CITC Newsletter — Spring 2011
A quarterly electronic newsletter from the Curry International Tuberculosis Center (CITC)
New Name for the Curry Center
2011 marks the 100th anniversary of the birth of Dr. Francis J. Curry (1911-1996), a pioneer in TB control for whom the Francis J. Curry National Tuberculosis Center was named in 1994. To continue honoring the impact of Dr. Curry’s contributions while at the same time recognizing the global importance of TB, the center has been renamed the Curry International Tuberculosis Center (CITC).
As CITC Principal Investigator Phil Hopewell, MD, announced at a press conference in San Francisco on World TB Day, March 24: “In recent years, CITC has expanded its operations to include educational outreach, research, and technical assistance around the world, with particular focus on countries having a high burden of TB. These activities involve collaborations with the World Health Organization, USAID, and many national TB control programs.”
Special guests at the press conference included Dr. Curry’s widow, Beryl, and two of their sons, William and Jim. The event was held at the Curry Senior Center, another facility that bears Dr. Curry’s name and embodies his legacy of commitment and service to vulnerable low-income communities.
The Center’s website address is now: www.currytbcenter.ucsf.edu
CITC’s continuing mission is to create, enhance, and disseminate resources and models of excellence, and perform research to control and eliminate TB in the United States and internationally. CITC is designated by the Centers for Disease Control and Prevention (CDC) as the Regional Training and Medical Consultation Center (RTMCC) for the Western Region, serving Alaska, California (including Los Angeles, San Diego, and San Francisco), Colorado, Hawaii, Idaho, Montana, Nevada, Oregon, Utah, Washington, Wyoming, and the U.S. Pacific Island Territories.
TB Program Notes
TB Program Notes is a new feature that highlights news, innovative activities, and other items of interest from TB programs in the Western Region. In this edition, programs from Colorado, Los Angeles, Oregon, San Francisco, Utah, and Washington report how World TB Day 2011 was observed in their jurisdictions.
The Colorado Coalition Against Tuberculosis (CCAT), which includes partners from the Colorado Department of Public Health and Environment, the Denver Metro TB clinic, and RESULTS, hosted its third annual “Stop TB Trot,” a 5-k run/walk to promote awareness of tuberculosis infection and disease in Colorado and around the world. The event attracted over 400 participants and raised almost $6,000 for the TB patient assistance fund, which helps provides underserved patients in Colorado with temporary housing, food, and transportation while they are on TB treatment.
The Los Angeles County TB Control Program joined forces with the American Lung Association in California, AIDS Healthcare Foundation, Asian Pacific Healthcare Venture, and the LA Gay and Lesbian Center to kick-off a re-invigorated “TB Coalition of Los Angeles County” with a networking luncheon and business meeting. Originally established several years ago to maintain a communication network and information exchange between all agencies involved in the prevention and treatment of TB in L.A. County, the rejuvenated coalition attracted attendees from 35 different entities, including community-based organizations that serve populations at highest risk for developing TB infection and TB disease.
The Oregon Health Authority observed World TB Day with special outreach to community medical providers. Letters were sent to 200 providers reminding them to consider TB in their differential diagnosis for those at risk along with information on how to obtain a consult from the Oregon TB program or the Curry Center. Provider packets also contained rulers for measuring TSTs, information cards on how to treat LTBI, and new patient education materials on the relationship between TB and smoking.
For the San Francisco Department of Public Health, TB Control Division, World TB Day was an opportune time to announce a significant milestone: For the first time in its history, the City and County of San Francisco logged under 100 new cases of TB (98 cases in 2010). At a press conference at the Curry Senior Center, speakers such as TB Controller Masae Kawamura, MD, Linda Civitello, CEO of Breathe California, and Joel Rubenstein of RESULTS San Francisco addressed the status of TB, new breakthrough diagnostics, and other regional/global impacts of TB.
The American Lung Association in Utah, in partnership with the Utah Department of Health and local health departments, presented a World TB Day conference with the theme, A Tuberculosis Profile: Globally, Nationally, and Locally. The conference targeted health care providers and the general public and featured presentations on topics such as: TB and international students, unusual side effects of TB medications, and a case study regarding TB medications and mental health.
