Bold Thinking at Abt: Global Health Security

Pat Shifflett

Vice President, US Health
Influenza surveillance, rapid response, H1N1 | Bio


In 2009, a new strain of flu alarmed doctors and public health departments. Killing pregnant women, children, young adults, and those with compromised immune systems, this new flu lacked a vaccine and struck thousands of people during the summer and early fall. All told, H1N1 affected an estimated 60 million people in the U.S. between April 2009 and April 2010. Of those cases, an estimated 12,500 people died with 87 percent of deaths in those under 65 years of age.

Summer is not typically flu season, recalls Pat Shifflett, Vice President, US Health. Shifflett, a public health nurse and consultant to the Centers for Disease Control and Prevention (CDC), knew that monitoring this novel flu virus, now recognized as H1N1, would be critical.

A Rapid Response when Speed Counts

While Abt had led infectious disease studies in the past, few of these studies were conducted in the thick of a pandemic. Explains Shifflett, “Right after I joined Abt, we started rapidly setting up H1N1 studies for CDC, and we learned a lot on how you rapidly ramp up during a time of crisis.”

Part of the H1N1 work meant examining the effectiveness of flu vaccine among priority populations such as pregnant women, health care workers and very young children. Shifflett emphasizes that vaccine success in the lab may seem promising but it is only when tested at scale that we can determine if it will work in the real world. Since that time, Shifflett and her team have expanded from U.S. flu studies to conducting flu studies around the world. Her team’s most recent studies include the burden of flu among infants less than one year old in four countries: Albania, Jordan, Nicaragua and the Philippines.

“Flu is often a discrete period of time, three to four months, and you don’t always know when it will start and when it will stop,” says Shifflett. “To study flu and vaccine effectiveness, you have to have everything set up and ready to go prior to the onset of flu season in order to catch people when they are sick. Our expertise is to set up influenza studies rapidly in advance of flu.” 

Study Launches in Six Months

The international infant burden study went from an idea of the key research questions to conducting data collection during flu season in  just six months. In that time, the team selected sites, developed a common protocol, cleared everything through many Institutional Review Boards, and started enrolling participants.

Says Shifflett, “It is one thing to set up a study in your city in six months. To set up an international study across four different countries that quickly was amazing.”

Abt rapidly assisted with project planning and coordination and Shifflett points out, each of the countries were also well equipped. Each country selected has a defined flu season, large populations for statistical analysis;  and strong research, laboratory and surveillance capacity. These are all critical factors, Shifflett says, in ensuring that a research study is successful.

“We have been able to respond when our clients need evidence for informed action,” says Shifflett. “That kind of rapid response is at the heart of global health security, no matter the type of infection, because when you’re talking about limited funding and good public policy, people need solid data for insight and action.”

Areas of Expertise

  • Infectious disease and control
  • International health
  • Training and technical assistance
  • Development of clinical and community guidelines
  • Public health policy development
  • Data analytics and evaluation
  • Survey design, development, and implementation