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TB Notes Newsletter

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No. 1, 2014


Paul Lawrence Grzybowski has joined the Applied Research Team of the Laboratory Branch as an Oak Ridge Institute for Science and Education (ORISE) Fellow. He will assist in the spoligotyping of M. tuberculosis (using the Ion Torrent instrument). Paul received his B.S. degree in chemistry from the Georgia Institute of Technology in 2012. During his time at Georgia Tech, he participated in research exploring new reaction mechanisms using indium catalysts to offer an efficient and cost effective way to synthesize large heteroaromatic compounds. These mechanisms were then used in the synthesis of flinderole C, a natural antimalarial product. Paul is interested in merging drug design and development with microbiology to find new methods to improve public health.

Christine Ho, MD, MPH, joined the Surveillance, Epidemiology, and Outbreak Investigations Branch as the Team Lead of the Epidemiology Team on February 3, 2014. Christine has a BA in Biophysics and Art from the University of California, Berkeley, which explains everything. She has an MPH in epidemiology, and she received her MD in 1993 and completed her residency at the University of California, San Francisco. She is Board Certified in Internal Medicine.

Christine was an Associate Professor of Medicine at the University of California, San Francisco, before joining CDC as a field Medical Officer in San Francisco, where she supervised contact investigations and led the development of new policies and procedures to improve completion rates for contact evaluations. While in San Francisco, Christine was the Co-Principal Investigator there for the Tuberculosis Epidemiologic Studies Consortium.

Christine moved to Atlanta in 2012 as a Medical Officer in the Field Services and Evaluation Branch. In that role, she has led the project on Post-marketing Surveillance of 12-Dose Isoniazid and Rifapentine, has co-chaired the DTBE workgroup on the Affordable Care Act, has been the CDC liaison for the federal corrections healthcare council, and has participated as a "Think Tank" member. In her new job with SEOIB, Christine will lead TBESC-II at a crucial juncture as the consortium decides its future direction in understanding and improving screening for latent TB infection.

Kartee Johnson has joined the Applied Research Team of the Laboratory Branch as an Oak Ridge Institute for Science and Education (ORISE) Fellow. Kartee will be helping evaluate the effect of the enzymatic activity of pyrazinamide (PZA) mutations in M. tuberculosis. This work will contribute to a better approach for determining drug resistance through conventional and molecular methods, important in clinical practice and clinical trials of new drugs. He received his B.S. degree in biology with a minor in French from Berry College, Rome, Georgia, in 2013. During his time at Berry, he participated in research projects including analyzing the spatial and temporal patterns of sexual dimorphism and sex ratio on Lindera benzoin (also known as spicebush), which was recently published in the Journal of the Torrey Botanical Society; and also examining the activities of a specific vaccine in mice.

Bryan Kim has left DTBE to take a position in the Division of Global HIV/AIDS. His last day in IRPB was March 21, and he started his new position in DGHA on March 23, 2014. In his new position, Bryan will serve as the Deputy Director for CDC's DGHA program in Lesotho based in Maseru. He will serve as the principal management and administrative person for all CDC/DGHA activities in country. Bryan will be responsible for formulating the program budget and presenting and defending resource requirements needed to carry out the office's long-term goals and objectives. He will oversee the overall planning, directing, and execution of several programmatic activities for the office. He will also be responsible for providing program and operational support to Lesotho's President's Emergency Plan for AIDS Relief (PEPFAR) activities.

As DTBE continues to increase its TB activities in Lesotho, Bryan will continue to provide in-country administrative and technical support to implement these activities. These activities include our ongoing TB drug resistance survey, and potential support to future Global Fund MDR TB technical assistance and TB/HIV related projects in Lesotho.

Bryan has been with DTBE/IRPB for 10 years, most recently serving as the Deputy Branch Chief for IRPB. Although we are sad about Bryan leaving the Branch and the Division, he will be in a key position to facilitate DTBE/IRPB's collaborative work in Lesotho and Southern Africa. Bryan has been interested in working overseas for several years and this is a wonderful opportunity for him.

