Chasing the sun, and TB

After growing up in Queensland, Professor Emma McBryde has spent the past decade in Melbourne, but she is now returning to the tropics to track multiresistant tuberculosis in Papua New Guinea and Far North Queensland

FOR an infectious diseases physician, Professor Emma McBryde is a damn fine mathematician.

Last month, Professor McBryde upped stumps from Melbourne – where she was the Head of Epidemiology in the Victorian Infectious Diseases Service at Royal Melbourne Hospital and Head of Modelling and Biostatistics at the Burnet Institute – to join the Australian Institute of Tropical Health and Medicine at James Cook University in Townsville, where she will lead research into TB and hospital-acquired infections.

It’s a return home in many ways for Professor McBryde, who is a Queenslander. She finished her MB BS at the University of Queensland in 1994, winning the University Medal on the way.

She gained Fellowship to the Royal Australasian College of Physicians in 2003, before completing her PhD at the Queensland University of Technology in 2006 on hospital-acquired resistance to SARS.

In 2011 she added a Master of Biostatistics from the University of Melbourne to her collection.

“My whole PhD was in the maths department at the School of Mathematical Sciences at QUT”, Professor McBryde tells the MJA.

“I always liked maths. And I was always interested in public health and the global burden of disease – thinking about the big factors.

“Infectious diseases is the best of specialties to do that because in some ways it covers a very broad spectrum across all systems.”

Professor McBryde’s research expertise is in mathematical and statistical modelling of infectious disease transmission in both hospitals and the community. Using Bayesian inference – a method of statistical inference in which Bayes’ theorem is used to update the probability for a hypothesis as evidence is acquired – she has modelled epidemics and pathogens including influenza, SARS, and antibiotic-resistant pathogens including MRSA, VRE, Acinetobacter and TB.1

In Townsville she has the opportunity to be close to one of the world’s hot spots for TB, Papua New Guinea, with the threat of the disease crossing the Torres Strait into Far North Queensland.

“I am excited to start working with people passionate about improving the lives of the people of Far North Queensland and the Asia-Pacific region”, Professor McBryde said at the time of her appointment at JCU.

“There are many challenges ahead but there is also great commitment and support from everyone at AITHM, JCU, and government at all levels.”2

Multidrug-resistant TB is highly prevalent in the Western Province of PNG and many patients come across the Torres Strait for treatment in Queensland clinics.

According to Simpson and Vincent (2011), “drug susceptibility testing shows high levels of resistance to other drugs in the MDR-TB cases (streptomycin 93%, ethionamide 87%, ethambutol 18%, pyrazinamide 10%) … unless treatment is guided by [drug-susceptibility testing], the risk of XDR-TB emerging is high”.3

“There’s still a lot of work to be done”, Professor McBryde tells the MJA. “It’s a hot spot and [the problem] is underappreciated.”

She says there are three things that give her job satisfaction.

“I enjoy facing down the conventional wisdom”, she says. “I also love teaching and learning – anything to do with discovery.”

And the third thing?

“I very much enjoy small group collaboration”, she says. “Watching two or three students working together, interested in the outcomes, seeing people picking up the threads.”

The outcomes of her work don’t necessarily become apparent quickly – more like “over geological time periods”, she says – so finding day-to-day job satisfaction relies on these small group interactions.

“Seeing people getting better as a collective – that’s very satisfying”, she says.

Up until her move back to Queensland Professor McBryde was conducting one TB clinic a week in Victoria and is hoping to keep up that level of hands-on clinical work in Far North Queensland.

“How and where I don’t know yet, but I’m enjoying settling in and getting to know people.”

With two children aged 10 and 7, Townsville, with its wide range of water-related activities, is shaping as paradise for Professor McBryde and her family.

“I don’t relax as much as I should”, she admits. “I’m very much looking forward to living up here.”