We would like to personally invite you to volunteer for a PIDS Committee and our other volunteer activities. We depend on input from you to ensure that the specialty of Pediatric ID continues to thrive. Please view the PIDS committee and volunteer opportunity descriptions at http://www.pids.org/about-us/pids-committees.html and let us know your top choices.

We guarantee that if you volunteer for an activity, we will find a way to get you involved. Some committees may not be able to accommodate all the membership requests, so we ask you to select your top 3 committee interests and any volunteer activity you are interested in. We are exploring innovative ways to keep all our volunteers involved, including workgroups/interest groups that can provide additional support and input to our most active committees. NEW this year is the Pediatric Transplant ID Committee. We are excited about this new committee and look forward to seeing it thrive in the years to come. Also NEW this year: if you are on a committee currently, but feel that the current assignment was an error or is not appropriate, please send an email to This email address is being protected from spambots. You need JavaScript enabled to view it.. We would like to clean up the lists so that assignments fit expertise as much as possible.

To view current committee membership assignments, go to http://www.pids.org/about-us/pids-committees/committees-at-a-glance.html.

Before the ID week meeting this year, we will review all applications and get back to you with either a committee assignment, workgroup assignment, or volunteer activity assignment. If somehow this does not happen, I invite you to email or call me personally and we will correct this.

Committee terms are for three years and we ask you to be prepared to engage energetically in the charge of the committee and be able to participate on conference calls and usually a face-to-face meeting once a year (generally scheduled during either IDWeek or the St. Jude/PIDS Research Conference). Committee membership and volunteer activities are great ways to set the stage for serving later as either a PIDS Officer or Board Member-at-Large.

Please click here to fill out the volunteer application. Applications are due no later than Friday, July 13, 2018. For more information on committees, please click here
 
We look forward to your help with setting our PIDS agenda!

“The Challenges of Viral Respiratory Healthcare-Associated Infections in Pediatrics”
Quach C, Shah R, Rubin LG. Burden of healthcare-associated viral respiratory infections in children’s hospitals. JPIDS. 2018; 7(1): 18-24.

It is well known that viral respiratory infections are a common healthcare associated infection (HAI) in children. For those of us who practice in states that have mandatory National Healthcare Safety Network (NHSN) reporting requirements for all HAIs, performing the necessary house-wide surveillance for respiratory viral HAIs (HA-VRI) becomes challenging in terms of time and IP resources especially during respiratory viral season when these viruses are circulating at high rates in the community. The prevalence of HA-VRI in children varies in the literature. There have been many reports of increased morbidity and mortality from HA-VRI especially in neonates and immunocompromised patients 1-4. Hospital laboratories that perform more sensitive testing, such as nucleic acid amplification, will diagnose more respiratory viruses. Detection of respiratory viral nucleic acid may also represent asymptomatic shedding. This is especially a concern for rhinovirus where prolonged shedding can make it unclear if a positive test represents shedding or infection. It is unclear how well the NHSN definitions perform for HA-VRI in children and how best to utilize IP resources to perform surveillance. We lack best practices for HA-VRI prevention and we lack antivirals against the most commonly identified viruses that cause HA-VRI. More information is acutely needed.

The study performed by Quach et al begins to help address some of these issues. They compared and assessed determinants of unit-specific HA-VRI incidence rates in two children’s hospitals during three respiratory viral seasons (2010-2013). This was a retrospective study of prospective cohorts at Montreal Children’s Hospital (MCH) and Cohen Children’s Medical Center (CCMC) in New York. Both hospitals have similar demographics (number of beds, level 4 NICU, PICU, bone marrow transplant unit, hematology oncology ward and general medical/surgical wards). Both hospitals had some wards with multiple beds per rooms. Prospective surveillance for HA-VRI used standard NHSN definitions that require compatible respiratory symptoms and viral detection. Both hospitals used the minimum number of days since admission and viral incubation periods to determine HA-VRI (shortest number of one day for influenza A/B at MCH and longest of 4 days for human metapneumovirus at CCMC). Only MCH conducted syndromic surveillance for HA-VRI. Both hospitals use a multiplex nucleic acid amplification test for viral detection on nasopharyngeal swabs or aspirates; MCH used an in-house assay that detects adenovirus, human metapneumovirus, influenza A and B, parainfluenza types 1,2,3 (PIV), respiratory syncytial virus (RSV), enterovirus, rhinovirus and coronaviruses 229E and OC43. CCMC used the Luminex TM multiplex nucleic acid amplification test which can detect the same viruses, however it cannot detect coronaviruses nor can it differentiate between enterovirus and rhinovirus requiring a supplemental test to differentiate between these two.

