. “Wet markets,” where people come into daily contact with animals, carry a high risk of pathogens mutating and moving from animals to humans. And, of course, there’s modern travel: There’s no such thing as a local outbreak of a highly infectious disease when you can get sick in Mongolia and be in New York City just 13 hours later. These problems are global, and solutions need to be global, too.

At the same time, improving local capacity and infrastructure is critical for controlling infectious diseases. For waterborne diseases, and to some extent even COVID-19, basic hygiene, sanitation and clean water serve a pivotal role in prevention. Our provision of hygiene materials in Haiti has been important for the midwife group’s COVID-19 response, and we’ve supplemented those materials with basic infographics in Haitian Creole on masking and social distancing.

Q: What do you think will cause the next big pandemic?

A: The most likely sources of pandemics are the respiratory viruses, like influenza and the coronaviruses. After that, perhaps the vector-borne diseases, like malaria.

Waterborne diseases that we need to keep a close eye on are the common, everyday bacteria that seem to be acquiring new genes of increased virulence, including E. coli, shigella and cholera. A lot of my earlier research focused on biofilms on surfaces, including water pipes. Biofilms provide an ideal environment for bacteria to mutate and potentially become more dangerous.

A pandemic of antimicrobial resistance is already here: Overuse of antibiotics and disinfectants is encouraging the evolution of more treatment-resistant pathogens. Well-known examples are the hospital-acquired, methicillin-resistant staphylococcus aureus (MRSA) and multidrug-resistant malaria.

Today, we are identifying new strains of the coronavirus that causes COVID-19. Will one emerge that is resistant to the vaccines we’ve developed? Our vigilance and rapid response abilities provide our only protection.