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No. 1, 2009

SURVEILLANCE, EPIDEMIOLOGY, AND OUTBREAK INVESTIGATIONS BRANCH UPDATE

14th Semiannual Meeting of the Tuberculosis Epidemiologic Studies Consortium (TBESC)

Approximately 25% of secondary TB cases are preventable at the time of contact investigation, said Dr. Mary Reichler, speaking at the 14th semiannual meeting of the Tuberculosis Epidemiologic Studies Consortium (TBESC). (Secondary TB is TB disease that develops in a contact as a result of transmission from an index patient.) Dr. Reichler is the CDC principal investigator for TBESC Task Order 2, “Prospective evaluation of immunogenetic and immunologic markers for susceptibility to M. tuberculosis infection and progression from M. tuberculosis infection to active TB.”

The study included 761 persons at nine sites in the U.S. and Canada. All were born in North America and had not received BCG vaccine, and 87 (11%) had documented conversion from tuberculin skin test (TST) negative to TST positive after exposure (defined as more than 180 hours of exposure to a culture-confirmed TB case). Dr. Reichler concluded that decreasing the time from TST reading to chest x-ray in contacts at high risk for TB would help prevent secondary cases.

Approximately 100 persons attended the TBESC meeting February 4–5 at the Crowne Plaza Ravinia Hotel in Atlanta. The attendees, including principal investigators, project coordinators, and other TBESC and CDC DTBE personnel, met to discuss recent TB epidemiologic research and to plan next steps needed for current research. TBESC researchers work at 16 sites across North America; each site represents a partnership between a research institution and a state or local health department. The primary purpose of TBESC is to conduct epidemiologic, behavioral, economic, laboratory, and operational research in TB prevention and control.

Attendees were welcomed by Dr. Kenneth Castro, Director of DTBE. After Dr. Castro’s welcome, Dr. Denise Garrett, TBESC team leader at CDC, described the progress of the TBESC Strategic Planning Workgroup in preparing for the new TBESC in 2011.

Both days included scientific sessions. On the first day, Dr. Reichler and Dr. Tim Sterling presented the data from Task Order 2. The second day featured presentations by two panel physicians, Drs. Redentor Asis and Luis Todd, and Dr. John Painter of the Division of Global Migration and Quarantine, on “Prevalence of TB and latent TB infection among visa applicants screened in Mexico, Philippines and Vietnam.” Dr. Kathy Moser also joined the group by conference line to discuss “Use of QuantiFERON-TB (QFT) Gold in immigrant and refugee children upon arrival in US, 2007–2008.” Of 6,984 children screened in the Philippines from October 2007 to September 2008, as many as 2,971, or 43%, had a positive TST at 10 mm. In Mexico, 5,111 of 25,106 children screened (21%) had positive TST results.

In 2007, San Diego County began using QFT blood tests to screen immigrant and refugee children with positive TST results (Class B2).  Of 187 Mexican children screened, 101 (54%) had positive QFT results, and of 91 Class B2 Philipino children with positive TST results, 35 (38%) also had positive QFT results.

Other meeting highlights included an update on the STAR process, a presentation by Julio Lopez and Arnette Mayhew from CDC’s Procurement and Grants Office (PGO), as well as updates from--

  1. The Publications and Presentations Committee,
  2. The External Relations Committee, and
  3. The Turning Research into Practice (TRiP) Workgroup

The 15th Semiannual TBESC meeting will be held July 22–23, 2009, in Boston, Massachusetts.

—Reported by Suzanne Beavers, MD, and Dolly Katz, PhD
Div of TB Elimination


 

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