HA-VRI rates per 1000 patient days were determined including virus (excluding coronavirus and patients who tested negative but were found by syndromic surveillance) and unit specific rates. Multivariable regression analysis was used to assess determinants for HA-VRI. The HA-VRI rate for the 6 virus groups studied was significantly higher at MCH than at CCMC (1.91 vs 0.80 per 1000 patient-days, respectively, P <.0001). Overall the rate was lowest in the NICU, however units with the lowest HA-VRI rate differed between MCH and CCMC (Heme/Onc ward vs NICU respectively). The rank order of viruses identified was similar between the two hospitals with rhinovirus most commonly identified followed by PIV and RSV. When viral etiology was compared by unit type, the highest rates were in the PICU with rhinovirus followed by adenovirus and Heme/Onc wards with rhinovirus followed by PIV in both hospitals. When adjusted for unit type and HA-VRI they found less than 50% single rooms in a given unit to be statistically associated with a higher rate (1.33 times higher rate (95% CI 1.29-1.37) regardless of unit type, however neither hospital had a NICU with single rooms. The authors speculate that single rooms might not be sufficient to prevent nosocomial acquisition in the absence of meticulous hand hygiene and housekeeping, but since most of these viruses are spread by contact and droplets decreased crowding in single rooms would likely prevent some transmission. Both hospitals had visitor restriction policies due to illness or young age, however both hospitals admitted that their policies were rarely enforced. Staff who were ill were instructed to stay home, but it is not known how well this policy was enforced at either hospital. It is likely that more IP resources would have been required to perform syndromic surveillance at MCH. The authors acknowledged that potential misclassification of some community acquired infections as HAIs might have occurred and systematic HA-VRI surveillance was not performed after discharge so some patients with HA-VRI may not have been identified.

Prevention of HA-VRIs is difficult. Asymptomatic shedding can occur in both healthcare workers (HCW), patients, parents/caregiver and visitors. Ill HCW presenteeism is common and lean staffing results in HCWs coming to work ill because they do not want to burden their colleagues 5,6,7,8. The same lean staffing may affect oversight of ill parents/caregivers and visitors allowing for importation of viruses from the community. The hospital environment quickly becomes contaminated and these viruses are then spread on HCWs hands to patients. Respiratory viruses can persist on dry surfaces from 2 hours-3 months depending on the virus9. There is a need for studies that evaluate best practices for HA-VRI prevention, along with visitor policies that align with family centered care, but which are still safe for other patients and HCWs. We need to ensure healthcare worker non-punitive policies for staying home if ill. In order achieve this we need to have adequate staffing in hospitals so an ill HCW can stay home and daily work can still be completed safely.

Written by: Jane M. Gould, MD

References:

