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In every population that encounters an infectious organism, a few individuals prove to be resilient—unfazed by that pathogen because they are either resistant to it (their immune systems keep the pathogen from multiplying to dangerous levels) or tolerant (they don’t get as sick as they otherwise might despite carrying high pathogen loads). Conventional disease treatments such as antibiotics have almost exclusively sought to emulate natural resistance by keeping patients’ pathogen levels as low as possible.
The chikungunya virus (CHIKV) is quickly spreading through the Western Hemisphere; as of May 15, 2015, the Pan-American Health Organization (PAHO) had tallied close to 1.4 million suspected cases and more than 33,000 confirmed cases since the virus’ first appearance in the Americas in December 2013. Spread by mosquitoes, chikungunya is rarely fatal but can cause debilitating joint and muscle pain, fever, nausea, fatigue and rash, and poses a growing public health and national security risk. Governments and health organizations could take more effective proactive steps to limit the spread of CHIKV if they had accurate forecasts of where and when it would appear. But such predictions for CHIKV and other emerging infectious diseases remain beyond the reach of current modeling capabilities.
As a result of combat exposure, warfighters may return home from deployments with psychological health challenges and find it difficult to reconnect with family and society at large. According to the Department of Veteran Affairs’ National Center for PTSD, studies show that between 12 and 25 percent of military personnel who had returned from Afghanistan and Iraq as of 2008 may suffer from PTSD. (1) Despite best efforts to improve awareness and care, additional studies reveal that only a small fraction of warfighters seek help dealing with psychological health issues.
The Technologies for Host Resilience (THoR) Program aims to develop new methods to maintain and optimize force health in the face of new and emerging infectious diseases. The goal is to discover the molecular mechanisms for tolerance of infection in animals, and develop therapeutic strategies that modulate the resilience of humans against infection. This capability would support military readiness by enabling warfighters to weather the storm of infectious diseases in low-resource or remote settings where pathogen-specific therapeutics or intensive care unit capabilities may not be locally available.
Currently, understanding and assessing the readiness of the warfighter involves medical intervention with the help of advanced equipment, such as electrocardiographs (EKGs) and other specialized medical devices, that are too expensive and cumbersome to employ continuously or without supervision in non-controlled environments. On the other hand, currently 92 percent of adults in the United States own a cell phone, which could be used as the basis for continuous, passive health, and readiness assessment.
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