Objectives:

After this class you will be able to:

How it relates to VCU MPH Competencies: 1A(1,3,6) 1C(1.2.6.7) 1D(1,5,8) 1F(all)

This class on genetics and public health will use a case-based approach to help you learn about contemporary issues at the intersection of public health and genetics.  Our overall goal is to encourage you to recognize the genetic aspect of public health problems.  Just as learning about infectious organisms two centuries ago altered public health practices, from sanitation to immunizations, new knowledge and technologies in genetics are altering and will continue to impact public health practices.  Genetic information influences health and disease across the life span, from preconceptional genetic counseling and fortification of flours with folate to improvements in our understanding of causes of death and disability, from newborn hearing screening where over half of congenital hearing loss is genetic to recognition of the familial risk factors inherent in, for example, Alzheimer disease, cancer, coronary artery disease and stroke. 

Is closing summer camps for children with muscular dystrophy because of their apparent susceptibility to the H1N1 virus a modern day John Snow water pump story?
Refs: Host Genetic Background Strongly Influences the Response to Influenza A Virus Infections
PLoS ONE. 2009; 4(3): e4857. Published online 2009 March 18.
Barkha Srivastava1, Paulina Błaz_ejewska1, Manuela Heßmann1, Dunja Bruder2, Robert Geffers3, Susanne Mauel4, Achim D. Gruber4, Klaus Schughart1*
1 Department of Experimental Mouse Genetics, Helmholtz Centre for Infection Research & University of Veterinary Medicine Hannover, Braunschweig, Germany, 2 Research Group Immunoregulation, Helmholtz Centre for Infection Research, Braunschweig, Germany, 3 Gene Expression Analysis, Department of Cell Biology, Helmholtz Centre for Infection Research, Braunschweig, Germany, 4 Department of Veterinary Pathology, Faculty of Veterinary Medicine, Freie Universita¨t Berlin, Berlin, Germany


Abstract

The genetic make-up of the host has a major influence on its response to combat pathogens. For influenza A virus, several single gene mutations have been described which contribute to survival, the immune response and clearance of the pathogen by the host organism. Here, we have studied the influence of the genetic background to influenza A H1N1 (PR8) and H7N7 (SC35M) viruses. The seven inbred laboratory strains of mice analyzed exhibited different weight loss kinetics and survival rates after infection with PR8. Two strains in particular, DBA/2J and A/J, showed very high susceptibility to viral infections compared to all other strains. The LD50 to the influenza virus PR8 in DBA/2J mice was more than 1000-fold lower than in C57BL/6J mice. High susceptibility in DBA/2J mice showed a higher viral load in their lungs, elevated expression of cytokines and chemokines, and a more severe and extended lung pathology compared to infected C57BL/6J mice. These findings indicate a major contribution of the genetic background of the host to influenza A virus infections. The overall response in highly susceptible DBA/2J mice resembled the pathology described for infections with the highly virulent influenza H1N1-1918 and newly emerged H5N1 viruses.

Your Challenge:

Imagine you have graduated with your MPH. It is your first week as Director of Public Health Genetics for Virginia. This class is going to walk you through 3 public health genetic issues that arrive on your desk that first week. How will you handle them?

Before class:

Background Information:
Key Words

Concepts:

An ongoing challenge for public health personnel is to incorporate current understanding of the science of health and disease in effective and ethical public health measures.  Your understanding of the relevance of the genetic components of your family health history to your own health and your willingness to think about these complex issues for society and public health are both part of your legacy.  Think genetically.

The National Coalition for Health Professional Education in Genetics (www.nchpeg.org), a coalition of more than 120 health professional organizations, and the CDC (http://www.CDC.gov/genomics/training/competencies/default.html) have developed a set of competencies in genetics for health professionals and for the public health workforce.  Review these competencies and continue to reflect upon them as you go through your MPH program.
The following have been identified as public health functions relevant to genetics:

Critical issues include:

[See: Genetics and Public Health in the 21st Century (Muin Khoury, Wylie Burke, Elizabeth J Thomson (eds.), New York, Oxford University Press, 2000) is a comprehensive monograph about using genetic information to improve health and human disease.]
  The following web sites may be useful for your further study.

Also, scan the following:

Supplements Containing Folic Acid (CDC 2007)

 

Continuation of Lecture: