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Ebola in West Africa. Credit: European Commission DG ECHO

UK Public Health Rapid Support Team (UK-PHRST)

A specialist team ready to respond to disease outbreaks around the world before they develop into health emergencies. The team also conducts rigorous operational research to improve epidemic preparedness.

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About

The UK-PHRST, funded by UK aid from the Department of Health and Social Care, supports low- and middle-income countries in investigating and responding to disease outbreaks and conducts research to improve our response to future epidemics.

Who we are

The UK-PHRST is a partnership between the London School of Hygiene & Tropical Medicine and Public Health England, with University of Oxford and King’s College London as academic partners.

About
About UK-PHRST 2 columns
About UK-PHRST
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About the team

Through the UK Public Health Rapid Support Team (UK-PHRST), the UK has the capacity to respond rapidly to disease outbreaks in low- and middle-income countries around the world and conduct operational research into epidemic preparedness, playing an important role in global health security. The team also works to help countries to build their own capacity for an improved and rapid national response to outbreaks.

The UK-PHRST is funded by UK aid from the Department of Health and Social Care and is a partnership between the London School of Hygiene & Tropical Medicine (LSHTM) and Public Health England (PHE). University of Oxford and King’s College London (KCL) are academic partners. The team’s Director is Professor Daniel Bausch.

Tackling disease outbreaks at their source at the earliest possible stage helps prevent their spread, saves lives, and is the most effective way to protect the UK. As of July 2018, the team has taken part in nine deployments in six countries.

Deployable team

UK-PHRST member in personal protective equipment. Credit: UK-PHRST
UK-PHRST member in personal protective equipment. Credit: UK-PHRST

The UK-PHRST comprises of a core team of experts ready to deploy overseas within 48 hours to support countries in responding to disease outbreaks.

The deployable team includes experts in tracking the progress of an outbreak (epidemiologists); in diagnosing the cause of an outbreak (microbiologists); in advising on outbreak control measures (infection prevention and control) and community responses to outbreaks (social scientists); and in developing the best clinical response measures (clinical researchers). The full team comprises:

  • Epidemiologists
  • Clinical researcher
  • Social scientist
  • Microbiologists
  • Data scientist
  • Infection prevention and control expert
  • Logistician

Deployment of the UK-PHRST is at the invitation of the host government or in response to requests made by the World Health Organization (WHO) or by the Global Outbreak Alert and Response Network  (GOARN).

Reservist team

In addition to the deployable team, the UK-PHRST will train a group of public health reservists to ensure the UK is able to scale up its response to any disease outbreak or health emergency. Information on how to join the public health reserve cadre will be posted as soon as it is available.

Case study: UK-PHRST action against Lassa fever

Lassa virus causes a potentially fatal haemorrhagic fever syndrome that, in its most severe form, is similar to Ebola virus disease. The virus is carried by a rodent called the “multimammate rat”, which is found across West Africa, infecting humans exposed to infected rodent excreta, with occasional secondary transmission between humans, including to healthcare workers. There are estimated to be hundreds of thousands of infections and tens of thousands of deaths due to Lassa fever every year, with transmission usually peaking during the dry season.

Outbreak response: Putting out the fire

Lassa fever reached epidemic proportions in Nigeria during the dry seasons of 2018 and 2019, prompting the Nigerian Centres for Disease Control to request support from the UK-PHRST. The UK-PHRST quickly deployed personnel to provide epidemiologic, laboratory, and logistical support to Nigeria to help bring the outbreak under control.

Research: Identify the causes of the fire

The UK-PHRST is collaborating with investigators in Nigeria and Sierra Leone – two countries where Lassa fever is hyperendemic and often leads to epidemic spread – to fill key knowledge gaps regarding this dangerous disease. These include studies exploring the clinical evolution and pathogenesis of Lassa fever and looking at the pharmacokinetics of ribavirin, a drug used to treat the disease but whose efficacy and mechanism of action remains to be determined.

In the laboratory, the UK-PHRST is working on the development of a less invasive diagnostic antibody test that can be performed on saliva (as opposed to on blood), which will facilitate field studies on risk factors for transmission. The UK-PHRST is also engaged in social science research to better understand healthcare seeking behaviour for febrile illness in an effort to encourage early recognition and presentation of care for people with Lassa fever, potentially allowing rapid implementation of life-saving care.

Capacity building: Preventing future fires

With an eye to the long-term, the UK-PHRST is helping to development clinical research capacity at the Kenema Lassa Ward in Kenema, Sierra Leone, one of the major care centres for the disease in West Africa. This will facilitate the study of novel therapeutic agents and vaccines for Lassa Fever, with the hope of ultimately being able to prevent the disease. In addition to enhancing the physical infrastructure in Kenema, the UK-PHRST has sponsored the training of local physicians in the use of various techniques, such as echocardiography to assess cardiac function, to better understand the pathophysiology of Lassa fever, and thus provide better clinical care.