The Washington State Department of Health joined the Washington State Tuberculosis Advisory Council and Seattle BioMed in commemorating World TB Day with a special “Global Health 101” community event focused on TB. Sponsored by the Firland Foundation and held at the Seattle BioMed building in Seattle, the event attracted 90 participants who learned from public health and research experts about the realities of treating TB and progress toward new drugs and vaccines. A hands-on experiment from a BioQuest scientist demonstrated the challenges of TB drug delivery — underscoring the biological barriers that make elimination of TB so difficult.
TB/HIV Caribbean Project Materials Now Available
CITC provides TB technical assistance to a partnership of agencies that helps local institutions in Caribbean countries to develop regional TB programmatic guidelines, TB and TB/HIV curricula and training, and onsite technical assistance. The project’s many accomplishments include the publication of guidelines, training modules, facilitator's guide, and job aides now available online.
The Regional Coordinating Unit (RCU) of the Caribbean HIV/AIDS Regional Training Network (CHART) at the University of the West Indies, the Caribbean Epidemiology Centre (CAREC) in Port-of-Spain, Trinidad & Tobago, the International Training and Education Center for Health (I-TECH) at the University of Washington and University of California, San Francisco (UCSF), and CITC have been working together since 2007 to support capacity building related to TB and TB/HIV prevention, treatment, care, and control in the Caribbean region. Key achievements to date include: several training-of-trainer workshops; clinical training; clinical consultation; nurses’ network; technical assistance; regional capacity building for doctors and nurses; and the development of regional TB and TB/HIV clinical and programmatic guidelines, with accompanying materials.
Activities in 2011 will focus on supporting the guideline implementation process for countries and transitioning project responsibilities from CITC and I-TECH to the CHART RCU for long-term sustainability. The project’s main participating countries are Antigua and Barbuda, Barbados, Belize, Dominica, Grenada, Jamaica, St. Kitts and Nevis, St. Lucia, St. Vincent and the Grenadines, Suriname, The Bahamas, and Trinidad and Tobago. Haiti and Guyana have also been involved. Financial sponsorship for this project has been provided by the U.S. Agency for International Development (USAID) and the Health Resources and Services Administration (HRSA) under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). The 2010 versions of the guidelines, training modules, facilitator's guide, and job aides are posted on the CHART-RCU website.
Philip Hopewell Honored with Lifetime Achievement Award from The Union-NAR
CITC Principal Investigator Philip C. Hopewell, MD, received the Lifetime Achievement Award from the International Union Against TB and Lung Disease – North America Region (The Union–NAR), in honor of his “outstanding commitment and many contributions to controlling tuberculosis here and abroad” during his career.
The award was presented to Dr. Hopewell at the organization's 15th Annual Conference on February 25, 2011, in Vancouver, British Columbia. At the podium, a former UCSF fellow and colleague of Dr. Hopewell, Charles L. Daley, MD, who now heads the Division of Mycobacterial and Respiratory Infections at National Jewish Health, offered words of praise for the distinguished honoree: “Phil Hopewell has impacted my professional life more than any other individual. As my mentor, he taught me how to be a better physician, scientist, and educator and he did this with humility and unwavering support. Whether as a healer, scientist, teacher or humanitarian, his work to improve global tuberculosis control has been truly impactful. I can think of no one more deserving of this year's Lifetime Achievement Award than Phil Hopewell.”
New TB Prevention Website
The International Training and Education Center for Health (I-TECH) recently announced the launch of a new online tuberculosis prevention toolkit, developed in collaboration with CITC. Targeted toward facility-level administrators and health care workers in communities with a high prevalence of TB and HIV, the toolkit is designed to provide clear guidance to help implement, monitor, and continuously improve TB prevention and control measures.
“For some time, the World Health Organization (WHO) and other policy leaders have been pushing for more robust TB infection control and prevention activities, particularly among people living with HIV,” says Dr. Christopher Behrens, I-TECH Medical Director. “We designed this resource to provide step-by-step guidance on how to get started, prioritizing areas that are easiest and have the most impact.”
The toolkit uses the “Three I’s” framework developed by WHO: Strengthening TB infection control practices; intensifying TB case finding among people living with HIV (PLHIV); and incorporating isoniazid preventive therapy into care and treatment for PLHIV.
