Michael Mina

Michael Mina
Emory University | EU · Department of Global Health

PhD

About

76
Publications
5,649
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
1,806
Citations
Additional affiliations
March 2014 - present
Princeton University
Position
  • PostDoc Position

Publications

Publications (76)
Article
Immunosuppression after measles is known to predispose people to opportunistic infections for a period of several weeks to months. Using population-level data, we show that measles has a more prolonged effect on host resistance, extending over 2 to 3 years. We find that nonmeasles infectious disease mortality in high-income countries is tightly cou...
Article
Infections with influenza viruses and respiratory bacteria each contribute substantially to the global burden of morbidity and mortality. Simultaneous or sequential infection with these pathogens manifests in complex and difficult-to-treat disease processes that need extensive antimicrobial therapy and cause substantial excess mortality, particular...
Article
Full-text available
Unlabelled: Community interactions at mucosal surfaces between viruses, like influenza virus, and respiratory bacterial pathogens are important contributors toward pathogenesis of bacterial disease. What has not been considered is the natural extension of these interactions to live attenuated immunizations, and in particular, live attenuated influ...
Article
Full-text available
Background: Infection with influenza A virus (IAV) increases susceptibility to respiratory bacterial infections, resulting in increased bacterial carriage and complications such acute otitis media, pneumonia, bacteremia, and meningitis. Recently, vaccination with live attenuated influenza virus (LAIV) was reported to enhance subclinical bacterial...
Article
Secondary bacterial infections due to Streptococcus pneumoniae and Staphylococcus aureus, responsible for excess morbidity and mortality during influenza epidemics, are often preceded by excess bacterial density within the upper respiratory tract. Influenza and pneumococcal vaccines reduce secondary infections within the lungs; however, their effec...
Article
Background: Measles virus infection induces acute immunosuppression for weeks following infection, and also impairs preexisting immunological memory, resulting in "immune amnesia" that can last for years. Both mechanisms predispose the host to severe outcomes of subsequent infections. Therefore, measles dynamics could potentially affect the epidem...
Article
Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system of unknown etiology. We tested the hypothesis that MS is caused by Epstein-Barr virus (EBV) in a cohort comprising more than 10 million young adults on active duty in the US military, 955 of whom were diagnosed with MS during their period of servic...
Article
Full-text available
Vaccines provide powerful tools to mitigate the enormous public health and economic costs that the ongoing SARS-CoV-2 pandemic continues to exert globally, yet vaccine distribution remains unequal among countries. To examine the potential epidemiological and evolutionary impacts of ‘vaccine nationalism’, we extend previous models to include simple...
Preprint
Full-text available
Vaccines provide powerful tools to mitigate the enormous public health and economic costs that the ongoing SARS-CoV-2 pandemic continues to exert globally, yet vaccine distribution remains unequal between countries. To examine the potential epidemiological and evolutionary impacts of 'vaccine nationalism', we extend previous models to include simpl...
Article
Background Improper or delayed activation of a massive transfusion protocol may have consequences to individuals and institutions. We designed a complex predictive algorithm that was packaged within a smartphone application. We hypothesized it would accurately assess the need for massive transfusion protocol activation and assist clinicians in that...
Article
Full-text available
In the face of vaccine dose shortages and logistical challenges, various deployment strategies are being proposed to increase population immunity levels to SARS-CoV-2. Two critical issues arise: how will the timing of delivery of the second dose affect both infection dynamics and prospects for the evolution of viral immune escape via a build-up of...
Preprint
Full-text available
As the threat of Covid-19 continues and in the face of vaccine dose shortages and logistical challenges, various deployment strategies are being proposed to increase population immunity levels. How timing of delivery of the second dose affects infection burden but also prospects for the evolution of viral immune escape are critical questions. Both...
Article
Medically important flaviviruses cause diverse disease pathologies and collectively are responsible for a major global disease burden. A contributing factor to pathogenesis is secreted flavivirus nonstructural protein 1 (NS1). Despite demonstrated protection by NS1-specific antibodies against lethal flavivirus challenge, the structural and mechanis...
Article
Full-text available
The future trajectory of the Covid-19 pandemic hinges on the dynamics of adaptive immunity against SARS-CoV2; however, salient features of the immune response elicited by natural infection or vaccination are still uncertain. We use simple epidemiological models to explore estimates for the magnitude and timing of future Covid-19 cases given differe...
