>> Good afternoon and welcome to the We Were There program to celebrate. Dr. Sherif Zaki. I'm Rima Khabbaz, former Director of the National Center for Emerging and Zoonotic Infectious Diseases, and it's a true honor to be co-hosting this program with Dr. Inger Damon and Chris Paddock of CDC. Thank you so much for joining us. We're going to start the program with a recorded greeting from Dr. Rochelle Walensky, CDC Director.

>> Thank you for joining us as we pay tribute to the legacy of Dr. Sherif Zaki, a remarkable scientist who solved many puzzles that perplexed others and saved many lives. We remember his extraordinary work done at CDC to protect the public's health and his life as a kind-hearted leader devoted to teaching and mentoring younger scientists across the globe. His loss is felt deeply by his many friends and colleagues here at CDC and around the world. Thank you for honoring him with your presence here today.

>> Thank you, Dr. Walensky. I first met Sherif in the late 1980s when we both worked in the Division of Viral and Rickettsial Diseases here at CDC under then-Director, Dr. Brian Mahy, and since then I've had the good fortune of not just calling him a colleague, he was a most valued colleague, and I witnessed his scientific brilliance and all of the numerous and amazing accomplishments that we're going to hear about today, but I also had the privilege of becoming friends with him and Nadia, so we were -- I count myself as a very good friend of Sherif and Nadia, and over the years, had the, you know, had the good fortune of witnessing Sherif, the person, with the same wonderful attributes that he brought to work as well, his sense of humor, his enthusiasm and passion, and as he pursued interests such as beautifying his environment through gardening, or his cooking. And he was an amazing cook. I noticed the same traits that helped him succeed professionally, his, like I said, I said passion and enthusiasm, also his deliberate approach, his meticulousness in doing things, his precision, especially in the kitchen. It was amazing. Anything that he prepared, from a simple dish to a most complex dish was just such a treat, and so I'm going to just share with you a short, small story, which is one time Sherif and Nadia came to our house for a meal, and Sherif showed up with a plate of hummus. Now the humor in this is that we make hummus all the time in our house and we pride ourselves of making pretty decent hummus from scratch, and here was Sherif with his -- in his understated, typically understated fashion with a plate of hummus saying, I just tried my hand making hummus and would you would you try it? He had a smile and his eyes were, you know, a twinkle in his eyes, so we did and boy that was actually much better hummus, different league than anything we make, and so we said, what did you do here, Sherif? Is there something different? He said, yeah, there's a secret. There's a little step or ingredient here. Can you guess? And after a long guessing game, he told us that actually, what he had done is boil his chickpeas and then proceeded to peel the chickpeas. Imagine that. Peel them one by one before throwing the chickpeas in the grinder with the other ingredients and that was the secret to making this amazingly creamy and it was best hummus. He had researched that method and tried it on us . So with that I -- it's a pleasure to introduce our first speaker today, Dr. Jim Hughes, who was Director of the National Center for Infectious Diseases at CDC, between 1992 and 2005. Jim is known to many of you, and for those of us who worked for him, you know, we remember fondly how whenever he called you in his office to discuss a challenge, he matched it with an opportunity for you to help address the challenge. And Jim, I believe, brought Sherif to CDC, so let's hear from him.

>> Good afternoon. We are here today to celebrate the remarkable career of Dr. Sherif Zaki and to recognize some of his numerous contributions to epidemic detection and response efforts. Sherif graduated from Alexandria University School of Medicine and received a PhD in experimental pathology from Emory. Fortunately, he joined CDC in 1988. At that time, Fred Murphy was Director of the National Center for Infectious Diseases. Fred, who is known for his electron microscopic image of Ebola virus from the first recognized outbreak of Ebola hemorrhagic fever in Zaire in 1976, is both a virologist and a veterinary pathologist, and played an important role in Sherif's recruitment and decision to join CDC. I first met Sherif during his recruitment, and got to know him well during the investigation of the outbreak of a severe acute respiratory illness, first recognized by Dr. Bruce Tempest an alert Indian Health Service clinician, who was caring for a young couple on the Navajo reservation in New Mexico in May 1993. Both were severely ill and soon died of an undiagnosed acute respiratory illness. CDC was notified as more cases were identified and diagnostic specimens were sent to CDC. You will hear more about this highly collaborative investigation from Tom Ksiazek who found evidence of a serologic response to a hantavirus, which surprised many of us. Stuart Nichol soon had PCR evidence, also suggesting that a hantavirus was responsible for the illness. Sherif and his colleagues went to work and soon had immunohistochemical evidence consistent with a previously unrecognized hantavirus in samples of lung tissue from deceased patients. I have vivid memories of reviewing the slides as Sherif carefully and patiently explained what we were seeing, which provided compelling evidence for a hantavirus etiology of what came to be known as hantavirus pulmonary syndrome. Subsequent studies identified deer mice as the reservoir of the virus. It was not until sometime later that the responsible Sin Nombre virus was isolated, reinforcing the importance of expecting the unexpected. Although the epidemic appeared to be limited to the Four Corners area, questions arose about whether it could be more widely distributed. The experience provided an impetus for development of both the unexplained deaths and critical illnesses project and for the Emerging Infections Network, the latter in collaboration with the Infectious Diseases Society of America. These two networks were important components of the CDC emerging infection strategy issued in 1994 in response to the 1992 report on emerging infections, Microbial Threats to Health in the United States. Speaking of microbial threats, Sherif and his group played a critical role in the recognition of and response to the anthrax attacks through the US Postal Service shortly after 9/11. The index patient with acute bacterial meningitis was identified by another alert ID clinician, Dr. Larry Bush, in South Florida. The patient worked for the National Enquirer. Initial diagnostic specimens were sent to the Florida State Public Health Laboratory, which developed evidence that the patient had anthrax meningitis, immediately triggering suspicions of bioterrorism. You will hear more about this from Jeff Koplan but once again Sherif and his colleagues played a critical role in the investigation. The geographic extent of the problem was initially uncertain. Before long, suspect cases of cutaneous anthrax were identified in a woman who worked for Tom Brokaw with NBC News in New York City, and in her young child. Specimens were sent to CDC where Sherif and his colleagues immediately got to work, and before long, my phone rang at about 2:30 a.m. one morning. It was Sherif who apologized for the timing of the call and then said in a very calm voice something to the effect of Jim, I think you should come in and have a look at these immunohistochemical stains, and you should probably also ask Jeff Koplan to join us. I called Jeff to give him a heads-up and we both soon join Sherif in the basement room of Building 1 with the multiheaded microscope where he explained what we were seeing. We all agreed that this provided pretty compelling evidence that we were dealing with a bioterrorism event. I will leave it to Jeff to describe the subsequent events in those early morning hours. Flash forward to February and March of 2003, and another outbreak of a Severe Acute Respiratory syndrome of uncertain cause, initially in southern China, and then in Hong Kong, home of the famous Hotel M, otherwise known as the Hotel Metropol where a super-spreading event occurred. Sherif and his group were again involved in efforts to identify the etiologic agent. Scott Dow, who was working in Vietnam became involved in case investigations there and arranged for diagnostic specimens obtained from a WHO physician involved in patient care and infection control in Hanoi annoying, who had unfortunately acquired the illness, to be sent to CDC. I have a vivid memory of a photo of an electron microscopic image taken by Cynthia Goldsmith with Sherif's group of the original SARS Coronavirus, with its distinctive morphologic features being shared by Cynthia at one of our daily epidemic update meetings. A report of this isolate, one of the earliest identified during the international investigation led by David Heymann at WHO, was soon published in the New England Journal of Medicine. These are just three examples from numerous outbreak investigations in which Sherif and his team played a central role during and after my time at CDC. Other examples include Ebola hemorrhagic fever, leptospirosis in Nicaragua, H5N1 influenza in Hong Kong, West Nile encephalitis, Rift Valley fever, and monkey pox to name a few. This pattern has continued in recent years with chikungunya and Zika, and last but certainly not least, COVID-19, among many others. As recently as last month, an article on SARS-CoV-2 and placenta and autopsy tissues from newborns, co-authored by Cynthia Goldsmith, Sherif, and many others appeared in the CDC journal Emerging Infectious Diseases. Sherif was a consummate disease detective with broad experience and expertise who will be sorely missed by his family, numerous friends and colleagues around the world. Results of work by Sherif and his team sometimes also provided important clues to pathogenic mechanisms and mode of transmission. He was a true leader in highlighting, reinvigorating and advocating for the field of infectious disease pathology. He will be remembered for his vision, humility, energy, diligence, persistence, calm demeanor, collaborative spirit, and for his commitment to teaching, training, team building and mentorship. He had a truly remarkable and distinguished career and has left an impressive legacy.

