Autumn 2017

5 Questions with an Infectious Disease Expert

A profile of Jonathan Abraham, an infectious disease expert

The Environment Issue

  • by Ekaterina Pesheva

What sparked your curiosity in emerging infectious diseases?

The Coming Plague by Laurie Garrett. I read it when I was a senior in high school. It included a chapter on Lassa fever virus in West Africa and described viruses that caused hemorrhagic fevers. I read that book and got hooked. By the time I was a sophomore in college, I had joined a lab that was working on Ebola. I’ve worked on emerging infectious agents ever since.

How does your work as a clinician inform your work as a basic science researcher?

I’ve always felt that my experience in clinical medicine inspires the research questions I pursue in the laboratory. I remember thinking hard about how antibodies can be used as infectious disease therapeutics when I was a fourth-year medical student. I was on rotation and saw how well a patient with leukemia responded to treatment with a biomolecule, an antibody-fusion protein. I wondered why we weren’t using such therapeutics against infectious agents.

Part of my interest in becoming an infectious diseases doctor grew from my interest in addressing disparities in health care. I come from a Haitian background. When I was growing up, I would hear people say that Haitians were to blame for the U.S. HIV/AIDS epidemic. This drove me to fight such stereotypes. I felt that my best approach was to not only treat patients but also study the mechanisms behind these diseases.

What are the toughest challenges in tackling emerging infectious diseases?

I think the toughest challenge is to move from a reactive state to a proactive approach. We’ve seen the Zika virus re-emerge. We have seen Ebola and West Nile. One of our more critical challenges is to determine how we can prepare ourselves against whole families of viruses, for example, have one vaccine against Zika and dengue viruses instead of different vaccines against each. The other risk we face is that in certain situations infection by one virus can make subsequent infections by related viruses worse. This is a challenge also in terms of vaccination. We must ensure that the vaccines we develop do not inadvertently enhance infection by related viruses we have not yet encountered.

How do you think climate change is affecting the emergence of infectious diseases?

A lot of troubling diseases are linked to humans’ exposure to various vectors, be they mosquitoes or rodents. I think there are precedents suggesting that the destruction of natural habitats and changes in vector habitat ranges caused by climate change could increase our risk of contracting new types of viruses.

What are some of the more pernicious myths about infectious diseases and global health?

There is a lingering idea that our nation’s geography will somehow protect us from future outbreaks. I’m glad it’s a myth that hasn’t yet been disproven, but it is one that makes us vulnerable. We are interdependent and really need to take care of each other. The safest world is one in which everyone is being vaccinated or being treated.

Image: John Soare