Global Health Chronicles

Dr. Kevin De Cock

David J. Sencer CDC Museum, Global Health Chronicles
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00:01:00 - Education and professional interests

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Partial Transcript: Could you tell us where you grew up and about your early family life?

Segment Synopsis: Dr. De Cock talks about his education and some of the influences on his early career choices as well as his interest in liver diseases, hepatitis and the new phenomenon of AIDS.

Keywords: assistant professor; economics; faculty member; fellow; infectious disease; liver disease; medical school; military service; politics; tropical medicine degree; viral hepatitis

Subjects: AIDS [acquired immune deficiency syndrome]; America; Belgium; England; Kenya; United Kingdom; University of Bristol; University of Nairobi; University of Southern California; hepatology

00:05:26 - EIS and serendipity

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Partial Transcript: What made you shift from clinical medicine and move towards public health?

Segment Synopsis: Dr. De Cock explains how he got introduced to the EIS program, and how he was assigned to a branch within CDC’s he had not considered but ended up to be an excellent fit.

Keywords: A. Redeker; H. Margolis; J. Maynard; Special Pathogens branch; hemorrhagic fevers

Subjects: AIDS; Brazil; CDC [Centers for Disease Control and Prevention]; California; EIS [Epidemic Intelligence Service]; HIV [human immunodeficiency virus]; NIH [National Institutes of Health]

00:07:55 - Work on retrospective cohort study

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Partial Transcript: You said that was --they actually had some studies that intersected with AIDS. Tell us a little bit about that first project.

Segment Synopsis: Dr. De Cock explains how he worked on a retrospective cohort study on blood samples collected in the 1976 Ebola outbreak in Zaire [now called the Democratic Republic of Congo] testing those samples for the HIV virus.

Keywords: Atlanta; Belgian nuns; D. Forthal; J. Mann; J. McCormick; K. Johnson; Kinshasa; Yambuku; hemorrhagic fever group; mission hospital; retrospective cohort study; seroconversion; special pathogens branch

Subjects: Central African Republic; Democratic Republic of Congo; Ebola; Flemish; HIV; Institute of Tropical Medicine Antwerp; New England Journal of Medicine; Projet SIDA; Zaire

00:15:15 - Projet RETRO-CI

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Partial Transcript: Why was there felt a need to have a project set up in Cote d’Ivoire? What were the goals of the project?

Segment Synopsis: : Dr. De Cock explains how the Cote d’Ivoire AIDS project began, starting with the third International Conference on AIDS in Washington. Challenges they faced in-country, and the rapid pace at which the Abidjan lab became a well-recognized, important research site.

Keywords: A. Porter; AIDS conference in Washington, D.C.; Abidjan; American Embassy in Abidjan; Antwerp; Atlanta; Fort Collins, Colorado; French Colonial links; HIV prevalence; Infectious Diseases department; J. Curran; J. La Montagne; J. McCormick; K. Holmes; K. Western; Kinshasa; L. Montagnier; M. Essex; M. Laga; New York City; P. Ghys; P. Piot; Paris; San Francisco; W. Heyward; Washington, D. C.; abortion; blood supply; blood tests; demographer; infrastructure; medical students; mortality rates; mortuaries; political and civil disturbances; research site; sex workers; university hospital; yellow fever epidemic

Subjects: AIDS; Africa; Burkina Faso; CDC; Cape Verde; Cote d’Ivoire; Guinea; Guinea-Bissau; HIV-1; HIV-2; Harvard; Institute of Tropical Medicine in Antwerp; Lancet; NIH; Nigeria; Projet RETRO-CI [Retrovirus Cote d’Ivoire Project]; Projet SIDA; Senegal; Treichville Hospital; West Africa; Zaire; lymphadenopathy-associated virus [LAV-2]

00:36:19 - HIV-1 and HIV-2

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Partial Transcript: You’re using the terms AIDS, and I think that can apply to both HIV-1 and 2.

Segment Synopsis: Dr. De Cock explains how the West African team differentiated between HIV-1 and HIV-2 and the difficulties of this serology and establishing mother-to-child transmission cohort studies.

Keywords: Abidjan; G. Noble; H. Jaffe; Infectious Diseases unit; J. Curran; Western blots; cholera beds; chronic diarrhea; mother-to-child transmission; receding infection; room number 24; serology; synthetic peptide-based tests; wasting syndrome

Subjects: AIDS; Africa; CD4 counts; HIV; West Africa

00:44:27 - Hospital Study and Clinique de Confiance

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Partial Transcript: What were the factors that led to this escalation and some of the differences that you saw in men versus women?

Segment Synopsis: Dr. De Cock explains the discrepancy in HIV prevalence between men and women in Abidjan and the cultural factors influencing that prevalence as well as setting up a testing clinic.

Keywords: Abidjan; Antwerp; Ghanaian women; Kinshasa; Matonge area of Kinshasa; O. Koudou; chiefs; condom; female sex workers; gay men; heterosexual; risk group; testing; transmission; women from Ghana

Subjects: AIDS; Clinique de Confiance; Cote d’Ivoire; East Africa; Ghana; HIV; STIs [sexually transmitted infections]; sex industry

00:53:40 - Tuberculosis in HIV-infected patients

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Partial Transcript: That was an area that really brought some fruitful findings. Can you tell us a little bit about that?

Segment Synopsis: Dr. De Cock explains how the team found the connection between tuberculosis and HIV, how finding these connections could help with prevention, control and training.

Keywords: HIV serology; Kinshasa; R. Bretton; S. Lucas; antiretroviral therapy; autopsied; blood donors; co-trimoxazole therapy; epidemiology; hospitalized patients, STI patients, tuberculosis patients, pregnant women; lung disease; pathologist; sentinel groups; training

Subjects: Africa; Belgium; England; National AIDS Program; Pneumocystis; United Kingdom; United States; tuberculosis

01:00:26 - Surveillance and case definitions

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Partial Transcript: I was curious about some of the challenges of a case definition in a country with limited resources. Talk a little bit about surveillance.

Segment Synopsis: Dr. De Cock discusses sentinel surveillance, creating a case definition, and how RETRO-CI is still in existence today, although it has become a PEPFAR site has weathered through political disturbances.

Keywords: A. Greenberg; Atlanta; Bangui; Geneva; HIV testing; J. McCormick; Kinshasa; S. Wiktor; case definitions; clinical case definition; co-trimoxazole study; infrastructure; interventions; mother-to-child transmission; political and civil disturbance; pregnant women; prevention; sentinel surveillance in pregnant women; short-course AZT [azidothymidine]

Subjects: AIDS; CDC; Central African Republic; Clinton administration; Cote d’Ivoire; EIS; HIV; Life Initiative; PEPFAR [President’s Emergency Plan for AIDS Relief]; RETRO-CI; UNICEF [United Nations Children’s Fund]; WHO [World Health Organization]; tuberculosis

01:09:00 - Final thoughts

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Partial Transcript: Just curious about when you reflect back on a career, what are your thoughts?

Segment Synopsis: Dr. De Cock concludes with his personal thoughts clinical medicine, the epidemic, his admiration for CDC, and his recent work on Ebola.

Keywords: ARVs [antiretroviral drugs]; EIS officer; London; clinical medicine; hemorrhagic fever; public health

Subjects: Ebola; RETRO-CI; West Africa; Western medicine; late-stage HIV disease