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TB Notes 4, 2004
No. 4, 2004
Recently we said farewell to Paul Poppe, our esteemed Deputy Director,
who retired in early January after 30 years of outstanding service
to CDC. After a thorough search for a replacement that yielded many
outstanding candidates for the position, we have hired Mr. Philip
Talboy as Deputy Director of the division and welcome him to the
DTBE family. Please see the Personnel Notes section for information
on Paulís career and contributions, as well as on Philís background
and previous assignments.
In other staff news, I am happy to report that Dixie Snider, Jr.,
MD, MPH, was formally selected as the Chief of Science for CDC and
the Agency for Toxic Substances and Disease Registry (ATSDR). Some
of us remember Dixie from his time in this division. In 1985, he
became Director of the Division of Tuberculosis Control and was
the major architect of the first strategic plan for the elimination
of TB in the United States, published in 1989. He was also a key
player in developing the national plan for addressing multidrug-resistant
TB. His friends and former colleagues in DTBE are delighted by the
In early November, DTBE announced the availability of its most
recent annual surveillance report, Reported Tuberculosis in
the United States, 2003. CDC has been collecting TB
surveillance data from all 50 states since 1953; thus, this yearís
report marks the 50th year of national TB surveillance.
While the number of TB cases (14,874) and the rate (5.1 per 100,000
population) both decreased yet again in 2003 from the previous year,
we note several concerning trends. TB cases in foreign-born persons
now represent 53% of all U.S. cases, and the case rate among these
persons is eight times greater than the rate for U.S.-born persons.
Moreover, the decline in total case numbers from 2002 to 2003 was
the smallest since 1992, and for the first time since 1989, the
number of TB deaths increased. To regain our national momentum against
this disease and accelerate the pace to achieve its eventual elimination,
we will need to not only continue our concerted efforts but increase
and intensify them.
The Advisory Council for the Elimination of Tuberculosis met in
Atlanta on October 6 and 7, 2004. The group welcomed two new members,
Professor Dick Fluck of Franklin and Marshall College in Lancaster,
Pennsylvania, and Dr. Jennifer Flood of the California TB control
program. Dr. Janet Collins, Acting Director of the National Center
for HIV, STD, and TB Prevention (NCHSTP), reported in the NCHSTP
staff updates that Dr. Eugene McCray, formerly of DTBE and for the
last several years director of the NCHSTP Global AIDS Program, has
been selected to be the Senior Scientific Advisor in CDCís Office
of Global Health. In other news, she mentioned the possibility of
a TB funding increase in the 2005 appropriation bill.
In my DTBE updates, I discussed the new formula that will be used
in determining funding levels for TB cooperative agreement recipients.
This new formula will be based on current numbers of TB cases and
other challenges (such as a high proportion of cases among foreign-born
and minority populations). I was also pleased to announce that all
50 states have now signed up to participate in the Genotyping Network.
Mr. John Seggerson gave an update on the National Coalition for
the Elimination of TB (NCET). We learned that NCET will be sponsoring
an advocacy training meeting on February 23 in Vancouver, Canada.
Dr. Lisa Panlilio reported on a respiratory protection stakeholders
workshop being held by CDC in Atlanta Nov. 30 and Dec. 1 (see my
update below). Dr. Charles Nolan discussed the events and trends
that suggest the need to revise the Control of Tuberculosis statement,
including the lack of progress against TB in foreign-born persons,
the slowdown in the U.S. rate of decline, and the fact that TB is
not disappearing in low-incidence areas. He reported that the revision
is underway. Sponsored by CDC, ATS, and the Infectious Diseases
Society of America (IDSA), the revision is being developed by a
19-member expert panel.
Dr. Reuben Granich provided an update on TB and HIV collaborative
activities, and described a key workshop that was held in Addis
Ababa, Ethiopia, on testing and surveillance of TB patients for
HIV. Charles Schable of the CDC Office of Terrorism Preparedness
and Emergency Response and Sarah Royce of California addressed opportunities
for collaboration between staff of TB programs and bioterrorism
programs. Dr. Michael Iademarco described the global efforts to
develop a new TB vaccine, indicating that important progress has
been made to date but that research must continue. A discussion
on the use and benefits of nucleic acid amplification tests was
lead by Dr. Tom Shinnick of DTBE and Kim Field, NTCA President.
The next ACET meeting was scheduled for February 16-17, 2005, in
As an update, the respiratory protection workshop held November
30 and December 1 was well attended, with 202 registrants. The attendees
represented industry, unions, and regulatory bodies, as well as
the fields of occupational medicine, infectious disease control,
and infection control and hospital epidemiology, providing good
representation of the various stakeholders. A number of research
issues germane to preventing transmission of airborne infectious
agents were identified, although it remains to be seen how and when
these issues will be addressed.
As we review our accomplishments of the past year and begin our
work for the new year, I would like to express to all of you my
heartfelt thanks for your hard work and dedication. Rest assured
that you are making a difference. Best wishes for a healthy and
Kenneth G. Castro, MD