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Northeastern Spotlight
Fall 2015
Volume 10 - Number 3

Dear Colleagues,

I hope you enjoyed your summer and are now ready for the wide range of course offerings that GTBI has in store for you this fall.

We resumed our web-based TB Grand Rounds on September 22nd with the topic of TB Transmission in a Daycare. Dr. Kristina Feja, Chief, Division of Pediatric Infectious Diseases at Saint Peter’s University Hospital and Marybeth Caruso, BSN, RN, Nurse Case Manager at Middlesex County TB Control Center presented the cases which generated an interesting discussion from the clinical and public aspects. We also hosted the four day Clinical TB Intensive Workshop in Newark, NJ. We had a diverse group of attendees from various programs in the region, including participants from international panel sites in Peru, India, Mexico and Papua New-Guinea.

GTBI also hosted three mini-fellows in September; Kway Aung, MD from Rikers Island Correctional Facility, New York City, John Parmer, PhD from CDC, Atlanta and Yulimar Vildosola, a physician from Mexicali, Mexico. In the same month, we also deployed our team of skilled education and training staff to various locations for offsite TB trainings in Albany, NY, Rehoboth Beach, DE, and Burlington, VT.

We are particularly excited about the upcoming 9th Annual TB Medical Consultants Meeting to be held in Newark on October 21 and 22. I always find the TB Medical Consultants Meeting to be incredible in terms of content and the opportunity to network with other colleagues from the region. On a parting note, don’t forget to check out our training calendar for upcoming courses.

Sincerely,
Alfred Lardizabal, MD

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Training Highlights

Managing Complexities in TB Infection and Disease

The conference, Managing Complexities in TB Infection and Disease, was held on September 29, 2015 in Albany, NY. This training was developed in close collaboration with New York State Department of Health and the Global Tuberculosis Institute.

The purpose of this training was to increase awareness and knowledge on the global status of tuberculosis (TB) and local management of TB. The content was tailored based on the need of TB staff across the state.

Jane Carter, MD provided a global perspective on TB including the new END TB Strategy. TB lab diagnostics pertaining to New York State was covered at length by Vincent Escuyer, PhD and Cheryl Kearns, MPH. Margaret Oxtoby, MD and Anil Vaidian, MD expanded on treatment for TB infection and provided an updated on the new 12 dose regimen. Alida Rivera de Davis, BSN, PHN brought her nursing perspective to the conference and shared very intriguing cases highlighting the role of TB case management. Douglas McQueen, MD simplified the complicated topic of managing drug interactions and side effects for the audience. Finally, Richard Blinkhorn, Jr., MD, FACP shed light on the topic of TB radiology with a presentation of various radiographic TB findings. The training concluded with a panel discussion to address questions that reflected challenges that participants face in their setting.  

The 75 attendees at the training came from 34 counties within New York State, including seven participants from the New York State Department of Corrections. Feedback from the conference evaluation indicated that the content was quite relevant and the information increased participants’ understanding of TB. One attendee remarked, “This was an excellent conference, bringing local health departments that have zero to few TB cases up to date on current treatment and practices!”

Submitted by Arpita Jindani, MSW MA

GTBI is interested in highlighting TB program efforts throughout the Northeast. If you would like to see your program featured in the next edition of the Northeastern Spotlight, please email Arpita Jindani (arpita.jindani@rutgers.edu).

 

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Product Update: TB Interviewing for Contact Investigation: A Practical Resource for the Healthcare Worker

This highly requested resource was recently re-printed and is now available for ordering. The set includes a booklet which provides a detailed outline of the TB interview process and an accompanying interview checklist as a quick reference. This resource is useful for TB control staff who conduct interviews as part of the TB contact investigation process and can be used as a training tool. 

Staff Profile: Henry Fraimow, MD- Volunteer Medical Consultant for the Global Tuberculosis Institute

Dr.  Henry Fraimow is an Associate Professor of Medicine at Cooper Medical School of Rowan University in Camden, New Jersey and he is also the senior medical consultant for the South Jersey Regional Program for TB. For those of you in the TB world who have not met Dr. Fraimow, calm, gentle, kind and caring are some of the adjectives used by individuals who have worked with him. Once you meet him in person, you will certainly agree with that!

photo of Dr. Fraimow

Dr. Fraimow went to Perelman School of Medicine at University of Pennsylvania and did his residency in internal medicine at Mount Sinai Medical Center. This was 1982, an era of the emerging AIDS epidemic and reemergence of TB that exposed Dr. Fraimow to treating patients with TB, AIDS and other tropical diseases. In his words, “I saw a lot of TB during my fellowship years but my formal training in TB really started at Cooper University, Camden in 2001. I have been at Cooper ever since.”

Dr. Fraimow has been an infectious disease specialist for over 25 years. When asked about what sparked his interest in TB, Dr. Fraimow responds, “I always had an interest in microbiology and TB has been a fascinating disease as it presents in many different ways but once you treat people they dramatically feel better.”
 
According to Dr. Fraimow, the biggest challenge in TB is that many of the patients are socially and economically marginalized. They are often dealing with other issues that impact their ability to focus on treating their TB disease. “I think we do a very good job to get them their medicines but most often resources to help them with social problems don’t exist. Our nurse managers help these patients navigate the system as well as other medical issues including diabetes, blood pressure and HIV,” adds Dr. Fraimow.

