While teaching her first class at Stanford last spring, Erin Mordecai wasn’t afraid to set the bar high. She challenged her students to tackle the emergence of Zika as the epidemic continued to grab headlines. She also made it known that, even though most of them were freshmen, they had a real shot at getting their research published.

Zika effects illustrated

Sixteen Stanford students in an introductory seminar explored the Zika epidemic and are now co-authors of a journal publication. (Image credit: R. Max Segnitz)

“I thought, ‘That would be so cool. I want to be published!’” said Sofia Ali, who was a freshman when she took the class. “I didn’t really know if we would follow through with it. It was just an idea.”

Nearly a year later, that exciting idea paid off. The 16 students in the seminar, plus Mordecai and a graduate student in the Peay lab, published their findings Feb. 9 in PLOS Neglected Tropical Diseases. Ali was lead author on the paper. (See video here.)

The classroom experiment was unusual in a field where most published scientific papers come from graduate students and faculty in established research labs. It was so extraordinary that in an online forum about the work, questions about how a class could publish a paper were as popular as those about the paper’s findings.

“I was really pleasantly surprised by the level of student buy-in and focus,” said Mordecai, who is an assistant professor of biology. “It was never a struggle to generate discussion or get people to participate. In fact, a couple of students did additional projects to contribute to the class beyond what was required.”

Zika from three perspectives

Mordecai had the students focus their Zika research efforts in three areas: environmental drivers, social drivers and social consequences. Working individually and then in teams, the class members drew conclusions in all areas and then combined their findings into the eventual paper.

One of the students’ most direct conclusions was that the increased spread of the virus is related to poverty, deforestation and natural disasters. Together, the class also found circumstantial support for potential correlations between the emergence of Zika and warmer-than-average temperatures, reduction in mosquito control efforts and global travel, among other factors.

Erin Mordecai

Stanford Assistant Professor of biology Erin Mordecai taught an introductory seminar on infectious disease, focused on different drivers and consequences of Zika. (Image credit: L.A. Cicero)

Jamieson O’Marr, a biology major who took the seminar as a sophomore, examined deforestation, which involved quantitative analysis on land-use change and its relationship to the spread of Zika.

“We found areas with lower forest cover had a higher rate of transmission,” said O’Marr. “This correlates to the fact that there is a lot of urbanization and land-clearing going on in Brazil, which could put even more people at risk.”

Looking at Zika’s potential social consequences, the class predicted that fear over Zika’s perceived risks would be central to defining public interest in the disease and treatment efforts, and that tourism in affected countries will likely suffer. They expected discussions about Zika to include significant focus on women’s reproductive rights. Women at risk of infection might want to postpone or terminate a pregnancy, which are contentious issues in many affected countries that have limited access to contraception and legal abortion. Because the virus is sexually transmitted, it could be transmitted during sexual assault.

A careful plan

From the very beginning, Mordecai worked to create an engaging class with participants who could keep the conversation fresh and innovative. She admitted students who study various topics, such as creative writing, mathematical sciences, video arts and biology, and also included upperclass members.

Mordecai knew that the emergence of Zika would allow the class to become experts relatively quickly regardless of their academic background and give them the opportunity to process new findings.

“It was really cool because it was on the news and we were doing research on it at the same time,” O’Marr said. “Every week we’d come and there’d be something new. Mordecai would incorporate those current papers into class and we’d have discussions on them and they really informed what we wanted the paper to be about.”

By developing their work in concert with new research, O’Marr said they learned how reactionary people tend to be in the face of disease, rather than looking at what caused it and how it could be prevented. They also were able to see how their early hypotheses stood up over time, such as when the April 16, 2016, earthquake in Ecuador was associated with a spike in Zika incidence in the Manabi province where the earthquake occurred. The students predicted this would occur due to disruptions in shelter and infrastructure.

With publication as a stretch goal, Mordecai broke down the course into manageable tasks and milestones and had students submit mid-quarter evaluations, aided by the Office of the Vice Provost for Teaching and Learning.

Getting to publication

Mordecai selected Ali as lead author on the paper from a group of final nominees for the job. Ali sent the first draft of the final paper in early June and – as other published researchers may understand all too well – spent the rest of the summer going over edits with Mordecai.

“It was intense but also very formative,” Ali said. “Mordecai was really great at explaining why her suggested changes were necessary or important. She also let me have a say in how I thought the paper should be structured.”

In combining the work of her classmates, Ali said she had the opportunity to better understand the deep complexity of their topic. This inspired her to try to replicate for the reader how she saw each piece of research come together to create what she referred to in the paper as the “multifactorial ‘perfect storm’” of Zika emergence.

With barely enough time to celebrate this special achievement, Mordecai is scheduled to teach her next introductory seminar, which will have students investigating how climate change affects mosquito-borne diseases using mathematical modeling. This class may not result in a publication, said Mordecai, but it will contribute to the research that is ongoing in her lab.

Additional co-authors of this research are Stanford students Olivia Gugliemini, Serena Harber, Alexandra Harrison, Lauren Houle, Javarcia Ivory, Sierra Kersten, Rebia Khan, Jenny Kim, Chris LeBoa, Emery Nez-Whitfield, Emma Rothenberg, Stephanie Sila, Anna Verwillow, Miranda Vogt and Adrienne Yang and R. Max Segnitz, a doctoral fellow in the Peay lab. Mordecai is also a member of Stanford Bio-X.

This paper is the product of a Stanford University Introductory Seminar: BIO 2N Ecology and Evolution of Infectious Disease in a Changing World. The Introductory Seminars program provided funding for the project. The research was also funded by the Stanford Center for Innovation in Global Health, the Stanford Woods Institute for the Environment and the National Science Foundation.