>> Thank you, Jim. Thank you so much for these remarks and for highlighting for us some of Sherif's accomplishments, many, many accomplishments in his career at CDC. It gives me great pleasure now to introduce our second speaker, Dr. Jeff Koplan. Jeff was CDC Director from 1998 to 2002, and so presided over the CDC response to the anthrax attacks, and Jeff, I believe, got to work with Sherif, as Jim mentioned, during anthrax attack and since then has collaborated with him numerous time, as we'll hear, most recently on the CHAMPS Project, the gates on the CHAMPS Project from that Jeff overseas from Emory. Jeff, over to you.

>> I'm pleased to be with you and honored to be here as part of this moving gathering. Today we're obviously here to honor Sherif Zaki, a highly respected and beloved scientist, colleague and friend. Let me start with a special hello and recognition of Sherif's wife, Nadia, and children Yasmin and Samy. Striking that all the speakers who didn't consult with each other as to what their content for how Sherif was, and what his attributes were, use many of the same words, and I think it's worth repeating them as we go through it because these are qualities and attributes that are unfortunately, notable by their absence and modern discourse and of public figures around the US particularly in the last early years of the 21st century, but we'll hear in regard to characterizing Sherif, we'll hear about his high intellect, his kindness, his being innovative, a practical problem solver, meticulous, not just with chickpeas, but with everything, generous, particularly of his time, humility, diligence, and a sense of humor and a wry wit. His -- whenever I think of him, I see that smile, which really can lighten up the room that he [inaudible]. These attributes, when present, contribute to a sense of community, both within a scientific and service institution such as the CDC, but also in the broader community as well. As Jim Hughes just related, the 2001 anthrax attack was a particularly compelling, riveting event in CDC history, and in an event like that, it was necessary and important, imperative indeed, to identify all cases of anthrax and establish a diagnosis that is clear and firm, and defendable. In the case as Jim indicated with the one of the cases was a very public individual in the sense that she was an employee and the administrative assistant to one of America's most popular newscasters. The suspects had received and had gone through her boss's mail innumerable times, and within that mail was an envelope that had been powdered with anthrax in a highly transmissible format. As Jim indicated, a specimen of the skin lesion had been sent to CDC overnight and while Jim's phone rang at 3:00, he and Sherif were not content to let me sleep through this event, and Jim called it at 3:00 with Sherif's urging to come in and see the finding. My initial reaction was well, I believe you guys, I'm sure you've done a great job. Then I got, "No, no. You needed to see this yourself," and indeed, it was 3:05 when we finished the call and I was in Clifton Road by 3:30 washed and dressed for the day. We could now say that we had identified an anthrax infection and identified by the world's premier immunohistopathologist, so a powerful finding now was given total credibility. At 7 a.m. I called Mayor Giuliani, then Mayor of New York City, who asked why was I calling him and I said, well, you know, we have this specimen from a newsroom in New York, and Mayor Giuliani was actively involved in all aspects of the disease control and the investigation in terms of being interested in it and thinking it was important. And he asked what the finding was, and I said, well, it was highly likely that this was anthrax. He shut -- he cut me off immediately and said, what would be in effect, don't give me your scientific blahdy-blah-blah. Cut the wishy-washy descriptor. Is that anthrax or not? And I said, "Yes, sir. It is." He said, "What's your level of assuredness?" And I said as close to 100% as you can get. And from then things fold it out from there. For the past several years, we at CDC and Emory have been able to work closely together with a talented CDC pathology team and Sherif in the multiyear -- in our multiyear Gates Foundation CHAMPS Project. Some of our other attendees are actively involved in this at this symposium Dianna Blau, Cindy Whitney, Rosie Henson, and all of our CHAMPS leadership team. We've all enjoyed very close ties with Sherif, his laboratory and colleagues and his work. The pathology lab has shared with us immunohistopathologic stains that have been instrumental in our identifying causes of death in children under the age of five. In this project, as part of our studies, Bill Gates made periodic visits to Atlanta, usually in conference rooms, sitting around seminar tables, etc., but on one visit, we brought him to see the pathology lab where Mr. Gates got a primer in identifying and differentiating liver tissue from pulmonary tissue, stains that light up when you look in the microscope, and lots of interesting stories attached to the investigation of these diseases. In the course of this meeting, Bill fell under Sherif's spell, and it took considerable effort to pry him away from the array of microscopes that were in front of him, and he kept looking over at the box that was filled with slides, and he'd only had the privilege of looking through six or seven of them. Now, to Sherif's credit, he knew when he had someone, and, and how it was important to indoctrinate them, and he was -- would completely pull out from these boxes. He'd say, well, here's one that you might find really interesting. And of course, he continued with this, while people were waving their hands. He was late for his next meeting. There was a car waiting for him. The world awaited Bill Gates, but Sherif wasn't going to let that mar this opportunity to show him what really counted at CDC in this investigation, and I have to say, it was highly amusing to watch this interaction, and another 10 minutes, if he'd just had 10 more minutes, I have no doubts that Sherif would have him encouraged to enroll in medical school, a residency program and a doctorate in histopathology. Sherif was taken from his family, friends, and work far too soon. We all miss him, but we all treasure the time we spent with him and the invaluable successes of his scientific career and warm relationships. Thank you.

>> Sherif, if nothing else was the remarkable combination of brilliance and humility.

