Working life: epidemiologist Dr Sema Nickbakhsh
by Guest Author on 19 Dec 2019
Dr Sema Nickbakhsh is a research epidemiologist at the MRC-University of Glasgow Centre for Virus Research. She describes the surprising relationships she’s found between flu and cold viruses, and why she enjoys looking at the bigger picture.
Career in brief:
- BSc (Hons) in Equine Science, The University of the West of England, Bristol
- MSc in Veterinary Epidemiology, The Royal Veterinary College / The London School of Hygiene and Tropical Medicine
- PhD in Veterinary Preventive Medicine, Epidemiology and Public Health, The University of Glasgow
- Research Assistant, Institute of Biodiversity, Animal Health & Comparative Medicine, The University of Glasgow
- Postdoctoral Research Fellow, School of Biological Sciences, The University of Edinburgh
- Postdoctoral Research Associate, MRC-University of Glasgow Centre for Virus Research
The great thing about epidemiology is that it’s very interdisciplinary. I study the patterns, causes and effects of health and disease conditions in large populations. This links together many different scientific fields, from biology and clinical studies, through to geography and the social sciences, using statistical and mathematical tools to validate observations and test new theories.
I think it’s really important that we have open communication across different science disciplines, from basic sciences through to data analysis and applied epidemiological work, so that eventually we can help to inform public health decisions.
My work is all about taking a bigger picture look. This contrasts with the work of a lot of my colleagues which is focused on understanding the biology of specific viruses. I’m currently looking at how the epidemiology of different types of respiratory viruses – the influenza virus, or flu, and common cold viruses, like the rhinovirus – may be interlinked as part of an ecological system.
In the same way as lions and spotted hyenas compete for food resources in the Masai Mara, we believe respiratory viruses may be competing for resources in the respiratory tract. These resources include the host cells they infect, which they need to exist and spread. Host cells can get destroyed during infection, or the immune system can cause them to go into ‘defence mode’, leading to fewer available cells and hence creating competition.
But beneficial relationships can also exist between pathogens. If you’re infected with flu, this can sometimes make you vulnerable to getting another infection. From a bacteria’s point of view this is a good thing, because the virus is helping the bacteria to invade the respiratory tract, resulting in infection. Co-operative relationships may be beneficial for both, or at least one, of the invading bugs.
And our new study is the first to reveal that both competitive and co-operative relationships may exist between respiratory viruses. One really striking pattern in our data shows that cases of the common cold-causing virus (rhinovirus) decline during winter, around the time that flu activity increases.
Studying how the spread of one virus may alter the spread of another, could allow us to forecast future infection trends and prepare medical facilities to treat people. And if flu stops common cold viruses from occurring, this may have implications for the impact of the flu vaccine. Could eliminating flu cases from the population give an advantage to the common cold? The common cold infects large numbers of people, has a high economic cost due to school absenteeism and the number of sick days people take off work, and can cause severe illness – particularly in young children and immuno-compromised individuals.
The next important step is to understand the biological mechanisms underpinning the close relationship between the cold and flu viruses and what direction these relationships take. For example, do flu infections prevent cold virus infections in winter, and do cold virus infections prevent flu infections in summer? With a new flu vaccination programme initiated in 2013 to target the UK child population, answering these questions will help us prepare for any indirect public health impact that vaccination may have on the spread of other respiratory viruses and could inform the design of new vaccine strategies
The data we used is collected as part of routine diagnostics in the NHS. We used data from the Greater Glasgow and Clyde Health Board, which is the largest NHS Health Board in Scotland covering a population of ~1 million, allowing us to analyse just over 44,000 cases of respiratory illness across a nine-year timeframe. Rather than testing for just one virus, the laboratories can screen for multiple viruses simultaneously in one individual.
I enjoy the creative side of science. I like thinking outside the box and bringing together new and different ways of thinking. I also enjoy the artwork side, so generating graphical representations of ideas and figures.
I’m inspired by people who take the approach of bringing together different areas of science. People who are less specific in their skills and people who take their research right through to the most impactful scales. People whose research ends up being applied to policy or to making decisions in public or veterinary health.
I didn’t know that I wanted to be a scientist until after my PhD. I took the mindset of studying what I was interested in and, eventually, I realised that my skills were best placed in research.
My career advice is to not get too caught up in the details. Your career path may just end up bringing together the different elements of everything you’ve already experienced.
As told to Isabel Harding