ICTMM16_Report

International Congress for Tropical Medicine & Malaria
18-22 September 2016, Brisbane Australia
CONFERENCE REPORT
“Having Australia host this international conference on tropical medicine and
malaria is testimony to the world class research undertaken here, and our
commitment to global health by understanding and addressing some of the world’s
most devastating, but neglected tropical diseases.”
ASID President Professor Cheryl Jones
The XIX International Congress for Tropical Medicine and Malaria (ICTMM 2016) was held at the
Brisbane Exhibition and Convention Centre from 18-22 September, attracting over 1500 attendees,
with invited speakers from 14 different countries. It was the first time for this event to be held in
Australia. Topics included tropical medicine, malaria, parasitology, infectious diseases, zoonoses,
veterinary and one health, travel medicine and more.
The Australasian Society for Infectious Diseases (ASID) co-hosted the Congress together with The
Australian Society for Parasitology Inc (ASP). ASID’s biennial Zoonoses Conference and the inaugural
Barrie Marmion Award for Research in Zoonoses were incorporated into the program.

TROPICAL MEDICINE HIGHLIGHTS: Malaria
The Congress opened with Professor John Reeder,
WHO, on the evolution of The Special Programme
for Research and Training in Tropical Diseases
(TDR), a global programme of scientific
collaboration that helps facilitate, support and
influence efforts to combat diseases of poverty.
He was followed by Dr BT Slingsby, CEO of Global
Health Innovative Technology Fund (GHIT), a
public-private partnership that leverages Japanese
innovation and leadership to advance R&D for
novel health technologies for the developing world. Innovative public-private partnerships to
stimulate R&D were a major theme of the Congress.
Read about GHIT’s new funding for a single dose antimalarial and vaccines for dengue + TB.
AUSTRALIAN MALARIA RESEARCH
From Australia, ASID’s Professor James McCarthy, QIMR, presented on the use of experimental
human malaria infection to improve the understanding of the pathogenesis of malaria and to
develop new diagnostics, drugs and vaccines. He was interviewed by Norman Swan from ABC’s
Health Report in the lead up to the conference.
Listen to the Health Report interview or read the transcript
Read the study published in the MJA that suggests breath biomarkers could be exploited in a
simple, malaria breath diagnostic.
Read the study on induced blood-stage Plasmodium vivax infection in healthy volunteers.
MALARIA VACCINE WITHIN REACH
Dr Stephen Hoffman – Sanaria’s PfSPZ malaria vaccine has yielded ‘unprecedented protection in
clinical trials and is found to be safe, easily administered and protects for at least a year’. The vaccine
received FDA fast track designation during the conference. By March next year Sanaria hope to have
completed phase 2 trials to establish dosage regimen with a view to launching the vaccine in March
2019. Strategy involves pursuing 2 parallel tracks to licensure: a vaccine for use in endemic regions
and a vaccine for travellers, military and expat workers. Hoffman’s presentation focused on how to
overcome the challenges faced in using this for elimination campaigns.
Read Sanaria’s media release on vaccine efficacy
Read the study published in Nature
Read Sanaria’s media release on FDA fast track designation
COLLABORATION PAVES THE WAY
Associate Professor Matthew Todd - A unique “open source” study has created a collaborative
patent-free environment that will accelerate the development of new malaria treatments, according
to lead researchers at the Univ. of Sydney. Read the media release or the research article in ACS
Dr Jorg Mohrle - A new potent antimalarial development candidate with potential for both
treatment and prevention of malaria has been identified by a collaboration between Medicines for
Malaria Venture (MMV) and an international network of partners. Read the media release

