Margaret Carrel

Carrel profile picture
Associate Professor
PhD, University of North Carolina, Chapel Hill
305 Jessup Hall
Office Hours: 
Thursdays: 11:00 AM - 12:30 PM
Fridays: 1:45 PM - 3:15 PM
Curriculum Vitae: 
Research Interests: 
geography of infectious disease, landscape genetics & disease ecology

Visit My Personal Website

My research centers on exploring geographic patterns of health and disease using GIS and spatial statistical techniques. The focus of my current research is to understand how complex interactions between people and environments result both in disease outcomes and the progressive evolution of human pathogens.

As a research emphasis, human-environment drivers of pathogenic evolution is situated in the emergent field of landscape genetics, which combines the spatial analytic techniques of landscape ecology and geography with the computational methods of population genetics. I am applying these landscape genetics methods to the study of H5N1 influenza in Vietnam, H1N1 in China, malaria drug resistance in the Congo and HIV drug resistance in North Carolina.

Projects based in Iowa examine the patterns of drug resistant Staphylococcus aureus, particularly in relationship to livestock production.  With funding from the Carnegie Corporation I am exploring how infectious disease patterns change in the wake of hurricanes, floods and other natural hazards.

While my research focuses on genetic outcomes, I do not expect incoming graduate students to have a background in genetics or phylogenetic methodology.  You can "learn on the job".



  •  GEOG 4150 Environment & Health: GIS Applications:  a discussion/lab class designed to introduce students to the variety of spatial statistical techniques used to analyze health outcomes.
  •  GEOG 3070 Hungry Planet: Global Geographies of Food:   explores how food environments are created and have changed through time, and the population and environmental repercussions of our current food system.


  • GEOG 4030 Senior Project Seminar: guides senior Geography and EPPL students in their last semester, helping them to develop and complete an independent research project and prepare for careers after graduation.


Previous Undergraduate

  • GEOG 3110 Geography of Health:   examines how populations interact with their environments in ways that produce or prevent disease outcomes. 
  • GEOG 1060 The Geography of Asia: From Japan to Pakistan:   explores the major issues facing contemporary Asia, including population growth, environmental degradation, human migration, emerging economies and natural disasters.


  • GEOG 6100 Germs, Genes and Geography: focuses on using spatial, genetic and epidemiological methods to understand patterns and processes of disease transmission, gene mutation, diffusion of drug resistance and more.
  • GEOG 6635 Crossing Borders: Transnational Disasters and Global Health: explore how interactions between people and their environments (natural, built & social) amplify and/or ameliorate disaster impacts, and what happens when the populations, environments, and disasters involved stretch across borders. 
Graduate Advisees: 


Miah Boyle, Ph.D. (expected 2026)

Caitlyn Grubbs, Ph.D. (expected 2025)

Zhuo "Austin" Tang, Ph.D (MA '21)


Barbara Keino, Ph.D. (2022)

Seungwon Kim, Ph.D. (2022)

Zachary Palmer, M.A. (2018)

Austin Rau, M. A. (2018)

Sean Young, Ph.D. (2017)

Yiqing "Sunny" Shang, M.A. (2014)

Grants & Funding: 



Investigator, Understanding infectious disease risk in the wake of hurricanes and floods in the United States, Carnegie Fellowship, Carnegie Corporation of New York, $200,000, 8/1/19-7/31/21

Co-Investigator, Epidemiological and Spatial Models of Malaria Transmission, NIH R01AI107949-01A1 (PI Meshnick), Iowa portion: $154,140, 04/01/2014-03/31/2020




Investigator, Impact of rural status and distance to nearest VA facility on infectious disease outcomes, Comprehensive Access & Delivery Research & Evaluation, VA Medical Research Foundation, $14,300, 8/15/14-7/30/15

Co-Investigator, Staphylococcus Aureus: Is Raw Meat A Risk Factor For Colonization And Infection? USDA 2011-67005-30337 (PI Smith), Iowa portion: $38,625, 4/1/2011-3/31/2016

Co-Investigator. Spatio-temporal Patterns of Drug-Resistant Malaria in the Democratic Republic of Congo.  NSF BCS-1339949 (PI Emch)  Iowa portion: $34,012.  9/1/13-2/28/17.