Preprint
COVID-19 is an ongoing public health emergency. Without a vaccine or effective antivirals, non-pharmaceutical interventions form the foundation of current response efforts. Quantifying the efficacy of these interventions is crucial. Using mortality data and a classification guide of state level responses, we relate the intensity of interventions to...
Article
Full-text available
SARS-CoV-2 presents an unprecedented international challenge, but it will not be the last such threat. Here, we argue that the world needs to be much better prepared to rapidly detect, define and defeat future pandemics. We propose that a Global Immunological Observatory (GIO) and associated developments in systems immunology, therapeutics and vacc...
Article
Full-text available
SARS-CoV-2 presents an unprecedented international challenge, but it will not be the last such threat. Here, we argue that the world needs to be much better prepared to rapidly detect, define and defeat future pandemics. We propose that a Global Immunological Observatory and associated developments in systems immunology, therapeutics and vaccine de...
Article
Full-text available
SARS-CoV-2 presents an unprecedented international challenge, but it will not be the last such threat. Here, we argue that the world needs to be much better prepared to rapidly detect, define and defeat future pandemics. We propose that a Global Immunological Observatory and associated developments in systems immunology, therapeutics and vaccine de...
Article
Vaccine-preventable diseases (VPD) including measles and mumps have been re-emerging in countries with sustained high vaccine coverage. For mumps, waning immunity has been recognized as a major contributor to recent outbreaks. Although unvaccinated individuals account for most cases in recent measles outbreaks, the role of immune waning remains unc...
Article
Measles virus is directly responsible for more than 100,000 deaths yearly. Epidemiological studies have associated measles with increased morbidity and mortality for years after infection, but the reasons why are poorly understood. Measles virus infects immune cells, causing acute immune suppression. To identify and quantify long-term effects of me...
Article
Full-text available
Measles virus (MV) is a highly contagious member of the Morbillivirus genus that remains a major cause of childhood mortality worldwide. Although infection induces a strong MV-specific immune response that clears viral load and confers lifelong immunity, transient immunosuppression can also occur, leaving the host vulnerable to colonization from se...
Data
The target cell, T cell, and antibody model calibrated with data from Lin et al. (2012). Points indicate data for (A) total lymphocytes, (B) MV-specific T cells, and (C) viral load; solid lines indicate the corresponding model predictions determined by maximum likelihood optimization. The activated T cell predictions are depicted before scaling for...
Data
Comparison of alternative general lymphocyte proliferation functions. Solid lines indicate lymphocyte dynamics predicted by the target cell and T cell model without lymphocyte proliferation (blue) and with early lymphocyte proliferation (orange); points indicate lymphocyte data from Lin et al. (2012). Each panel corresponds to an individual macaque...
Data
Representative parameter confidence intervals from individual 55V. Histograms show fitted parameter estimates obtained from 500 bootstrap samples. R0 was calculated from the fitted parameters as pβS0/cδ; similarly R0* was calculated as pβ(S0 + A0)/c(δ + kA0). Shaded regions encompass the 90th percentiles. (PDF)
Data
Uncertainty analysis for the target cell and T cell model. Each point represents the output (summarized here as total viral load) obtained from 1 of 100 different parameter sets generated by Latin Hypercube sampling. The corresponding distributions and box plots for each individual are outlined in black. (PDF)
Data
Sensitivity of the target cell addition simulation to experimental conditions. The relative change in viral load (or ‘relative effect’) was recalculated whilst: (A) the number of added target cells was varied between 1000, 2000 (original condition), and 3000 cells/μl; and (B) the timing of target cell addition was varied between 0.5, 1 (original co...
Data
Partial rank correlation coefficient analysis to assess sensitivity of the predicted time to rebound in the best fitting model. Each bar represents a different parameter, and the absolute height represents the magnitude of model sensitivity to that parameter. Positive values indicate that an increase in parameter value causes a positive change in t...
Data
Further details of experimental data, model formulations, and fitting procedures. (PDF)
Data
Comparison of alternative transmission kinetics using AICc. Each row represents a different individual and columns represent different model structures (in order of increasing complexity from left to right). For each individual, numerical values indicate the difference in AICc between each model and the model with the lowest AICc (and hence best st...
Data
Comparison of alternative adjusted cell-cell transmission kinetics using AICc. Each row represents a different individual and columns represent different model structures. The original model (with infectious virus) is on the left, and the adjusted cell-cell transmission model (with different numbers of cell neighbors) is on the right. For each indi...
