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No. 3, 2006
Dear Colleague:
We have had a busy spring, pursuing our regularly recurring
activities and observing some changes. Among the changes, DTBE has
recently lost two esteemed colleagues. We noted with much sadness the passing
on May 22 of a luminary in international health, Dr. J.W. Lee,
Director General of the World Health Organization (WHO). Prior to
taking this position, Dr. Lee was instrumental in the successful
launching of the global Stop TB Partnership, which is now a model
for multinational partnerships. We were fortunate to have had such a
truly remarkable person devote his talents to the international
public health arena. We have also lost Dr. Ida Onorato, who was
formerly the chief of the DTBE Surveillance and Epidemiology Branch
before moving to the Division of HIV/AIDS Prevention. She passed
away on May 31 after a battle with cancer.
We will also miss the distinguished presence at CDC of Dixie E.
Snider, Jr., M.D., M.P.H., as he retires from his position as Chief
Science Officer for CDC after more than 33 years of outstanding
service to the agency. Fortunately for CDC, he will
continue to provide advice and guidance as a consultant to the CDC
scientific leadership team. Dr. Snider joined CDC in 1973 and spent
much of his early career as an expert in tuberculosis and other mycobacterial diseases. From 1976 to 1985, he served as Chief,
Research and Development Branch, Division of Tuberculosis Control.
In 1985, he became Director of the Division of Tuberculosis Control
and was the major architect of the strategic plan for the
elimination of tuberculosis in the United States, as well as a key
player in developing a national plan for addressing multidrug-resistant
tuberculosis. He left our division in 1993, and for the past 13
years he has focused his efforts on improving the quality and
integrity of science at CDC and on improving the science
infrastructure. Most recently, Dr. Snider
was the Chief Science Officer
for CDC and ATSDR. He was the primary advisor to the Director on
scientific and medical matters and provided agency-wide scientific
leadership. Dr. Snider’s many responsibilities included developing
policies and procedures for ensuring that integrity and excellence
in science are maintained; articulating and enforcing standards of
ethical, equitable, and respectful conduct of all CDC’s enterprises;
and responding to the CDC Director’s requests to engage in and
respond to a variety of scientific and management issues. Dr. Snider
was the recipient of a number of distinguished honors, including the
William C. Watson, Jr., Medal of Excellence, the United States
Public Health Service (USPHS) Outstanding Service Medal, the USPHS
Meritorious Service Medal, and the Secretary’s Award for
Distinguished Service.
World TB Day, March 24, was observed in a number of U.S. sites,
including here in Atlanta. DTBE staff organized a truly impressive
day of events in observance of the day and in celebration of the
accomplishments of TB control staff throughout the country. Please
see the article in this issue about the events and the activities
held here at Corporate Square.
On March 30, 2006, CDC staff members in Atlanta were honored with
a visit by Dr. George Comstock, another of TB control’s luminaries
and a legend in the field of U.S. TB epidemiology. He gave an
informal talk entitled “Musings About TB Control,” which was
followed with a question and answer period. After joining the
Commissioned Corps and serving as a USPHS Commissioned Officer
during World War II, Dr. Comstock served in several public health
assignments from 1946 to 1955, including one in Muscogee County,
Georgia. There he conducted research that provided data on the risks
of reactivation of TB among persons with latent TB Infection, data
still being used. During that period he also did research to
evaluate the BCG vaccine; his findings resulted in the U.S.
recommendation against BCG vaccination of children because of lack
of efficacy. In the late 1940s, he joined the Division of TB
Control; from 1956 until 1962, when he retired from the Division, he
served as its chief of epidemiologic studies. Later, in the 1960s,
he conducted research in Alaska that demonstrated the effectiveness
of isoniazid preventive therapy—again, data still being used
to guide policy. He
also served as the first chairman of the Advisory Council for the
Elimination of Tuberculosis. The depth and the breadth of his
accomplishments are tremendous. We were impressed with his keen
insights and charmed by his simple and unpretentious manner, and we
consider ourselves fortunate to have had this opportunity.
The 55th annual Epidemic Intelligence Service (EIS) Conference
was held in Atlanta April 24 to 28, 2006. The primary purpose of the
EIS Conference is to provide current EIS officers training
and experience in making scientific presentations. The conference also
provides an opportunity for scientific exchange regarding current
epidemiologic topics; highlights the breadth of epidemiologic
activities at CDC; provides a setting where EIS professional
networks can be strengthened among new, current, and former EIS
officers; and provides a forum for recruitment of new EIS officers.