  1. Zinna S, Lakshmanan A, Tan S, McClaughry R, Clarkson M, Soo S, Szatkowski L, Sharkey D. Outcomes of nosocomial viral respiratory infections in high-risk neonates. Pediatrics 2016; 138(5)
  2. Spaeder MC, Fackler JC. Hospital-acquired viral infection s increases mortality in children with severe viral respiratory infection. Pediatr Crit Care Med 2011; 12: e317
  3. Chow EJ, Mermel LA. Hospital-acquired respiratory viral infections: incidence, morbidity and mortality in pediatric and adult patients. Open Forum Infect Dis 2017 4(1)
  4. Simon A, Khurana K, Wilkesmann A, Muller A, Englehart S, Exner M, Schildgen O, Eis-Hubinger AM, Groothuis JR, Bode U. Nosocomial respiratory syncytial virus infection: impact of prospective surveillance and targeted infection control. Int J Hyg Environ Health. 2006; 209(4): 317-24.
  5. Szymczak JE, Smathers S, Hoegg C, Klieger S, Coffins SE, Sammons JS. Reasons why physicians and advanced practice clinicians work while sick: a mixed-methods analysis. JAMA Pediatr. 2015; 169(9): 815-21.
  6. Tan PC, Robinson G, Jayathissa S, Weatherall M. Coming to work sick: a survey of hospital doctors in New Zealand. NZ Med J. 2014; 127(1399):23-35.
  7. Bracewell LM, Campbell DI, Faure PR, Giblin ER, Morris TA, Satterthwaite LB, Simmers CD, Ulrich CM, Holmes JD. Sickness presenteeism in a New Zealand hospital. NZ Med J. 2010; 123(1314): 31-42.
  8. Schneider D, Winter V, Schreyogg J. Job demands, job resources, and behavior in times of sickness: an analysis across German nursing homes. Health Care Manage Rev. 2017 Mar 3. [Epub ahead of print].
  9. Kramer A, Schwebke I, Kampf G. How long do nosocomial pathogens persist on inanimate surfaces? A systematic review. BMC Infect Dis 2006, 6:130-138.

Many parents have questions about their children’s vaccines. Although you may not provide routine immunizations as an infectious disease specialist, you can still serve as a trusted information resource for parents. CDC’s National Center for Immunization and Respiratory Diseases (NCIRD) has a number of resources available to help you talk with parents about vaccines:

For more information, email This email address is being protected from spambots. You need JavaScript enabled to view it. or visit cdc.gov/vaccines

Pediatric ID specialists are viewed by administrators and other physicians as valuable contributors to the delivery of high quality medical care, according to a new study published in Hospital Pediatrics. Their contributions in many areas, however, can be difficult to measure, which may lead administrators to overlook their value and under-allocate resources, the findings suggest.

The study, which was supported by PIDS, sought to identify perceptions that clinical and administrative stakeholders working in hospitals that provide pediatric care have about the value of pediatric ID physicians. Ninety-seven physicians and administrators from five hospitals in different regions of the U.S. were included. Analysis of open-ended, qualitative interviews revealed numerous ways in which pediatric ID specialists are thought to provide value.

Pediatric ID specialists’ perceived contributions to quality care included the effective treatment of patients with unusual infections or those that respond poorly to initial treatment, the optimization of antimicrobial use, and the ability to serve as outpatient homes for complex patients. Interview respondents also indicated that these specialists provide value by facilitating communication with patients, families, and other specialties. Additional perceived contributions included important system- or hospital-wide activities, such as antimicrobial stewardship and infection prevention.

Much of this valuable work, however, is not easily reimbursed by payers or captured by current metrics for physicians’ labor. This uncertainty caused some administrative respondents in the study to question how many pediatric ID specialists and related resources are needed to achieve high quality care, improve patient outcomes, and reduce costs, the study authors found.

The findings build on previous research investigating the value of cognitive specialties that has largely focused on clinical outcomes, such as mortality, readmissions, length of stay, or cost. The study adds to the understanding of how the pediatric ID specialty, in particular, is perceived and is part of PIDS’ ongoing efforts to demonstrate the value of the specialty to the health care system. The study’s lead author is Julia E. Szymczak, PhD, of the University of Pennsylvania Perelman School of Medicine, and other authors include several PIDS leaders.

The latest Journal Citation Reports® have recently been released, and we are excited to announce that Journal of the Pediatric Infectious Diseases Society (JPIDS) has received its first Impact Factor.  The journal's Impact Factor is 2.456.

"This milestone reflects the increasing attention to the high-quality work published in JPIDS and is the result of the ongoing efforts and dedication of the journal editorial team," said Dr. Paul Spearman, President, Pediatric Infectious Diseases Society "We now anticipate greater discoverability and dissemination of our content to the pediatric infectious diseases community and to the wider pediatric community." 

