How a lifetime of research has benefited a Texas border community

Photo from 1975 shows Dr. McCormick administering the polysaccharide vaccine to a female patient during the meningitis epidemic. The country’s massive effort resulted in the vaccination of 80 million Brazilians in less than three months. — Brazil, 1975 – McCormick administers the newly created polysaccharide vaccine during the meningitis epidemic. The country’s massive effort to combat the disease resulted in the vaccination of 80 million Brazilians in less than three months.

After decades of investigating infectious diseases around the world, Joseph McCormick, MD, founded the Brownsville location of The University of Texas School of Public Health (now UTHealth Houston School of Public Health-Brownsville), where he has overseen extensive health studies on the local population, including community-based participatory research and clinical trials, culminating in more than 20 years of invaluable data.

By the spring of 1965, the United States was embroiled in the Vietnam War, Malcolm X had been fatally shot, and images of demonstrations had become a regular feature of the nightly news. LBJ was set to pass the Voting Rights Act, having signed the Civil Rights Act just the year before. The midpoint of the most volatile decade in modern U.S. history was underscored by protests, assassinations, and division—amid an entire generation’s call to “Make love, not war.” Around the same time, a young, idealistic, and bilingual Joseph McCormick, fresh out of college with degrees in chemistry and mathematics, was preparing to embark on a journey to the Democratic Republic of the Congo (DRC) to teach math and science to French-speaking Congolese high school students. Having gained its independence from Belgium just five years earlier, the DRC was enduring its own tumultuous period of growth and rebellion amid a series of coup d’états. Much like America awakening to its cultural and political realities, McCormick’s eyes would soon be forever opened to the dire complexities of global health. The transformative experience abroad would inspire him to apply to medical school—a decision that would launch a storied and fruitful career.

The 1970s

After completing an MD from Duke University, an MS in public health from Harvard, and residency at Children’s Hospital of Philadelphia, McCormick joined the Centers for Disease Control and Prevention (CDC) in 1973. As an epidemiologic intelligence service officer, he was assigned to the Bacterial Special Pathogens Branch and became chief of the department within two years. He went on to assist the Brazilian government and the Pan American Health Organization in the investigation of what was, at the time, the largest outbreak in history of meningococcal disease.

The next stop was West Africa to study the emerging viral disease Lassa fever. In 1976, McCormick established a research program in Sierra Leone and subsequently authored more than 50 publications on the disease, including an article in the New England Journal of Medicine on the successful clinical trial of ribavirin treatment for acute Lassa fever, the first such successful treatment of a viral hemorrhagic fever. In addition, his CDC laboratory demonstrated a successful recombinant vaccine for Lassa virus in a nonhuman primate model.

That same year, McCormick returned to the Congo (Kinshasa) to assist in an outbreak of hemorrhagic fever in the Mongala District that resulted in the discovery of Ebola virus disease (EVD). Given his experience in the region, fluency in French, and familiarity with the Lingala language, he investigated the outbreak and a newly identified one in southern Sudan, traveling 800 km by dirt road between the two. His report concluding that the outbreaks were unrelated, though initially met with skepticism, proved correct according to molecular studies of the viruses. McCormick’s team described the clinical and epidemiological characteristics of Ebola virus, and his collection of sera played a crucial role in the later investigation of the natural history of HIV in Africa, published in the NEJM. He went on to investigate the third outbreak of EVD in 1979, and was able to produce much of the early characterizations of Ebola virus in the laboratory.

The 1980s

In 1982, McCormick’s CDC team identified the Haantan virus that causes hemorrhagic fever with renal syndrome (HFRS). Upon hearing of cases of lymphadenopathy syndrome among Congolese in Belgium, McCormick launched the first comprehensive field and clinical study of HIV/AIDS in Africa in 1983. The team characterized 38 cases of the disease in Kinshasa, the capital and largest city of the DRC, and described the first indication of the extensive heterosexual transmission. McCormick went on to establish Project SIDA in Kinshasa in 1984, and worked with the World Health Organization to set up the first meeting in Africa on AIDS in Bangui, Central African Republic, in 1985. In the latter half of the decade, he was an advisor to the Pasteur Institute in Paris until 1991.

