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International Health

Department Alumna
Anne Rimoin, PhD, MPH

Assistant Professor
Department of Epidemiology, UCLA

Department alumna Anne Rimoin, PhD, MPH, was recently in Baltimore for the American Society for Microbiology’s Biodefense and Emerging Disease Research meeting.  She presented her findings there on the rising incidence of monkey pox in the Democratic Republic of Congo (DRC). While visiting friends and colleagues at the Bloomberg School, she agreed to discuss how she became one of the world’s preeminent experts on emerging infectious diseases, especially monkey pox, and to offer some advice to current and future students interested in global epidemiology. 

Dr. Anne Rimoin in the Democratic Republic of CongoDr. Rimoin, a graduate of the Global Disease Epidemiology and Control Program (GDEC), is currently an assistant professor in the Department of Epidemiology at UCLA where she focuses on emerging infectious diseases, especially those of animal origin that affect central Africa. The majority of her research is based in the Democratic Republic of Congo, a country she has long had an affinity for.  She is fluent in French and conversant in the local Bantu language, Lingala, which helped her establish trust with local rural populations, who can be wary of outsiders—for good reason based on their history of colonization and civil wars.  She has even established a foundation to help build local capacity in the country called Congo BioMed. Its mission is to promote local biomedical research and training, and to deliver aid. “My philosophy is that you can’t just take data out of a country. It’s very hard to build capacity through standard research grants. Nevertheless, one can’t expect people who receive world-class training abroad to go back to their home countries if there’s no place for them to use that expertise.” 

“Hopkins is my benchmark,” Dr. Rimoin began when asked about her time at Hopkins and how it prepared her for her current research work. “Methods and mentorship is my mantra, and I had both at Hopkins,” she continued. While her passion has always been pediatric and emerging infections, she explained, her dissertation was on the diagnosis and treatment of strep throat to prevent rheumatic heart disease.  At first, she wasn’t certain how strep throat fit into her plan to work in global infectious diseases.  She soon learned that rheumatic heart disease—the result of untreated strep throat—is a leading cause of cardiac illness in the developing world. Unlike in the U.S., the infection is not always diagnosed or treated appropriately in much of the world.

Her advisers, Professors Joanne Katz and Mark Steinhoff, also stressed how important it was to learn research from the ground up.  “Professor Steinhoff gave me a lot of responsibility. I was the program manager for a multi-center study to look at diagnosis of strep throat. I had to develop research protocols, train staff, and supervise the data management, among other things.”  With a grant from the Center for Clinical Trials, she developed her own nested study to assess the intravenous versus oral treatment of strep throat. She summed up her training at Hopkins with a string of superlatives, saying that Professor Katz continues to be her role model as a woman in epidemiology and international health.   

After graduation Dr. Rimoin became a program officer at the National Institute of Child Health and Development (NICHD). One of her projects there was to set up a malaria study in Africa. While the malaria work was based in the DRC and Zambia, the focus was not on emerging infections and zoonotic diseases. “My training from the Department, however, prepared me to propose my own add-on study.” She suspected that the prevalence of monkey pox was higher in the DRC than estimated, but there was no funding to do disease surveillance because it was perceived to be too difficult given the lack of infrastructure in the country.  “I had learned the tools doing my dissertation research, so I was able to apply them however I wanted.” Because her proposal leveraged the resources of the larger malaria project, she was awarded the funds to pursue the research she was most passionate about.

That research has revealed that the prevalence of monkey pox has increased twentyfold over the last 30 years in the DRC. “In an ironic twist, one of the triumphs of public health—the eradication of small pox—has created an opening for monkey pox to reemerge.” People are no longer vaccinated against small pox, which also provided protection against monkey pox. In addition, the displacement of much of the population has resulted in an increase in the consumption of bush meat, the primary source of transmission. For many reasons, the conventional wisdom held that monkey pox did not pose a viable threat, which underscores the importance of disease surveillance. Monitoring disease patterns not only makes it possible to know which diseases to addresses, but by being prepared to react quickly it can prevent epidemics before they start. 

As a final piece of advice to students, Dr. Rimoin “can’t stress enough the importance of doing primary data collection in country. They must get their hands dirty because there’s no way to replicate that experience in high-income countries.” She tells her students at UCLA what one of her mentors told her, “Everyone has to be willing to do windows. Handing everything to students is actually a disservice because that’s not how it happens in the real world.”
 
To learn more about Dr. Rimoin’s work, visit her UCLA website
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--Brandon Howard, March 2010