Dr. Fraimow is an optimist; in addition to highlighting the challenges in TB, he wants to make it clear that there are a lot of enjoyable moments as well. Treating patients with TB is a tremendous opportunity to educate them. He says, “People come to TB clinics with their preconceptions of the disease. They are often terrorized, stigmatized and they think about their TB diagnosis as a death sentence! I can help them understand the disease better.”

When asked to advise a health care professional who is new to the world of TB, Dr. Fraimow reflects that in spite of how people seem to react to a diagnosis of TB, there is nothing to be afraid of. TB is a disease which we can cure in almost everybody. “The big part of our job is to quell the overreaction among the patient, family and physicians. Quell the craziness!” exclaims Dr. Fraimow.

Dr. Fraimow has a variety of interests outside of work. He is a voracious reader who loves science fiction, he also enjoys running and he is an avid sports fan who supports the Phillies and Eagles. Dr. Fraimow’s wife Jacqueline works in New York City (NYC) so he spends a fair amount of time in NYC as well. He calls himself a self-taught cook and baker. “Oh and I have a small research lab, where I do research on antibiotic resistance,” concludes Dr. Fraimow in his humble manner.

Dr. Fraimow is also a volunteer medical consultant for GTBI and regularly responds to requests for clinical consultations and lends his TB-HIV expertise as a faculty member for our training courses.

Submitted by Arpita Jindani, MSW, MA   

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Announcements: Mini-Fellowship

GTBI offers mini-fellowship trainings to provide first-hand knowledge and experience in carrying out TB control activities. The goal of our mini-fellowship program is to share TB expertise and knowledge with health care providers from a variety of settings. This mini-fellowship offers a tailored training experience based on the individual’s need, areas of practice and communities served, and specific topics of interests and matches their objectives with appropriate activities. For additional information on how to take advantage of this unique opportunity, please contact our Training Director, Anita Khilall at 973-972-9102 or send an email to anita.khilall@rutgers.edu.

photo of minifellows

Pictured above in September 2015 (Left to right): GTBI Executive Director, Dr. Alfred Lardizabal with mini-fellows Dr. John Parmer, GTBI staff Mark Wolman and mini-fellow Dr. Yulimar Vildosola.

 

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Upcoming Northeast RTMCC Training

The New Jersey Medical School Global Tuberculosis Institute (GTBI) sponsors courses and webinars on tuberculosis.  GTBI webinars are open to all participants in the United States.  For in-person courses, GTBI prioritizes participants from the Northeast Region (Baltimore, Connecticut, Delaware, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York City, New York State, Pennsylvania, Philadelphia, Rhode Island, Vermont, and Washington, DC), which is served by GTBI.
Click here for the list of upcoming trainings.

Medical Consultation

GTBI faculty and staff respond to requests from healthcare providers seeking medical consultation. We also provide consultation on nursing, case management and contact investigation issues on request. Consultants can be reached by calling the TB Info-line: 1-800-4TB-DOCS (1-800-482-3627) or by email (mc_gtbi@njms.rutgers.edu)

During each consultation, the GTBI consultants will advise callers about resources/TB Programs in their jurisdiction. In addition, TB programs will be informed of TB cases with public health implications such as MDR/XDR-TB, pediatric TB in children <5 years of age, or potential outbreak situations.

More information about our consultation service can be accessed at http://globaltb.njms.rutgers.edu/services/medicalconsultation.html

Links - Other TB Resources

Division of Tuberculosis Elimination
The mission of the Division of Tuberculosis Elimination (DTBE) is to promote health and quality of life by preventing, controlling, and eventually eliminating tuberculosis from the United States, and by collaborating with other countries and international partners in controlling tuberculosis worldwide.

Find TB Resources Website
This website provides a central, comprehensive searchable database of international, national, state, and local TB-related education and training materials for TB healthcare workers, health professionals, patients, and the general public. Users can also submit their education and training materials as well find information on funding opportunities, TB organizations, TB mailing lists, and TB images.

TB Education & Training Network (TB ETN)
The TB Education and Training Network (TB ETN) was formed to bring TB professionals together to network, share resources, and build education and training skills.

Regional Training and Medical Consultation Centers' TB Training and Education Products
This website provides a searchable list of all RTMCCs' resources.

TB Wire Newsletter
Contents include:

  • Announcements
  • Washington Update
  • Linkable Journal Abstracts
  • Resources/Training
  • Selected TB Reports 
  • Grants, Job Opportunities
  • Meetings, Conferences & Events
  • To subscribe to this service, click here

Other RTMCCs  
The Curry International Tuberculosis Center serves: Alaska, California, Colorado, Hawaii, Idaho, Nevada, Oregon, Utah, Washington, Federated State of Micronesia, Northern Mariana Islands, Republic of Marshall Islands, American Samoa, Guam, and the Republic of Palau.

The Heartland National Tuberculosis Center serves: Arizona, Arkansas, Kansas, Louisiana, Missouri, New Mexico, Nebraska, Oklahoma, and Texas.

The Mayo Clinic Center for Tuberculosis serves:  Illinois, Indiana, Iowa, Michigan, Minnesota, Montana, North Dakota, Ohio, South Dakota, Wisconsin, and Wyoming

The Southeastern National Tuberculosis Center serves: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, Puerto Rico, West Virginia, and the U.S. Virgin Islands.

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Key Contacts

  • Alfred Lardizabal, MD - Executive Director
  • Mitchell Gayer, MS, MPH - Deputy Director
  • Amee Patrawalla, MD - Medical Director
  • Anita Khilall, MPH - Program Director, Education and Training
  • Lee B. Reichman, MD, MPH - Senior Advisor

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