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Northeastern Spotlight
Spring 2016
Volume 11 - Number 2

Dear Colleagues,

We’ve had a busy first quarter here at GTBI, with a number of webinars, trainings and mini-fellows. Several GTBI staff had posters and presentations at the combined National TB Controllers Association and Union North American Region (NAR) Conference in Denver in February, where we were happy to see many of you as well! This was the last year of my rotation as Program Chair for The Union NAR conference, and I was pleased to be part of the inaugural collaborative conference of the two organizations.

Like many of you, and our partners at CDC, we commemorated World TB Day, which is observed on March 24th and is intended to raise awareness around TB and its devastating impact on individuals, families, communities and society.  CDC released its preliminary 2015 data on TB in the US on March 24, 2016, which showed a leveling off of TB rates. For those of us who have worked in TB for many years and remember much higher rates, this leveling off reminds us all of the need to be vigilant in prevention and management of TB.  Further evaluation of available data by CDC is required to understand the causes of the trend.

Here at GTBI we were involved in three events during the week of World TB Day.  Given the challenges seen recently, with more complex cases including medical comorbidities and complex social needs, all of our events touched on the themes of partnership and collaboration in the effort to eliminate TB.
As you will read about in this newsletter, we continued our long collaboration with the New York City Department of Health and Mental Hygiene Bureau of TB Control on their annual World TB Day conference, this time in collaboration with the Mailman School of Public Health at Columbia University. Themes included collaborating with stakeholders and community partners.  We also collaborated with the Philadelphia Department of Public Health and Drexel University Dornsife School of Public Health to highlight partnership, including collaboration with those working in refugee health and homeless services.  Finally, the 2nd annual World TB Day Symposium here at Rutgers New Jersey Medical School brought together clinicians and research scientists with presentations and lively discussion from members of both groups.

I hope you enjoy this edition of the newsletter, and all of us at GTBI look forward to continuing collaboration with you on TB training and consultation!

Sincerely,
Alfred Lardizabal, MD

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Training Highlights: World TB Day Activities

Global is Local: Opportunities & Challenges to TB Elimination in New York City – New York, NY  

GTBI collaborated with the New York City Department of Health and Mental Hygiene Bureau of TB Control and Columbia University Mailman School of Public Health to offer an annual World TB Day conference. The conference was held on March 21, 2016 and took place on the Columbia campus in Manhattan.

Speakers and topics were carefully chosen to address the needs of more than 165 TB healthcare professionals from the Tri-State area in attendance.  The conference highlighted global and local epidemiology, community-based approaches to TB outbreak response, scientific challenges and implications for mycobacterial persistence and prevention, and closed with what we need to do to eliminate TB at home and abroad. One panel discussion drew parallels between New York City and South Africa and lessons learned from drug resistant TB/HIV outbreaks and the other panel addressed interventions for promoting patient-centered TB care. The conference was well-received due to the diverse perspectives and content as well as the combined efforts of the partners involved.

Submitted by Jennifer K. Campbell, MPH, CHES - Training and Consultation Specialist 

Current Concepts in Clinical Care and Translational Science – Newark, NJ

GTBI collaborated with the New Jersey Department of Health TB Program and the Public Health Research Institute to plan its second annual TB symposium on March 22, 2016. The symposium was held at Rutgers New Jersey Medical School in Newark, NJ.

Plenary sessions focused on public health and clinical aspects of TB care as well as current efforts in translational TB research. The morning session included global and domestic strategies for TB elimination, clinical updates in TB diagnosis and treatment, and the patient perspective. The afternoon session featured talks on the immunological detection of M. tb infection, assessing drug penetration in lung lesions, exploring the relationship between air pollution and TB and learning from the past to plot a course to future TB drugs. A poster session displayed projects and efforts in relevant areas by local students, TB program staff, clinicians, and researchers. More than 95 healthcare professionals were in attendance; the range of topics and content experts were cited as major strengths.  

Submitted by Patricia Woods, RN, MSN – Trainer and Consultant, Clinical Programs

Fostering Partnerships for TB Elimination in Philadelphia – Philadelphia, PA

The Philadelphia Department of Public Health, Drexel University Dornsife School of Public Health and the Global Tuberculosis Institute co-sponsored a world TB day conference which was held on March 24, 2016 in Philadelphia, PA.   

