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Emory Rollins School of Public Health
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Peter  Teunis

Visiting Professor

Adjunct or Visiting, Global Health

I have a joint appointment at the Centre for Infectious Disease Control in the Netherlands (National Institute of Public Health, RIVM) and the Department of Global Health.

At the Centre for Infectious Disease Control I work as a biostatistician in the Epidemiology and Surveillance Unit, as a member of a group that is charged with developing new methods for infectious disease surveillance. My main interests are:

1. Use of outbreaks of infectious disease as a source of information for dose response relations (infectivity of pathogens in humans)

2. Development of quantitative methods for serology, in particular use of serum antibodies as biomarkers of infection

3. Tracking infections in human populations during outbreaks (who infected whom?)

4. Method development for quantitative microbiology: interpretation of microbial data for use in risk assessment

When I am in Atlanta I work on waterborne disease in the Centre of Global Safe Water (among other things) and teach a short course during spring break, called: "Introduction to Microbial Risk Assessment" (GH506/EH547).

Microbial Risk Assessment

As a (relatively) young approach to the study of infectious disease microbial risk assessment has seen rapid growth as a tool for providing a rational scientific basis for decision making in public health. Risk assessments construct forward projections of risk, using a bottom-up approach: quantitative estimates of human exposure to microbial pathogens are translated into risk of health effects (infection, acute illness, burden of disease). For many environmental pathogens (water- or foodborne, or transmitted via fomites and dust) the risks are low, so that they cannot be measured directly by traditional epidemiological methods. In some communities exposure may be high but via several concurrent pathways such that contributions of individual sources cannot be measured in an epidemiological study. Careful study of the numbers of such microbes in the environment and their intake by humans then makes it possible to estimate exposure and the associated health risks.

The course (1 credit) is 5 days long and consists of a series of morning lectures introducing basic concepts like: what is risk and how can it be quantified, statistical inference on microbial data (the likelihood function and its use in quantitative microbiology), and how to estimate microbial concentrations and ratios of concentrations. These introductions make up about half of the lectures, the remaining lectures present various case studies as examples of applications of microbial risk assessment. These include: outbreaks of infectious disease as a source for dose response data, risk assessments for the fecal-oral and the respiratory pathways, how to study the transmission network during an outbreak of infectious disease, and the importance of discrete events (of human behavioural origin) in microbial risk assessment. The afternoons are used for hands-on experience. Questions (and answers) are provided, dealing with all main issues presented in the lectures, and a selection is used for groupwise discussion. Computer applications are included, using the statistical platform "R". Each student receives a small assignment, dealing with a problem from risk assessment practice. At the end of the course the results are presented to the group and discussed.
 

Contact Information

, GA

Email: p.teunis@emory.edu

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Publications

  • , , Low seroprevalence of Q fever in the Netherlands prior to a series of large outbreaks., Epidemiology and Infection, Feb 16, 1-9
  • , , The application of an enzyme-linked immunosorbent assay or an immunofluorescent assay test leads to different estimates of seroprevalence of Coxiella burnetii in the population. , Epidemiology and Infection, Feb 15, 1-6
  • , , Human beings are highly susceptible to low doses of Trichinella spp., Epidemiology and Infection , ,
  • , , Low predictive value of seroprevalence of Toxoplasma gondii in cattle for detection of parasite DNA. , International Journal of Parasitology , 41(3-4), 343- 354
  • , , Norovirus disease associated with excess mortality and use of statins: a retrospective cohort study of an outbreak following a pilgrimage to Lourdes., Epidemiology and Infection, 139(3), 453-463
  • , , Dose-response modeling of Salmonella using outbreak data. , International Journal of Food Microbiology, 144(2), 243-249
  • , , Enteric virus infection risk from intrusion of sewage into a drinking water distribution network. , Environmental Science and Technology, 44(22), 8561-8566
  • , , Estimation of the likelihood of fecal-oral HEV transmission among pigs. , Risk Analysis , Dec 22. doi, 10.1111/j.1539-6924.2010.01546.x
  • , , Evaluation of ELISA test characteristics and estimation of Toxoplasma gondii seroprevalence in Dutch sheep using mixture models., Preventive Veterinary Medicine, 96(3-4), 232-240
  • , , High infectivity and pathogenicity of Influenza A virus via aerosol and droplet transmission., Epidemics, 2(4), 215- 222
  • , , Incidence and Reproduction Numbers of Pertussis: Estimates from Serological and Social Contact Data in Five European Countries, PLoS Medicine , 7(6):e1000291, (1-10)
  • , , Seroepidemiological studies indicate frequent and repeated exposure to Campylobacter spp. during childhood., Epidemiology and Infection, Oct. 26, (1-8)
  • , , The effect of mask use on the spread of influenza during a pandemic. , Risk Analysis , 30(8), 1210- 1218
  • , , Transmission of Novel Influenza A(H1N1) in Households with Post-Exposure Antiviral Prophylaxis., PLoS ONE , 5(7): e11442, (1-10)
  • , , Usefulness of seroconversion rates for comparing infection pressures between countries. , Epidemiology and Infection , Apr 12, 1-8
  • , , Within-host dynamics of Trichinella spiralis predict persistent transmission in rat populations., International Journal of Parasitology , 40(11), 1317-1324
  • , , Characterization of drinking water treatment for virus risk assessment., Water Research, 43(2), 395- 404
  • , , Bordetella pertussis strains with increased toxin production associated with pertussis resurgence., Emerging Infectious Diseases, 15(8), 1206-1213
  • , , Differences in clinical presentation between norovirus genotypes in nursing homes. , Journal of Clinical Virology, 46(4), 341-344
  • , , Enhanced hygiene measures and norovirus transmission during an outbreak., Emerging Infectious , 15(1), 24-30
  • , , Estimation of incidences of infectious diseases based on antibody measurements. , Statistics in Medicine , 28(14), 1882-1895
  • , , Long-term inactivation study of three enteroviruses in artificial surface and ground waters, using PCR and cell culture. , Applied and Environmental Microbiology , 75(4), 1050-1057
  • , , Norovirus outbreaks in nursing homes: the evaluation of infection control measures. , Epidemiology and Infection, 137(12), 1722-1733
  • , , Seasonal patterns in time series of pertussis., Epidemiology and Infection , 137(10), 1388-1395
  • , , Transmission risk of human trichinellosis. , Veterinary Parasitology , 159(3-4), 324-327
  • , , Usefulness of sero-surveillance for Trichinella infections in animal populations. , Veterinary Parasitology , 159(3-4), 345-349