Ideally, the teams will visit families as soon as possible after children die, ask about their symptoms and, if given permission, photograph the bodies and take needle biopsies from lungs, brains, livers, spleens, kidneys and other organs.
The Bill & Melinda Gates Foundation plans to create a network of disease-surveillance teams in poor countries to do “minimal autopsies” on children to plumb causes of child mortality and also possibly spot emerging epidemics, the foundation announced Wednesday.
Although the effort will be modest at first — a $75 million donation to start small teams in six countries — the foundation hopes to expand to as many as 25 Asian and African countries with dozens of members on each team.
The network will include the U.S. Centers for Disease Control and Prevention (CDC) and Emory University’s Global Health Institute.
The surveillance teams could fill a crucial gap in detecting disease outbreaks. Local media sometimes report unusual clusters of illness and deaths, reports of which may reach the World Health Organization in Geneva or circle the world on disease-surveillance websites. But it can still take days or weeks until the true cause is determined. That happened in rural Guinea when West Africa’s large Ebola outbreak first began smoldering, for example.
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Ideally, the teams will visit families as soon as possible after children die, ask about their symptoms and, if given permission, photograph the bodies and take needle biopsies from lungs, brains, livers, spleens, kidneys and other organs. The samples will be sent to WHO-certified regional laboratories or to the CDC in Atlanta, to establish the cause of each child’s death.
Although the teams will initially focus on one limited area each, once they are trained, it would be possible to send them to any area where mysterious illnesses erupt.
“Their day jobs will be tracing childhood deaths, but if needed, they could be repurposed to track an epidemic,” said Dr. Scott Dowell, a former CDC epidemiologist who is now the foundation’s deputy director for epidemiology and surveillance.
One public-health expert called the idea “provocative” and potentially very useful.
“If it can be done in a culturally sensitive way, so that parents will permit the biopsies and the photographs; we could learn a whole heck of a lot,” said Dr. William Schaffner, the chairman of the department of preventive medicine at Vanderbilt University’s medical school.
The network is to be known as Child Health and Mortality Prevention Surveillance, or Champs.