>> So I've known Sherif since I was an EIS officer way back in 1998, and even then he was at the center of the whirlwind of what was CDC and all of the amazing outbreak investigations that were going on in the Division of Viral and Rickettsial diseases at that time. And over the 23 years I worked at CDC, I got to know him a lot better, and I realized he's more than just sort of this mythical man, this amazing pathology person that was at the heart of everything. He was a lot feistier than people gave him credit for. He was humble and he was an incredibly caring individual who cared deeply about the cases he worked on, the people whose lives he touched and his staff, but he was also someone who was willing to stand up when he felt maybe justice wasn't being done to a case, and I remember Sherif coming to yells across the table one time when he felt that a subject matter expert was steering CDC down a path that could harm people. He really cared passionately about what he did and the value of pathology to these amazing outbreak investigations, and I was very impressed to see that side of Sherif come out when CDC was under fire, and he got his way.

>> Yeah, he was special. You know, that's kind of a no brainer because we're doing this. It wasn't like, hey, let's just pick somebody who passed away and lavish praise. Yeah, he drove people -- he drove anybody who worked with him crazy, because he was so focused and persistent and never gave up and, you know, so we would be spending a gazillion hours at the microscope, you know, reviewing cases and things, you know, for -- and it was always -- there was always a reason for it.

>> Well, welcome to the audience here and the audience online. I'm Inger Damon, Director of the Division of High-Consequence Pathogens and Pathology, and I've known Sherif as a colleague for my 20-plus years here at CDC and have served as his supervisor as division director for seven of those years. Sherif was really an engaged and animated colleague, and I think you've heard some great stories from our prior speakers. Sherif's enthusiasm wasn't reserved for special occasions or audiences. He brought his energy, curiosity and enthusiasm to work every day. Early on in my career here, I worked in the smallpox research agenda, and I remember when he got in slides from the Armed Forces of Institute Pathology from deceased cases of smallpox from the late '40s, and was enthusiastic to show me what he had seen in those slides by looking at immunohistochemistry, and what did this tell me about disease pathogenesis and what we were doing on the smallpox research agenda? As division director, he was always an eager meeting participant, often, as you've heard from others, driving lively discussions on the latest case investigations in the latest unknowns. Weekly branch chief meetings with Sherif were never boring, and they were usually productive as a result of his engagement. There are many gifted scientists at CDC, but there aren't as many that can match Sherif's excitement for the work, so our next speaker -- and there's some really lovely speaker biographies in the program that has been put together and is available online -- our next speaker, Tom Ksiazek is a former colleague of ours from the CDC, who is now at the University of Texas Medical Branch, so welcome, Tom.

>> First of all, it's a pleasure to be here, and I thank the sponsors for allowing me to come in person and present. So I'm going to talk largely about the collaborative efforts between the special pathogen branch and infectious disease pathology, and I'm going to give you a list of the various pathogens that we collaborated with over the years. I can do it myself, I guess.

>> No.

>> No?

>> I wouldn't.

>> You're going to do it.

>> Yeah.

>> Okay. So the relationship between special pathogens and the pathology group, infectious disease pathology activity is sort of summarized here. For our group, pathogens often cause deaths, and that led to the availability or at least attainability of tissues. The development and use of the immunohistochemistry required immune reagents and this was a natural collaboration. We largely either had reagents on hand, or we could quickly make them that could be used in collaborative efforts. Often we were involved in new pathogens, a glimpse at the disease process that would be obtained or are performed by the pathologist, particularly with the addition of immunohistochemistry was often a very important part of that process, and I think the results, everyone would agree, involved a great collaborative science. I'm going to use one example to sort of illustrate this and then perhaps go over. The first encounter was already mentioned by Dr. Hughes, a mystery disease in the southwest resulting in a pulmonary syndrome which eventually led to the isolation and naming of a virus called Sin Nombre. Next. And this is the earliest photo I could find of Sherif, I think from the early 1990s, about the time of the hantavirus outbreak. Next. The Four Cor -- this is a just a litany of how rapidly this all came together. It was an unknown disease. I think no one suspected the outcome in terms of the type of virus that was responsible, but we rapidly with CDC at large coordinated efforts and obtained materials, and were able to come up with an answer. Next slide. And it made a fairly big splash. I don't have a People Magazine, but it was even in People Magazine, I think, when the first week after the outbreak. You see the New York Times there as well as local newspapers from the region in which the outbreak occurred. Next. And those of you who aren't familiar, the syndrome was essentially people going from a pulmonary X-ray, which might show a few signs to a trained radiologist, to a complete whiteout that no one could miss and very often the death of the patients that were involved. The first hint, Dr. Hughes mentioned, was actually a serologic test that was done with known hantaviruses at the time. We ran a large panel of other pathogens at the branch worked on but we got hits, essentially with these hantaviruses. In this slide are image of a fax that was actually sent by Pierre Rollin and myself. I was up visiting with some Russian scientists at Fort Dietrich, at the time, sort of became emblematic of the outbreak. Next slide, please. So the role of histology and immunochemistry played a large role, I think in the early revelation of the pathogenesis of this organism. Again, it's actually quite unlike other known hantaviruses, and I think a lot of people were surprised by what can be shown in terms of pulmonary involvement, and that was definitively done by the use of immunohistochemistry. Next slide. And this is a follow up review of the syndrome, and on the right-hand side, you can see the presence of antigen and pulmonary cells. That sort of is the key. It doesn't actually destroy the lungs. It rather precipitates an immune response, and cytokine storms that are responsible for the pathogenesis and the fluid leak into the lungs. Next slide. And we eventually and again, IDPA played a large role. When we were able to isolate the virus, you can actually see the similarity to other hantaviruses. It's this took months to do not because of inability, but just the time it takes to isolate hantaviruses. Next, please. And these viruses are still with us, and the signal and early events of this led eventually to the discovery of a large number of hantaviruses, which still persist as problems in the Americas. Next slide. Next slide. So this is just a list of outbreaks that the branch, special pathogens, were involved in that over time, did include a lot of participation from IDPA. Next. Next slide. And there are a number of these that were very notable. I just reviewed the HPS or hantavirus pulmonary syndrome, the Ebola virus in 1995 outbreak, the first one in 20 years in Kikwit. A new diagnostic assay using skin snips was developed during that outbreak. Nipah has been mentioned, that outbreak in Malaysia in '98 and '99. SARS has also been mentioned. These were all sort of collaborative efforts, often our branch receiving materials and making viral isolates. These were in the days that preceded next-generation sequencing, so this was done very rapidly and the old fashioned way. West Nile, rabies and LCM transplant cases, these weren't pathogens that we normally worked on with the exception of LCM, but specimens from near and far came and the etiology of people who had been transplanted from a donor who had the infectious agent, another new Ebola virus in 2007-2008. In Uganda, Bundibugyo, previously unknown. Pierre Rollin was able to do a post on a physician who succumbed. One of the last events that I was involved in are the two lowest ones, Lujo, a new arenavirus pathogen between Zambia and South Africa in which a number of patients transmitted the virus from one to another and there were a number of fatalities. And finally, an outbreak of Reston virus, which is probably one of the reasons that Dr. Peters and myself ended up here at CDC, in swine and the infection of some individuals. Next slide. So I'm just going to go through a series of photos that sort of document the various events that we collaborated. That was, I think following the Ebola Zaire outbreak This is SARS. You can see the current-at-that-time Secretary of Health and Human Services as well as Dr. Gerber getting around the multiheaded microscope. I think I also see Dr. Hughes there. Next slide. This is when 18 was coming online. Those are the overhead mechanical spaces, Sherif and myself. Next slide. When I finally did depart, a very, to me, important and emotional momento were EMs or slides showing immunohistochemistry from various outbreaks we had collaborated on. Next slide. And Dr. Peters and Dr. Nichol from our branch and Sherif at a gathering in in Galveston, Texas. And same thing, another meeting in Galveston with Sherif, and Sherif and an event honoring Dr. Walker also in Galveston, Texas. And one of the other "we were there" events that I have participated in was the 25th anniversary of the hantavirus and some of the principles and speakers at that event. I think that's the last slide. Namaste Thank you very much for your attention.

