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Researchers to study neurological effects of Zika virus in young children

Researchers at the University of  Colorado Anschutz Medical Campus and the Baylor College of Medicine will join with Guatemalan investigators in a major study examining the clinical outcomes of children infected with the Zika virus after being born, focusing on long-term brain development.

“We now know the severe effects of Zika in the fetus and the unborn child if the mother gets the infection during pregnancy,” said Edwin Asturias, MD, co-principal investigator of the study and director of Latin American Projects at the Center for Global Health at the Colorado School of Public Health. “But if the virus is able to affect the developing brain of an infant or a child, this will have enormous consequences to a generation of children in areas where the virus has spread.”

Dr. Edwin Asturias of the Center for Global Health at the Colorado School of Public Health.


The study, funded by the National Institutes of Health, has been approved by the Ministry of Health in Guatemala and will take place in the rural southwestern coast of that country. Along with the Zika virus, the region is also endemic for the dengue and chikungunya virus transmitted by the same mosquito that carries Zika.

“We are enrolling infants in the first year of life and children up to 5 years of age who will be followed over one year to see if they become infected with Zika virus, and then we will be looking at the effects of the infection in the infants’ and children’s neurodevelopment,” said Dr. Flor M. Muñoz, associate professor of pediatrics in the section of infectious diseases at Baylor and principal investigator of the study. “We will look for neurologic or neurodevelopmental effects specifically, including effects on hearing and eye problems, because we know that the virus has the potential to cause central nervous manifestations.”

Zika virus has been known to affect babies in utero when the mother is infected during pregnancy, but little is known about what happens when infants are infected in early life, Muñoz said.

“Our concern is that a developing brain in early life can be impacted significantly,” she said. “It’s an important question to address not just for children that live in the endemic areas, but also for children who travel to these areas.”

Recruitment for the study will take place through a clinic created by the University of Colorado’s Center for Global Health in Guatemala. The goal is to follow 500 infants and their mothers for one year to determine if they become infected by the Zika virus. Neurologic exams and age-appropriate neurodevelopmental testing will be run for the duration of the study to identify changes in children infected with Zika virus.

Researchers will also be enrolling 700 children between the ages of 1 and 5 years, including 300 children known to have been exposed to dengue or Zika viruses while participating in a previous dengue study, and 400 who are siblings of the infants in this study. They will be tested periodically and evaluated for symptoms of flavivirus-like illness to determine if they have been infected by Zika, dengue or chikungunya viruses. Investigators will monitor serial neurologic examinations and developmental milestones in the children to determine if the Zika virus infection is associated with any neurologic or developmental changes.

Dr. Edwin Asturias examining children in Guatemalan clinic.
Dr. Edwin Asturias examining a child in Guatemalan clinic.

Muñoz and Asturias will collaborate with colleagues from the Fundacion para la Salud Integral de los Guatemaltecos (FUNSALUD) clinic in Guatemala. The clinic, affiliated with the Colorado School of Public Health and Children’s Hospital Colorado, is led by Dr. Antonio Bolaños. It has a full complement of local investigators, nurses and laboratory technicians along with Emory University’s Vaccine Treatment and Evaluation Unit (VTEU) research laboratory led by Dr. Mark Mulligan.

Neurodevelopmental testing will be conducted by three local psychologists under the leadership of Dr. Amy Connery of Children’s Hospital Colorado in Aurora, Colo. The study will last three years and results will be reported throughout the study. More information can be found at the NIH Zika website.


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CU Anschutz Spring Commencement 2017

More than 1,300 graduates from a wide range of health care disciplines celebrated their achievement with friends and family at CU Anschutz Commencement on May 26. The ceremonies included the graduation of the 10,000th student from the CU Anschutz Medical Campus in its current location, reflecting the campus’s tremendous growth since relocating from the location at 9th Avenue and Colorado Boulevard.

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Film uncovers life-threatening risks temp workers face

An hour and a half into his first day on the first job of his life, 21-year-old Lawrence Daquan “Day” Davis was killed.

The story of his untimely death is the focus of the award-winning film, “A Day’s Work,” screened recently at an event hosted by the Colorado School of Public Health’s Center for Health, Work & Environment.

Screening of Day's Work at CU Anschutz
At the film screening are, from left, Sarah Shikes, Executive Director, El Centro Humanitario; David DeSario, Producer, “A Day’s Work”; and Chris Lorenzo, Safety and Occupational Health Manager, Occupational Safety and Health Administration (OSHA).

Day Davis reported for work at a Bacardi bottling plant in Jacksonville, Fla., on Aug. 16, 2012. Looking proud in a bright orange vest and protective eyeglasses, Davis posed for a selfie in the bathroom mirror and texted his girlfriend. Later, as Davis cleaned up broken glass under a palletizer, a machine used to pack and stack products, another worker turned the machine on. The palletizer pushed cases down the conveyor belt, then onto the pallet below. That was when workers nearby heard a yell.

First responders arrived minutes later. But it was too late. Davis was already dead. He was crushed under 60 cases of bottles, weighing roughly 2,000 pounds.

