Center Highlight: Capturing the flu in Colombia with Dr. Dib

The DPCC Communications team interviewed Juan C. Dib, MD, MPH/TM, PhD, Professor and Coordinator of the graduate program in Tropical Medicine at Magdalena University in Colombia, President of the Colombian Association of Parasitology and Tropical Medicine, former director of Research in Public Health at the Colombian National Institute of Health, and current Director of the Tropical Health Foundation. Dr. Dib collaborates with Drs. Jorge Osorio, Stacey Schultz-Cherry, and Paul Thomas as part of the St. Jude Center of Excellence for Influenza Research and Surveillance (SJCEIRS).

A passion for infectious diseases in his genes

Imagen Solicitada

Evangelista Mojica, a member of the Wiwa tribe of the Sierra Nevada de Santa Marta, with Dr. Juan C. Dib (right) discussing the different types of kissing bugs.

Dr. Dib’s extensive career as a multidisciplinary scientist and physician is reflected in his contributions to the fields of molecular biology and epidemiology of tropical infectious diseases in Colombia. “I always wanted to understand why some [people] get infected and get sick, while other get infected and do not. [Human] genetics combined with pathology and pathogen genetics interested me,” said Dr. Dib. These interests led him to study Trypanosoma cruzi infection in indigenous populations inhabiting the mountainous Sierra Nevada de Santa Marta, Colombia. T. cruzi, a parasite that causes Chagas disease, is spread by the kissing bug; despite living in routine contact with the bugs that transmit Chagas, members of these communities display inherent resistance to the disease. A better understanding of the genetic differences that contribute to fighting off the parasite may eventually inform medical treatments.

Capturing influenza across cultures

The considerable biodiversity, migratory bird populations, and year-round circulation of influenza viruses makes the Sierra Nevada de Santa Marta unique. Dr. Dib joined the CEIRS community through a surveillance project in this region conducted by Drs. Jorge Osorio and Stacey Schultz-Cherry of SJCEIRS. Building on his work with indigenous peoples inhabiting this region, he recognized the potential for understanding the biology of influenza in these vulnerable populations. “I realized it would be very interesting to study [influenza in] indigenous communities because they have been isolated from other people and in contact with wild animals for many years,” said Dr. Dib, noting that such natural selection may reveal unique host genes and immune responses tied to susceptibility or resistance to infectious diseases, including influenza.

“[These indigenous communities] are now moving up and down the mountain and coming into contact with other humans,” says Dr. Dib, perhaps allowing for the introduction of new influenza viruses. His research goal is to look at exposure to influenza viruses based on serum antibodies within these isolated indigenous communities. Evidence from previous studies suggests that antibodies against influenza viruses vary among the different tribes found in the Sierra Nevada and are drastically different from non-indigenous peoples. The reasons for these differences will be under investigation and could be due to factors apart from exposure to the virus, such as differences in the immune response attributable to host genetics.

Climbing heights and an impact against influenza

Scientific challenges are not the only obstacles that come with Dr. Dib’s work. Gaining access to study sites in Santa Marta de Sierra Nevada can take days, and indigenous peoples generally show higher mortality rates for respiratory infectious diseases. Many members of the Sierra Nevada’s indigenous communities have never seen medical doctors and have limited access to vaccination programs and health care facilities. Therefore, this collaboration has the potential for substantial humanitarian impact by providing a surveillance system using SJCEIRS technology and expertise. Knowledge of what influenza viruses are circulating together with understanding the risk factors associated with infections, such as exposure to animals and relationships with the non-indigenous peoples of the region, will enhance medical care.

An even bigger picture

Dr. Dib and Evangelista Mojica (right) work to construct housing structures to prevent and control Chagas disease. Image courtesy of Tropical Health Foundation

Dr. Dib and Evangelista Mojica (right) work to construct housing structures to prevent and control Chagas disease. Images courtesy of Tropical Health Foundation

Establishing trust with community leaders has been critical for his efforts. “We need a cultural understanding between indigenous and non-indigenous [peoples],” said Dr. Dib. These communities have a different perspective. Referring to centuries of exploitation by conquistadors and tourists, he feels strongly that “the community needs to be involved, and the work needs to be important to them. They are helping us learn about health and biology.” Consideration for how people live and the cultural, economic, and political factors that impact their lives is important, as these factors may impose unique risks. Dr. Dib emphasized the value of working in these communities as the perfect place to “combine disciplines to help people all over the world.”

Words of wisdom

Dr. Dib’s advice for young scientists mirrors his ethics, philanthropic mind, and work philosophy. With an astute eye for the big picture, he advises, “think about what you are affecting, and channel what you do with your life’s work to generate positive change.”  He reflects that perhaps the way we do and think about science could have a greater impact if “we consider humans not only as patients, but as generators of change and spokespeople for the health of communities and the planet.”