To celebrate this important achievement, we have curated a selection of highly cited articles from recent years and made them free to read online. Read Now

06/25/2018

Paul Auwaerter, MD, MBA, President IDSA
Melanie Thompson, MD, Chair HIVMA
Paul Spearman, MD, FPIDS, President PIDS
Keith Kaye, MD, MPH, FSHEA

Contact

IDSA: Jennifer Morales This email address is being protected from spambots. You need JavaScript enabled to view it.

PCI Public Relations (312) 558-1770 This email address is being protected from spambots. You need JavaScript enabled to view it.

The consequences to individual and public health of continuing “zero-tolerance” border policies and of large scale detention of thousands of weakened and vulnerable individuals will be longstanding and far-reaching.

The separation of immigrant families at our borders has run counter to principles of promoting wellbeing and preventing disease, as well as of prioritizing compassion, empathy and the best interests of children that must be part of any healthy society. That separation has challenged the first step in the most basic health services of collecting medical histories, including of immunizations. While Department of Health and Human Services and U.S. Centers for Disease Control and Prevention policies provide immunizations and basic health exams for unaccompanied minors, immigrants and refugees, whether these policies are being followed remains unclear at best.

All detained persons should be provided appropriate hygiene including access to soap, showers, clean clothes, safe water, access to appropriate healthcare, and to the best practices that protect the health of individuals and the public.

Basic practices of hygiene and infection prevention have already been demonstrated to be lacking, with reported outbreaks of chicken pox as well as scabies and other infections among those detained, indicating just some of the potential for widespread transmission of illnesses the policy has created. The possibilities for the spread of tuberculosis and other airborne diseases, including measles, as well as vector-borne illnesses, including ones resistant to antibiotics, continues to concern us.

As organizations of more than 12,000 infectious diseases, pediatric infectious diseases and HIV physicians, as well as healthcare epidemiologists, the Infectious Diseases Society of America, the HIV Medicine Association, the Pediatric Infectious Diseases Society and the Society for Healthcare Epidemiology of America call for speedy reunification of children with their families.  We remain deeply concerned that the policy of detaining large numbers of people, including entire families is leading to conditions that can fuel the spread of infections, and call for a thorough evaluation of the conditions and the consequences of their detention and of the public health ramifications.

 

House Passes Bills that Address Infections Related to the Opioid Epidemic

6/13/2018

Statement of the Infectious Diseases Society of America, the HIV Medicine Association and the Pediatric Infectious Diseases Society 

Contact: IDSA: Jennifer Morales This email address is being protected from spambots. You need JavaScript enabled to view it.

PCI Public Relations (312) 558-1770 This email address is being protected from spambots. You need JavaScript enabled to view it.

The U.S. House of Representatives voted overwhelmingly last night to approve the Eliminating Opioid-Related Infectious Disease Act and the Substance Use Disorder Loan Repayment Act of 2018. The Infectious Diseases Society of America, the HIV Medicine Association, and the Pediatric Infectious Diseases Society strongly support these bills. They will expand surveillance of infections (including HIV, hepatitis B and C, endocarditis, and other communicable health threats) associated with substance use disorders, authorize provider training to coordinate care for both infectious diseases arising from substance use and addiction, and provide loan repayment for health professionals caring for patients with substance use disorders (including those treating related infections).

As Societies with more than 12,000 infectious diseases, pediatric, and HIV physicians, IDSA, HIVMA, and PIDS made recommendations reflected in the Eliminating Opioid-Related Infectious Diseases Act, including the addition of endocarditis, a heart valve infection, to the list of infections related to the opioid epidemic. Not currently under national surveillance, endocarditis in most cases is a severe, acute illness requiring hospitalization that is different from viral infections associated with injection drug use such as HIV and hepatitis C virus (HCV).  For HIV and HCV, individuals can live with the conditions for years before prominent symptoms occur requiring acute care and engagement with the medical system. Surveillance or monitoring of endocarditis and other bacterial infections will lead to more timely identification of injection drug-related outbreaks. We also strongly support the provider training component of the bill and are pleased that the bill now recognizes the importance of training and care coordination for infectious diseases and addiction to help ensure better patient outcomes.