Data
Partial rank correlation coefficient analysis to assess sensitivity of the target cell and T cell model. Each bar represents a different parameter, and the absolute height represents the magnitude of model sensitivity to that parameter. Positive values indicate that an increase in parameter value causes a positive change in the measured model outpu...
Data
Quantification of the relative change in viral load using individual 55U as an example. In each panel, upper green lines indicate the treatment effect ((A) T cell depletion or (B) target cell addition) and lower green lines indicate the corresponding control simulation. The effect of each treatment is calculated as the difference in the area under...
Data
The target cell and T cell model without lymphocyte proliferation, calibrated with data from Lin et al. (2012). Points indicate data for (A) total lymphocytes, (B) activated T cells, and (C) viral load; solid lines indicate the corresponding model predictions determined by maximum likelihood optimization. The activated T cell predictions are depict...
Data
Sensitivity of the T cell depletion simulation to experimental conditions. The relative change in viral load (or ‘relative effect’) was recalculated whilst: (A) the initial number of activated T cells (A0) was varied between 0.01, 0.1 (original condition), and 1 cells/μl; and (B) the duration of T cell suppression was varied between 3, 4 (original...
Data
Relative effect of T cell depletion and target cell addition for different parameter modifications. For each macaque, the relative effect of each experiment is calculated as the difference in the area under the viral load curve (AUC) between the experimental and control simulations, normalized by the AUC of the control simulation. Results for each...
Data
Cumulative development of MV-specific memory T cells. For each macaque, the development of MV-specific memory T cells can be predicted by tracking the activated T cells that transition to the susceptible cell compartment. Solid lines indicate the predictions of the best-fitting target cell and T cell model, and each color represents an individual m...
Data
Comparing drivers of viral clearance with alternative lymphocyte proliferation functions. Three different functions are used to model the proliferation of susceptible lymphocytes, δ^(t): (A) no proliferation; (B) constant proliferation; and (C) constant proliferation within a temporary timeframe. For each macaque, the impacts of T cell depletion an...
Data
Model comparisons using AICc when general lymphocyte proliferation is omitted (i.e. δ^(t)=0∀t). Each row represents a different individual and columns represent different model structures (in order of increasing complexity from left to right). For each individual, numerical values indicate the difference in AICc between each model and the model wit...
Data
Representative pairwise parameter correlations from individual 55V. Fitted parameter estimates were obtained from 500 bootstrap samples. Colors and numerical values indicate the magnitude of correlation; correlations above a standard significance threshold (i.e. p > 0.05) are depicted in white. (PDF)
Data
Functions governing T cell activation. Three different functions are used to model the activation of MV-specific T cells, f(V): (A) activation that is proportional to viral load; (B) activation that saturates at high viral loads; and (C) constant activation within a discrete timeframe. Solid lines indicate f(V) for each model, and each color repres...
Data
Functions governing lymphocyte proliferation. Three different functions are used to model the proliferation of susceptible lymphocytes, δ^(t): (A) no proliferation; (B) constant proliferation; and (C) constant proliferation within a temporary timeframe. Solid lines indicate δ^(t) for each model, and each color represents an individual macaque (with...
Data
Comparing the drivers of viral clearance between the pooled and individual fits. For each individual (or pooled) fit, the impacts of T cell depletion and target cell addition on viral load were calculated as the difference in area under curve (AUC) between the experimental and control simulations, normalized by the AUC of the control simulation. Re...
Data
Comparison of alternative T cell activation functions using AICc. Each row represents a different individual and columns represent different model structures (in order of increasing complexity from left to right). For each individual, numerical values indicate the difference in AICc between each model and the model with the lowest AICc (and hence b...
Data
Comparison of alternative general lymphocyte proliferation functions using AICc. Each row represents a different individual and columns represent different model structures (in order of increasing complexity from left to right). For each individual, numerical values indicate the difference in AICc between each model and the model with the lowest AI...
Article
Full-text available
Objective To test the hypothesis that measles infection increases the incidence of non-measles infectious diseases over a prolonged period of time. Design A population-based matched cohort study. Data sources This study examined children aged 1–15 years in The Health Improvement Network UK general practice medical records database. Participants i...
Article
The measles virus is among the most transmissible viruses known to infect humans. Prior to measles vaccination programs, measles infected over 95% of all children and was responsible for over 4 million deaths each year. Measles vaccination programs have been among the greatest public health achievements reducing, eliminating endemic measles in the...
