Notes from the Director

Dear Colleague:

Looking back over 2017, I would like to thank the staff of CDC’s Division of Tuberculosis Elimination (DTBE) and our partners in public health for their collective efforts that led to another successful year. The accomplishments and major activities of the year include the following:

In recognition of World TB Day in March, DTBE recognized 13 TB Elimination Champions working to expand latent TB infection testing and treatment in their communities. DTBE released preliminary TB surveillance data for the United States. In November, the full surveillance report was released. There were 9,272 reported TB cases, reflecting continued, albeit slow, progress in combatting TB.

The 2017 National TB Conference in April, sponsored by the National Tuberculosis Controllers Association in collaboration with the Association of Public Health Laboratories, was held in Atlanta, GA. The conference highlighted innovative work in TB prevention, management, and care across the country. It also paved a way forward as TB professionals came together to discuss their challenges and share best practices on how to achieve TB elimination in the United States.

This year DTBE developed creative communication and education tools, including Implementing an Electronic Directly Observed Therapy (eDOT) Program: A Toolkit for Tuberculosis (TB) Programsand a new video, “5 Things to Know About TB.” The video highlights the continuing problem of TB in the United States and the importance of addressing latent TB infection though targeted testing and treatment. We also had the privilege of sharing the experiences of four TB survivors through the TB Personal Stories project.

DTBE established the National Tuberculosis Molecular Surveillance Center (NTMSC) at the Michigan Department of Health and Human Services (MDHHS) Bureau of Laboratories. The center will be equipped to perform both conventional genotyping and whole genome sequencing (WGS) for all isolates of Mycobacterium tuberculosis.

The Tuberculosis Epidemiologic Studies Consortium (TBESC) developed and is currently testing a new latent TB infection surveillance system – Surveillance for TB Elimination Management System (STEMS). STEMS is a real-time case management and surveillance system for latent TB infection currently used by all TBESC health department sites and the Dr. Bates Outreach Clinic at the Arkansas Department of Health.

Several long-time DTBE staff retired this year. Frances Tyrrell, MPH, MT (ASCP), SM—Laboratory Consultant; Wanda Walton, PhD, MEd— Branch Chief for the Communications, Education, and Behavioral Studies Branch (CEBSB); Glenda Newell— Statistical Assistant/Analytic Steering Committee Coordinator in the Surveillance, Epidemiology, and Outbreak Investigations Branch (SEOIB); Michael Fraser—Public Health Advisor in the Field Services Branch (FSB), and Stefan Goldberg, MD— Senior Medical Officer in the Clinical Research Branch (CRB).

Thank you for everything you do in the fight to end TB.

Philip LoBue, MD, FACP, FCCP
Director,
Division of Tuberculosis Elimination
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

Communications, Education, and Behavioral Studies Branch Updates

TB Program Managers’ Course

The overall purpose of the TB Program Managers’ Course is to improve the planning and managerial capabilities of new TB program managers throughout the country. The course is designed for TB controllers, program managers, public health advisors, and nurse consultants with programmatic responsibilities at the state, big city, territory, or regional (within a state) level.

Laboratory Branch Updates

Eighth Anniversary of Molecular Detection of Drug Resistance Implementation

DTBE implemented a clinical laboratory service, Molecular Detection of Drug Resistance (MDDR), for U.S. TB Control Programs in September 2009. The service uses Polymerase Chain Reaction (PCR) to amplify targeted genetic loci followed by DNA sequencing to detect mutations associated with drug resistance. Culture-based drug susceptibility testing (DST) is also performed.

Clinical Research Branch Updates

The Latest News from the TB Trials Consortium (TBTC)

TBTC Study 31 (also known as ACTG A5349; “Rifapentine-containing treatment shortening regimens for pulmonary tuberculosis: A randomized, open-label, controlled phase 3 clinical trial”) continues to enroll. As of December 7, 2017, the study had a total of 1,522 participants, 61% of target enrollment. The AIDS Clinical Trials Group (ACTG) network is collaborating with TBTC, contributing substantially to enrollment.

Data Management, Statistics, and Evaluation Branch Updates

TB Education and Training Network (TB ETN)/ Program Evaluators Network (PEN) Webinar Summary

On December 7, 2017, the TB Program Evaluators Network (TB PEN) hosted a webinar through the National Prevention Information Network titled “Reporting for TB Infection from Diagnosis to Treatment Completion: Forging the Surveillance System of the Future with Lessons from the Past” and was presented by Andrew Tibbs. Mr. Tibbs is a senior epidemiologist with the Massachusetts Department of Public Health and chairs a latent TB infection surveillance workgroup for the Society for Epidemiology in TB Control (SETC), a subcommittee of the National Tuberculosis Controllers Association (NTCA).

New CDC Publications

October 2017

Reaves EJ, Shah NS, France AM, Morris SB, Kammerer S, Skarbinski J, Bradley H. Latent tuberculous infection testing among HIV-infected persons in clinical care, United States, 2010-2012. Int J Tuberc Lung Dis. 2017 Oct 1;21(10):1118-1126. doi: 10.5588/ijtld.17.0041. PMID: 28911355.

Sigal GB, Segal MR, Mathew A, Jarlsberg L, Wang M, Barbero S, Small N, Haynesworth K, Davis JL, Weiner M, Whitworth WC, Jacobs J, Schorey J, Lewinsohn DM, Nahid P. Biomarkers of Tuberculosis Severity and Treatment Effect: A Directed Screen of 70 Host Markers in a Randomized Clinical Trial. EBioMedicine. 2017 Oct 24. pii: S2352-3964(17)30417-6. doi: 10.1016/j.ebiom.2017.10.018. [Epub ahead of print] PMID: 29100778.