The Substance Use Disorder Loan Repayment Act will address the need for a trained health workforce sufficient to detect, control and deliver coordinated care for infections with an escalating incidence as a result of increasing injecting drug use. Compared to five years ago there are 20 percent fewer physicians entering training programs for infectious diseases and HIV medicine, raising great concern about shortfalls in expertise exactly when most needed. This bill will help to attract the diversity of healthcare providers necessary to provide prevention, care, and treatment services to individuals with substance use disorders, including infectious diseases and HIV providers.

These bills are part of a package of legislation passed by the House yesterday to address the opioid crisis, and the effort reflects a bipartisan commitment to confronting the combined public health threats of the growing opioid epidemic and the outbreaks of infectious diseases the crisis has fueled. We urge the U.S. Senate to advance these measures so that they may rapidly become law.

The SECURE -- Securing Experts to Control, Understand, and Respond to Emergencies -- Act (HR 5998), a bill that would establish Epidemic Intelligence Service student loan repayment at the Centers for Disease Control and Prevention, was introduced today by Rep. Jan Schakowsky (D-IL). This bill would represent a critical step in strengthening the infectious diseases public health workforce by allowing medical school loan repayment for physicians participating in the CDC’s two-year public health emergency preparedness and response fellowship program.
 
While similar programs at NIH and HRSA’s National Health Service Corps offer loan repayment to encourage careers in biomedical research and patient care in underserved communities, that opportunity does not now exist for careers in public health preparedness and response. HR 5998 would fill this gap.
 
IDSA was instrumental in developing this proposal, and is urging its passage. PIDS is assisting IDSA in spreading the word to our members.  Please take two minutes now to ask your representative to co-sponsor HR 5998.
 

Dinny was Professor of Community Paediatrics from late 1995, as well as a highly experienced specialist in Pediatric Infectious Diseases with many years of service to Starship (and previously Princess Mary Hospital), Kidz First/Middlemore Hospital and the University of Auckland since 1977. She was hugely respected as an academic researcher in the field both in New Zealand and internationally with over an impressive portfolio of publications. Dinny was an international expert in Rheumatic Fever and instrumental in researching and developing successful school based prevention programs which are a testament to her passion and persistence in developing timely access to quality health services on behalf of our children.

From 2002, when meningococcal disease was at epidemic levels, Dinny worked tirelessly at the national and international level in developing a vaccine and then setting up and leading clinical trials culminating in mass MeNZB vaccination program in 2004 -2008. Dinny was a champion in involving local communities and schools from the start. Her passion to reduce the inequitable burden of infectious diseases in our child community is an example to us all and will be her lasting legacy. Her career achievements will have touched many generations of New Zealand children as well as pediatricians who benefited from her wisdom and teaching.

This news will be a shock to many, as it has been to us. Her passion, leadership, and tenacity to improve the health of disadvantaged children will be sorely missed and remembered with great fondness - moe mai ra e te rangatira.

We send our love and condolences to her husband John, children William and Harry, and their families

Kua hinga te tōtara i Te Waonui a Tāne.
A mighty tōtara has fallen in the forest of Tāne.

Pediatric infectious diseases is an exciting, rewarding, and intellectually stimulating specialty, as well as one that is critical to maintaining good health in children and adolescents. Despite these characteristics, however, there are concerns that too few young physicians are entering the field to meet growing needs.

A new commentary published in JPIDS examines the looming shortage of physicians pursuing pediatric ID, factors behind the problem, and possible solutions to address it. Drawing on physician surveys, recent ID fellowship program match results, and perceptions of both compensation trends and available employment opportunities, the commentary describes the current state of the specialty and implications for the future. Led by Janet R. Gilsdorf, MD, of the University of Michigan Medical School and a past president of PIDS, the commentary authors also suggest ways forward. These include a list of practical steps pediatric ID physicians should take at their own institutions today to attract medical students and residents to the field.