Article
Interactions between pathogens and commensal microbes are major contributors to health and disease. Infectious diseases however are most often considered independent, viewed within a one-host one-pathogen paradigm and, by extension, the interventions used to treat and prevent them are measured and evaluated within this same paradigm. Vaccines, espe...
Article
Background: High energy missiles can cause cardiac injury regardless of entrance site. This study assesses the adequacy of the anatomic borders of the current "cardiac box" to predict cardiac injury. Methods: Retrospective autopsy review was performed to identify patients with penetrating torso gunshot wounds 2011-2013. Using a circumferential g...
Article
Airborne pathogens — either transmitted via aerosol or droplets — include a wide variety of highly infectious and dangerous microbes such as variola virus, measles virus, influenza A viruses, Mycobacterium tuberculosis, Streptococcus pneumoniae, and Bordetella pertussis. Emerging zoonotic pathogens, for example, MERS coronavirus, avian influenza vi...
Article
Full-text available
Airborne pathogens — either transmitted via aerosol or droplets — include a wide variety of highly infectious and dangerous microbes such as variola virus, measles virus, influenza A viruses, Mycobacterium tuberculosis, Streptococcus pneumoniae, and Bordetella pertussis. Emerging zoonotic pathogens, for example, MERS coronavirus, avian influenza vi...
Article
Background: Despite the lethality of injuries to the heart, optimizing factors that impact mortality for victims that do survive to reach the hospital is critical. Methods: From 2003 to 2012, prehospital data, injury characteristics, and clinical patient factors were analyzed for victims with penetrating cardiac injuries (PCIs) at an urban, leve...
Article
Background: This study evaluates patterns of injuries and outcomes from penetrating cardiac injuries (PCI) at Grady Memorial Hospital, an urban, level I trauma center in Atlanta, Georgia, over 36 years. Methods: Patients sustaining PCIs were identified from The Trauma Registry of the American College of Surgeons and the Emory Department of Surge...
Article
Background: Each year, 200,000 patients undergo an in-hospital cardiac arrest (IHCA), with approximately 15-20% surviving to discharge. Little is known, however, about the long-term prognosis of these patients after discharge. Previous efforts to describe out-of-hospital survival of IHCA patients have been limited by small sample sizes and narrow...
Article
Across a range of pathogens, resistance to chemotherapy is a growing problem in both public health and animal health. Despite the ubiquity of coinfection, and its potential effects on within-host biology, the role played by coinfecting pathogens on the evolution of resistance and efficacy of antimicrobial chemotherapy is rarely considered. In this...
Article
Previous investigations have demonstrated that activation with the type II interferon, IFN-γ, downregulates alveolar macrophage (AM) phagocytosis of Streptococcus pneumoniae. While these studies have shown clear effects at discrete time points, the kinetics of the macrophage response to IFN-γ over time, with respect to pneumococcal phagocytosis, ha...
Article
Coinfections with common bacterial respiratory pathogens and influenza viruses are well-known causes of disease, often via synergistic interactions between the influenza virus, the bacteria, and the human host. However, relatively little is known about interactions between atypical bacteria and influenza viruses. A recent report by Reinton et al. e...
Article
Full-text available
Acute otitis media (AOM) caused by Streptococcus pneumoniae remains one of the most common infectious diseases worldwide despite widespread vaccination. A major limitation of the currently licensed pneumococcal vaccines is the lack of efficacy against mucosal disease manifestations such as AOM, acute bacterial sinusitis and pneumonia. We sought to...
Article
The use of massive transfusion protocols (MTPs) is now common in civilian trauma settings, and early activation of MTP has been shown to increase survival of MTP recipients. Numerous MTP prediction tools have been developed; however, they are often cumbersome to use efficiently or have traded predictive power for ease of use. We hypothesized that a...
Article
Full-text available
Intestinal barrier function is regulated by epithelial tight junctions (TJs), structures that control paracellular permeability. Junctional Adhesion Molecule-A (JAM-A) is a TJ-associated protein that regulates barrier, however mechanisms linking JAM-A to epithelial permeability are poorly understood. Here we report that JAM-A associates directly wi...
Article
Influenza and respiratory bacterial synergy, a term often used when describing the relationship between these two highly divergent phyla of respiratory tract pathogens, has been known and documented for nearly a century (1-3).…
Article
Damage control resuscitation (DCR) has improved outcomes in severely injured patients. In civilian centers, massive transfusion protocols (MTPs) represent the most formal application of DCR principles, ensuring early, accurate delivery of high fixed ratios of blood components. Recent data suggest that DCR may also help address early trauma-induced...