Ian Crozier, MDMedical Affairs Scientist, Frederick National Laboratory, NIAID Integrated Research Facility, Fort Detrick, Maryland, USA

Ian Crozier is a Medical Affairs Scientist at the Frederick National Laboratory in Fort Detrick, Maryland. From this position, he supports the NIAID Integrated Research Facility (IRF) at Fort Detrick in a position designed to be bidirectionally agile between the human bedside and in vitro/animal model investigation of host–filoviral (and other high-threat pathogen) interactions. His extensive experience at the Ebola virus disease (EVD) clinical bedside makes him well-suited to lend expertise from the human context to this proposal aimed at identification of the molecular mechanisms underlying the dysregulated immune response to Ebola virus.

He trained as an internal medicine and infectious diseases clinician, then had a long post-training experience instructing African clinicians and providing clinical care at the bedsides of patients with HIV/AIDS, tuberculosis, and other tropical infectious diseases in Uganda. In August 2014, early in the Western African EVD outbreak, his clinical experience was jump-started when he was deployed by the World Health Organization (WHO) to an under-resourced, overwhelmed Ebola Treatment Unit in Kenema, Sierra Leone. It was very clear that despite four decades of attention to this pathogen, they needed to understand more about the human–Ebola virus interaction to improve patient outcomes in these settings. Deep interest in exploring this interaction was subsequently catalyzed by personal experience as a critically ill EVD patient and then as EVD survivor. As the field had what was really the first high-resolution examination of acute (human) EVD, its clinical sequelae, and viral persistence in EVD survivors, new questions rapidly emerged that subsequently informed and fueled interest in understanding the host–pathogen interaction, with the ultimate goal of improving human outcomes in African settings.

In early 2015, work toward this goal began with Emory University clinicians/scientists and the WHO, and has subsequently evolved into his current position with the Frederick National Laboratory. Regarding acute EVD, initial work focused on understanding clinical disease and the dysregulated host immune response (at higher resolution), as well as efforts to define and improve previously underappreciated and under-emphasized approaches to the supportive care of the EVD patient. Regarding the sequelae of EVD, efforts with an Emory Eye Team focused on characterizing and developing clinical care protocols for newly appreciated EVD-associated uveitis, including addressing unknowns around the potential persistence of Ebola virus in the eyes of African survivors. A subsequent position with the WHO EVD survivor team lent both high level (e.g., development of survivor care guidelines, tracking Ebola virus persistence and residual risk associated with persistence in the semen of male EVD survivors) and three-country, on-ground expertise in training Western African (Sierra Leone, Liberia, Guinea) clinicians in the care of the EVD survivor. These guidelines have been subsequently adapted in recent outbreaks in the Democratic Republic of the Congo (DRC).

Since an October 2017 start with the Frederick National Laboratory (based at the IRF at Fort Detrick), continuing work at the human bedside is now complemented by more basic scientific interrogation of the same questions in in vitro and animal models of EVD. Regarding the latter, relevant ongoing projects at the IRF have focused on the development of advanced therapeutic candidates for EVD, including the use of combination therapy, as well the development of appropriate models to explore Ebola viral persistence and clinical sequelae. Regarding human disease, at the request of the WHO, his position has enabled multiple deployments (over more than five months of the ongoing 2018-2020 EVD outbreak in the DRC) to provide in-country technical expertise inside Ebola Treatment Units in North Kivu, Ituri, and South Kivu provinces. This work has focused on training African clinicians in and optimizing the delivery of advanced supportive care and the safe use of experimental therapeutics, initially under the MEURI compassionate use protocol and then as a member of the PALM randomized controlled trial of EVD therapeutics study team. In addition, he has been a key leader in the development of first-in-kind WHO Advanced Case Management for Clinicians training in the DRC and in Uganda and Tanzania/Zanzibar. It is expected that this agility to the human bedside will continue in ongoing and future filoviral disease outbreaks.

He continues also to lend technical expertise in scientific (e.g., as the current Filovirus Animal Non-Clinical Group [FANG] co-lead) and global health spaces (e.g., invited subject matter expert for WHO guideline development groups related to EVD in pregnant women and Ebola viral persistence in EVD survivors), as well as in frequent speaking invitations in international, national, and academic settings.

Link: https://en.wikipedia.org/wiki/Ian_Crozier