>> You know, he's so humble, and he gave everybody credit for what, you know, they would do. And people enjoyed working with him or working for him. It was just a real pleasure, and he was so good. He solved one problem after another, you know? And I wonder now what's going to -- who's going to stew those solutions, you know, for the future? You know? He was very important to the United States, quite frankly. He was a national treasure.

>> He was the groundbreaker that allowed, you know, pathology to become a part of public health and CDC's response to public health emergencies, and I think was, you know, always was looked to and played an invaluable role in every emergency response that the agency has contributed to since he joined.

>> He was widely known for his expertise and his contribution to human medicine and pathology, but what a lot of people don't know is that he also was an early champion of One Health and One Medicine and he really believed in bringing human pathologists and veterinary pathologists and clinicians together at the microscope to study infectious diseases.

>> Hey, well, thank you. Thanks, Tom, and thanks for all these wonderful memories that people have been sharing. I think just a quick few comments, and then I'll introduce Ruth Lynfield. Sherif loved, as you've heard, really loved to share the joy of discovery, and it made him a favorite of guests who visited the branch to hear more about pathology at CDC. He had a real gift for engaging with people ranging from congressional staff to media reporters, to Secretaries of various cabinet level positions in the US government. He was a tireless advocate for the branch's work and he would encourage non-scientists to gather around the multiheaded scope, which you've seen in a number of images and slides, demonstrating to them the tools of pathology. He really excelled at explaining how pathology could allow us to understand and to detect infectious diseases and how important the findings work to implement public health control measures. Our next speaker, Dr. Ruth Lynfield is the lead epidemiologist from Minnesota. She's on the board of our scientific council are also in a leadership position. We'll talk more about her experiences. Over to you, Ruth.

>> Thank you so much, Inger. It is such an honor to be here. I'm going to talk a little bit about the partnerships that Sherif forged with a focus on epidemiologists and medical examiners in Minnesota. You have already heard about Sherif's kindness and warmth. These traits and his encyclopedic knowledge and curiosity made him unique. Sherif actively encourage partnerships between medical examiners and public health professionals and adding on additional unique qualities, Sherif always made himself available to answer a question or consult for an M.E. or an epidemiologist. His door was always open and he encouraged us to visit IDPB, which I did with my colleague, Dr. Stacy Holzbauer, as you saw in the picture. We were able to visit a number of times, and were always welcomed. We loved joining the group around the multiheaded scope, and were able to experience a tiny sense of what it would be like to be a part of Sherif's team. Sherif was instrumental in the success of the Unexplained Death and Critical Illness program in Minnesota. We began the surveillance in 1995 as part of the Emerging Infections Program, as mentioned by Dr. Hughes. The goals included identifying new pathogens, identifying sudden unexplained deaths due to known pathogens, identifying/monitoring epidemiological features of fatal infections, and improving pathological diagnosis. As part of this program, cases are reported to the Minnesota Department of Health and specimens are sent to our public health lab for additional diagnostic testing. Some are also sent on to IDPB. Sherif supported the program in a number of important ways, including consultation and evaluation of cases, and special projects. An example, fatal infections in persons with substance use. He supported our annual medical examiner conference and participated. And he also sent other IDPB experts to participate yearly. He was a mentor for NDHPEs and for Minnesota MEs. I'd like to share just a few of the examples of the public health benefit of the UNEX program in Minnesota. Although not all of these cases were evaluated by IDPB, Sherif inspired and supported our work. Examples include identifying cases caused by pathogens which result in specific public health interventions, such as Meningococcus, a case of polio in an immunocompromised person who had a vaccine-derived strain, tuberculosis and Legionella, detecting and being able to count the most severe cases of vaccine-preventable diseases including pneumococcus influenza, identifying nationally notifiable infectious disease deaths such as HIV, finding pathogens new to Minnesota such as Rickettsia rickettsii, Powassan and Naegleria, identifying cases that uncovered distinct epidemiology. For example, during the H1N1 pandemic, deaths at home were different than those in a hospital. They occurred in younger people who had fewer underlying conditions. Other identified ideologies of interests have included fusobacterium , Coxiella burnetii, group A strep necrotizing myositis, capnocytophaga, also EVALI, a non-infectious condition. The partnership with the IDPB was important in Minnesota in assessing deaths and children due to influenza or RSV. Notably, 60% of pediatric influenza and 30% of pediatric RSV deaths in Minnesota were detected through UNEX. Evaluation at IDPB also helped distinguish between colonization and infection, such as in many cases of Streptococcus pneumoniae. Some examples where IDP evaluation was key, a previous previously well man in his 50s developed a three-week illness with fever, vomiting, and weakness, and he collapsed at home. He was found to have a cloudy pericardial effusion and pancarditis with lymphoplasmacytic inflammation. Immunostaining at IDPB was positive for Borrelia burgdorferi, the agent of Lyme disease. IDPB was instrumental in determining the etiology of death in a premature baby who died two hours after birth. Lymphoplasmacytic inflammation was found in multiple organs. onionskin perivascular fibrosis was noted, as well as necrosis in liver, lymph nodes and adrenals. PCR positive for treponema pallidum, the agent of syphilis, was found in lung, liver, skin and umbilical cord. In 2019, Minnesota, along with many other states detected acute respiratory injury in association with the e-cigarette or vaping product use. IDPB evaluated and described the injury and fatal EVALI cases including a patient from Minnesota, who had diffuse alveolar damage and foamy macrophages noted in multiple air spaces. You can see in Figure D with osmium tetroxide stain for lipids, there's a globular, dark brown staining and foamy alveolar macrophages, and of note vitamin E acetate was found in the bronchial alveolar lavage of this patient. The multistate investigation pointed to THC vaping products contaminated with Vitamin E acetate as a cause of the lung injury. Having worked in public health for more than 25 years, but particularly during the last two, I really appreciate this quote from Sherif in a 2007 interview. There are so many viruses and bacteria we don't know anything about, that we don't have tests for. We think we know everything, but we don't know the tip of the iceberg. I feel Sherif's passion, curiosity, wisdom and humility in this quote. I'd like to end with words of our deep appreciation from the Minnesota Unexplained Death and Critical Illness Program. Sherif had a major impact on our understanding of and our public health approach to critical and fatal infectious illnesses. His leadership, mentorship, partnership, kindness, support and expertise will never be forgotten. His work touched innumerable people, and he left a strong legacy, and he made us better public health specialists and better people. Thank you. Back to you, Inger.