Background to the UK-PHRST

Former Public Health Minister, Nicola Blackwood meets Martin Hibberd and Sonal Shah on a visit to LSHTM to launch the UK-PHRST in 2016. Credit: London School of Hygiene & Tropical Medicine/ Anne Koerber
Former Public Health Minister, Nicola Blackwood meets Martin Hibberd and Sonal Shah on a visit to LSHTM to launch the UK-PHRST

The Ebola crisis in West Africa in 2014/15 highlighted the need for the international community to develop a system to help countries respond to and control disease outbreaks that pose a threat to public health, before they develop into a global emergency.

The UK Public Health Rapid Support Team was developed as part of the UK contribution to global health security and to complement the World Health Organization’s work on the Global Health Emergency Workforce. The team is funded over five years by £20 million made available from the UK official development assistance budget. Former Public Health Minister Nicola Blackwood officially announced the launch of the team in November 2016.

The London School of Hygiene & Tropical Medicine was chosen to lead the UK-PHRST in partnership with Public Health England. LSHTM is a world authority in public and global health research. During the Ebola crisis, LSHTM staff advised governments, analysed data to assist in response planning, conducted clinical trials of vaccines and treatments, provided a free online course for healthcare professionals, developed culturally sensitive interventions to change behaviour in local communities, volunteered on the frontline in Ebola treatment centres, and carried out research to strengthen the global response to future infectious disease epidemics. LSHTM was also involved in the response to the Zika virus outbreak and ongoing related research.

Further information:

Who we are

The UK Public Health Rapid Support Team is jointly run by the London School of Hygiene & Tropical Medicine and Public Health England, with University of Oxford and King’s College London as academic partners.

Team Block
UK-PHRST Director

Daniel Bausch

UK-PHRST Director (LSHTM / PHE)

UK-PHRST Deputy Directors

Anna
Seale

Associate Professor
UK-PHRST Deputy Director for Research (LSHTM)

Olivier le Polain

Epidemiologist / UK-PHRST Deputy Director for Operations (PHE)
UK-PHRST Core Deployable Team

Jonathan Ashcroft

Microbiologist (PHE)

Hilary
Bower

Assistant Professor
Epidemiologist (LSHTM)

Ben Gannon

Microbiologist (PHE)

Annelies Gillesen

Clinical Research Nurse (Oxford University)

Peter Horby

Professor of Emerging Infectious Diseases and Global Health (Oxford University)

Emilio Hornsey

Infection control nurse (PHE)

Thibaut Jombart

Associate Professor in Outbreak Analytics (LSHTM)

Ioannis Karagiannis

Field Epidemiologist (PHE)

Patrick Keating

Research Fellow / Data Scientist (LSHTM)

Matt Knight

Logistician (PHE)

Olivier le Polain

Epidemiologist / UK-PHRST Deputy Director for Operations (PHE)

Hana
Rohan

Assistant Professor
Social scientist (LSHTM)

Alex Salam

Clinical Researcher (Oxford University)
UK-PHRST Programme Managers

Thom
Banks

Manager
(LSHTM)

Katie Carmichael

UK-PHRST Operations and Deployments Manager (PHE)

Arlinda
Cerga-Pashoja

Research Fellow
UK-PHRST Training Manager (PHE)

Susan Ismaeel

UK-PHRST Programme Manager (PHE)

Elizabeth McFarland

UK-PHRST Logistics Manager
UK-PHRST Academic Steering Committee

Daniel Bausch

UK-PHRST Director (LSHTM / PHE)

Miles Carroll

Professor (PHE)

John
Edmunds

Professor
(LSHTM)

Professor Ian Goodfellow

Professor of Virology (Cambridge University)

Judith
Glynn

Professor
(LSHTM)
(LSHTM)

Peter Horby

Professor of Emerging Infectious Diseases and Global Health (Oxford University)

Isabel Oliver

Director of Field Epidemiology (PHE)
(LSHTM)

Olivier le Polain

Epidemiologist / UK-PHRST Deputy Director for Operation (PHE)

Cathy Roth

Senior Research Fellow (DFID)

James Rubin

Assistant Director of The Department of Psychological Medicine (KCL)

Anna
Seale

Associate Professor
Chair of UK-PHRST Academic Steering Committee (LSHTM)
(LSHTM)
Deployments
UK Public Health Rapid Support Team (UK-PHRST) Deployments 2 columns
UK Public Health Rapid Support Team (UK-PHRST) Deployments
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Mudslide in Sierra Leone. Credit: UNICEF
Mudslide in Sierra Leone. Credit: UNICEF

The UK Public Health Rapid Support Team (UK-PHRST) receives requests for deployment through WHO-GOARN, direct requests from the government of the state affected by the epidemic, or through the UK Emergency Medical Team and DFID.