TROPICAL MEDICINE HIGHLIGHTS: TB, HIV, Zika
Snapshot: TB Priorities for Australia
The soon-to-launched National Strategic Plan will inform
those involved in TB care but also other Commonwealth
and State and Territory Departments in areas where a
'Health in All Policies' approach is needed. The plan aligns
with WHO guidance on how to approach the elimination of
TB from the global health landscape.
For Australia this will mean targeting populations within our community that have higher rates of TB
and higher risk of developing TB. Many of these persons may not have yet arrived in Australia as
nearly 90 per cent of Australia's active TB cases were born overseas, usually in a country with high
TB incidence. TB usually takes months/years to develop after initial infection but can take decades.
Snapshot: HIV
Professor Sharon Lewin updated the audience on the search
for an HIV cure. The world simply can’t afford to put
everyone with HIV on lifelong treatment, she said, and a
cure will be essential.
Today, achieving long-term remission of the virus is
considered a “functional cure” for HIV. However,
measurement of such remission needs to be standardized
across the industry to allow for better comparison of
research on this topic. Other cure studies presented include
“shock and kill” studies in various European countries,
whereby the virus is activated and then treated with a
vaccine; and a clinical trial of adults who initiated treatment
early and then stopped medications while being closely
monitored. HIV cure research can benefit from advances in
cancer research, as well, Lewin concluded.
Watch a video interview with Sharon Lewin
Snapshot: Zika Virus
Zika Virus continued to peak interest, with Dr Federico Costa providing an update from Brazil. Their
current perspective is that ZIKV causes a congenital infection and syndrome distinct from other
causes of microcephaly. However, he raised caveats in attributing the entire burden of microcephaly
to congenital Zika syndrome. An effective response to this emergency will require systematic
investigation of pregnant women and newborns, a serologic test that detects exposure in utero and
stratifies risk among women of child bearing age, and a fundamental understanding of all modes of
ZIKV transmission in order to project future trends and risks.
Travel Medicine: A message for GPs
Given the boom in travel, tropical medicine should not be considered an exotic field for GPs, writes
ICTMM Presenter Dr Colleen Lau.
Read her article in Medical Observer and the media release issued by ASID.

BURDEN OF DISEASE: Aboriginal Populations
Snapshot: Global burden of
neglected diseases
PLOS Neglected Tropical Diseases co-Editor-in-
Chief Dr Peter Hotez’ presentations brought into
sharp focus the changing health landscape, with
widespread poverty-related neglected diseases
occurring predominantly among the poor living in
wealthy G20 countries. Such findings represent a
significant departure for the way in which we usually think about global health and as a result have
important policy implications for the G20 leaders and governments. This concept - “Blue Marble
Health” - was first expressed in 2011 and is now in a new book with 38 new research papers.
Investigators are invited to continue contributing new papers to this collection. Read more in PLOS.
Indigenous Australia
Dr Peter Hotez also focused on diseases of poverty in global Aboriginal populations, who account for
15 per cent of global poverty even though they comprise only 5 per cent of the global population.
In Australia, the greatest burden of neglected tropical diseases is in Indigenous populations in
remote and rural areas of the Northern Territory:
Strongyloidiasis: hyperendemic and often associated with (HTLV-1) co-infection
Hookworm: caused by Ancylostoma duodenale
Intestinal protozoan infections
Ectoparasitic scabies
Secondary group A streptococcal (GAS) infections & impetigo (extremely common)
Post-streptococcal sequelae: including glomerulonephritis and rheumatic heart disease. (In
some cases secondary staphylococcal infections occur.)
Trachoma: still common in remote rural areas, although recently the Australian government
committed to eliminating this disease.
Melioidosis (Burholderia pseudomallei' infection): also common during the wet season.
ASID Focus: Rheumatic Fever
ASID issued a media release from the Congress on Rheumatic Fever:
“Rheumatic Fever is a disease of poverty and neglect, normally associated with developing
countries. However, the highest rates of Rheumatic Fever in the world are actually found here, in
Australia’s Indigenous children.”
Professor Bart Currie, Director of RHD Australia and ASID Secretary.
The Australian guideline for prevention, diagnosis and management of acute rheumatic fever and
rheumatic heart disease provides a clear opportunity to turn this around by identifying standards of
care, introducing evidence based management strategies and ensuring high-risk populations receive
the same standard of care as that available to other Australians. Read ASID’s media release.

