Lab Matters Fall 2016 - Page 14

partner profile Leonard Peruski by Nancy Maddox, MPH, writer Leonard Peruski, PhD, oversees laboratory operations in the Global Disease Detection network in CDC’s Division of Global Health Protection. He previously directed CDC’s Global Disease Detection Regional Center in Guatemala, and served as laboratory chief of the agency’s International Emerging Infections Program in Thailand. Peruski joined CDC from the Indiana University School of Medicine, where he was associate professor of microbiology and immunology. His earlier career includes stints at the National Institutes of Health and the Naval Medical Research Center. In 1994 he was commissioned in the US Navy and stationed in Cairo, Egypt, where he studied diarrheal disease. Peruski earned his PhD at the University of Michigan School of Medicine. Here, he shares insights from his peripatetic career curbing infectious disease and from his current post, advancing the Global Health Security Agenda. Q You have worked all over the world dealing with some of the most common and most exotic and most dangerous pathogens around, including the Ebola virus. What are the top three lessons you’ve learned regarding how to contain infectious pathogens in resourcelimited settings? A Great question. My answer is not really from a microbiology perspective. The US is amazing at containing outbreaks. But what we do here oftentimes can’t work in middle- and low-income settings, where they might not have trained staff or what we consider “normal” supplies, such as PPE (personal protective equipment) kits. You might go into a lab and they’re using latex gloves, which can break down in hot and humid environments. They might have the latest and greatest PCR equipment, but the electricity is so bad they can’t use it. So, first you have to understand where you’re working—the culture, the people, the location. A lot of people get frustrated with that. It’s more than just knowing about the disease. Second, when you get there, you will not have all the answers. Your training may be in molecular microbiology, but you will need to be a generalist, a Swiss army knife. You may have to do a serology assay, or teach people how to fill out forms, or teach people how to pack specimens for shipping, or sit with a family and explain why you need to have an autopsy done on a dying child. You need to be a scientist, a mentor and a diplomat. At the same time, you can’t compromise your standards. You can embrace the culture, but you can’t dumb anything down. Some folks in the field get “high” on the rush of being in an exciting, exotic setting and get lost. But at the end of the day, 12 LAB MATTERS Fall 2016 no matter how long you work, you will go home. You will leave those people behind, and they will have to continue, and you need to make them independent. Q You also have experience in the field following intentional release of infectious pathogens, having led the US Department of Defense team that deployed to New York City (NYC) after the 2001 anthrax attack. How does the public health response differ in naturally-occurring versus terrorism-related outbreaks, if at all? A I’ve found that there’s panic in both situations. But in an intentional outbreak, the problem is there’s so much information flowing