Additional authors of the new commentary, “Pediatric Infectious Diseases Meets the Future,” are Paul Spearman, MD, of Cincinnati Children’s Hospital Medical Center; Janet A. Englund, MD, of the University of Washington in Seattle; Tina Q. Tan, MD, of Northwestern University Feinberg School of Medicine in Chicago; and Kristina A. Bryant, MD, of the University of Louisville School of Medicine.

Prevalence of Pertussis Antibodies in Maternal Blood, Cord Serum, and Infants from Mothers With and Those Without Tdap Booster Vaccination During Pregnancy in Argentina

Fallo AA et al. Journal of the Pediatric Infectious Diseases Society, Volume 7, Issue 1, 19 February 2018, Pages 11–17, https://doi.org/10.1093/jpids/piw069

Pertussis-related morbidity and mortality are highest among infants. In 2012, the Advisory Committee on Immunization Practices recommended Tdap vaccination for all US pregnant women during their third trimester, irrespective of their immunization status. Few studies have evaluated the optimal time for immunizing pregnant women. A study by Fallo and colleagues examined the kinetics of pertussis toxin immunoglobulin G levels (IgG-PT) among infants born to mothers immunized with the Tdap vaccine during pregnancy in Buenos Aires, Argentina.

Healthy pregnant women (aged 18-44) who delivered a singleton child at a public hospital and had not received a Tdap vaccine since 6 years of age were enrolled from 2011 to 2012 (n=99); women who delivered their child at the same center and received a Tdap vaccination were recruited from 2013 to 2014 (n=105). The control group was healthy non-pregnant women aged 18-44 (n=69). Women with current or chronic medical conditions and women with antibody levels suggestive of recent pertussis infection were excluded, along with newborns with a birth weight <2000 g. There were no significant differences in demographics or exposure to household children/adolescents among the three groups of subjects. The mothers received their Tdap vaccine at, on average, 13.2–36.6 weeks.

Paired maternal and umbilical cord blood samples were collected at the time of delivery, processed and frozen at −20°C until blind testing at the Argentina National Reference Center. IgG-PT level was measured using a Centers for Disease Control and Prevention–validated specific pertussis IgG enzyme-linked immunosorbent assay (ELISA). Purified pertussis toxin (Protein Express, Inc, Cincinnati, OH) was used as the positive control. The assay was calibrated to the World Health Organization international reference standard, 06/140. The lower limit of quantification was 1 ELISA unit (EU)/mL. In each assay, values lower than 1 EU/mL were assigned a value of 0.5 EU/mL.

IgG-PT concentration of >20 EU/mL at birth is considered “seropositive” with ≥5 EU/mL defined as the protective level.   In this study nonpregnant women had significantly higher concentrations of IgG-PT than the pregnant women who were not vaccinated (IgG-PT GMCs were 14.4 EU/mL (95% CI, 10.2–20.1 EU/mL; range, 2.7–85.5 EU/mL) and 9.8 EU/mL (95% CI, 8–12.1 EU/mL; range, 0.5–68.1 EU/mL respectively; p=0.03); 16 (16.1%) of the pregnant women had an IgG-PT level of <5 EU/mL.  Lower antibody level among non-vaccinated pregnant women was thought to be due to the immune modulation observed during pregnancy. At birth, the mothers with and without a Tdap vaccine had serum IgG-PT geometric mean concentrations (GMCs) of 35.1 and 9.8 ELISA units (EU)/mL, respectively (P < .0001); cord blood GMCs were 51.3 and 11.6 EU/mL, respectively (P < .0003); cord blood IgG-PT levels were <5 EU/mL in 2.9% and 16.1% respectively (P < .001). There was a linear correlation in IgG-PT levels between paired mother and cord serum samples. The IgG-PT level was <5 EU/mL in 3 (2.9%) of 105 immunized mothers and 33 of 105 (31.4%) had a level of <20 EU/mL. 2 of 105 (1.9%) cord samples had an IgG-PT level of <5 EU/mL.  Vaccination timing had no impact on maternal or cord serum levels; however, there were lower antibody levels at delivery in mothers vaccinated before 20 weeks of gestation. No correlation was found between cord IgG-PT concentrations and maternal age or infant birth weight.