“There are very simple, inexpensive actions that make an enormous difference in successful TB infection control and prevention, but implementers are often overwhelmed by competing demands,” says Dr. Behrens. “We hope that this resource will provide a roadmap and action steps for implementing the Three I’s in all facilities, particularly those that provide care for PLHIV.”
Visit the TB Prevention Toolkit.
TB Nurse Coalition Seeks Members
The National Tuberculosis Nurse Coalition (NTNC) is seeking members to join its collective voice for nurses working in TB control activities, and to advocate for TB elimination throughout the nation.
NTNC advises and supports the TB control officials of state, local, and territorial governments by providing a coordinated nursing perspective on issues vital to the success of TB prevention and control programs. The NTNC is part of the National TB Controllers Association (NTCA).
NTNC membership is open to all nurses who work in TB control programs, case manage TB patients, or are retired TB control staff members. All nurses who join NTCA become members of NTNC.
Membership to NTNC/NTCA
Upcoming Training Courses
CITC’s schedule of upcoming training courses (through November 2011) offers a variety of courses for clinicians and public health providers.
May 4-5, 2011
Seattle, WA
Tuberculosis Clinical Intensive
Two-day intensive for physicians and other licensed medical professionals who diagnose and treat tuberculosis.
May 6, 2011
Seattle, WA
Nurse Case Management Workshop
One-day update for nurses, communicable disease investigators, and other licensed medical care providers who work with tuberculosis patients
May 25, 2011
Sierra Vista, AZ
HIV, TB and Meth in 2011: What Border Clinicians Need to Know
Co-sponsored by: Pacific AIDS Education and Training Center (PAETC); the U.S./Mexico Border AETC Steering Team (UMBAST); and CITC
July 20, 2011
National, Web-based Seminar
TB? Maybe Not: The Differential Diagnosis of Tuberculosis
Two-hour web-based seminar for clinicians and others who are involved in the diagnosis of active TB.
August 23-26, 2011
San Francisco, CA
Tuberculosis Program Manager's Intensive
Four-day intensive for nurses, physicians and other health professionals working as tuberculosis program managers.
September 20-22, 2011
San Francisco, CA
Tuberculosis Clinical Intensive
Three-day intensive for physicians and other licensed medical professionals who diagnose and treat tuberculosis.
September 21-23, 2011
Los Angeles, CA
Communicable Disease Investigation Training course
Co-sponsored by California Department of Public Health
Three-day training for communicable disease investigators who work in TB control programs.
September TBA, 2011
Billings, MT
Nurse-to-Nurse Training
One-day customized training for nurses who work in Montana.
October 12, 2011
Tacoma, WA
Washington State Annual TB Training Conference
Co-sponsored by the Washington Department of Health and the Firland Foundation One-day training conference focusing on the needs of TB providers in the Northwestern United States
October 18-21, 2011
San Francisco, CA
Case Management / Contact Investigation Intensive
Four-day training for nurses, communicable disease investigators, and medical social workers.
November 15, 2011
San Francisco, CA
TB Cohort Review
One-day training for TB control program staff involved in cohort reviews. Multidisciplinary teams from programs are encouraged to apply.
For periodic updates on additional trainings, complete course descriptions, and application forms, view our training section.
Mini-Fellowship Applications for 2011 Available Online
CITC offers mini-fellowship trainings to TB care providers (MDs, nurses, support staff) from the western region of the U.S. to provide firsthand knowledge and experience in carrying out TB control activities.
Mini-fellowships are designed to meet the individual needs of participants by assessing areas of practice and communities served, and matching identified objectives with appropriate activities. Learn more.
Nurse-to-Nurse Applications for 2012
CITC’s Nurse-to-Nurse Training Program brings direct and customized training to nurses working in the field. Local jurisdictions that want to apply to host a 1-day course in 2012 will find applications available on the CITC website.
Faculty Profile
To better acquaint our readers with the corps of TB experts that comprise our training and medical consultation faculty, each issue of CITC Newsletter presents a profile of a CITC faculty member. In this issue we feature Jennifer M. Flood, MD, MPH.