Trend Towards Temp and Greater Risk

Increasingly, employers are outsourcing work to temporary workers, freelancers, and other contractors. A 2015 report by the Government Accountability Office found that 40 percent of the workforce in 2010 had “alternative work arrangements.” This percentage included company and independent contractors and on-call, temporary, self-employed, and standard part-time workers. And these numbers are growing.

Sadly, this means more workers are at greater risk of being injured, or even killed, on the job. Temporary workers are at least twice as likely to be injured at work compared to permanent employees, according to a 2013 ProPublica analysis.

“Research shows that temp workers are often overlooked when it comes to being adequately trained on how to do their jobs safely. They are falling through the cracks,” said Lee Newman, MD, ColoradoSPH professor and director of the Center for Health, Work & Environment on the CU Anschutz Campus.

A Day's Work film screened
A scene from the film ‘A Day’s Work.’

A former temporary worker himself, the producer of “A Day’s Work,” David DeSario, cites fear of retribution as one reason why temporary workers face higher risk.

“If a temp worker speaks up about a safety or health concern, they might not be working there the next day. Their jobs are vulnerable. They need people in the safety and health community and they need a voice through worker-run organizations,” DeSario explained.

Valuing Safety

DeSario’s film is a sobering reminder of the human cost of employer safety violations and serves as a call to action.

“The joy of this film is going back and telling Day’s family all the groups they have been able to reach,” said DeSario. “This film is about reaching people who work in public health. People who work on the ground every day and have the power to influence what’s happening out there.”

Experts at the Center for Health, Work & Environment are researching the best ways to keep workers safe and healthy, even as the employer-employee relationship changes.

“There is mounting evidence that there is a good business case for promoting healthier and safer workplaces,” Newman said. “In our ongoing research, we are establishing and testing best practices that can be readily adopted, even by small businesses, to create a happier, more engaged, and more productive workforce.”

One way to make a difference, for temporary and permanent workers alike, is to encourage employers to create a company culture where safety is a core value.

“Companies have to follow regulations and policies, but their workforce also needs to feel supported. They need to feel like the place they work, their managers, and their co-workers have their back in every instance. That is why culture is important,” said Natalie Schwatka, PhD, AEP, a researcher at the center and instructor at the Colorado School of Public Health. “Safety culture is about the employee’s perception of how much their employer values them and cares about their safety.”

Making a sound business case for why employers should invest in the health and safety of their employees can be challenging, especially for employers who rely on a temporary or contract workforce. But researchers at the Center for Health, Work & Environment see an opportunity to make a case for return on investment.

“Employers should care about all of their workers. Any safety incident results in lost productivity and damage to product, regardless of the status of the worker involved,” said Schwatka.

To learn more about the Center for Health, Work & Environment’s work and other upcoming events like their recent screening, visit

Guest contributor: Avery Artman, communications and media coordinator, Center for Health, Work & Environment, Colorado School of Public Health.

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MaLaura Creager earns doctor of pharmacy degree from CU Skaggs School of Pharmacy

MaLaura Creager with her daughter
MaLaura Creager with her daughter

MaLaura Creager has experienced quite a lot in her life. She and her brother are the first in their family to obtain bachelors’ degrees. And, MaLaura will be the first to attain her doctor of pharmacy degree from CU Skaggs School of Pharmacy.  “My family is so, so proud,” says Creager, who will have her own cheering section at Commencement when 20 family members descend on Colorado to share her excitement.  “They are so impressed that I will be a pharmacist.” 

For Creager, the mantra “it’s not if you go to college, but when” that many families embrace was not reality. 

Even though her family valued education, they just didn’t know how to get there.   “I didn’t understand applications or the process. There was no one to work through it with, so I thought I couldn’t go because I couldn’t afford it,” Creager says. 

Growing up in Utah and one generation removed from the farm, college was not as encouraged for women. In this day and age, that seems like a pretty foreign concept.  But for Creager, “It was considered an unnecessary expense to fulfill my dream of going to school.”  So, years passed. “It took a long time to overcome the barriers and discover financial aid,” says Creager. By the time she started her undergraduate program in Biology at Utah State she was already 27 and a single mother of a four-year-old daughter. 

“I applied and got some scholarships and took a leap of faith.” She quit her job and lived off her scholarships. “It was terrifying. There was no one to fall back on,” Creager recalls. 

In 2008, the economy bottomed out and she thought, “Oh, great. We’ll be homeless.”  But her tenacity pulled her through. “I never thought about dropping out or skipping a year.  I knew I just had to keep on going.” 

For Creager, the challenges were real. 

It wasn’t just simply that Creager was a single mother going to school.  She was a single mother with a special needs child. 

“In some ways having a high functioning autistic child has really provided me with an entirely different perspective.  It’s helped tremendously with patient care,” says Creager who looks at her daughter’s condition as an issue of diversity versus disability.  Her daughter, Evelyn, is 16 years old now and an autism advocate.  “She’s taught me a lot — especially to accept the diversity of different types of brains,” says Creager. The two will be on their next adventure together when Creager goes to her PGY-1 residency at Lovelace Medical Center in Albuquerque. 

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