The first deployment of the UK-PHRST took place in April-May 2017, when two epidemiologists and one clinical researcher deployed through GOARN to the Somali Regional State of Ethiopia to support an escalating outbreak of acute watery diarrhoea.

This was followed in May-June 2017 by a deployment through GOARN to Nigeria when a team of two epidemiologists and one laboratory microbiologist assisted in the response to an outbreak of cerebral meningitis.

The UK-PHRST’s first bilateral deployment was to Sierra Leone (August-September 2017) when two epidemiologists, two microbiologists, one logistician, two Field Epidemiology Training Programme (FETP) fellows and the UK-PHRST Director were deployed. In this instance they assisted in the establishment of water-borne disease surveillance and assessment of diagnostic capacity at Connaught Hospital in Freetown in the wake of heavy rains, flooding and landslides in and around the capital.

In October – November 2017, two epidemiologists and one clinician were deployed to Madagascar though GOARN to support the response to an outbreak of pneumonic plague affecting primarily two large urban centres.

This was followed by a deployment to Bangladesh (December - January 2017/18) when a team consisting of an epidemiologist, a FETP fellow and an Infection Prevention Control (IPC) specialist worked alongside the UK Emergency Medical Team and DFID in support of the international response to the outbreak of diphtheria in the displaced Rohingya population in refugee camps in Cox’s Bazar.

The second bilateral deployment came in February-March 2018 in Nigeria, when an epidemiologist, FETP fellow, case management specialist and a logistician supported the government in controlling a large outbreak of Lassa fever through field-level interventions, logistics, capital-level data analysis and intervention strategy. This fostered a good partnership between UK-PHRST and Nigeria Centre of Disease Control (NCDC). In February-March 2019, UK-PHRST were invited to support the control of the a Lassa fever outbreak in Nigeria once more. 

During February – March 2018, two epidemiologists and one infection prevention and control specialist were deployed to Bangladesh once again to support the WHO response to surveillance and monitoring of infectious disease outbreaks in the Rohingya refugee camps in Cox’s Bazar. In July 2018 an IPC specialist was redeployed to Cox’s Bazar.

In May-June 2018 during the Ebola outbreak in DRC, UK-PHRST deployed two epidemiologists and a data scientist to support with strengthening the alert system, including case investigation, protocol development, epidemiological analysis and data management.

The UK-PHRST is still actively engaged in the ongoing Ebola outbreak in DRC and has been instrumental in providing senior epidemiological support and in setting up the analytical cell, which is fully operational at the strategic coordination level (currently in Goma). 

In 2019, deployments of UK-PHRST epidemiologists, data scientists and IPC specialist in response to the Ebola outbreak in DRC, have been continuous through GOARN.

Research
Research UK Public Health Rapid Support Team (UK-PHRST) 2 columns
Research UK Public Health Rapid Support Team (UK-PHRST)
Paragraph
Wall with Ebola messages in Freetown, Sierra Leone, 2014. Credit: Jimmy Whitworth
Wall with Ebola messages in Freetown, Sierra Leone, 2014. Credit: Jimmy Whitworth

When not responding to disease outbreaks, the UK Public Health Rapid Support Team (UK-PHRST) conducts rigorous operational research to improve epidemic preparedness and enhance our understanding of how best to tackle these threats in the future.

The team’s work will help generate an evidence base for best practice in disease outbreak interventions.

The London School of Hygiene & Tropical Medicine (LSHTM) leads an academic consortium which includes University of Oxford and King’s College London to carry out this research.

LSHTM

At LSHTM there are academics from a range of disciplines who are involved in research related to the UK-PHRST. Their areas of expertise include epidemiology, mathematical modelling, anthropology, community engagement and trust, virology, bacteriology, mental health and clinical research.

Projects include:

Epidemic Response Anthropology Platform

The UK-PHRST funds the Epidemic Response Anthropology Platform, which is a partnership between LSHTM and the Institute of Development Studies. The platform is a resource to support a humane and effective response to epidemics. It aims to promote evidence on the social dimensions of epidemics in different contexts and to improve the way this evidence is used in response planning. The platform builds networks of anthropologists and other social scientists with regional or subject expertise and connects them to policy makers, scientists and humanitarian response workers involved in responding to outbreaks.