I want to again congratulate all of our EIS Officers for their
outstanding presentations, and I am particularly proud to note that
two DTBE staff were honored with awards at the conference: Kevin
Cain, MD, who has recently completed his 2-year EIS assignment with
DTBE, was the recipient of the Paul C. Schnitker International
Award, and Kashef Ijaz, MD, was awarded the Philip S. Brachman
Award. To find out more about the awards and the conference, please
see the article about the conference in this issue.
On May 16 and 17, staff of the Communications, Education, and
Behavioral Studies Branch, along with RTI International, sponsored
the “Summit to Stop TB in the African-American Community,” the
second meeting DTBE has convened on this topic. Attendance at this
meeting exceeded expectations and it was deemed very successful. CDC
brought together representatives of several diverse organizations to
increase their awareness about the importance of TB and to
strategize ways to reduce the disproportionate burden of TB in the
African-American community. I was on hand, along with Dr. Louis
Sullivan, former U.S. Secretary of Health and Human Services
(HHS); Dr.
Garth Graham, Deputy Assistant Secretary for Minority Health, HHS;
and Dr. Kevin Fenton, NCHHSTP Director, to address the meeting
attendees. Participants proposed a number of action items to be
carried out in the next year.
The 101st American Thoracic Society (ATS) International
conference was held again in San Diego, California, from May 19 to
26, 2006. A limited number of DTBE staff attended this conference.
The ATS International Conference is the largest, most prestigious
scientific meeting devoted to the presentation and discussion of new
research findings and the latest clinical developments in
respiratory, critical care and sleep medicine. During the
Conference, more than 15,000 attendees heard over 5,000 original
research presentations related to the prevention, diagnosis and
treatment of respiratory diseases such as
tuberculosis, lung cancer, chronic
obstructive pulmonary disease (COPD), asthma, allergies,
sleep-related disorders, and cystic
fibrosis.
The 2006 National TB Controllers Association (NTCA) Workshop was
held June 13–15, 2006, at the Sheraton Buckhead Hotel, in Atlanta,
Georgia. Invited participants for the 2006 workshop included state
and big city TB controllers, TB nurse consultants, TB program
managers, DTBE field staff, and Regional Training and Medical
Consultation Centers leadership. The theme of the meeting was
“Eliminating TB: Fighting the Enemy." I am very happy to state that
the meeting was a resounding success. The general sessions were ably
moderated by Phil Griffin, TB Control Director of Kansas; John
Bernardo, TB Control Officer of Massachusetts and President of the
NTCA; and Jane Moore, Nurse Consultant from Virginia. We heard a
truly inspiring and entertaining keynote speech, “Remembering Why
We’re Here,” from Thomas Daniel, MD, Professor Emeritus of Medicine
and International Health at Case Western University, as well as an
update from our former CDC colleague, Romel Lacson, on the
Amaya-Lacson TB Photovoice Project. Throughout the conference, you
probably noted a collection of artwork on display in the covered
walkway; these are the result of an art therapy program offered by
Bellevue Hospital in New York City to alleviate the mental and
emotional stress of isolation for patients. Dr. Irene David, who was
on hand at the conference to talk about the artwork, has an article
in this issue about the program. On Tuesday, Wednesday, and
Thursday, the participants broke out into smaller groups to hear
about and discuss the recently issued guidelines that have come out on
infection control, contact investigations, corrections, and the TB control statement; DTBE research activities;
laboratory issues; genotype usage and guidelines; QuantiFERON
guidelines; targeted testing and LTBI projects; and issues dealing
with multidrug resistance and HIV coinfection. A social event on
Tuesday evening was highlighted by the announcement and presentation
of awards, as well as the distribution of numerous door prizes. On
Wednesday, we had an opportunity to learn about the four TB Regional
Training and Medical Consultation Centers, meet their staff, and
hear about their plans. On Thursday, we heard a moving and amazing
presentation about Hurricane Katrina and the comments of the TB
controllers involved in responding to it: Jim Cobb of Florida,
Charles DeGraw of Louisiana, Nancy Keenon of Alabama, Mike Holcombe
of Mississippi, and Charles Wallace of Texas. Afterwards, John
Bernardo and I “sent the troops out to fight the enemy,” charging
participants to eliminate TB; use team work; be prepared through
training and skill-building; acquire the proper equipment and tools;
and last, but not least, improvise, adapt, and overcome! We hope to
have as successful a meeting next year, when we reconvene here in
Atlanta June 11–14, 2007, at the Crown Ravinia Perimeter
Mall Hotel.
Please save the date!
Kenneth G. Castro, MD
Last Reviewed: 05/18/2008 Content Source: Division of Tuberculosis Elimination
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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