Investigator. Spatial patterns of reported Acinetobacter baumannii incidence and drug resistance. Comprehensive Access & Delivery Research & Evaluation, VA Medical Research Foundation, $28,562, 8/15/13-7/30/14

Co-Investigator, Evaluating the impact of environmental contaminants on neurocognitive functioning in schoolchildren: a novel geographical analysis of NHANES and SABINS Data, Seed Grant, Environmental Health Sciences Research Center, University of Iowa (PI Sander) $9,273.75,  5/1/12-12/30/13

Investigator, MRSA risk in veterans and proximity to CAFOS, Comprehensive Access & Delivery Research & Evaluation, VA Medical Research Foundation, $20,375.25, 6/1/13-8/1/13                                                                                                                                                 

Selected Publications: 


Deutsch-Feldman, M., Aydemir, O., Carrel, M. et al. (2019) The changing landscape of Plasmodium falciparum drug resistance in the Democratic Republic of Congo. BMC Infect Dis 19: 872

Thompson, P., Parr, J.B., Holzmayer, V., Carrel, M., et al. (2019) Seroepidemiology of Hepatitis B in the Democratic Republic of the Congo. American Journal of Tropical Medicine & Hygiene 101 (1): 226-229.


Ohl, M. E., Carrel, M., Thurman, A., Mengeling, M., Vander Weg, M., Hudso, T., Vaughan-Sarrazin, M. (2018). Availability of healthcare providers for rural veterans eligible for purchased care under the Veterans Choice Act. BMC Health Services Research, 18, 315. 

Smith, T. C., Thapaliya, D., Bhatta, S., Mackey, S., Engohang-Ndong, J., Carrel, M. (2018). Geographic distribution of livestock-associated Staphylococcus aureus in the United States. Microbes and Infection, 20(6), 323-327. 

Suda, K. J., Livorsi, D. J., Goto, M., Forrest, G. N., Jones, M. M., Neuhauser, M. M., Hoff, B. M., Ince, D., Carrel, M., Nair, R., Knobloch, M. J., Goetz, M. B. (2018). Research Agenda for Antimicrobial Stewardship in the Veterans Health Administration. Infection Control & Hospital Epidemiology, 39(2). 

Young, S. G., Kitchen, A., Kayali, G., Carrel, M. (2018). Unlocking pandemic potential: prevalence and spatial patterns of key substitutions in avian influenza H5N1 in Egyptian isolates. BMC Infectious Diseases, 18(1), 314. 


Mwandagalirwa, M. K., Levitz, L., Thwai, K. L., Parr, J., Goel, V., Janko, M., Tshefu, A., Emch, M., Meshnick, S. M., Carrel, M. (2017). Individual and household characteristics of persons with Plasmodium falciparum malaria in sites with varying endemicities in Kinshasa Province, Democratic Republic of the Congo. Malaria Journal

Martin, B. E., Sun, H., Carrel, M., Cunningham, F. L., Baroch, J. A., Hanson-Dorr, K. C., Young, S. G., Schmit, B., Nolting, J. M., Yoon, K.-J., Lutman, M. W., Pedersen, K., Lager, K., Bowman, A. S., Slemons, R. S., Smith, D. R., DeLiberto, T., Wan, X.-F. (2017). US feral swine were exposed to both avian and swine influenza A viruses. Applied and Environmental Microbiology

Carrel, M., Zhao, C., Thapaliya, D., Bitterman, P., Kates, A. E., Hanson, B. M., Smith, T. C. (2017). Assessing the potential for raw meat to influence human colonization with Staphylococcus aureus. Scientific Reports

Carrel, M., Goto, M., Schweizer, M. L., David, M. Z., Livorsi, D., Perencevich, E. N. (2017). Diffusion of clindamycin-resistant and erythromycin-resistant methicillin-susceptible Staphylococcus aureus (MSSA), potential ST398, in United States Veterans Health Administration Hospitals, 2003-2014. Antimicrobial Resistance & Infection Control, 6(55). 

Carrel, M., Zahrieh, D., Young, S.G., Oleson, J., Ryckman, K.K., Wels, B., Simmons, D.L, & Saftlas, A. 2017. High prevalence of elevated blood lead levels in both rural and urban Iowa newborns: Spatial patterns and area-level covariates.  PLoS One. 12(5): e0177930.

