Profile: Former Fogarty Scholar Dr Jessica Manning helps Cambodia respond to COVID

May / June 2020 | Volume 19, Number 3

May / June 2020 Global Health Matters newsletter [PDF <1M]

Dr. Jessica Manning works with a child patient in a clinic setting in Cambodia while others look on.
Photo courtesy of Tyler Mahal

Dr. Jessica Manning’s work in Cambodia grew out of her
2008 Fogarty fellowship in Mali, where she learned how to
operationalize a malaria study.

By Susan Scutti

When Cambodia identified its first patient with COVID-19 in late January, former Fogarty Scholar Dr. Jessica Manning leapt into action. Newly trained to use a small, technological device, she was able to quickly sequence the genome of a virus sample and post it on Nextstrain, the global collaboration database. It was among the first 20 to be shared on the site, which now includes thousands of SARS-CoV-2 genomes. “That was a really big step for us - to be the first lab from a developing country to contribute to the global knowledge base.” The collective effort provides insights for vaccine development and helps track the transmission, mutation and spread of the novel coronavirus.

Manning’s pandemic-related duties did not end there. As Science Attaché at the U.S. Embassy in Phnom Penh, she helped develop clinical algorithms for potential positive cases among the diplomatic corps stationed in Cambodia. She also is setting up a sero-prevalence study and expanding sequencing capabilities there with the additional funding she received from her employer, NIH’s National Institute of Allergy and Infectious Diseases (NIAID).

Last year, Manning’s NIAID lab had acquired the new sequencer and research funding for a project supported by the Bill and Melinda Gates Foundation and the Chan Zuckerberg Initiative. Given the growing global incidence of mosquito-borne diseases such as malaria and dengue, Manning’s study aims to use genomic sequencing to identify pathogens in samples collected from people suffering from fevers. She intends to gather data to map vector-borne disease incidence, model transmission risk and identify target areas for interventions - important for authorities with limited resources for insecticide spraying and other measures.

But her main research focus is investigating the potential for a universal vaccine for diseases transmitted by mosquitos, created from the insects’ spit. “We know that saliva actually worsens disease, so if we can have the body mount a protective response against saliva, we may be able to attenuate the actual pathogen’s effects - be it dengue, zika, malaria - whatever is carried by the mosquito,” she said.

Manning has just published results of what may be the first clinical trial of a mosquito spit vaccine in The Lancet. Conducted at the NIH Clinical Center in 2017, the study tested for safety and side effects in 49 healthy volunteers, who received one of two versions of the vaccine or a placebo. The results were promising but further research is needed to determine the effectiveness of a mosquito saliva vaccine.

Manning’s work in Cambodia grew out of her 2008 Fogarty fellowship in Mali, where she learned how to operationalize a malaria study after first establishing a genomics lab in Bamako to process samples gathered across the resource-scarce nation.

“Fogarty changed my life,” she recounted. “I had never lived in the developing world and it was a character-building experience in ways that I had never considered. It was eye-opening, impactful and meaningful and I knew then that this was going to be my career.”

That fellowship helped her understand what she would need to succeed, which led her to complete a master’s in epidemiology to deepen her quantitative skills. She also learned patience.

“Fogarty taught me that everywhere you go, you have to drink the tea. You have to just sit there and not talk and understand what’s happening so that ultimately you can begin to achieve the scientific objectives you came with,” she noted. “Cultural fluency is the key. It’s the number one thing that has to happen and I think it’s the hardest to learn.”