TROPICAL MEDICINE HIGHLIGHTS: Paediatrics and Mycology
ASID Focus: PAM
Research presented at the Congress and then published in the Medical Journal of Australia (MJA)
drew attention to an a very rare but fatal brain infection mostly affecting children. This follows the
death of a 12 month-old boy at Townsville Hospital. Primary Amoebic Meningoencephalitis (PAM)
is caused by amoeba such as Naegleria fowleri and is typically found in warm fresh water, such as
ponds, lakes, rivers, hot springs and poorly maintained municipal water supplies. Rural and remote
communities are particularly at risk, where hot bore water and long surface pipelines promote the
growth of large concentrations of the disease-causing amoeba. ASID President Professor Cheryl
Jones warned health professionals and communities to be on alert to PAM with summer
approaching, and respond immediately to any suspected infections by alerting their laboratories to
look for amoebae.
Read the ASID media release on PAM
Read the study in MJA
Related coverage: MJA Insight; Medical Observer; SMH;
TROPICAL MEDICINE HIGHLIGHTS: Mycology
The ASID-run Tropical Mycology session at the ICTMM included presentations by Ed Zulstra, Wieland
Meyer and Isabella Gremiao.
Fungal Diagnostics in Resource Poor Settings
Wieland Meyer and Debbie Marriott
The global burden of fungal disease is difficult to assess but likely to be significantly underestimated
due to inadequate surveillance, lack of recognition of fungal infection and poor
diagnostic tests.
However, it is likely that fungal infections add a substantial burden to health care making rapid,
accurate and affordable diagnosis essential.
Diagnostic modalities include direct microscopy, histopathology, culture, antigen testing,
molecular techniques.
This presentation discussed the pros and cons of each.
Read a news article in the Lancet: “Bringing fungal infections in from the cold”
IN THE NEWS
Data from Labceutics’ Infectious Disease Lap Mapping Program
Marketwired
Laboratory Testing Data From More Than 19 Tropical and Developing Countries Provides Unique
Insight Into Potential for Outbreak and Resistance Tracking Using Molecular Diagnostics.
Rat lungworm study sheds light on disease
Hawaii Tribune Herald
East Hawaii Island is the epicenter for rat lungworm infections, said ... part of theInternational
Congress for Tropical Medicine and Malaria.

SNAPSHOT: PUBLIC HEALTH IN THE PACIFIC
ASID Focus: Antimicrobial Resistance
Nicola Townell
Pacific Island countries are developing and implementing national AMS programs.
They face significant challenges: lab detection of resistant organisms + surveillance, lack of
antimicrobial guidelines, poor awareness and understanding of AMR and infection control
practices, lack of local leadership and external support.
Discussion of case study: Solomon Islands
Success of program dependent on multi-disciplinary educational approach w local HCW taking
ownership of the program whilst collaborating with international supporting partners.
Labs’ ability to perform susceptibility testing and clinicians’ level of knowledge and understanding
in respect to diagnosis, management and prevention of infection requires further attention.
Read the WHO report on tacking AMR in the Solomon Islands
ASID Focus: Newly Recognised Cause of Chronic Skin Ulceration
Sally Roberts
Haemophilus ducreyi is the causative agent of chancroid, a genital ulcer disease common in
developing countries.
There is increasing evidence to support its previously unrecognised role as a causative agent of
chronic skin ulceration in children pin South Pacific Island Countries and Territories (PICT).
2 recent studies in PNG and SI have demonstrated high rates of H. ducreyi in skin lesions.
Additional work is needed to better understand the role of H. ducreyi in chronic skin ulceration.
Read a study by Sally Roberts in PLOS Neglected Tropical Diseases
Role of Tropical Islands in Globalising of Emerging Arboviruses
Van-Mai Cao Lormeau
Zika virus (ZIKV) appeared for the first time in the Pacific in 2007, expanded regionally and, in 2015,
emerged in Brazil. This study found that remote islands, with small populations mostly
immunologically naïve for new emerging arboviruses, combined with an environment highly suitable
for mosquito-borne diseases, should be considered as ideal hubs for virgin soil outbreaks of such
viruses, and subsequent geographic expansion through international travel. In addition, if remote
tropical islands experience outbreaks before more populated continental countries, such areas could
serve as sentinel sites.
Cervical Cancer Prevention in Emerging Nations
Ian Frazer
The HPV vaccine has been successfully delivered to preteen girls in Bhutan and Vanuatu, but
sustaining the programs has proven challenging despite donated vaccine, and government and
community support. Different modes of cervical screening have been trialled in Vanuatu, and the
best combination of sensitivity and specificity was obtained with HPV testing amongst over 30 year
olds. The CareHPV test has been successfully delivered under tropical conditions, but central
laboratory facilities are necessary for reagent storage. Provision of QA and QC, and assuring
compliance with follow up from positive screening tests remains a challenge.
Read about in Ian Frazer in Vanuatu

