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Northeastern Spotlight
Summer 2017
Volume 12 - Number 2

Dear Colleagues,

It was nice to see many of you at the National TB Controllers Association Conference in April and interacting with you at the RTMCC breakout session. As always, this is an opportunity for us to connect with you all face to face and receive feedback on how best to meet the needs in the region. Earlier this year, we experienced some personnel changes and I am pleased to announce our two newest health educators who have joined the Education and Training Unit. Shwata Suresh Kumar and Amy Lewis are the newest additions to our GTBI family and we hope you will get the opportunity to work with them in the near future.

We would also like to follow up on previous communications about making this newsletter useful and relevant for you all, our partners in TB prevention and care. Therefore, we would like to ask that you complete a brief survey to provide feedback and suggestions for changes. Please click on this link to access the survey: https://www.surveymonkey.com/r/B3Z5YMY. Your input will be used to make improvements!

Sincerely,
Alfred Lardizabal, MD

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Training Highlights:

TB Intensive Workshop - Newark, NJ

This semi-annual TB Intensive Workshop was held on April 4-7, 2017 at GTBI in Newark, NJ. This comprehensive course covered current concepts in the diagnosis and treatment of TB, key aspects of patient management, and special topics such as extrapulmonary TB, pediatrics, and TB-HIV. A former patient who was treated for multi-drug resistant TB and who is now a strong advocate for TB shared his story, including the physical and mental toll that TB takes on an individual. He was able to impart how he overcame some of the struggles he faced and moved from patient to advocate, not only advocating for more research and funding for TB but also providing moral and emotional support to others who are undergoing similar experiences with TB. Additionally, the course highlighted the experience of public health staff on the front lines for TB, including video depictions of a day in the life of field staff who interact with patients in their homes and the community setting.

The 33 attendees included nurses, physicians and other health professional working in TB. The participants felt that the training expanded their knowledge of TB; they found the interactive sessions and the case presentations to be useful. Many indicated that they would recommend this training to other healthcare providers and there was a suggestion to continue some of the conversation online after the live course to continue to facilitate networking and shared experiences and resources among the course participants.

Submitted by Shwata Suresh Kumar, BA, PGDM (Public Health) – Health Educator

New England TB Clinician’s Conference – Worcester, MA

The New England TB Clinician’s conference was held on May 11, 2017 at the University of Massachusetts Medical School in Worcester, MA. The conference was opened by a TB survivor and advocate who shared his experience with the disease, including some of the most challenging aspects and the factors that enabled him to get through treatment. This testimony was a valuable reminder of how important that work is that we are all engaged in and emphasized the role of patient-centered care as we work toward TB elimination. The main topics that were discussed included a review of recent TB guidelines, TB and TNF alpha inhibitors, provider tools for decision-making around LTBI testing and treatment, global perspectives in MDR-TB management, and the intersection between TB and diabetes. Case presentations highlighted the complexities and practical aspects of treating multi-drug resistant TB as well as TB and diabetes. The use of role playing during the case presentation accentuated the patient-provider interaction and provided a unique learning experience.

There were a total of 81 attendees, including physicians, nurses, and public health professionals from a variety of settings. The attendees indicated that they enjoyed the case presentations, patient perspective, and combination of topics that addressed research and practice. It was a great opportunity to bring together TB experts and practitioners in the field to promote collaboration and networking!

Submitted by Anita Khilall, MPH – Program Director, Education & Training

Vermont TB Update, Burlington, VT

GTBI in collaboration with the Vermont Department of Health offered a one-day conference on May 18, 2017 in Burlington, Vermont. Speakers included faculty from the Global TB Institute and locally from Vermont who are well versed in the clinical, public health, nurse case management, and laboratory aspects of TB. The topics addressed local needs and areas of interest, including current updates in TB, epidemiological trends, diagnosis and treatment for TB infection, diagnosis and treatment for TB disease and collaborations on TB care. The attendees had multiple opportunities for discussion and to get answers to all their TB concerns and questions.

There were 33 attendees who were primarily physicians and nurses. The content was well received, particularly the discussion on TB testing and replacing TSTs with IGRAs. The attendees expressed that it was a great TB refresher course as most of them take care of TB patients sporadically due to the low prevalence of TB in Vermont.