Approximately 90 TB healthcare professionals attended the conference. Topics included current TB trends in Philadelphia, challenges and opportunities for TB elimination in the United States, collaborative efforts to address TB locally, and clinical updates on TB. A panel discussion showcased partnerships between refugee health, healthcare for the homeless and the Philadelphia TB Program.
The conference closed with a second panel discussion on the diagnosis and treatment of TB infection in specific patient populations. The interaction between participants and speakers provided an opportunity to address questions and engage in stimulating discussion. Audience feedback showed that the conference exceeded their expectations.

Submitted by Arpita Jindani, MSW, MA – Health Educator

 

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Product Updates

TB & Cultural Competency Newsletter: Notes from the Field

Patient Centered TB Care: Meeting in the Middle—Nigeria to New Hampshire,newsletteris the latest issue of the newsletter, which highlights the perspective of a TB patient and the provider and explores the cultural differences around the patient-provider relationship. It also includes a point of view from a TB advocate and opportunities for patients to harness the power of their experience.

Have you or a colleague faced a TB case that was challenging due to a patient’s cultural beliefs or practices being dissimilar from your own? We would love to highlight your case in an upcoming issue. Please contact Jennifer at jennifer.k.campbell@rutgers.edu if you have a case that might be of interest.

Staff Profile: David Schlossberg, MD Medical Director, Philadelphia Department of Health

If you attended the NTCA conference this year, you will remember Dr. David Schlossberg was the recipient of the 2016 National TB Controllers Association’s William Stead TB Clinician Award. Dr. Schlossberg has been the Medical Director of the Philadelphia Department of Public Health TB Control Program since 2005, where he provides clinical care for adult TB patients and oversees contact investigations, program management and evaluation, as well as educational efforts of the program.

David SchlossbergDr. Schlossberg is known among his colleagues and staff for his notable academic and clinical teaching in Philadelphia. He is on the faculty at Temple University School of Medicine, Thomas Jefferson University Sidney Kimmel Medical College, and the University of Pennsylvania Perelman School of Medicine. He also provides bedside teaching in the Lawrence Flick Memorial Clinic to adult infectious diseases (ID) fellows from surrounding ID training programs and has received several teaching awards at area medical schools and hospitals. When asked about how he captures the interest of young clinicians to get them to learn about TB, Dr. Schlossberg emphatically says, “I tell them, it is a fascinating disease, including its antiquity. It is also one of the great masqueraders! However, the good news is that we have a handle on this and it can be treated. The best part is to be able to make the right diagnosis and cure the patient.”

Dr. Schlossberg’s interest in education transcends teaching; he is a world renowned expert in TB as evidenced by his role as the editor of six editions of the American Society of Microbiology’s textbook, Tuberculosis and Non-Tuberculous Mycobacterial Infections. He has authored numerous manuscripts on TB, reporting on basic science and his clinical research, as well as numerous reviews and textbook chapters. He has edited close to 30 books and truly enjoys that role.

Lee Reichman, MD, GTBI Senior Advisor, comments “David is one of the unsung heroes in the TB world. He quietly runs an efficient and effective TB program in Philadelphia. One of his greatest contributions to the TB world is the key textbook on TB that David wrote when there were no such textbooks available!” 

In order to better understand his passion for books and editing, it is useful to revisit his past. As an undergraduate student at Yale University, he majored in English and then attended Tufts Medical School. He went on to complete his residency in internal medicine at Mount Sinai Hospital and an ID fellowship at Emory University. Dr. Schlossberg reflects on his educational experience as an English major and how it shaped him, “Getting a liberal arts education was a very gratifying experience and it has served me well in my career in medicine. If you are more open to other subjects such as literature and drama, you are also more in tune with understanding patient cues.” If you have ever heard Dr. Schlossberg speak at a conference, you can be certain that his lectures are never dry. He captures the attention of his audience by making his lectures on TB sound like poetry. And this is not an exaggeration!

It is always interesting to learn what motivates people in their work. For Dr. Schlossberg, “the most motivating factor of working in TB is to see patients, their clinical response to TB and watching it resolve with treatment. It is very dramatic; you can’t compare it to anything else.” Since TB is frequently not included in the differential diagnosis and is often misdiagnosed as community acquired pneumonia, Dr. Schlossberg emphasizes the importance of teaching young medical professionals about TB, and he always encourages residents and fellows to join him at the TB clinic.