Kathryn Koski is the winner of the January NCHHSTP Director's Recognition Award. Kathryn receives this award in recognition of her planning, professional leadership, and exceptional coordination of four unprecedented events over the last 8 months. In May, DTBE began coordinating efforts to move from Corporate Square's Building 11 to Building 12. Already underway at the time was DTBE's response to the budget sequestration and planning for a potential government shutdown. To add another layer of complexity, the Division Director and Deputy Director had recently accepted long-term details. Throughout the last 8 months, it is remarkable that despite intense pressure, Kathryn never lost her composure or sense of humor, and remained calm, approachable, compassionate, and committed to public health. She's been able to lead DTBE through a smooth office space transition, re-work the Division budget for sequestration, plan for the furlough, and serve as Acting Deputy Director without compromising her work ethic or jeopardizing the quality of her work.

Bonnie Plikaytis is serving as acting chief for the Laboratory Branch until a new chief can be selected. Bonnie has 35 years of service as a microbiologist at CDC, 25 of which have been in the mycobacteriology laboratory. In 2007 she became the deputy for the Laboratory Branch. She is no stranger to the responsibilities of the branch chief position, having served as acting branch chief for 18 months from November 2008 until June 2010. During her previous time as acting chief, she laid the foundation for the current portfolio of branch activities including the molecular detection of drug resistance service, applied research on mechanisms of drug resistance, and systems research to strengthen laboratory capacity. We thank Bonnie for her willingness to serve while DTBE recruits a permanent Laboratory Branch Chief.

Benjamin (Ben) Silk, PhD, Lieutenant Commander, U.S. Public Health Service, has joined the Molecular Epidemiology Activity in SEOIB, DTBE. Ben has over 15 years of experience in surveillance, outbreak investigations, and applied research related to infectious diseases. He began his career as a Peace Corps Volunteer in El Salvador. Since then, he has worked at the local and state levels for health departments in California, Georgia, and Louisiana. Ben completed his doctoral studies in epidemiology at Emory University's Rollins School of Public Health. In 2008, he joined CDC as an Epidemic Intelligence Service (EIS) Officer with the Respiratory Diseases Branch in NCIRD. After EIS, Ben served as a subject matter expert on listeriosis with the Enteric Diseases Epidemiology Branch in DFWED. He is especially interested in invasive and bacterial diseases that affect vulnerable populations.

David Temporado was presented with the Associate Director for Laboratory Science (ADLS) Quarterly Award on February 19, 2014, for his extraordinary contributions to NCHHSTP and to DTBE's Laboratory Branch. He successfully orchestrated the move of over 93,000 isolates of M. tuberculosis from the genotyping contract laboratories to CDC.

For the past 10 years, DTBE has funded two contract laboratories, one in Michigan and one in California, to genotype one isolate of M. tuberculosis from each culture-confirmed case of TB. With the contracts expiring in September 2013, he made arrangements to purchase freezers for housing the isolates at CDC, and to transport the isolates from the contract laboratories to CDC. He coordinated the process, working closely with PGO, the CDC genotyping project officer, and the staff at the contract laboratories. This complex project consisted of acquiring equipment, specialized transport services, and replacement freezer racks. It also involved logistics to gain entry into the contract laboratories storing the isolates and coordination of personnel at each site to oversee the movement of the shipment. The arrangements took 9 months to complete, and the highly specialized delivery of 93,000 vials containing Biosafety Level 3 organisms maintained at -80°C arrived safely this January. These isolates are a valuable collection, as the genotyping information is linked to the surveillance data in the TB GIMS database, allowing for tracking of outbreaks and transmission of TB.

Mr. Temporado's extraordinary efforts as project coordinator, his commitment to the task, and his tenacious attention to detail are all greatly appreciated and resulted in a successful mission. Because of Mr. Temporado's devotion to his job and the Laboratory Branch, Dr. Edwin Ades was pleased to give him the recognition he deserves.

The ADLS office recognizes NCHHSTP's laboratory scientists and staff by presenting the Quarterly NCHHSTP ADLS Recognition Award to an FTE, contractor, or fellow who has demonstrated outstanding work ethic and greatly contributed to the mission of his/her branch.