Submitted by Arpita Jindani, MSW, MA – Health Educator

 

Staff Profile: Richard Oatis, Baltimore, MD

When most of us think of the healthcare professionals involved in the care of TB patients, physicians, nurses, and perhaps public health staff come to mind; however, we may be less likely to think of the critical role that a lab scientist plays as part of the healthcare team. This is precisely the reason we want to introduce you to Richard Oatis, Scientist Supervisor at the Maryland Department of Health and Mental Hygiene’s Mycobacteriology Lab.

In the photo above: Richard Oatis at his lab

Richard’s current role includes general management of Maryland State Mycobacteriology Lab including training and educational presentations, establishing lab protocols and procedures, procurement of supplies, working on grant applications and administration. However, running a fully functioning lab is a complex affair.

To gain more insight about Richard, we have to backtrack a little. Tracing back to his college days, he initially pursued a BS in Biology and was interested in veterinary school. He recalls, “I took a course on vertebrae morphology and it bored me to tears. That’s when I decided veterinary school was not for me. I also had to study microbiology as a course curriculum and I really got into it.” After graduating from Loyola University in Maryland with a Bachelor of Science in Biology, Richard applied for a temporary position in the HIV lab. While he was in the process of applying for a permanent position, there was an opening in the TB Lab and he jumped at the opportunity.

Fast forward to 2017, Richard definitely seems well suited to his current role as you can hear the excitement in his voice each time he talks about mycobacteriology and TB. In his words, “I really enjoy the sense of community in the TB world. Other diseases are less complex but TB is very involved. I especially enjoy my interaction with a wide range of health professionals such as TB nurses, hospitals, case managers and emergency room staff.”

TB control is front and center on Richard’s mind. He is driven by the need to provide relevant information in a time sensitive manner as it relates to making decisions to interrupt or prevent ongoing TB transmission. He also plays an active role in educating healthcare professionals on the misconceptions about TB testing.


In the photo above: Maryland's Mycobacteriology Lab                                                

Richard acknowledges that there are certain challenges he faces as a TB laboratorian, “A lot of it comes back to what I said earlier that the treatment of TB is very complex. There are a lot of moving parts to it so we have to be able to keep up with that and prevent potential resistance from developing.” Despite the challenges, working in the field of TB gives him an immediate sense of making an impact.

We asked Richard, what advice would you have for a health care professional who is new to the TB world? Richard ponders and adds, “Try and learn as much as you can about TB. Talk to everyone including the lab personnel, clinical care team as well as the field staff. Cross training is essential in understanding the big picture of TB control!”

There are plenty of other activities that keep Richard engaged when he gets an opportunity to escape the lab. He happens to be a big music fan and listens to a lot of electronic experimental music. He also has a penchant for bar trivia on Greek and Roman mythology. If you are ever in doubt whether Jupiter or Zeus was the king of gods, Richard can certainly come to your rescue! He also loves to travel, especially to beach destinations. If you are interested in going fossil hunting at the beach, down in Maryland, Richard can provide some guidance on that as well!

Submitted by Arpita Jindani, MSW, MA – Health Educator

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 Announcements and Awards:

GTBI congratulates the recipients of the New England TB Hero Award and the 2017 National TB Controllers Association Awards in the Northeast Region

Carol Pozsik TB Nursing Award

Karen Galanowsky, RN, MPH, State TB Nurse Consultant for the New Jersey Department of Health TB Program, was presented with the 2017 Carol Pozsik TB Nursing. The Carol Pozsik TB Nursing award is traditionally given to a nurse who has exceptionally contributed to service, care, dedication and/or leadership in the field of public health TB nursing.


In the photo above: Karen Galanowsky, receiving the 2017 Carol Pozsik TB Nursing Award

Unsung TB Champion Award

This year the NTCA introduced a new award category to recognize outstanding work by an individual working on the front lines of a TB program, conducting contact investigations, educating the community about TB, providing DOT services, and building relationships of trust and respect. Both recipients of this award hailed from the Northeast!

