Esther Ellen Freeman | |
---|---|
Born | 1979 (age 44–45) |
Alma mater | |
Scientific career | |
Institutions |
|
Thesis | The role of herpes simplex virus Type 2 in the spread and control of HIV in four Sub-Saharan African Cities (2006) |
Esther Ellen Freeman (born 1979) is an American physician who is an Assistant Professor of Dermatology at the Harvard Medical School and Director of Global Health Dermatology at Massachusetts General Hospital. Her research considers HIV infection with AIDS-defining malignancies, including Kaposi's sarcoma. During the COVID-19 pandemic Freeman established the American Academy of Dermatology register of COVID-19 skin complaints, through which she identified the novel symptom of COVID toes.
Freeman attended Milton Academy. [1] As a child she was a competitive skier, and competed in the national championships at the age of twelve. [1] [2] By the age of fifteen Freeman was a member of the United States freestyle skiing team. [1] Freeman earned her undergraduate degree at Dartmouth College. [1] Throughout her college career she skied in World Cup competitions and was a member of the Dartmouth sailing team. [1] During her studies at Dartmouth, Freeman spent time in Kenya and Mexico. In 2002 she was selected as a Marshall Scholar, and moved to the United Kingdom to complete her graduate studies. [1] She was a graduate student at the London School of Hygiene & Tropical Medicine, where she studied HIV dermatology. [3] After completing her doctorate Freeman returned to the United States, where she started a medical degree at Harvard Medical School, and soon after completed her specialist training in dermatology.[ citation needed ]
In 2011 Freeman began work with the World Health Organization, drafting guidelines on how to treat skin conditions that were associated with HIV in the developing world. [4] For these efforts she was awarded the 2012 American Academy of Dermatology Members Making a Difference Award. [5]
In 2013 Freeman was appointed Director of Global Health Dermatology at the Massachusetts General Hospital. Here she continued to investigate HIV dermatology, with a particular focus on Kaposi's sarcoma. [6] She serves on the leadership team of the International Alliance of Global Health Dermatology. [7]
Freeman is a member of the American Academy of Dermatology task force on coronavirus disease. [8] As part of this effort, she launched and helped to compile a registry of skin complaints of COVID-19 patients. [9] [10] [11] Freeman had expected that coronavirus patients would present with viral rashes. By April 2020 it emerged that around half of the patients who presented with dermatological manifestations of coronavirus disease had so-called "COVID toes". [8] COVID toes are pinkish-reddish lesions that can turn purple as the coronavirus disease progresses (akin to pernio or chilblains), [12] but are distinct from purpura fulminans . [8] [13] They typically last for two to three weeks and can without specific treatment. [14] The physiology behind COVID toes is not understood, but could occur due to inflammation of the toe tissue, inflammation of the blood vessel wall or small blood clots on the inside of the blood vessel. [8] [15] Freeman has shown that even asymptomatic carriers can present with COVID toes, and that most patients in the dermatological register with COVID toe are in their 20s and 30s. [8] She has said that if people have these symptoms have no other cause to have such toes, they should try and get a COVID-19 test. [16] [17] Lindy Fox, a dermatologist in San Francisco, reported that despite it not being the right time of year for chilblains, she was seeing "clinics filled with people coming in with new toe lesions". [17]
Incubation period is the time elapsed between exposure to a pathogenic organism, a chemical, or radiation, and when symptoms and signs are first apparent. In a typical infectious disease, the incubation period signifies the period taken by the multiplying organism to reach a threshold necessary to produce symptoms in the host.
WHO Disease Staging System for HIV Infection and Disease in Adults and Adolescents was first produced in 1990 by the World Health Organization and updated in September 2005. It is an approach for use in resource limited settings and is widely used in Africa and Asia and has been a useful research tool in studies of progression to symptomatic HIV disease.
The CDC Classification System for HIV Infection is the medical classification system used by the United States Centers for Disease Control and Prevention (CDC) to classify HIV disease and infection. The system is used to allow the government to handle epidemic statistics and define who receives US government assistance.
A herpetic whitlow is a herpes lesion (whitlow), typically on a finger or thumb, caused by the herpes simplex virus (HSV). Occasionally infection occurs on the toes or on the nail cuticle. Herpes whitlow can be caused by infection by HSV-1 or HSV-2. HSV-1 whitlow is often contracted by health care workers that come in contact with the virus; it is most commonly contracted by dental workers and medical workers exposed to oral secretions. It is also often observed in thumb-sucking children with primary HSV-1 oral infection (autoinoculation) prior to seroconversion, and in adults aged 20 to 30 following contact with HSV-2-infected genitals.
A vertically transmitted infection is an infection caused by pathogenic bacteria or viruses that use mother-to-child transmission, that is, transmission directly from the mother to an embryo, fetus, or baby during pregnancy or childbirth. It can occur when the mother has a pre-existing disease or becomes infected during pregnancy. Nutritional deficiencies may exacerbate the risks of perinatal infections. Vertical transmission is important for the mathematical modelling of infectious diseases, especially for diseases of animals with large litter sizes, as it causes a wave of new infectious individuals.