>> Thanks, Ruth. So I'll introduce one additional speaker, and then we'll turn it over to Dr. Paddock as the moderator. Okay, one second.

>> He was renowned as a mentor, and he's mentored many, many pathologists. I'm just one of many that's been able to learn from him over the years.

>> So as a mentor, Sherif really couldn't help mentoring everybody, whether you were a member of his staff, whether you were in his professional sphere, or even if you were sort of in a supervisory level over him, he was going to mentor you.

>> We had a lot of international guests. I mean, we had a lot of like Emory rotation students come to do their residencies, a lot of international guests. He always opened up his home. He always had everyone over to eat. Anytime we would have someone visiting, you know, it would be on the weekend, we'd all get together and make them feel welcomed.

>> So as you've heard, there are a number of people who came through Infectious Diseases Pathology Branch or the activity as it was known before it became a branch, to train for different periods of time and learn the infectious disease pathology techniques that were developed by Sherif and then expanded in terms of also thinking about molecular testing which Julu Bhatnagar in the group is now leading, and I think he really has left behind a legacy and imprinted his experience and his training and his approach to looking at tissues in terms of determining the cause of disease or understanding pathogenesis to a next generation of scientists, and I think for us at CDC, the true testament to Sherif's legacy is the group in IDPB itself, so just really broadly looking across human pathology, veterinary pathology, using molecular techniques, looking at novel techniques that could be developed, immunohistochemistry, bringing in medical officers and epidemiology and thinking about how the whole package fit in in terms of the public health mission of the agency. It's really outstanding, and it's a strong group, and it is truly a legacy to Sherif's mentoring and thoughtfulness in terms of developing a program here. So our next speaker here is Dr. David Walker, also a former CDC employee. He's now professor of pathology at UTMB. He's engaged with the branch multiple times in his career, and I'll turn it over to Dr. Walker.

>> Thank you, Inger. Well, I'm a pathologist whose deepest interest for more than 50 years has been infectious diseases. I met Sherif Zaki in Chapel Hill, North Carolina in 1983, when I was Associate Professor --

>> Dave, excuse me one second.

>> -- at the [inaudible] university of North Carolina.

>> David, can you turn your camera on so we can see you, please?

>> No, I didn't really want to.

>> There you go. Thank you.

>> Sherif has just arrived from Egypt and was visiting our department, and I would have welcomed him into our -- no, go back please. I would have welcomed him into our residency program or into our PhD doctoral research program, but when he asked me if he could pursue both a residency in pathology and a PhD in experimental pathology simultaneously, I replied, no, you cannot serve two masters simultaneously. This was my lack of vision. I subsequently trained an outstanding pathologist, PhD scientist simultaneously since then at UTMB. Sherif moved on to Emory University where he accomplished what he set out to do. He was already a trained pathologist, having accomplished a residency in pathology at the University of Alexandria, and he successfully completed his pathology residency and his PhD at Emory in 1989, and then he became chief of the molecular pathology and ultrastructure activity at the Viral and Rickettsial Diseases Division. I served as an external reviewer in 1989, and again, as a reviewer simultaneously with the review of the special pathogens branch in 1996. In my role as external reviewer, I upset Sherif greatly when I recommended that his activity receive more resources to accomplish even more. He was convinced that he would be required to devote effort to other areas of CDC that would take away from his true focus, which was with a special pathogens branch. The ensuing result of the recommendation was that he received more resources and he had more autonomy, and he had greater impact on the CDC mission, and I believe it provided greater satisfaction for Sherif as well. As I developed vector borne emerging and tropical diseases research at the University of Texas Medical Branch in Galveston with construction of extensive biosafety Level 3 laboratories, and plans for constructing a biosafety Level 4 laboratory, I sought to recruit Sherif to UTMB. We were both excited about our future possibilities that would occur when he joined us. Were both excited about what we could accomplish. However, I felt it would be better for him if he waited until the [inaudible] biosafety level four laboratory was completed, and the BSL-4 program was ready to begin before his coming to Galveston. I told Sherif that he would accomplish more at CDC in the interim than he would during that period at UTMB and that we should wait a year for him to come to UTMB. The CDC recognized the serious loss that would occur if Sherif left and made a generous counteroffer. They increased the resources for him and his role in CDC, substantially. Indeed, at the CDC, he accomplished so much as a result that benefited the nation and the world, that it is doubtful that he would have achieved as much if he had established such a program in diagnostic and experimental pathology as we envisioned in Galveston. Throughout his life in America, Sherif and I were not only respected colleagues, but in fact warm, close friends. I always looked forward to our times together at national meetings. The American Society of Tropical Medicine and Hygiene and the US and Canadian Academy of Pathology. I reveled in his tremendous contributions to infectious diseases discovery, diagnosis, and pathology. I missed him greatly at the US and Canadian Academy of Pathology meeting when he was away in Singapore and Malaysia investigating what turned out to visit the discovery of Nipah virus. I admired his bravery in insisting that the first bioterrorist associated media case was inhalational anthrax in the face of other agencies' insistence that it was not. Next slide, please. And here we see the bacteria Bacillus anthracis that cause anthrax that he demonstrated. And in fact, Sherif had prepared for the threat of bioterrorism by developing immunohistochemical methods for detection of catalogue of potential agents about terrorism, including Bacillus anthracis. He was ready. I marveled at his key contribution to discovery of Sin Nombre virus in the Four Corners region of the southwestern US as a cause of hantavirus pulmonary syndrome. So in sum, Sherif has contributed tremendously to the understanding of emerging infectious diseases. At its appearance, an emerging disease is a combination of clinical signs and symptoms, the basis of which is unknown, because it's all we have is the radiographic imaging and some clinical laboratory observations [inaudible] the organs that might be affected. The disease, the nature of the damage, the host response are unknown, until the pathologic lesions are determined. Pathologic mechanism that mediates the disease, especially in viral and intracellular bacterial infections, cannot be addressed until the target cells of infection are identified. Next slide. Sherif and his team had done this time and time again, and here we see an image that's similar to one we saw before with the red being the Sin Nombre virus and the target being the endothelial cell in the alveolar sept of the lung, explaining the increased vascular permeability and the acute respiratory distress syndrome, the hallmarks of the disease. Next slide. That the endothelium infection, cytopathology, vasculitis and thrombosis in the brain are the basis of the Nipah virus encephalitis, and here we can see a blood vessel with a multinucleated giant endothelial cell on the right. In the lower left, we can see that it is infected with the Sin Nombre virus shown in red. Next slide. The Zika virus infection of cerebral neurons during the first trimester of pregnancy are the basis of microcephaly and its complications seen here with the staining of the cerebral neurons of this developing bright. Next slide. The SARS-Coronavirus-2 infection of type two and type one pneumocytes, alveolar macrophages, airways epithelium, and systemic endothelial cells is a substrate of diffuse alveolar damage and thromboembolic events in COVID-19. Sherif and his team made these valuable contributions. Performance of autopsies on outbreaks of disease of unknown [inaudible], determination of pathologic lesions, correlation with suspected cross-reactive serology, application of the appropriate battery of catalogued antibodies in developing immunohistochemical demonstration of suspected etiologic agents, detection of the etiologic agents by electron microscopy, design of polymerase chain reactions and sequencing of the DNA or the tools and approaches which Sherif led so effectively for the benefit of public health. Next slide. I miss Sherif Zaki and I'm sure that I'll always miss him. He was the world's best infectious disease pathologist, and maybe more importantly, a dear friend. Thank you.

