Leading the fight against infectious disease

Capt. Kyle Petersen, D.O.'94, and Adam W. Armstrong, D.O.'96
Capt. Kyle Petersen, D.O.’94, and Adam W. Armstrong, D.O.’96

NAMRU-6Capt. Kyle Petersen, D.O.’94, FACP, FIDSA, and Adam Armstrong, D.O.’96, FACP, are serving as commanding officer and executive officer, respectively, of the Naval Medical Research Unit No. 6 (NAMRU-6). Based in Lima, Peru, it is the Navy’s busiest overseas research lab.

Both are fellows in the American College of Physicians and are on the faculty of the Uniformed Services University of the Health Sciences. They have extensive backgrounds in infectious disease and, between them, numerous military medals and other honors. Petersen’s military service included deployment on the USNS Comfort for the assault phase of Operation Iraqi Freedom and to the Joint Task Force, Guantanamo Bay, Cuba. Armstrong’s assignments include program head for the clinical trials and military studies program at U.S. Naval Medical Research Unit Number 3 in Cairo, Egypt, and as senior medical officer to a Provincial Reconstruction Team in Afghanistan. 

Petersen was named executive officer of NAMRU-6 in 2011, taking command in 2013; Armstrong was appointed its executive officer in 2013. DMU Magazine recently talked with these two leaders.

Describe the primary roles and responsibilities of NAMRU-6.

KYLE PETERSEN: NAMRU-6 consists of 14 active duty military, two civilian government employees and 300 Peruvian technicians, scientists and staff employed through the U.S. State Department or as contractors. It’s a great international collaborative team of U.S. and Peruvian citizens.

We focus on four research areas. The first is developing vaccines and medicines to protect soldiers from diseases while they’re deployed. There are diseases in other countries we don’t see in the U.S. Peru gives us a platform to do this research.

Children in developing nations and adults in developed countries are similar immunologically. Adults in developing countries likely have had some of the infectious diseases and partial immunity, while the children – like adults in the U.S. – don’t have any. If kids get sick here, often their families don’t have the resources or ability to take them to a clinic or hospital. If we can develop treatments for kids here and they do well, those treatments will be effective for adults in the U.S. That helps protect people in the developing world, and the Navy benefits, too.

Our second big area is global health security. We’re an early warning system as one of five sites, three Navy and two Army, around the world to watch for disease outbreaks. We can characterize strains of influenza, for example, that show up every year. The strains that emerge in the tropics are likely to show up in Iowa in six months. We collect data on those strains to develop the annual vaccine.

We inform countries of the potential for pandemic disease outbreaks like SARS [severe acute respiratory syndrome], Avian influenza or MERS CoV [Middle East respiratory system coronavirus] as well.

Adam Armstrong and Kyle Petersen with the NAMRU-6 team at the Puerto Maldonado field site in the Amazon rainforest, Peru.
Adam Armstrong and Kyle Petersen with the NAMRU-6 team at the Puerto Maldonado field site in the Amazon rainforest, Peru.

Our third area relates to our diplomatic mission: We are a center for development of scientific knowledge in Peru. We bring technology to Peruvian universities and laboratories so they can get experience using it.

Different diagnostics come out every year; we can buy and try them early on and then observe which ones become widely accepted by providers.

We use new technology to diagnose patients with fevers. We can sequence all DNA in a specimen, throw all the data in a database and match it with existing databases of genes. We subtract the patient DNA and rebuild the whole genome for new pathogen discoveries. We did this for the H1N1 that spread in 2009 and 11 new viruses last year.

That allows people in Peru to learn the latest and greatest science rather than being 20 years behind. A very big focus of Peruvian President Ollanta Humala is science and technology. Peru is largely agricultural and needs to develop industry. Science and medicine are one focus. So we use my and Capt. Armstrong’s labs to train people in science.

The fourth area is that we provide a lot of support to our military partners for outbreak investigation, and U.S. military personnel provide significant humanitarian aid for disaster relief, increasingly with our allies in the region. These partnerships give people in other countries a good impression of America and their own military, and we build friendships among military medicine.

Talk about your jobs.

ADAM ARMSTRONG: The positions we have are mostly administrative. It’s a lot of personnel, budgeting. We help facilitate operations to allow the scientists to do their science.

The fun thing about my job is I get to see things a little higher up, how they work. In that way, it allows me to play a role in all of our activities.

The challenge is how to work through the financial constraints, how to do the best job you can given the resources and needs. It’s critical that we educate people on the value of what we’re doing, for example that we have a drug like malarone as a result of our work. Often people don’t know we’re doing this important type of work. Like a lot of public health work, it goes unrecognized. Yet a lot of the vaccines we use day to day came out of these labs.

PETERSEN: We’re stationed at a Peruvian Navy base. We have about a half-dozen buildings including labs and freezers to house 20,000 specimens collected since 1983. We maintain those so, for example, we can see whether an outbreak of dengue or influenza this year is like that of a previous year.

One of the challenges of our work is making sure people understand the importance of international collaboration. Infectious diseases respect no boundaries. Regardless of your political ideologies, they’re going to impact your country’s citizens both in regard to mortality and economically. There needs to be a spirit of international cooperation and collaboration even with countries we may not like so well. Pandemics really affect all of us.

Nothing we do here we do solo. We work with partner-nation public health professionals, veterinarians, scientists and others. If people are not working across professions with a team approach, you can’t improve public health or stop outbreaks. It will be worse than a Hollywood movie.

Share something about your background.

PETERSEN: I call myself a “Star Trek” nerd. I have a lot of curiosity and I love new technology. I tend to be an early adapter. I’m very curious as to why something happens, why something is wrong with a person. I like anything I can do to come up with new technologies and medicines to help people.

In January 2003, I found out I was going to deploy on USNS Comfort, then waited for three months before President [George] Bush officially declared war on Iraq. I was supposed to get married that May, but we had to reschedule our wedding. On Comfort, we were taking Marine casualties. After that I spent about eight years at the National Naval Medical Center in Bethesda, seeing more casualties. It was a very big honor for me to take care of those heroes, but also psychologically draining to see these 18-year-olds severely injured.

ARMSTRONG: In 2010, I was assigned as the senior medical officer to a Provincial Reconstruction Team in a western province of Afghanistan to help develop health infrastructure. Luckily, with my medical, infectious disease and public health background, I was uniquely positioned for that work. Plus I had served in Cairo, Egypt, so I knew the Middle Eastern viewpoint and had some insights on their religion as well as health issues.

PETERSEN: We’re proud DMU alumni. I think it’s a great school for all medicine in general. When I started my internship, I was with a guy from Harvard and one from the Uniformed Services University. When we started on rounds, I was intimidated that first week, but I was the best prepared and most knowledgeable on rounds. Don’t let anyone tell you DMU isn’t a great school just because it’s relatively small and in Iowa.

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