Young, S.G., Carrel, M., Kitchen, A., Malanson, G.P., Tamerius, J., Ali, M., & Kayli, G. 2017. How's the Flu Getting Through? Landscape genetics suggests both humans and birds spread H5N1 in Egypt. Infection, Genetics & Evolution. 49: 293-299


Livorsi, D., Goto, M., Carrel, M., Jones, M., McDanel, J., Nair, R., Alexander, B., Bekc, B., Richardson, K., & Perencevich, E. (2016) Regional variations in fluoroquinolone non-susceptibility among Escherichia coli bloodstream infections within the Veterans Healthcare Administration. Antimicrobial Resistance & Infection Control. 5:38.

Young, S.G., Carrel, M., Malanson, G.P., Ali, M.A., & Kayali, G. (2016) Predicting Avian Influenza Co-infection with H5N1 and H9N2 in Northern Egypt. International Journal of Environmental Research & Public Health. 13(9): 886.

Carrel, M., Young, S.G., & Tate, E. (2016) Pigs in Space: Determining the Environmental Justice Landscape of Swine Concentrated Animal Feeding Operations (CAFOs) in Iowa. International Journal of Environmental Research & Public Health. 13(9): 849.

Nair, R,, Wu, J., Carrel, M., O’Brien, A., Quick, M., Farina, S., Wardyn, S., Thapaliya, D., Grenier, D., & Smith, T.C. (2016) Prospective multicenter surveillance for Staphylococcus aureus infections, 2011-2013. Diagnostic Microbiology and Infectious Diseases. 85: 360-366.

Girotra, S., van Diepen, S., Nallamothu, B. K., Carrel, M., Vellano, K., Anderson, M. L., McNally, B., Abella, B., Sasson, C., & Chan, P. S. (2016) Regional Variation in Out-Of-Hospital Cardiac Arrest Survival in the United States. Circulation. 10.1161/CIRCULATIONAHA.115.018175

Carrel, M., Janko, M., Mwandagalirwa, M.K., Morgan, C., Fwamba, F., Muwonga, J., Tshefu, A.K., Emch, M. & Meshnick, S. (2016). Changing spatial patterns and increased rurality of HIV prevalence in the Democratic Republic of the Congo between 2007 and 2013. Health and Place. 39: 79-85. doi:10.1016/j.healthplace.2016.02.009


Carrel, M., Perencevich, E.N. & David, M.Z. (2015) Emergence and Spread of USA300 MRSA, United States, 2000-2013, From Published Reports on 33,543 Isolates. Emerging Infectious Diseases. 21(11): 1973–1980. doi:10.3201/eid2111.150452.

Carrel, M. (2015) Disease at the molecular scale: Methods for exploring spatial patterns of pathogen genetics. In Spatial Analysis in Health Geography. Delmelle, E., Paez, A. & Kanaroglou, P. eds. London: Ashgate.

Carrel, M. & Bitterman, P. (2015) Personal Belief Exemptions to Vaccination in California: A Spatial Analysis. Pediatrics. 136 (1). doi: 10.1542/peds.2015-0831.

Warden, S.E., Forshey, B., Farina, S., Kates, A., Nair, R., Quick, M., Wu, J., Hanson, B., O’Malley, S., Shows, H., Heywood, E., Beane-Freeman, L., Lynch, C., Carrel, M. & Smith, T. (2015) Swine farming is a risk factor for infection with and high levels of carriage of multi-drug resistant Staphylococcus aureus. Clinical Infectious Diseases. doi: 10.1093/cid/civ234.

Lund, B.C., Carrel, M., Gellad, W.F., Chrischilles, E.A. & Kaboli, P.J. (2015) Incidence-based versus prevalence-based measures of inappropriate prescribing in the Veterans Health Administration. Journal of the American Geriatrics Society. DOI: 10.1111/jgs.13560

Eko, K., Forshey, B., Carrel, M., Schweizer, M., Perencevich, E., & Smith, T. (2015) Molecular characterization of methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization and infection isolates in a Veterans Affairs hospital. Antimicrobial Resistance & Infection Control. 4:10. 10.1186/s13756-015-0048-5.

Mosher, H.J., Krebs, E.E., Carrel, M., Kaboli, P.J., Vander Weg, M.W. & Lund, B.C. (2015) Trends in Prevalent and Incident Opioid Receipt: an Observational Study in Veterans Health Administration 2004–2012Journal of General Internal Medicine. 30(5):597-604. 10.1007/s11606-014-3143-z.

