West Nile Virus Hits Homeless in Houston
Kristy Lillibridge, D.V.M., and her team of student "disease detectives" at the UT School of Public Health are finding Houston fertile territory for studying epidemics.

Lillibridge is researching West Nile virus and other diseases spread by insects such as mosquitos and ticks. Her studies in Houston have focused on risk factors for West Nile virus encephalitis, or inflammation of the brain. Her latest study is on Houston's homeless population, and she and her students have visited homeless shelters and taken blood from more than 400 street people, a broad sampling of the 10,000 people estimated to be homeless in Houston's population of 3.4 million.

"The homeless are far more likely to be hospitalized with West Nile virus than the general population," explains Lillibridge, assistant professor of epidemiology at the UT School of
Public Health. "In 2002, when we had the first outbreak of
West Nile in Houston, we had seven homeless out of 90 hospitalized cases."

Research on those 2002 cases suggested that high blood pressure and drugs such as cocaine and amphetamines that cause high blood pressure might increase the risk of a West Nile virus infection developing into encephalitis.

Her research focused on the homeless because they have so
much outdoor exposure and are more likely to be bitten by mosquitos that carry the virus. She will conduct a second study on clinical features and risk factors of West Nile virus encephalitis in children.

What makes Lillibridge's homeless study doubly important is that it provides her students real experience in the field that they don't get in the classroom. She has organized the Student Epidemic Intelligence Society (SEIS), an organization at the UT School of Public Health inspired by the elite group of "disease detectives" she previously belonged to at the Centers for Disease Control (CDC) in Atlanta.

Lillibridge organized the SEIS when she came to the UT School of Public Health in 2002 and was immediately called to help out with the West Nile outbreak. "Health workers are always in short supply, especially during outbreaks, and students are anxious to get experience in the field," she says. "So I realized both the health departments and students at the School of Public Health could benefit. I could create an organization to train students for outbreak investigations and also provide a community service to help health departments with an epidemic surge capacity during times of great need."

The SEIS has about 50 members, all of whom are graduate or Ph.D. students. Many worked with Lillibridge on the homeless project, and the field experience they receive is a bonus to their resumes when they graduate and start looking for jobs. And no one is more qualified to guide their field work than Lillibridge, who has helped quell epidemics all over the world as a member of the CDC's Epidemic Intelligence Service.

For her superior work as a disease detective, Lillibridge was named the Epidemic Intelligence Service "Officer
of the Decade" from the CDC during the celebration of the 50th anniversary of the elite group.

"I have had some amazing outbreak experiences," she recalls. They include working on polio eradication for three months in Bangladesh and investigating unexplained illness and death in injected heroin users in Ireland, an outbreak of plague in Wyoming, and the original West Nile virus outbreak in New York City in 1999.