Cord blood IgG-PT levels were higher than those of maternal serum. Placental antibody transference efficiencies (the ratio of cord blood GMC to maternal GMC) were 1.46 and 1.18 for mothers with and those without a Tdap vaccination, respectively. 

After birth, the investigators analyzed the IgG-PT kinetics in newborns born to immunized mothers.  The IgG-PT GMCs were 17.7 EU/mL in 36 infants in their first month of life and 11.6 EU/mL in 32 infants in their second month of life, representing decreases of 76% and 63.5%, respectively, from cord sample levels. This decay was earlier than that suggested by Van Savage et al.  (1) and predicted by Eberhardt et al (2). Therefore, the investigators proposed that an antibody level higher than 20 EU/mL at birth was desirable.  All infants with a IgG-PT GMC higher than 20 EU/mL at birth had a level of >5 EU/mL at 2 months of age; however, 20 of 105 (19%) had a cord level of <20 EU/mL.  No infants in this study developed pertussis. Figure 3 shows the decay of IgG-PT in infants during their first 1 and 2 months of life. 

The authors concluded that infants born to immunized mothers had significantly higher antibody levels during the first 2 months of life, and suggested that more prospective studies to determine the optimal timing of Tdap vaccination during pregnancy.

References

5/21/2018

The Ebola outbreak in the Democratic Republic of Congo announced May 8 has highlighted meaningful advances as well as critical needs that continue in the wake of the epidemic across Sierra Leone, Guinea and Liberia that ended two years ago. Because of an immediate response by the World Health Organization and partners to the confirmation of one case in the remote rural Bikoro health zone, mobile laboratories are in operation, 14 cases have been confirmed, and contact tracing as well as community engagement are underway. People who have been potentially exposed to the virus will receive a promising, investigational Ebola vaccine. All of this represents remarkable progress, due to investments in science, in practice, and in the recognition that solidarity is essential to effective infectious disease interventions globally. WHO officials Friday cited the swiftness, collaboration, and coordination of the response so far among the reasons that the outbreak does not now meet their criteria for declaring a Public Health Emergency of International Concern.

But the challenges remain formidable, with the remoteness of the region where the first cases were discovered, and the vulnerability of neighboring communities, cities and nations, posing a daunting combination of obstacles to the response, and risk of international spread. The identification of four cases in Mbandaka, a city of 1.2 million people, confirms the urgency of closing gaps in resources and capacities that fuel the spread Ebola. For those reasons, the WHO committee will revisit the threats posed by this advancing outbreak.

It is essential now to take stock of what needs to be done, not just to reach, diagnose, and care for those who have been affected by this outbreak, and to contain its spread, but to improve future responses, and prevent future threats from Ebola and other diseases. Funding allocated by Congress in 2014 to support responses to the outbreak in West Africa have gone a long way toward supporting the enhanced global health security needed to accomplish those goals. Continued investments in global health security and biomedical research are essential to maintaining the momentum now underway. On the same day the Ebola outbreak in the Democratic Republic of Congo was announced, however, the White House made its own announcement, of a proposal to rescind $252 million of funding supporting USAID’s global health security efforts.

As organizations of more than 12,000 infectious diseases, pediatric infectious diseases and HIV physicians, as well as infection prevention specialists, the Infectious Diseases Society of America, the HIV Medicine Association, the Pediatric Infectious Diseases Society and the Society for Healthcare Epidemiology of America offer our solidarity, support, and expertise to the outbreak response in the Democratic Republic of Congo. We urge Congress to support those efforts as well, by rejecting White House rescission proposals and by basing robust funding for global health security and biomedical research on the realities reflected in the current Ebola outbreak.

Paul Auwaerter, MD, MBA, President IDSA
Melanie Thompson, MD, Chair HIVMA
Paul Spearman, MD, FPIDS, President PIDS
Keith Kaye, MD, MPH, FSHEA

Contact
IDSA: Jennifer Morales This email address is being protected from spambots. You need JavaScript enabled to view it. 
PCI Public Relations (312) 558-1770 This email address is being protected from spambots. You need JavaScript enabled to view it. 