>> And about how Sherif was so humble and quiet and kind and I'm like going no, no, no. So I'm glad to maybe offer a slightly spicier perspective for everybody.

>> Just legend, you know, in his own right, but yet this kindness, this humility, this, you know, approachability that he possessed is such a rare, just such a rare combination of characteristics in a person, particularly someone at that level. He always made you feel included. He, you know, just really accepted where you were at the time, always supportive. You know, just -- you know, I remained under his supervision for under 20 yours. I mean, I think that's a testament to the kind of person and supervisor he was.

>> And so there was a lot of speculation at the time, you know, was it pesticides causing these birth defects or what? And it was really Sherif and looking at those specimens from those infants that really did nail it down, and I think that was one of Sherif's greatest legacies.

>> Hello, I'm Chris Paddock and I'm honored to be with you here today as a co-host of this event. Sherif was a close friend and colleague of mine, from almost the first day that I joined the agency in 1995. One aspect of Sherif's personality that some persons may not be aware of was his fiercely competitive streak. Whatever he did, he wanted to do well, and he also liked a contest. Over the years, we had many friendly competitions outside of work, such as who made the best fajitas or who caught the most fish, but were we're both fond of gardening, so naturally, we contested whose grass was the greenest and most weed-free, or whose garden produced the most vegetables each year. Sherif almost always won, in part because he took each of these endeavors far more seriously than me, but mostly because he excelled at most everything he attempted. A year or two ago, I was looking at some tomatoes that I had recently planted in my garden, and to my great delight, I saw a single, beautiful ripe tomato, the first of the season and far earlier than I expected. Of course, I snapped a photograph on my cell phone, and I sent it to Sherif with a message stating that I had outperformed him in the category of the year's first ripe tomato. About 15 minutes later, I received an image on my own cell phone from Sherif, revealing a cluster of huge, very red, very ripe tomatoes dangling from one of his tomato plants in his garden. Oh, well. It wasn't until several weeks later that he shared the truth with me. As soon as he saw the photo I had sent him, he grabbed several large ripe tomatoes that he had just purchased from the grocery store and went back to his garden and attached them to his otherwise fruitless plants. Then he snapped the photo and sent it back to me. There are many things I miss about Sherif. We honor him today as a remarkable scientist, but he was so much more than that, and in many ways, it is his sense of humor and his playfulness that I miss the most. Our next speaker is Professor John Crump, beaming in from New Zealand. Several years ago, John asked me if I knew anybody at CDC who could help him with an unexplained deaths project he was conducting in Tanzania. He specifically needed a pathologist with expertise in infectious diseases, and hopefully someone who understood the challenges of working overseas. I told him yes, as a matter of fact, I can think of someone who satisfies all those criteria, and more. John.