It is the rare public health professional who possesses the skill, dedication, and sheer courage to assume leadership of TB control in a state like California, home to 37 million residents and 20% of the nation’s TB cases. Jennifer Flood, MD, MPH, is such a rarity. Recently named Chief of the TB Control Branch of the California Department of Public Health (CDPH), her 25-year career in infectious diseases has well-prepared her to lead a jurisdiction in which, on average, a new case of TB is reported every 3 hours; approximately 3 million persons are infected with LTBI; and each year, over 10,000 suspect cases are reported and 20,000-30,000 contacts are identified.
Dr. Flood was born and raised in Northern California. As an undergraduate, she studied physiology at University of California, Berkeley (UCB), and then earned her medical degree at University of California, San Francisco (UCSF), followed by a residency in Internal Medicine. Dr. Flood continued her medical training with a fellowship in Infectious Diseases at UCSF, and a Masters in Public Health, Epidemiology, at UCB. Her earliest public health mentors include the renowned Dr. Gail Bolan and Dr. Art Reingold, whose great passion for disease detective work and public health provided lasting inspiration for Dr. Flood.
At this stage in her career, Dr. Flood focused on sexually-transmitted diseases (STDs) in the Division of STD Control at the San Francisco Department of Public Health, first directing clinical research and training and later serving as medical director at the City Clinic. From there she transitioned to the TB Control Branch at the State, where she was soon promoted to Chief of the Surveillance and Epidemiology Section, a position she held until late last year.
Since 1999, Dr. Flood has served as principal investigator for a long list of TB research projects, ranging from genotyping, contact investigation, and MDR-TB to surveillance for foreign-born cases. In 2009, Dr. Flood was given the prestigious Henry A. Renteln Award from the California Tuberculosis Controller’s Association, recognizing her “significant contributions to TB control in the State.”
During the past decade, the scope of Dr. Flood’s work has extended well beyond California into the global arena. She has served as a consultant for TB screening, treatment, and surveillance programs in Vietnam, Nepal, Mexico, and the Republics of Armenia and Georgia. These international experiences have profoundly impacted Dr. Flood, motivating her to strengthen TB control in the countries from which California’s population of TB patients originates.
Dr. Flood is Assistant Clinical Professor of Medicine at UCSF, and from 2004-2008 she served on the federal Advisory Council on the Elimination of TB (ACET). A member of the CITC faculty since 1990, Dr. Flood has been a curriculum advisor for several CITC clinical courses and has trained health providers on TB epidemiology, surveillance, and screening. She served as co-editor and contributing author of the joint CDPH/CITC publication, Drug Resistant Tuberculosis: A Survival Guide for Clinicians.
As the state’s top TB control official, Dr. Flood oversees an agency comprised of 45 dedicated staff members who provide support to 61 local health jurisdictions. The opportunities and challenges that lie ahead are surely formidable, and anyone who has worked with Dr. Flood can attest that she is equal to the task.
Gisela Schecter, MD, MPH, a founding CITC faculty member and former TB Controller of San Francisco, applauds her longtime colleague: “Jenny Flood has been a critical mainstay of the California TB Control Branch since 1998. Not only does Jenny know all the TB numbers and what those numbers might mean, but she also knows people. She is beloved by her staff and coworkers and highly respected by colleagues in California, nationally, and internationally.”
Contact Us
Curry International Tuberculosis Center
3180 18th Street, Suite 101
San Francisco, CA 94110-2028
Telephone: 415-502-4600
Fax: 415-502-4620
Warmline TB medical consultation: 877-390-6682 (toll-free) or 415-502-4700
tbcenter@nationaltbcenter.ucsf.edu
www.currytbcenter.ucsf.edu
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CITC Newsletter
CITC Principal Investigator: Philip C. Hopewell, MD
RTMCC Co-Principal Investigators: Philip C. Hopewell, MD, and L. Masae Kawamura, MD
Task Order #1 Principal Investigator: Elizabeth Fair, PhD
Task Order #19 Co-Principal Investigators: Elizabeth Fair, PhD, and Christine Ho, MD
RTMCC Medical Director: Lisa Chen, MD
CITC Director: Tom Stuebner, MSPH
Training Administrator: James Sederberg
Research Administrator: Baby Djojonegoro, MS, MPH
CITC Newsletter Editor: Kay Wallis, MPH
CITC Web Developer: Mari Griffin, MS