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TB Notes 4, 2004

No. 4, 2004

Dear Colleague:

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 good news.

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 Atlanta.

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 happy 2005.

Kenneth G. Castro, MD


Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Tuberculosis Elimination -

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