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Africa, 1982 – The WHO mpox (monkeypox) investigation team; Joseph McCormick, far right.

The 1990s

In the early ’90s, McCormick began a study on malaria in Western Kenya. Upon establishing an immunology laboratory in Kisumu, he led a comprehensive project to assess the natural history of malaria infection in children. The program, now the Centre for Global Health Research, is part of the Kenya Medical Research Institute in Kisumu and continues to conduct large-scale studies of malaria and HIV.

In 1993, the newly married McCormick and his wife, noted epidemiologist and microbiologist Sue Fisher-Hoch, headed for Pakistan, where McCormick served as chair of the Department of Community Health Sciences at Aga Khan University Medical College. During his four-year tenure, McCormick created the Research Officer Program, still in place today, to provide community-based research opportunities for medical school graduates. He also developed the first family medicine program in Pakistan, which became a standalone department, one of the largest in the medical school. In 1997, McCormick returned to the Pasteur Institute where he created the first epidemiology program for Pasteur Mérieux, now Sanofi Pasteur, the French pharmaceutical giant.

Brownsville

In 2001, McCormick returned to the U.S., where he subsequently founded the Brownsville campus of UTHealth Houston School of Public Health. At the time, the city was listed by the U.S. Census Bureau as the poorest in the nation. Composed of about 90% Latinos, primarily from Mexico and Central America, the population had a mean age of 45 and an average annual household income of just over $20,000. Recognizing the opportunity to make an impact on a community in need, McCormick chose the area for his extensive, longitudinal research. He oversaw construction of the space for the school and created the first clinical research unit in the Rio Grande Valley in 2003, and the Cameron County Hispanic Cohort (CCHC) in 2004 with funding from a P20 grant from the National Institutes of Health under the umbrella of the Hispanic Health Research Center. The program inspired the creation of the Collaborative Action Board and Tu Salud ¡Si Cuenta!, a community outreach organization that provides wellness programs and initiatives.

The Cameron County Hispanic Cohort (CCHC)

The CCHC includes more than 5,000 individuals, ages 8 and up, from the Texas-Mexico border communities of Brownsville, Harlingen, and Laredo. It is the largest cohort of its kind in the U.S. The random protocol allows the research team to estimate prevalence of chronic disease in the population. The staff of the clinical research unit (CRU), who are recruited from the community and trained, call on households where they describe the purpose of the cohort and related studies. Those who agree to participate provide extensive household data and subsequently complete health questionnaires, physical measurements, and imaging at the CRU facility. The team also collects and stores serial serum, plasma, DNA, RNA, urine, and stool specimens. Follow-up visits are conducted every five years, with data in the biobank going back more than 20 years. The innovative model assesses changes in disease patterns over time and associates them with changes in the transcriptome, proteome, lipidome, and gene methylation thanks to the longitudinal biobank.

McCormick’s group shares six NIH grants with collaborators on subjects including diabetes, lipid genetics, liver cancer, and an NIH-funded clinical trial. They have published more than 115 peer-reviewed journal articles on the CCHC. Collaborators include: The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences, the University of Houston, Vanderbilt University, the University of North Carolina, the Icahn School of Medicine at Mount Sinai, and Queen Mary University of London. In August 2023, McCormick’s team was awarded a prestigious grant funded jointly by the National Human Genomic Research Institute, the National Cancer Institute, and the National Institute of Environmental Health Sciences for multi-omics research on human health and disease. McCormick is also co-chair of the consortium created by the grant, which will support the work of six disease study sites: Columbia University, University of California San Diego, University of California San Francisco, University of Illinois Chicago, University of Southern California, and UTHealth Houston.

Today, McCormick continues to work as a practitioner, researcher, teacher, and physician scientist in public health. Over the course of 23 years at UTHealth Houston School of Public Health, where he holds the James H. Steele, DVM, Professorship, he served as regional dean for 19 years and founded several teaching initiatives, dual four-year MD and MPH degrees (now in eight medical schools), and an accelerated MPH degree for undergraduates. Now in their 80’s, McCormick and Fisher-Hoch agree that working in the Cameron County community has been their most rewarding endeavor to date.