Rebecca Stevens from Global Tuberculosis Institute’s Lattimore Practice was honored with the NTCA’s Unsung TB champion award. Rebecca has over 24 years of experience in the field of TB as a Public health Representative in Newark, NJ.  Dr. Lee Reichman, Senior Advisor and founder of GTBI remarks, “Rebecca is the unsung hero of TB control. She exemplifies what a field staff member should be like. She is well known for her empathy and all her patients were cured because of her dedication." Rebecca’s sincerity toward her patients is truly outstanding and well noted by TB prevention and control colleagues in the domestic and global arenas.


In the photo above: Rebecca Stevens surrounded by her family at the NTCA Award Ceremony


Linda Ellison, Public Health Investigator from the Baltimore City Health Department (BCHD) was also recognized with the Unsung TB Champion Award. Linda has been with the BCHD TB program for 23 years where she has routinely worked evenings and weekends (without recognition) if she thinks it will help her patients to complete their TB treatment. Dr. Maunank Shah, Medical Director from the BCHD TB program at Johns Hopkins University states, “Linda does so much more than observation of medications, that her job or impact cannot be easily quantified or characterized; it is with trepidation that I contemplate how many staff and resources it will take to maintain TB treatment success should Linda ever decide to retire.” Linda’s rapport with the patients and other health professional serves as a tremendous attribute that all of us can learn and implement.


In the photo above: Linda Ellison and colleagues from the Baltimore City Health Department, Maryland Department of Health & Mental Hygiene and Johns Hopkins University

 

2017 New England TB Hero Awards

New England TB Hero is an award presented by the New England Tuberculosis Consortium to recognize an extraordinary contribution to the care or management of patients with TB and LTBI or an activity that greatly enhanced TB prevention and control efforts in a locality or in a state.

Sally Cook, RN is an Infectious Disease Nurse Epidemiologist the Vermont Department of Health. While she is able to respond to any reportable infectious condition, TB is her passion. Sally has guided and mentored novice nurses in the realm of all things TB with her knowledge and expertise. This is especially invaluable in helping to maintain knowledge and proficiency in TB in the setting of a low incidence state. She is also very perceptive to the needs of the TB patient as she understands the impact of TB on both the patient and their family members and the difficulties of navigating DOT and multiple healthcare appointments along with trying to hold down a job or raise a family (or both). Whether it is dropping off sputum at the state lab, counseling a newly diagnosed patient, or offering encouragement to a colleague, Sally is the glue holding the TB program together!  

In the photo above: Sally Cook, RN receiving the 2017 New England TB Hero Award from Laura Ann Nicolai

Dr. Sybille Liautaud is the Director of TB Clinic at Baystate Medical Center’s Mason Square. She is approachable, caring, soft spoken, and tremendously devoted to the battle against tuberculosis. Dr. Liautaud is compassionate about all of the patients’ needs and works with the team of public health nurses to ensure each patient gets the individual attention they need. She tries to be diplomatic and fair as she requires support and effort from her coworkers to make the team successful. Dr. Liautaud has grown in her knowledge as TB diagnostic and treatment modalities have changed over the years and it is her experience and instincts that often initially play a key role in diagnosing TB. She provides the TB community with a mind, heart and soul through the care she provides!

In the photo above: Dr. Sybille Liautaud receiving the 2017 New England TB Hero Award from Dr. John Bernardo and Jennifer Cochran

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GTBI 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, including clinical, nursing, public health, and programmatic issues. Consultants can be reached by calling the TB Info-line (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. More information about our consultation service can be accessed at: http://globaltb.njms.rutgers.edu/services/medicalconsultation.html

Web-Based TB Grand Rounds

Please note that we will be taking a break for TB Grand Rounds during the summer. Please join us when we resume our bimonthly sessions beginning on September 8, 2017. If you would like to be added to our email list or if you have a case to present, please contact Arpita Jindani at 973-972-4811 or arpita.jindani@rutgers.edu.

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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.

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.

Other RTMCCs  
The Curry International Tuberculosis Center serves: Alaska, California, Colorado, Hawaii, Idaho, Nevada, Oregon, Utah and Washington.

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
  • Rajita Bhavaraju, MPH, PhD- Deputy Director
  • Anita Khilall, MPH - Program Director, Education and Training
  • Lee B. Reichman, MD, MPH - Senior Advisor

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