The contribution of social science research to outbreak response

This work was led by Shelley Lees and Karl Blanchett (LSHTM). The project had two components:

  • Component one consisted of exploring the views and experiences of anthropologists and other social scientists, and key information from organisations involved in infectious disease responses on the role of social scientists.
  • Component two consisted of conducting secondary data analysis of research concerning community views and experiences of the Ebola response during the 2014 to 2016 Ebola epidemic.

An oral presentation was delivered at the Quebec Outbreak Intervention Symposium 2017, with Shelley Lees being invited as a main speaker. Manuscripts describing the work are being finalised.

This project has raised the profile of the UK-PHRST within the social science community. A social science working group has been formed at LSHTM to support the research team, which will be sustained. The findings of this work helped define the profile of the social researcher to be recruited into the UK-PHRST and have also guided the social science working group when developing the social science research strategy. On a wider scale, these findings will inform contemporary debates about the role of social scientists and anthropologists in outbreaks, and on how to engage with affected communities.

Effect of acute illness on contact patterns, Malawi

This work was led by Judith Glynn (LSHTM). Understanding population mixing patterns are vital for predicting how infectious diseases move through communities. This project aimed to assess how acute illness affects contact patterns in a rural African setting in northern Malawi. We recorded contacts over 48-hours following a clinic consultation for acute illness and again 2-3 weeks later for the recovered person and for their mother/carer, if a child.

We documented changes in contact patterns when ill and these findings will help to refine models of infection transmission, which are essential for understanding how infections spread, and for planning appropriate interventions. We are preparing a paper for publication.

Study of the aetiology of severe undifferentiated febrile illness outbreaks in Sudan

This work was led by Hilary Bower (LSHTM), Tom Fletcher (Liverpool School of Tropical Medicine), and Mubarak Mustafa El Karsany (Karary University/Federal Ministry of Health (FMoH)).

The research aims to assist the FMoH of Sudan to identify the causative agent(s) of outbreaks of febrile illness associated with haemorrhagic symptoms that occur regularly in the country and to inform public health intervention and diagnostic capacity for them.

The study involves testing legacy samples from an outbreak in Dafur in 2015/16 (~500 case; 18% case fatality) at PHE Porton Down, and developing a prospective study with a FMoH and Karary University team to encourage more rapid identification and better description of the disease in future outbreaks.

To date, a set of stored outbreak samples have been prepared and transferred, with the collaboration of colleagues from the National Public Health Laboratory (NPHL) and FMoH agreement, to PHE Porton Down and tested on a bespoke panel of molecular and serological assays covering a broad range of likely pathogens. Results have been shared with the Ministry and will be published shortly. A prospective study protocol has been developed with ethical approval from LSHTM, Karary University and the FMoH Technical Review Board, and a seven-person team has been trained in study implementation, with basic logistics also in place for a rapid start if/when an outbreak occurs. If no outbreak of the syndrome occurs within the current grant period, the protocol will remain in place ready to be triggered by Sudanese colleagues and we anticipate a request for UK-PHRST support may be made at that time.

Our project has created a new and strong collaboration with the FMoH and the NPHL, and provided a good example of UK research collaboration and support to improve outbreak investigation and control in Sudan. As health scientists in Sudan emerge from the period of sanctions, we hope these relationships with key outbreak-related departments of the FMoH will create further opportunities to assist outbreak response and International Health Regulation capacities in the country.

Establishing real-time evaluations of WASH on disease outbreaks in emergency settings

This work was led by Oliver Cumming and Lauren D’Mello-Guyett (LSHTM). The project aimed to combine the academic experience of LSHTM and the operational experience of Médecins Sans Frontières (MSF) to strengthen the evidence base for Water, Sanitation and Hygiene (WASH) interventions used in disease outbreaks in emergency settings in low and middle-income countries (LMICs).

The role of WASH interventions as a means to both preventing and controlling infectious disease outbreaks is well established. However, at a practice and policy level, there have been calls to address the evidence gap as to how WASH interventions can be best mobilized to support during outbreak responses. We therefore developed approaches for evaluating the WASH component of MSF outbreak responses with a particular focus on study designs and methods that are appropriate for cholera outbreaks during complex emergencies.

Using these approaches to more rigorously evaluate WASH interventions will help strengthen the effectiveness of routinely delivered interventions for cholera control and improve access and outcome among vulnerable populations in low income settings.

Three summary reports are available from our field site visits to MSF projects in Nigeria and South Sudan, evaluating the ability, risks, and ethical considerations to be able to conduct operational research in such a setting. These are supplemented by a desk-based study including interviews with MSF staff in Central African Republic and Democratic Republic of Congo (DRC).