Carrel, M., Patel, J., Taylor, S., Janko, M., Mwandagalirwa, M., Tshefu, A., Escalante, A., et al., (2015) The geography of malaria genetics in the Democratic Republic of Congo: a complex and fragmented landscape.  Social Science & Medicine. 133: 233-241. 10.1016/j.socscimed.2014.10.037.


Carrel, M., Eron, J.J., Emch, M. & Hurt, C.B. (2014) Spatial epidemiology of recently acquired HIV infections across rural and urban areas of North Carolina. PLoS ONE. 9(2): e88512.

Carrel, M., Schweizer, M.L., Sarrazin, M.V., Smith, T.C., & Perencevich, E.N. (2014) Residential proximity to large swine confined animal feeding operations is associated with increased risk of MRSA colonization at time of hospital admission in rural Iowa veterans. Infection Control & Hospital Epidemiology. 35 (2), 190-192.


Wan, X-F., Carrel, M., Long, L., Alker, A. & Emch, M. (2013) Perspective on emergence and re-emergence of amantadine resistant influenza A viruses in domestic animals in China.  Infection, Genetics & Evolution. 20: 298-303.

Carrel, M. & Emch, M. (2013) Genetics: A new landscape for medical geography. Annals of the Association of American Geographers. 103(6): 1452-1467.

Winston, J., Escamilla, V., Perez-Heydrich, C., Carrel, M., Yunus, M., Streatfield, P.K., & Emch, M. (2013) Protective benefits of deep tubewells against childhood diarrhea in Matlab, Bangladesh.  American Journal of Public Health. 103(7), 1287-1291.


Carrel, M., Emch, M., Nguyen, T., Jobe, T. & Wan, X-F. (2012) Population and environment drivers of H5N1 avian influenza evolution in Vietnam. Health & Place 18(5): 1122-1131

Carrel, M., Wan, X-F., Nguyen, T., & Emch, M. (2012) Highly pathogenic H5N1 avian influenza viruses exhibit few barriers to gene flow in Vietnam. EcoHealth. 9(1): 60-69.


Carrel, M., Wan, X-F., Nguyen, T., & Emch, M. (2011) Genetic Variation of Highly Pathogenic H5N1 Avian Influenza Viruses in Vietnam Shows Both Species-Specific and Spatiotemporal Associations. Avian Diseases 55(4): 659-666.

Carrel, M., Escamilla, V., Messina, J., Giebultowicz, S., Winston, J., Yunus, M., Streatfield, P.K., & Emch, M. (2011) Diarrheal disease risk in rural Bangladesh decreases as tubewell density increases: a zero-inflated and geographically weighted analysis. International Journal of Health Geographics 10:41. doi:10.1186/1476-072X-10-41.

Emch, M., & Carrel, M. (2011). Neighborhoods & environmental determinants of infectious diseases. In J. Nriagu (Ed.), Encyclopedia of Environmental Health. Elsevier.


Carrel, M., Voss, P., Streatfield, P.K., Yunus, M. & Emch, M. (2010) Protection from annual flooding is correlated with increased cholera prevalence in Bangladesh: a zero-inflated regression analysis. Environmental Health 9(13). doi:10.1186/1476-069X-9-13.

Carrel, M., Emch, M., Jobe, R.T., Moody, A. & Wan, X-F. (2010) Spatio-temporal Structure of Molecular Evolution of H5N1 Highly Pathogenic Avian Influenza in Vietnam. PLoS One 5(1): e8631. doi:10.1371/journal.pone.0008631


Carrel, M., Emch, M., Streatfield, P.K., & Yunus, M. (2009) Spatio-temporal Clustering of Cholera: The Impact of Flood Control in Matlab, Bangladesh, 1983-2003. Health & Place 15(3): 741-752.


Carrel, M. & Rennie, S. (2008). Demographic & Health Surveillance: Longitudinal Ethical Considerations. Bulletin of the World Health Organization 86: 612-616.

Wan, X-F., Nguyen, T., Smith, C., Zhao, Z., Carrel, M., Davis, C., Balish, A., Luo, F., Emch, M., Klimov, A. & Donis, R. (2008). Genesis of Highly Pathogenic H5N1 Avian Influenza Viruses in Vietnam from 2001-2007: Introduction, Inheritance, Adaptation, and Selection. PLoS One 3(10): e3462.