Viral encephalitis is inflammation of the brain parenchyma, called encephalitis, by a virus. The different forms of viral encephalitis are called viral encephalitides. It is the most common type of encephalitis and often occurs with viral meningitis. Encephalitic viruses first cause infection and replicate outside of the central nervous system (CNS), most reaching the CNS through the circulatory system and a minority from nerve endings toward the CNS. Once in the brain, the virus and the host's inflammatory response disrupt neural function, leading to illness and complications, many of which frequently are neurological in nature, such as impaired motor skills and altered behavior.
Virus latency is the ability of a pathogenic virus to lie dormant within a cell, denoted as the lysogenic part of the viral life cycle. A latent viral infection is a type of persistent viral infection which is distinguished from a chronic viral infection. Latency is the phase in certain viruses' life cycles in which, after initial infection, proliferation of virus particles ceases. However, the viral genome is not eradicated. The virus can reactivate and begin producing large amounts of viral progeny without the host becoming reinfected by new outside virus, and stays within the host indefinitely.
Herpes simplex virus1 and 2, also known by their taxonomic names Human alphaherpesvirus 1 and Human alphaherpesvirus 2, are two members of the human Herpesviridae family, a set of viruses that produce viral infections in the majority of humans. Both HSV-1 and HSV-2 are very common and contagious. They can be spread when an infected person begins shedding the virus.
Genital herpes is a herpes infection of the genitals caused by the herpes simplex virus (HSV). Most people either have no or mild symptoms and thus do not know they are infected. When symptoms do occur, they typically include small blisters that break open to form painful ulcers. Flu-like symptoms, such as fever, aching, or swollen lymph nodes, may also occur. Onset is typically around 4 days after exposure with symptoms lasting up to 4 weeks. Once infected further outbreaks may occur but are generally milder.
Herpes gladiatorum is one of the most infectious of herpes-caused diseases, and is transmissible by skin-to-skin contact. The disease was first described in the 1960s in the New England Journal of Medicine. It is caused by contagious infection with human herpes simplex virus type 1 (HSV-1), which more commonly causes oral herpes. Another strain, HSV-2 usually causes genital herpes, although the strains are very similar and either can cause herpes in any location.
Lawrence Corey is an American immunologist and virologist known for his work in the development of antiviral therapies and vaccines, particularly for herpes simplex virus (HSV) and HIV/AIDS.
The central nervous system (CNS) controls most of the functions of the body and mind. It comprises the brain, spinal cord and the nerve fibers that branch off to all parts of the body. The CNS viral diseases are caused by viruses that attack the CNS. Existing and emerging viral CNS infections are major sources of human morbidity and mortality.
A sexually transmitted infection (STI), also referred to as a sexually transmitted disease (STD) and the older term venereal disease (VD), is an infection that is spread by sexual activity, especially vaginal intercourse, anal sex, oral sex, or sometimes manual sex. STIs often do not initially cause symptoms, which results in a risk of transmitting them on to others. The term sexually transmitted infection is generally preferred over sexually transmitted disease or venereal disease, as it includes cases with no symptomatic disease. Symptoms and signs of STIs may include vaginal discharge, penile discharge, ulcers on or around the genitals, and pelvic pain. Some STIs can cause infertility.
Kaposi's sarcoma (KS) is a type of cancer that can form masses on the skin, in lymph nodes, in the mouth, or in other organs. The skin lesions are usually painless, purple and may be flat or raised. Lesions can occur singly, multiply in a limited area, or may be widespread. Depending on the sub-type of disease and level of immune suppression, KS may worsen either gradually or quickly. Except for Classical KS where there is generally no immune suppression, KS is caused by a combination of immune suppression and infection by Human herpesvirus 8.
Herpes simplex, often known simply as herpes, is a viral infection caused by the herpes simplex virus. Herpes infections are categorized by the area of the body that is infected. The two major types of herpes are oral herpes and genital herpes, though other forms also exist.
A cold sore is a type of herpes infection caused by the herpes simplex virus that affects primarily the lip. Symptoms typically include a burning pain followed by small blisters or sores. The first attack may also be accompanied by fever, sore throat, and enlarged lymph nodes. The rash usually heals within ten days, but the virus remains dormant in the trigeminal ganglion. The virus may periodically reactivate to create another outbreak of sores in the mouth or lip.
Herpes esophagitis is a viral infection of the esophagus caused by Herpes simplex virus (HSV).
The stages of HIV infection are acute infection, latency, and AIDS. Acute infection lasts for several weeks and may include symptoms such as fever, swollen lymph nodes, inflammation of the throat, rash, muscle pain, malaise, and mouth and esophageal sores. The latency stage involves few or no symptoms and can last anywhere from two weeks to twenty years or more, depending on the individual. AIDS, the final stage of HIV infection, is defined by low CD4+ T cell counts, various opportunistic infections, cancers, and other conditions.
Almyra Oveta Fuller was an associate professor of microbiology and immunology at University of Michigan Medical School. She served as the director of the African Studies Center (ASC), faculty in the ASC STEM Initiative at the University of Michigan (U-M) and an adjunct professor at Payne Theological Seminary. Fuller was a virologist and specialized in research of Herpes simplex virus, as well as HIV/AIDS. Fuller and her research team discovered a B5 receptor, advancing the understanding of Herpes simplex virus and the cells it attacks.
Judith Glynn is a Professor of Epidemiology at the London School of Hygiene & Tropical Medicine. She worked on the Karonga Prevention Study on HIV and Tuberculosis in Malawi. She is also a sculptor.