Three “sleeper protocols” that could be adapted for urban or rural contexts and/or closed or open settings within DRC have been developed. Ethical approval has been granted on the basis that an update will be submitted when an appropriate study site has been identified at the start of a conducive cholera outbreak. The collaboration has continued with MSF with plans to implement the protocols in DRC during the next cholera outbreak. Copies of the reports and protocols can be obtained on request from oliver.cumming@lshtm.ac.uk.

Building readiness for real-time pathogen sequencing for surveillance and control of infectious disease outbreaks

This work was performed by teams from PHE and LSHTM. The aim of the study was to take advantage of new technologies for near-real time genome sequencing in the field. We aimed to develop specific genome sequencing primers for selected viruses capable of causing outbreaks, validate sequencing methods and primers using UK returning traveller clinical samples and evaluate MinION sequences in relation to MiSeq,

Equipment is now in place within UK PHRST for amplicon-based viral whole-genome-sequencing on the MinION, primer sets have been designed and provisioned for 4 dengue virus serotypes, 3 chikungunya lineages, and 5 Lassa virus lineages. The UK PHRST lead microbiologist has been trained in the use of the MinION and the primer sets, a bioinformatic pathway has been developed in-house at LSHTM. Testing shows DENV-1,2,3 and CHIKV Asia and ECSA schemes are fully effective at detecting viruses with good genome coverage.

However, the schemes were less effective for DENV-4, CHIKV West Africa and Lassa; most likely due to lack of a relevant reference genome and future work could be done to establish this. A strategy for amplicon-based Crimean Congo Haemorrhagic Fever (CCHF) virus genome sequencing has also been developed by PHE using a separate funding source. The primers and protocol are also available to the UK PHRST. All established protocols could now be field tested for further integration into the PHRST.

We aim to transfer technology to laboratories in West Africa and evaluate performance in an LMIC setting, and utilize sequence clustering and other bioinformatics tools to determine the performance of sequence results in identifying transmission.

University of Oxford

The Epidemic Diseases Research Group Oxford (ERGO) delivers on the clinical operational research theme and contributes to the core deployable team and the training and capacity building in low and middle income countries. ERGO is led by Professor Peter Horby and the group aims to reduce the health and socioeconomic impact of emerging and epidemic infections by conducting and enabling clinical research in this area.

Since the launch of the UK-PHRST, members of the Oxford team have worked in Ethiopia, Nigeria, Madagascar, Sierra Leone, Nigeria, China and Cambodia, either as part of deployments or on research projects with local staff.

Selected research projects completed by ERGO:

Rapid needs appraisal to inform clinical research priorities in response to (re-) emerging outbreaks

This work was led by Louise Sigfrid together with Alex Salam, Catrin Moore and Peter Horby.

The evidence base for the response to epidemics of (re-)emerging pathogens is limited. Research is rarely an early priority, there are many challenges at the outset of an epidemic, and there is a limited window of opportunity to implement research.

This means it is important that the priorities for research are rapidly, but rigorously defined during the earliest stages of an epidemic, while considering ethical aspects and ensuring the potential for a direct clinical and public health impact.

A methodology for rapidly (≤5 days), systematically and transparently identifying key knowledge gaps to inform research priorities during emergency outbreaks was developed in collaboration with Evidence-Aid and Cochrane response.

The intention is that the outcome from the rapid research needs appraisal will be used to inform clinical research prioritisations.

The methodology was piloted in July 2017 using a Lassa fever outbreak scenario and the results compared with expert opinions collected from Lassa fever experts to inform the final version of the protocol.

The methodology was presented at the Global Evidence Summit in South Africa in September 2017.

Patient data quality improvement in epidemics: An audit of West African Ebola data

This work was led by Amanda Rojek, Alex Salam, Peter Horby and the Infectious Diseases Data Observator.

Good medical record keeping is a challenge, particularly in humanitarian public health emergencies, and this is likely to impact clinical care for patients.

The overall aim of this project was to evaluate the quality of clinical data from patient records from the West African Ebola outbreak (2014/15).

The project was divided into 3 sub-projects:

  • A systematic review and metaanalysis of published clinical data from the West African Ebola outbreak
  • A questionnaire for healthcare workers, investigating their perceptions of the quality of clinical record keeping whilst working in West African Ebola Treatment Centres
  • An audit of clinical data from 5,000 Ebola virus disease clinical case records from West Africa

This project will help generate an evidence base for best practice for medical record keeping in disease outbreaks and humanitarian emergencies in developing countries.

An evaluation of syndromic surveillance and clinical characterisation of EEID syndromes in refugee camps

This work was led by Amanda Rojek together with Karl Blanchet (LSHTM) and Peter Horby.

