Closing the gap on infectious diseases affecting Indigenous Australians

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  Last updated August 14, 2018 at 3:05 pm

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Simone Reynolds found an itch for studying infectious diseases and closing the gap for health outcomes of Indigenous Australians.



Dr Simone Reynolds is an Aboriginal woman who descends from the Kalkadoon tribe of North Queensland and the Koiari tribe of central Papua New Guinea. As an Indigenous researcher she is an advocate for engaging Indigenous students in science.


A molecular biologist and biochemist who studies infectious diseases, she has spent over a decade studying scabies and its interactions with the immune system in the hopes of finding potential drug targets.


Despite a recent career change to a different field, she still finds herself in infectious diseases. She is now an Indigenous Postdoctoral Fellow for The End Rheumatic Heart Disease Centre for Research Excellence (END RHD CRE), but this time she is working on developing a vaccine for the bacteria that causes strep throat.


It’s the diseases that have been relevant to her which have always caught Simone’s interest. Inspired by an interest in malaria developed from a childhood spent moving throughout the east coast of Australia and Papua New Guinea, she studied a Bachelor of Science in Biochemistry and Molecular Biology at university.


Then as a young researcher, she joined a laboratory which worked on both malaria and scabies. It was that laboratory which brought her to scabies research – and continued to stay there for eleven years as a research officer in the Infectious Disease Program at QIMR Berghofer.


Scabies tricks the immune system


Simone likens scabies to having intense head lice. Scabies is highly contagious, caused by a burrowing mite that literally gets under the skin causing an excruciating itch. The scabies mite Sarcoptes scabiei are so tiny they are essentially invisible to the naked eye, measuring about 0.2 mm to 0.4 mm long.


It’s particularly common in Indigenous communities in the remote parts of Australia, and predominantly affects children within the first two years of life, explains Simone.


“It’s so common in these communities, that unfortunately it’s become quite normalised. So people just short of live with scabies, which I just find a horrifying prospect,” explains Simone, and why she felt she had to take the opportunity to make a contribution to the knowledge around scabies.


Simone’s previous research focused on a family of scabies mite proteins, known as anti-complement proteins, that interact with a component of the human immune system called complement. Complement acts as a surveillance system destroying pathogens and preparing other immune systems for attack.


Simone found that the scabies mite anti-complement proteins were binding to complement, but not activating complement and thus avoiding triggering an immune response. Thus allows the mite to evade detection and establish an infection.


Credit: Steschke/Wikipedia


The tricky thing about scabies infections is that they cause an allergic reaction, and with that the unbearable itch. Scratching the itch can lead to breaking the skin and secondary bacterial infections, which develop as scabies sores.


Even then, it’s not as simple as that.


“Unfortunately a lot of the bacteria that’s associated with scabies skin sores are also associated with the development of chronic diseases such as rheumatic fever, and rheumatic heart disease and downstream chronic kidney diseases,” exasperates Simone.


“We see scabies as a gateway disease, it’s a horrible intolerable disease. If we’re able to close the gate on the mite, we see it that we’re potentially closing the gate on these associated pathogenic bacteria as well.


“At its core, my research was about understanding the nuts and bolts of how the parasite engages/interacts with its host – us. In understanding that interaction we hoped to manipulate it through therapeutic controls.


“I feel like I’m actually contributing something to the knowledge system but back to my community as well.”


It’s those interactions between pathogens and hosts that Simone still explores in her current work with the bacteria behind strep throat and rheumatic fever and rheumatic heart disease.


Strep throat can lead to rheumatic heart disease


In Australia, rheumatic heart disease (RHD) takes a heavy toll on remote Aboriginal communities.


“If you look at the statistics alone, in areas, particularly in Australia, where scabies is endemic, the highest rates of rheumatic fever and rheumatic heart disease also occur,” explains Simone.


It is caused by a Group A Streptococcus (Strep A) bacterial infection of the throat and skin, which without treatment, can result in permanent damage to the heart.


There is currently no vaccine for Strep A.


Simone hopes to change that with her current research to develop a vaccine against the bacterial pathogen Streptococcus pyogenes, which plays a critical role in the development of rheumatic fever and rheumatic heart disease.


Untreated, the infection can manifest in a person as acute rheumatic fever (ARF). Repeated cases on ARF can lead to heart valve damage, which is known as rheumatic heart disease.


Part of the aim for The End Rheumatic Heart Disease Centre for Research Excellence is to end RHD as a public health priority and ‘close the gap’ between Aboriginal and non-Aboriginal Australians.


RHD is considered a third-world disease yet certain populations in Australia have some of the highest rates seen anywhere. About 3-5 per cent of Aboriginal people living in remote and rural areas have the condition.


It is a disease that is preventable but yet RHD affects more than 6,000 Aboriginal and Torres Strait Islander Australians, and a further 33 million people around the world.


Strep infections can be relatively easily treated with antibiotics, however, the progression to rheumatic fever and RHD exposes the gaps and inequalities of primary healthcare in certain populations.


RHD is a lifetime condition, it requires monthly penicillin injections for these rest of your life. Maintaining these injections is a hurdle on its own for those in rural and remote communities.


Culturally appropriate materials are important when communicating with affected communities. It’s important to give those directed affected the disease a voice in the research process.


Working towards improving life for Indigenous Australians


Giving a voice to those with lived experiences is important. Simone sits on the Governance Board for the National Centre for Indigenous Genomics (NCIG), which holds an Indigenous majority. They advise on appropriate and respectful genetic and genomic research that will benefit Indigenous Australians.




“Our task as custodians of the NCIG collection is to ensure its conservation and protection, establish ethical codes around its use and access, and ensuring that it is utilised for the benefit of Indigenous Australians,” explains Simone.


Outside of the research she is an advocate for engaging Indigenous students in science and has been involved in university and high school education and support programs since 2010. Dr Reynolds has also consulted on both NHMRC and Lowitja Institute committees that aim to build Indigenous researcher capacity.


The video footage this interview was based on was gathered by the Australian Science Media Centre (AusSMC).




About the Author

Kelly Wong
Contributing editor for News + Events and the online producer at Australia's Science Channel. I have a background in immunology, food blogging, volunteering, and social media. I'm passionate about creating communities on social media and getting them excited about science. I enjoy good food and I am on an eternal mission to find the best ice cream. Find me on Twitter @kellyyyllek

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Science and technology is as much a part of our cultural fabric as art, music, theatre and literature. They play a significant role in our daily lives, yet, in a world dependent on science, we often take them for granted. Australia’s Science Channel believes every citizen has a right, and a responsibility, to be informed, and our mission is to create programs to bring that about.


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