BARRIE MARMION ZOONOSES AWARD
“The Barrie Marmion Zoonoses Award gives us the opportunity to further shine the spotlight on our
achievements, by highlighting the best zoonoses-related research being presented here. We are
thrilled to offer this award to Dr Stephen Graves, for his invaluable contribution to Q Fever research.”
Professor Cheryl Jones, ASID President
ASID”s Barrie Marmion Zoonoses Award was presented at the Congress to Professor Stephen
Graves, Director of the Australian Rickettsial Reference Laboratory, for his work on Q Fever.
Read ASID’s media release about the Barrie Marmion Zoonoses Award and find out how
you can apply for 2017.
Q Fever Fatigue Syndrome
Professor Graves provided an update on Q Fever Fatigue Syndrome, emphasising the challenges of
diagnosis and likelihood of misdiagnosis. He recommended vaccinating all Australian teenagers in
rural areas in their last year of school. “Q Fever is a preventable disease that can have disasterous
consequences,” he said.
View Professor Graves slides on what you need to know about Q Fever.
Read ‘The natural history of acute Q fever: a prospective Australian cohort’ by Stephen
Graves and others in QJM.
Q Fever in Children
Associate Professor Clare Nourse presented on chronic recurrent multifocal Q fever
osteomyelitis in children. This rare manifestation of chronic Q fever infection is poorly understood,
and effective treatment options have not been established, leading the presenter to refer to it as ‘one
of the most significant clinical conundrums of today’.
Read new research by Clare Nourse and others is The Paediatric Infectious Disease Journal.
Q Fever in Companion Animals
Dr Amada Shapiro from UNSW presented on Q
Fever in companion animals in Australia,
reinforcing the need for vaccination in cat
breeders, highlighting low awareness and
touching on potential novel sources of infection
requiring further study.
Read ASID’s media release.
Read the article in Medical Observer

ICTMM 2016 IN PICTURES
Left: Over 1500 people attended
ICTMM 2016 from all around the
world.
Right: Conference Convenor
Professor David Looke gives the
opening address.
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The ICTIMM 2016 social program provided multiple networking opportunities, including a fantastic
Congress dinner at the beautiful Lone Pine Koala Sanctuary, which was fully booked. Attendees
enjoyed a traditional Australian BBQ in the world’s first and largest koala sanctuary, with over 130
koalas. Other events associated with the Congress were an Early Career Breakfast, hosted by ASP
and ASID for over 160 attendees, 8 workshops, which ran throughout the Congress, and a Technical
Tour of a Phase I Clinical Trial facility. The Congress was highly successful and has significantly
increased ASID’s international profile.