There is an unprecedented global forced migration, with the UN Refugee Agency (UNHCR) estimating that more than 65 million people are in need of protection. At least 12 million of these are living in refugee camps, which are a high risk environment for disease outbreaks.

This work aimed to improve the provision of accurate and comprehensive clinical information that verifies an outbreak, characterises the likely cause and severity of illness, and identifies populations at risk.

The team collected prospective data from thirteen refugee camps across Greece, where research nurses observed clinical consultations with recently arrived refugees presenting with syndromes consistent with outbreak prone infectious diseases.

The data were collected to find out the extent to which the risks for infection, severity of infection and clinical manifestations of infection were assessed and recorded.

The study findings were published in BMC Medicine.

ERGO have several research projects currently underway. These include: Rapid identification and characterisation of avian influenza viruses by direct Nanopore sequencing in collaboration with Institut Pasteur du Cambodge; ongoing cohort study: clinical characterisation and microbiological diagnosis of patients with suspected pneumonic plague in collaboration with Institut Pasteur de Madagascar; an adaptive study of the pharmacokinetics of Favipiravir in patients with severe influenza in collaboration with the Ministry of Science and Technology of the People’s Republic of China and the China-Japan Friendship Hospital in Beijing; Lassa fever cohort study based in Sierra Leone in collaboration with Kennema Hospital.

In collaboration with the WHO/Tropical Diseases Research (TDR) programme, ERGO developed and ran a training curriculum on generating clinical evidence during outbreaks in lower and middle income countries (the Clinical Research During Outbreaks Course - CREDO). The delivery of the curriculum will build capacity overseas for an improved and rapid national research response to disease outbreaks. CREDO received accreditation for the African Academy of Sciences in 2017. The work was presented in October 2017 as a poster at the 10th European Congress on Tropical Medicine and International Health, Antwerp, Belgium.

King’s College London

Research into the mental health aspects of infectious disease outbreaks is led by a joint team from the NIHR Health Protection Research Unit in Emergency Preparedness and Response at King’s College London and the South London and Maudsley NHS Foundation Trust.

Projects already completed by the team as part of their UK-PHRST work include studies to understand the feasibility and effectiveness of small group therapy for staff in Sierra Leone who worked in Ebola treatment centres, the preliminary results of which are available in the International Journal of Social Psychiatry.

Ongoing work involves assessing whether it is possible to ‘screen’ people who wish to work on future infectious disease outbreaks, to identify and support people at risk of experiencing distress as a result of this work. For further information, please contact Dr James Rubin at KCL.

Publications
Scientific Papers
Rapid research needs appraisal methodology
Sigfrid L, Moore C, Garritty C, Maayan N, Lutje V, Marshall R, Salam A, Pestridge C, Buckley B, Soares-Weiser K, Clarke M, Horby P.
2017
Open Access Framework (https://osf.io/8qn6v/). Date created: 20 November 2017.
The Breadth of Viruses in Human Semen
Salam AP, Horby PW
2017
Emerging Infectious Diseases; 23(11): 1922-1924. doi:10.3201/eid2311.171049.
Training peers to treat Ebola centre workers with anxiety and depression in Sierra Leone
WatermanS, Hunter ECM, Cole CL, Evans LJ, Greenberg N, Rubin GJ and Beck A
2018
International Journal of Social Psychiatry; 1–10 (DOI: 10.1177/0020764017752021
The Epidemic Diseases Research Group field team. Clinical assessment is a neglected component of outbreak preparedness: evidence from refugee camps in Greece
Rojek AM, Gkolfinopoulou K, Veizis A, Lambrou A, Castle L, Georgakopoulou T, Blanchet K, Panagiotopoulos T, Horby PWand
2018
BMC Med. 2018; 16: 43. Published online 2018 Mar 19. https://doi.org/10.1186/s12916-018-1015-9
Real-Time Modeling Should be Routinely Integrated into Outbreak Response
Bausch DG and J Edmunds
2018
Am J Trop Med Hyg (in press)(PMID: 29611508
A qualitative study assessing the feasibility of implementing a group CBT based intervention in Sierra Leone
Waterman S, Cole CL, Greenberg N, Rubin GJ, Beck A
2018
British Journal of Psychiatry International (in press)
Meningococcus serogroup C clonal complex ST-10217 outbreak in Zamfara State, Northern Nigeria
Brenda A. Kwambana-Adams, Rahab C. Amaza, Catherine Okoi, Murtala Rabiu,
Archibald Worwui, Ebenezer Foster-Nyarko, Bernard Ebruke, Abdul K. Sesay,
Madikay Senghore, Abdullahi S. Umar, Rabi Usman, Adamu Atiku, Garba Abdullahi,
Yahaya Buhari, Rabiu Sani, Husaini U. Bako, Bashir Abdullahi, Alliyu I. Yarima, Badaru Sikiru,
Aderinola Olaolu Moses, Michael O. Popoola, Eme Ekeng, Adebola Olayinka, Nwando Mba,
Adamu Kankia, Ibrahim N. Mamadu, Ifeanyi Okudo, Mary Stephen, Olivier Ronveaux,
Jason Busuttil, Jason M. Mwenda, Mohammed Abdulaziz, Sulaiman A. Gummi,
Adebayo Adedeji, Andre Bita, Linda Omar, Mamoudou Harouna Djingarey,
Wondimagegnehu Alemu, Umberto D’Alessandro, Chikwe Ihekweazu & Martin Antonio
2018
Scientific Reports open access. Date created: September 2018
Isolation of viable Zika virus from spermatozoa
Alex Salam ;Peter Horby
2018
The Lancet Infectious Diseases
Outbreaks in a Rapidly Changing Central Africa — Lessons from Ebola
Vincent J. Munster, Daniel G. Bausch, Emmie de Wit, Robert Fischer, Gary Kobinger, César Muñoz‑Fontela, Sarah H. Olson, Stephanie N. Seifert, Armand Sprecher, Francine Ntoumi, Moses Massaquoi, and Jean‑Vivien Mombouli
2018
New England Journal of Medicine
Action not justification: how to use social science to improve outbreak response
Hana Rohan, Daniel G Bausch, Karl Blanchet
2018
Posted December 18, 2018 by PLOS Channels
Updates
Updates List Block
Disease outbreaks in low and middle income countries: New free online course launched