>> Thanks, Chris. Good afternoon, everyone. I've known Sherif since I served as an Epidemic Intelligence Service Officer in the class of 2000 assigned to the then-Foodborne and Diarrheal Diseases Branch, back in the days when 1600 Clifton Road looked more like the photograph on your right. I'd been schooled in the value of infectious diseases pathology during my earlier training in infectious diseases and medical microbiology before coming to the CDC, and so I was keenly aware of Sherif's work and the work of his group, and some of the many landmark contributions that they've made, and that have been described by others this afternoon. Indeed, this seminar is not long enough to tell of all the mysteries solved and contributions made. In the fall of 2001, my Epidemic Intelligence Service class was heavily involved in the investigation of an outbreak of illness and death among people handling the mail in the United States. Among other things, I have vivid memories of days spent visiting small hospitals in western North Carolina, reviewing patients admitted with severe disease to be sure that we'd not missed any previously unidentified people with illnesses that might be associated with this event. We found no additional patients associated with the outbreak in western North Carolina. And as you heard from Jim Hughes and Jeff Koplan, it was of course, Dr. Zaki and his team who was central to solving this mystery, including through examination of tissue from a skin lesion of an NBC television anchor assistant who recalled handling a suspicious letter with powder. And as you heard, Sherif's team made both the figurative call on the cause of the outbreak and the literal call to Jim at 3 a.m. on October 12th, 2001, and Jeff Koplan, then CDC Director, and as we now know the illnesses had arisen in New York and Florida were linked and were deliberately spread by mailed envelopes containing anthrax spores. I spent the years after Epidemic Intelligence Service working in northern Tanzania and remained an admirer of Sherif's work from afar. It wasn't until 2016 that I got the opportunity to collaborate closely with him on a project. I had been working with colleagues in Tanzania for more than a decade on severe febrile illness, and we'd come to the point of realizing that we knew the least about the patients we wanted to know the most about, those who died during the acute phase of the illness before we had time to confirm a microbiological diagnosis in life. It was hard to know how to prevent these deaths without knowing what the patients had died with. Dr. Ann Marie Nelson of the Armed Forces Institute of Pathology and in the Joint Pathology Center, well known for her AIDS autopsy studies through [inaudible] and then Zaire, had been a pathology mentor of mine during my medical microbiology training at Duke University Medical Center, and had agreed to support the team of early [inaudible] Tanzanian pathologists in this endeavor. However, she encouraged me to talk to Sherif to get his input on immunohistochemistry and other techniques needed to do this project really well. Feeling a bit bashful and reluctant to add to Sherif's already enormous workload, as Chris Paddock said, I sought his perspective on whether he thought it would be okay to ask for Sherif's involvement. Chris said something like Sherif doesn't say no to anything. And well, this proved to be accurate and I'm forever grateful to both Ann and Chris for encouraging this collaboration. Much has been said about Sherif's numerous and highly impactful scientific contributions, but Chris's comment alluded to Sherif's incredible generosity, curiosity and work ethic and provides a good seg from Chris -- from Sherif the scientist to Sherif the person, because as great a scientist is Sherif was, it was his many personal characteristics that had endeared him to so many. Nadia, Yasmin and Samy I recall with great fondness the visit to Council Bluff Drive one weekend in the spring of 2016. When I arrived, Nadia ushered me through to the garden in the back where Sherif -- could you go back a slide? -- where Sherif and some junior colleagues visiting the Infectious Diseases Pathology Branch were preparing what seemed like a small farm for spring planting. Sherif looked very happy and at home in this setting. From there, Sherif, Nadia, and I visited the amazing Orchid Center at Atlanta Botanic Gardens. We had lunch with Yasmin and Samy where stories were told, including of Sherif's love for adventure. I think that his skydiving exploits were mentioned, and we wrapped up the day with some grocery shopping at Trader Joe's on the way home. In brief, although I didn't get the opportunity to assist with the home gardening project, I felt like part of the family as I think everyone who worked with Sherif did. Next slide. Later that year, Sherif came to Tanzania for the launch of the febrile deaths autopsy project to mentor the Tanzanian pathologists and to give advice on setting up our study. I think it was then that I learned Sherif spent some of his youth in Daraa Salaam, Tanzania, while his father was posted there with the International Labor Organization. Next. Sherif seemed delighted to be back in Tanzania, excited to be involved in the project, and as you'll see from the tribute video, our Tanzanian pathology colleagues were thrilled to have the opportunity to benefit from Sherif's extraordinary knowledge and expertise as they further develop their own department. Like me, and I think everyone else who knew Sherif, we quickly understood that his kind, gentle and unpretentious demeanor was combined with brilliant intellect, vast experience and more knowledge than many rows of pathology textbooks could contain. When Sherif spoke, you didn't want to miss a softly spoken word because it was almost certainly gold. In the years that followed, it was a thrill to interact with Sherif, Dr. Rose Martinez, and the team. I always look forward to visits to Sherif's office in the Infectious Diseases Pathology Branch. Not only was it filled with many interesting things, there was usually something astonishing on the microscope stage, often of considerable importance to solving or understanding a major public health problem. And whatever mundane matter I was there to talk about, no one was ever in any doubt that what we really wanted was for Sherif to show us what was on the microscope stage, and to glean from his delight in teaching and sharing his knowledge, usually told with a twinkle in the eye, and in the form of a mystery to be solved. Now all the Tanzania work was not complete when we lost Sherif. We are committed to completing it and to recognize his contribution and that of Rose and the team. Already the results to date have uncovered unexpected causes of fatal febrile illness there, including interepidemic Rift Valley fever, as well as anthrax, although this time from infected animals rather than powder-filled envelopes. Next. We were asked to provide a seven-word title for our talk, and to come up with mine, I wrote a very long list of Sherif's numerous exemplary characteristics as a scientist and as a person that reflected my memories of him and those of my Tanzanian colleagues. I boiled it down to these seven words, unassuming, generous virtuoso who improved our world. I do think that Sherif was an example to all of us at CDC and more widely in health. What better way to spend your days than to use your skills, that in Sherif's case, were manifold, doing what you love with the goal of helping people, whether family, friends, colleagues, or those we will never meet, but who have benefited down the road from a mystery solved through persistence and determination. Next. I miss Sherif a lot, so I can't imagine how it's been for you, Nadia and Yasmin and Samy, but we want you to know that we loved every minute with Sherif, and we wish we had many more. It's been a great honor to be part of recognizing his many impactful scientific contributions, but also and perhaps more so, to acknowledge Sherif as a person, kind, humble, gentle, generous, unpretentious, brilliant, enthusiastic, persistent, determined and welcoming. It was those characteristics too that made him a role model for so many of us and a legacy that we hope to share with others as he did unreservedly with us. Thank you. Back to you, Chris.

>> I came to know Dr. Zaki in 2016 when he visited our department during the launching of [inaudible]. He has been instrumental in my career. Great man has left us but his memories remains forever. We condole with the family, with our deepest heartfelt condolences.

>> No one has been more impactful in leaving such a tremendous and profound legacy than Sherif Zaki, and for that I think, not only am I grateful and his colleagues at CDC are grateful, but I think the world is -- has a tremendous debt of gratitude for this remarkable human being and the life he led.

>> Thank you, John, for that wonderful tribute. Our final speaker today is my friend and colleague, Dr. Wun-Ju Shieh. As you can imagine, Sherif cast a shadow about a mile long and a mile wide, and it could be challenging to establish a unique identity when working with an intergalactically recognized professional. The person who did this best was Shieh, the pathologist who worked side by side with Sherif for 25 years, and gracefully emerged as an internationally, if not intergalactically, recognized ID pathologist in his own right. Shieh.

