Interview with Dr Katie Hampson
Dr Katie Hampson is a research scientist at the University of Glasgow. She has conducted research on zoonotic and infectious diseases, with a particular interest in rabies transmission and the impact of mass vaccination programmes.
1. Katie, your research has mainly been on zoonotic and infectious diseases, what got you into this topic and what do you hope to see developing in this area?
I started working on diseases transmitted between domestic animals, wild animals and humans for my PhD. My interests were in population dynamics and I’d previously been working on conservation problems, where the issue was typically how to prevent populations from heading towards extinction. Switching to disease dynamics has been great, because it has allowed me to keep thinking about population dynamics, but now I am usually asking how can we push (virus) populations towards extinction.
My PhD research initially focused on rabies spread between domestic animals and wild animals and people. But it quickly became apparent that in these populations in Tanzania domestic dogs are the drivers of rabies. So over the years my work has become increasingly public health focused. I would love to see rabies being championed as a zoonosis where joint efforts between the human and animal sector actually lead to disease elimination.
2. Do you think mass dog vaccination programmes are an effective solution to eradicating rabies in humans?
Yes absolutely. The vast majority of human rabies deaths from around the world result from a type of rabies that is maintained in domestic dog populations. Mass dog vaccination programmes can eliminate this disease from domestic dog populations and therefore the source of disease in humans. The issue is not really whether mass vaccination is an effective tool, but how mass vaccination programmes can be delivered and sustained effectively in populations where the disease remains a problem. Mass vaccination programmes have been so effective that they have eliminated rabies from high-income countries around the world. In contrast, we see the worst rabies problems in the poorest countries, where there is limited capacity and resources to coordinate and sustain these programmes.
3. In your recent research paper ‘Difficulties in Estimating the Human Burden of Canine Rabies’ you have outlined that the surveillance of rabies is ineffective in many regions, what do you think the biggest obstacle is?
Because rabies is now considered a disease of history in high-income countries, it is easy to forget how real the problem is in countries where the disease still circulates. The burden study was aiming to redress that. Most people who die of rabies come from poor households and communities, where there are no official birth or death certificates and no official cause of death is designated. Moreover, the main reasons why people are most likely to die in these poorer places are because: 1) dog vaccination programmes are not implemented to interrupt disease transmission and 2) life-saving post-exposure vaccines are not available or affordable in these communities. So not only are there no reliable official sources of information on these deaths, but this results in an entrenched problem: limited disease reporting means no political will to invest in disease prevention. I think it will be hard to move beyond this unless there is more incentive for reporting. Typically we see that when disease control programmes start, then there is an incentive to improve surveillance to assess what the impacts of control efforts are. Perversely this can cause a spike in reported disease at the start of a disease control programme rather than a decline – because suddenly many of the cases that would go unreported are now being detected because surveillance is in place. So in essence I think the biggest obstacle to surveillance is actually getting dog vaccination programmes underway. Once they start, better surveillance should follow.
4. Do you think using mobile phones for rabies surveillance could improve overall surveillance?
Yes, I think in many parts of the world where road infrastructure is extremely limited, the massive mobile phone penetration that has occurred in recent years could be transformative. Mobile phones can connect people in remote areas, so it is possible to monitor a disease situation in real-time, and provide support and feedback that otherwise would not be possible. Relying on paper-based surveillance often means waiting months or years to compile information, which is not conducive to a rapid response! Many of the ways in which mobile phones may help are very basic. For example, for rabies, it is important that health workers and veterinary workers in the same community work closely with one another, and that community-level workers are in close communication with coordinators at the district level. Mobile phones can help to strengthen those relationships, but there needs to be a reason to develop those relationships - that means putting rabies control and prevention measures in place. So yes, mobile phone are definitely an excellent tool, but they are only part of the solution.
5. In your opinion, what is the biggest socio-economic impact of zoonotic diseases?
It is difficult to pin down the single biggest socio-economic impact of zoonoses, because they vary considerably depending on the disease. The common thread for most zoonotic diseases though, is that they disproportionately impact the poor and in that way they become part of both cause and effect. It is harder to control diseases in places with fewest resources or capacity. I think the solutions require strong health systems and health and veterinary sectors to work effectively together. We’ve seen from Ebola just how fragile health systems are in some of the most impoverished communities. That said, I am also optimistic, that implementing disease control and prevention measures for rabies will build that capacity and those relationships to tackle many other zoonotic diseases of concern.
* Any views or opinions represented in this interview are personal and belong solely to the interviewee, and do not necessarily represent the views or policies of World Animal Protection.