Experts from the UK Public Health Rapid Support Team have contributed to a new Massive Online Open Course (MOOC) from the London School of Hygiene & Tropical Medicine.

This course is for those interested in, studying or working in global and public health. This includes government stakeholders; health practitioners and NGO employees - particularly those working in countries regularly affected by infectious disease outbreaks.

Recent outbreaks of emerging and re-emerging infectious diseases have shown we need to be able to coordinate responses to disease outbreaks at the regional, country and global level. On this free course, participants will explore disease outbreaks, discovering what outbreaks are and why they matter as well as the different responses to such outbreaks. They will also consider the future of outbreak preparedness.

Find out more

UK Public Health Rapid Support Team deploys more experts to support Ebola outbreak response

Public health specialists from the UK Public Health Rapid Support Team are supporting the Democratic Republic of Congo to tackle the country’s Ebola outbreak as it reaches the one-year mark.

Those deploying to the country include a data scientist, an expert in tracking outbreaks (epidemiologist), and an infection and prevention control expert who will work with local scientists. The deployment is at the request of the World Health Organization’s Global Outbreak Alert and Response Network following the recent decision to declare the outbreak a Public Health Emergency of International Concern.

Read the full announcement

Chief Medical Officer recognises contribution of UK-PHRST to improving global health

In her final annual report before leaving the role, Dame Sally Davies – Chief Medical Officer, England, and Chief Medical Advisor to the UK – chose to ‘address the UK’s engagement with health at a global level’. Her report showcases the work of the UK Public Health Rapid Support Team and includes a case study of the team’s work to support Nigeria in tackling Lassa Fever.

Read the full report

What is it like responding to the ongoing Ebola outbreak in the Democratic Republic of Congo and deploying to emergencies?

Q&A with UK-PHRST’s Dr Olivier le Polain. 

Olivier le Polain is the senior epidemiologist and deputy director for operations of the UK Public Health Rapid Support Team.

He has been a member of the team for just under two years and in that time has deployed to Madagascar to respond to an outbreak of pneumonic plague, to Bangladesh amidst the Rohingya refugee crisis and most recently to the Democratic Republic of Congo. The latter was to support the response to two consecutive Ebola virus disease (EVD) epidemics, one in Equateur Province (May – July 2018) as well as the ongoing large outbreak which has affected the Eastern provinces of North Kivu and Ituri since August 2018.

Olivier talks about his experience on the ground in the DRC during the ongoing Ebola epidemic, the importance of working in partnership with other countries and organisations and his experience on the UK-PHRST so far. 

Read the interview

Online to on the ground – helping health workers engage with local communities during epidemics

A new online resource which aims to strengthen the control response to disease outbreaks has been developed by the London School of Hygiene & Tropical Medicine (LSHTM) and the Institute of Development Studies. The Epidemic Response Anthropology Platform is funded by the UK-PHRST and will work with, and build, networks of anthropologists and other social scientists with regional or subject expertise, and connect them to policymakers, scientists and humanitarian response workers involved in responding to epidemics.