>> Thank you for the introduction. I'm here today with a heavy heart. However, I will do my best to bring back some happy memories and laughter in the next few minutes to commemorate my distinguished colleague and dear friend, Captain Zaki. Those of you who know me well probably on I was surprised to see the title of my presentation because I'm an aficionado of sci-fi movies, such as Star Wars and Star Trek. Okay, next slide, please. Inspired by the opening narration of every episode of Star Trek, this is my opening narration. Captain Zaki had led IDPB to seek out new pathogens and new infections in the microbial galaxy and boldly go where no pathologist has gone before. Isn't it relevant? My [inaudible] with Captain Zaki started in March 1995 [inaudible] when I was doing my 30-year pathology residency at Vanderbilt Medical University Center. It's the first time I attended the USCAP or the United States and Canadian Academy of Pathology annual meeting, and the Binford-Dammin Society companion meeting. Binford-Dammin Society is organized by a small group of pathologists with a special interest on infectious disease pathology. After the companion meeting, Dr. Sherif Zaki from CDC announced a one-year fellowship position in his laboratory, and I approached him immediately to introduce myself and disclose my interest in that position. That's the first time I met with Sherif, and it turns out to be the most critical moment in my professional career. To make the long story short, I applied for the position several months later, moved down to Atlanta, and start my fellowship in Sherif's lab. Ever since then, I participate every USCAP and Binford-Dammin Society meeting until 2020. Unfortunately, the 2020 annual meeting became the last one I attended together with Sherif. Even without his presence, Sherif's legacy and his influence on infectious disease pathology will last forever. Let's rewind the timeline back to 1995. The very first outbreak investigation I was involved after joining CDC was the large Ebola outbreak in Kikwit, Zaire. We worked closely with our colleagues at virus special pathogens branch and came up with many interesting findings, such as using the skin biopsies and IHC testing for diagnosis and surveillance of Ebola that Tom Ksiazek just described earlier. I'm glad I can still squeeze in the memorial T-shirt recently, but of course only after shaving off 35 pounds. Of course after my retirement, I've really been telling this to many of my friends. That's one big benefit to be a retiree. The most important outbreak investigation in my professional career occurs several months later after I started the fellowship during October and November 1995. Two health centers in the neighboring rural areas in western Nicaragua reported an increase in the number of patients with an illness characterized by fever, chills, headache, and some dying with pulmonary hemorrhage and shock. Initially, it was thought to be caused by Mysterio virus. We received several fatal cases with autopsy tissues, and after ruling out various hemorrhagic fever viruses, Sherif and I decided to expand our testing to include some possible bacterial pathogens, and after several days and nights of hard working, we identify Leptospiras of bacteria pathogens in the autopsy samples. This photo, was certainly not taken at that time, but our facial expression was pretty close to this photo at the moment we saw numerous Leptospira antigens to the left in tissue samples by immunohistochemical staining. It's already midnight. We're tired and hungry and Sherif took me to a nearby pizza house and treated me with a hot delicious pizza, the best pizza in my life, and this outbreak was quickly under control since the etiologic bacteria is preventable, controllable and treatable. This is the most important outbreak investigation in my professional career, because after this, CDC decided to recruit another pathologist. Well, thanks to Dr. Ruth Berkelman, the Deputy NCID Director and Dr. Jim Hughes, the NCID Director at that time who recognized the usefulness of pathology in public health. Over the years, Sherif and I often considered ourselves as my microscopic detectives trying to catch those microbial killers, especially during an unexplained outbreak. If we don't identify and catch the etiologic pathogen soon enough, it will continue to hurt people like a serial killer. This is really the fun part of our job, trying to utilize all the information and the laboratory methods to solve the puzzles. In this regard, Sherif is also the captain leading a squat with a special mission. A very unique skill of Captain Zaki's squad is the capability of performing high-risk autopsy to collect tissue samples for crucial testing. Personally, I think this is the most challenging and exciting part of my job. I was able to go to the frontline with a team or individually and perform autopsy for the investigation of an outbreak or a difficult case. It's like a microscopic version of CSI, Crime Scene Investigation. And the unique ability to view and explore the disease process bestows pathologists as the pathfinder to study novel pathogens, with structure function correlation as the guiding principle, and modern molecular and immunologic technologies as the exploring tools. Pathologists can assume a dynamic role in diagnosis, especially to provide an insightful prospective for clinical, pathologic and microbiological relation of emerging infections. My career at CDC started with the 1995 Ebola outbreak, and ended with the COVID-19 global epidemic, which is surprisingly still ongoing. There were numerous exciting investigations and never a dull moment during those 25 years, and I really owe my career highlights to Sherif's vision and leadership. Sherif and I share a lot of things in common, including educational background, professional interests, and family profile. We are both first generation immigrants to the US. He came from Egypt. I came from Taiwan. We both graduated from a foreign medical school, and receive our PhD education and pathology residency training in the US. We are both interested in infectious disease pathology, and like to explore the uncharted territory of novel pathogens. We are both the only son in the family. He has three sisters where I have four. As a matter of fact, I treated Sherif like my younger brother in private, because I'm almost two years older than he was, and both of us are lucky to have a very supportive spouse and family. Oh, even our -- the part of our top of our head looks alike. Okay. To grow up in the female-predominant family helps both of us to cope with our working environment because IDPB has been a female-predominant branch over the past two decades, as you can see from these group photos. And I would like to take today's opportunity here to thank my previous colleagues at IDPB for their contribution and the dedication. All work and no play makes Jack a dull boy as we always say, or should we say, make Jill a dull girl, since IDPB is a female-predominant branch. Certainly the Jills and Jacks at IDPB are not dull. We had a lot of fun activities in addition to our hard work, and every occasions are so memorable that they are glued to my digital photo album and etched in my memory forever. At the end of this presentation, I would like to express my utmost gratitude to Sherif for his friendship, inspiration and leadership. Please rest in peace, dear Sherif, my friend, my brother, my captain. Thank you.

>> Contrary to legend, Sherif did not create the infectious disease pathology program at CDC. He unquestionably transformed this discipline at the agency and quite possibly worldwide, and as you've heard from each of today's speakers, his contributions to this aspect of science and medicine might never be equal. Nevertheless, an infectious disease pathology program existed at CDC when Sherif became a staff pathologist here more than three decades ago. The pathologists he joined were adequate for the time, but were fundamentally stuck in the past, using techniques that in most cases were over 100 years old, and they generally dismissed the emerging technologies such as immunohistochemistry, and molecular biology that Sherif recognized and hoped they would adopt. In fact, it would be Sherif years later, who harnessed and applied these tools in ways that forever changed the future of infectious disease pathology, but when he first arrived, there were those in the CDC pathology program who neither recognized nor valued these transformational methods. Many years later, Sherif told me somewhat wistfully that he once overheard his colleagues say among themselves, Sherif is not a real pathologist. As inaccurate and ultimately comical as this comment was, I believe it instilled in Sherif a fierce motivation for the remainder of his career at the agency, and if you'll allow me to digress for one moment, I'd like to tell a story about another person whom I believe is familiar to most of you. Tom Brady, considered by many to be the greatest quarterback of all time, was picked up by the New England Patriots in the sixth round of the 2000 draft as the 199th player to be selected by any team. 22 years later, Brady holds nearly every NFL quarterback record, has won seven Super Bowls, five Super Bowl MVPs, and was awarded the league's Most Valuable Player title three times. And Tom Brady never forgot that the league selected 198 players ahead of him in 2000, providing him enormous motivation to excel for the rest of his career, but motivation will only take a person so far. Those who become the greatest of all time possess innate talent, intelligence, perseverance, a remarkable work ethic, and perhaps many intangible gifts from the universe that are bestowed to only very, very few people. And today, we honor and celebrate a man who applied these attributes to become the greatest infectious disease pathologist of our generation, and perhaps for all time. Before I end, let me remind you that Tom Brady never won a Super Bowl entirely by himself. He was surrounded by extremely talented teammates, coaches and trainers who contributed to his greatness, and were inspired by Brady to be the best version of themselves, and so before we go, I wish to acknowledge Sherif's remarkable teammates past and present, from the branch that he defined. The scores of staff pathologists, histotechnologists, molecular biologists, electron microscopists, epidemiologists, and admin personnel, who for three decades, contributed to Sherif's accomplishments and legacy, many of whom remain active in IDPB today to the great good fortune of this agency. I can only imagine what it's like to be on a winning Super Bowl team, but in some ways, I think I have an idea. I worked with Sherif in IDPB for 11 years, and recall the exhilaration we all felt as we sat at the multiheaded scope as Team IDPB established an otherwise unimaginable diagnosis that initiated a cascade of consequential -- excuse me -- consequential public health responses. And finally, let me acknowledge Sherif's dear family who's with us here today, who are as much if not more, a part of that same team by caring for him and providing him comfort, compassion, and the safe harbor to recover from the demands and expectations of being the greatest of all time. Without them, Sherif could not have been the person he became and the man who we remember and honor and miss here today. I want to thank the many persons who made this event possible, listed on this slide. And to all of you here in person and joining our webcast, we hope this event provided you with a lasting image of an amazing scientist, an exceptional colleague, and a wonderful human being. We also invite you to watch the tribute video on the We Were There website. This video features colleagues and staff members who spoke from the heart about what Sherif brought to their own lives and careers. For those of you in the room with us today, the video will follow immediately. In the next one to two weeks, we will make this entire presentation available on the We Were There website, which is cdc.gov/wewerethere. Thank you all for joining us today to remember Sherif Zaki, the science and the man. Goodbye.

[ Applause ]