>> 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.
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 ]