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Ebola Outbreak: UK Public Health Rapid Support Team deploying to DRC

On 8 May 2018, the Democratic Republic of Congo (DRC) Government declared a new outbreak of Ebola Virus Disease (EVD)—the country’s ninth outbreak. The UK-PHRST is deploying to the Democratic Republic of Congo to help control the outbreak. The three UK-PHRST team members deploying include two experts in tracking outbreaks, LSHTM’s Hilary Bower and Olivier le Polain from Public Health England, and data scientist Patrick Keating from LSHTM.

The team is expected to remain in the DRC for around six weeks, during which time they will help track the spread of the outbreak, and will also support in establishing robust data systems that will help align crucial information gathering. The UK-PHRST also has expertise in various other key areas for Ebola response, such as laboratory diagnostics, that can be deployed should they be needed.

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How does the UK Public Health Rapid Support Team investigate and respond to disease outbreaks?

Q&A with team Director, Prof Dan Bausch.

In April 2017, Professor Daniel Bausch was appointed Director of the UK-PHRST. Prof Bausch is a specialist in emerging infectious diseases trained in internal medicine, infectious diseases, tropical medicine, and public health. He has extensive experience in sub-Saharan Africa, Latin America, and Asia combatting deadly global health threats such as Ebola virus, hantavirus, and SARS coronavirus.

A year on from the team's first deployment, Prof Bausch tells us more about the team and how they work to assist in managing disease outbreaks.

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UK Public Health Rapid Support Team deploys to Sierra Leone to help prevent disease outbreaks

The UK Public Health Rapid Support Team (UK-PHRST) is deploying to Sierra Leone to help reduce the risk of a disease outbreak following the deadly landslides in Freetown.

Following natural disasters, outbreaks of water-borne diseases such as cholera can occur, particularly where there is a lack of access to clean water and sanitation. Given the scale of the disaster in Freetown, the local capacity to detect and control a disease outbreak is limited and the Government of Sierra Leone has requested international support.

The UK-PHRST team deployed to Sierra Leone includes experts in tracking the progress of an outbreak and diagnosing its cause, as well as a logistician. It will be working alongside Sierra Leone health system professionals and other experts in disaster relief to support the Sierra Leone Government’s response. As the UK-PHRST’s deployment progresses, it will continue to provide support and share expertise with our partners in Sierra Leone to strengthen the health system beyond the immediate response.

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UK Public Health Rapid Support Team appoints first Director

Professor Daniel Bausch has been appointed Director of the new UK Public Health Rapid Support Team (UK-PHRST).

Prof Daniel Bausch, a specialist in emerging infectious diseases trained in internal medicine, infectious diseases, tropical medicine, and public health, will take up the position of Director of the UK-PHRST in April. He has extensive experience in sub-Saharan Africa, Latin America, and Asia combatting deadly global health threats such as Ebola virus, hantavirus, and SARS coronavirus.

His most recent role was as the Technical Lead for the Epidemic Clinical Management Unit in the World Health Organization's (WHO) Pandemic and Epidemic Diseases Department. He is a tenured Professor at the Tulane University Health Sciences Center in the United States and has served as a regular consultant for the WHO, the United Nations and the US National Institutes of Health. In addition to his expertise in the sciences, Prof Bausch places a strong emphasis on capacity building in all his projects and also has a keen interest in the role of the scientist in promoting health and human rights.

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UK Public Health Rapid Support Team to support Nigeria control Lassa fever outbreak

The UK Public Health Rapid Support Team (UK-PHRST) has deployed to Nigeria to help control an unusually large outbreak of Lassa fever, a viral haemorrhagic illness that can cause severe symptoms and sometimes death.

Lassa fever outbreaks occur in most years in Nigeria but on a lower scale. Given the size of the current outbreak and the risk of further spread locally, the Government of Nigeria has requested support from the UK-PHRST.

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UK Public Health Rapid Support Team launched

The London School of Hygiene & Tropical Medicine has been chosen to jointly run the newly established UK Public Health Rapid Support Team in partnership with Public Health England. Public Health Minister Nicola Blackwood announced the £20m initiative, to help prevent global health emergencies on behalf of the UK Government. It means the UK has a fully operational specialist team that is ready to be deployed anywhere in the world within 48 hours to tackle disease outbreaks which have the potential to develop into major health emergencies.

It will continually monitor infectious disease outbreaks around the world, identifying situations where the deployment of specialist expertise could help mitigate threats. When not responding to a disease outbreak, the team will research how best to deal with different types of outbreak scenario as well as training a group of public health reservists so the UK maintains the capability to rapidly scale up responses to outbreaks.

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