Dr. Schlossberg’s clinical judgment and his ease of patient interaction have won him the admiration of his colleagues and students. Dr. Aabha Jain, Infectious Diseases Fellow, says “I had the privilege of being able to shadow Dr. Schlossberg during my second year as an ID fellow. In my weeks shadowing him, I was able to see how he easily communicates with patients from various areas of the world, using different languages with ease, and helping them understand and cope with TB while they are sick.  He is an excellent clinician and also a great teacher, spending extra time during the rotation to make sure future ID clinicians understand and learn the hardships that come with treating TB.” 

Barbara Seaworth, MD, Medical Director of the Heartland National TB Center, remarks “My perception of David time and time again is how much he cares about what happens to the people he treats, how concerned he is when they miss work or school because they are on isolation or when they have difficult toxicities or slow treatment responses.  He clearly knows much more about each person than merely the details of the case.  He knows each of them as distinct individuals.”

When asked about how he perceives the future of TB, Dr. Schlossberg points to the concurrent research and developments in TB drugs and vaccines as promising for the future. Better understanding of TB immunology will play a vital role in interventions aimed at early detection. He believes, repurposing drugs for treatment of TB also offers hope and excitement. We are on the threshold of different advances in TB that have the potential to make a much needed impact. 

With his impressive academic and clinical responsibilities, you would think that Dr. Schlossberg wouldn’t have much free time!  However, he is an active traveler and when he isn’t teaching or seeing patients, you might find him playing tennis or practicing Tai Chi and Chi Gong. Clearly, Dr. Schlossberg is an accomplished well-rounded academic, clinician and person who is widely admired and respected by his patients, students and peers. As reflected by his receipt of the 2016 TB Clinicians award from NTCA, the TB community is lucky to count him as a member and is grateful for his outstanding contributions.

Submitted by Arpita Jindani, MSW, MA - Health Educator  

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Announcements and Awards:

At the National Tuberculosis Controllers Association (NTCA) conference held on February 23-26, 2016 in Denver, three awardees from the Northeast Region received individual awards.

Mark LobatoMark Lobato, MD was the recipient of the Dixie Snider Award for his commitment to helping various state and local tuberculosis (TB) programs within the New England region meet their responsibilities and realize their potential through collaboration. The Dixie Snider Award recognizes a CDC employee who has provided outstanding support, through partnership with a state or local tuberculosis community, in interest of tuberculosis control and prevention. 

Pictured (left to right): Lynn Sosa, MD and Mark Lobato, MD

 

Nancy Baruch, RN, MSN, MBA from the Maryland Department of Health and Nancy BaruchMental Hygiene, Baltimore received the TB Controller of the Year Award. Ms. Baruch has worked tirelessly in the field for public health for over 21 years and has provided leadership for the Maryland TB Program and mentored numerous staff and students. The TB Controller of the Year Award is the National Tuberculosis Controller’s highest award. It recognizes an outstanding contribution and impact on tuberculosis prevention and control at the local, state, regional, or national level. The award recognizes what TB controllers are all about!

Pictured here (left to right): John Bernardo, MD, Anita Khilall, MPH, Nancy Baruch, RN, MSN, and Alfred Lardizabal, MD

 

Schlossberg AwardDavid Schlossberg, MD, Medical Director of the Philadelphia Department of Public Health TB Control was the recipient of the William Stead TB Clinician Award. You can read more about him in the Staff Profile of this issue. The William Stead TB Clinician Award recognizes outstanding commitment and performance by a clinician providing tuberculosis care, leadership, or mentoring.

Pictured above (left to right): David Schlossberg, MD, Edward Zuroweste, MD and Alfred Lardizabal, MD

 

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Upcoming Northeast RTMCC Training

GTBI sponsors courses and webinars on tuberculosis. 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). Click here for a list of upcoming trainings.

TB Consultation Service

GTBI has over 25 years of experience in offering TB clinical care, prevention and education services. Our experts are available to answer a wide variety of TB-related questions, related to clinical, nursing, public health, and programmatic issues. Consultants can be reached by calling the TB Info-line at
1-800-482-3627 or by email (mc_gtbi@njms.rutgers.edu)

During each consultation, GTBI consultants will advise callers about resources/TB Programs in their jurisdiction. More information about our TB 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.

Registration is now open for the TB ETN and TB Program Evaluation (PEN) conference. For additional information, please send an email to tbetn@cdc.gov

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

TB Wire Newsletter
Content include announcements, current journal articles, available resources and training activities, upcoming meetings and conferences, etc. 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
  • Amee Patrawalla, MD - Medical Director
  • Anita Khilall, MPH - Program Director, Education and Training
  • Lee B. Reichman, MD, MPH - Senior Advisor

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