The Tuberculosis Surveillance Quality Assurance Training Team members are the worthy recipients of the DTBE Director's Quarterly Recognition Award for the second quarter of 2014. Members of the team are Lilia Manangan, Cheryl Tryon, Elvin Magee, Sandy Price, Stacey Parker, Robert Pratt, Kai Young, Juliana Grant, Angela Starks, Beverly Metchock, Glenda Newell, Lori Armstrong, Rachel Yelk Woodruff, Carla Jeffries, Alstead Forbes, Derrick Felix, Ann Lanner, Amera Khan, Smita Ghosh, and Roque Miramontes.

CDC's transition to a web-based surveillance system created a need for a standardized quality assurance (QA) process to govern the collection and reporting of high-quality TB data. QA of surveillance data is paramount to surveillance programs, but no current internal or external model existed to describe the QA process. The team developed the first comprehensive national QA training program for TB surveillance data in the U.S., which standardized methodologies, skills, and tools. The team's innovative efforts resulted in the development of the following:

  • The QA process focuses on the five QA components, which are case detection, data accuracy, data completeness, data timeliness, and data security and confidentiality.
  • The QA guide provides policies and procedures for conducting each of the QA components, as well as definitions, study questions, and examples of the QA tools.
  • The QA toolkit includes approximately 50 QA tools (i.e., tables, charts, graphs, processes, and templates) that were developed by staff from CDC and various jurisdictions.

The QA training course focused on the QA process and five components. The course format included presentations from faculty (DTBE subject matter experts) with interactive activities. Participants completed exercises to apply the content to realistic situations, shared experiences and answered questions, and described how they conduct QA in their own jurisdictions and overcome challenges.

Despite challenges imposed by various TB surveillance systems, economic constraints, and new diagnostic technologies, the team developed QA strategies with innovation and collaboration.

Congratulations to the Tuberculosis Surveillance Quality Assurance Training Team for this well-deserved honor.

In Memoriam

Charles P. Felton, M.D., 87, of Palisades, NY, died January 16, 2014. Charles, or Chuck, was born May 6, 1926, in New Orleans, LA. He graduated from St. Augustine's Seminary in 1944, received a B.S. degree from Xavier University in 1949, and earned a Doctorate of Medicine from the University of Geneva, Switzerland, in 1956. He and Hiroko ("Susie") Felton married in 1958, building a home together in Palisades, NY, where they raised their three sons.

Chuck was an esteemed Clinical Professor Emeritus of Medicine at Columbia University's College of Physicians and Surgeons and Chief of Pulmonary Medicine at Harlem Hospital Center. He spent his career fighting TB in America's urban communities, Haiti, and beyond. He traveled extensively around the world, but loved most to spend time at home with family, gardening and cultivating his bonsai.

In lieu of flowers, the family is requesting that donations be made to the American Lung Association in New York or to the Charles P. Felton National Tuberculosis Clinic at Harlem Hospital Center.

John "Gus" Caras, 85, passed away on January 28, 2014, after a long battle with Alzheimer's Disease. Born in Greece on January 20, 1929, he came to the United States in 1947 at the age of 18. He served in the U.S. Army for 2 years at Fort Bragg in North Carolina. Following his military service, he attended the Georgia Institute of Technology in Atlanta, where in 1958 he earned a bachelor's degree in Chemical Engineering and in 1967 earned a master's degree in Information and Computer Science.

He began his career as a chemist with Thiokol Corporation in Huntsville, Alabama, and also worked for the Army Missile Command designing rocket propellants. In 1966 he moved to Atlanta with his family and joined CDC's Division of TB Control, where he worked as a statistician for many years, retiring in 1992. He worked with Dr. Dixie Snider and later with Dr. Rick O'Brien. Among other things, Gus was a co-author with Dixie Snider and Don Kopanoff on the investigations related to INH hepatitis that are often cited.

Gus was very proud of his Greek heritage, and was a lifelong member of the Greek Orthodox Church. He enjoyed spending time with his grandchildren, traveling, and watching Georgia Tech football. In lieu of flowers, donations may be made to the Annunciation Greek Orthodox Cathedral, 2500 Clairmont Road, N.E.; Atlanta, GA 30329.

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