05/10/2018 

The Infectious Diseases Society of America, the HIV Medicine Association the Pediatric Infectious Diseases Society and the Society for Healthcare Epidemiology of America call on Congress to reject legislative attempts, including House Resolution 3 introduced Wednesday evening, that advance the Trump administration’s rescissions package. The resolution and the administration proposal both undercut future budget deals, thus endangering critical investments in public health, treatment and biomedical research programs, including activities to combat infectious diseases.

HR 3 mirrors the administration’s proposal by rescinding $7 billion in budget authority for the State Children’s Health Program. Such a cut would dramatically reduce resources available to House and Senate appropriators as they determine funding for vital health programs, including infectious disease and HIV domestic and global programs at the National Institutes of Health, the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the State Department, and USAID.

HR 3 also follows the administration’s proposal to rescind $252 million of USAID funding for combating Ebola and other emerging infectious disease threats through the Global Health Security Agenda. This is deeply concerning to the members of IDSA, HIVMA, PIDS and SHEA. The most recent outbreak of Ebola in the Democratic Republic of Congo, announced by the World Health Organization on the same day, highlights the shortsightedness of the proposal, as well as the urgency of efforts to build capacities to detect, prevent, and respond to infectious disease outbreaks where they originate.

Congress recognized this priority by directing part of the remaining emergency funding allocated in response to the 2013-to-2016 Ebola outbreak in West Africa to global health security programs in the omnibus funding bill for fiscal year 2018. The funding supports surveillance, laboratory capacity, and public health workforce strengthening in countries with limited public health resources. It is essential to averting future devastating outbreak impacts like those caused by the Ebola crisis across three West African countries, and to protecting the health of Americans at home and abroad. Funding for global health security strengthening activities is available through September 2019 – the administration’s attempt to rescind remaining funding would impact the ability of USAID to stop outbreaks at their source.

HR 3 also would undermine efforts to combat the critical and growing global health threat of antimicrobial resistance, with cuts to funding that supports health provider training to prevent health care associated infections and expanded surveillance of drug-resistant bacteria. In addition, a proposed $148 million rescission of funds allocated to the Animal and Plant Health Inspection Service at the Department of Agriculture threatens efforts to address disease outbreaks from re-emerging diseases, including the avian influenza.
Ultimately the outcomes of the rescission package announced by the administration Tuesday and echoed in HR 3 will not be savings, but added costs, when the effects of infectious diseases abroad, and failures to stop them at their source, come home.

Contact: IDSA: Jennifer Morales This email address is being protected from spambots. You need JavaScript enabled to view it.
PCI Public Relations (312) 558-1770 This email address is being protected from spambots. You need JavaScript enabled to view it.

Paul Auwaerter, MD, MBA, President IDSA
Melanie Thompson, MD, Chair HIVMA
Paul Spearman, MD, FPIDS, President PIDS
Keith Kaye, MD, MPH, FSHEA

IDSA and HIVMA guide legislation responding to opioid ID impacts

As key Committees in Congress turned their attention to the opioid crisis, IDSA and HIVMA ensured their legislation addressed the intersection of infectious diseases and substance use disorders, as well as the need to build ID and HIV provider capacity into the response.

The Senate Health, Education, Labor and Pensions Committee modified its Opioid Crisis Response Act in response to IDSA/HIVMA recommendations to include infective endocarditis in addition to viral hepatitis and HIV in new surveillance activities and to include clinicians caring for patients with infectious diseases related to substance use in new loan repayment opportunities through the National Health Service Corps. Because of our advocacy, the bill also now authorizes infectious diseases testing through comprehensive opioid recovery centers that would be created under the bill. The HELP Committee approved this important legislation on April 24, and the full Senate is expected to consider it this summer. Read More.

May 15 webinar to offer advocacy tips
 
IDSA, HIVMA, and PIDS have scheduled an advocacy webinar on ways to engage policymakers at home and in Washington, DC-and you're invited. In addition to practical tips on building relationships with elected officials as well as their staff members, and conducting productive meetings, IDSA and HIVMA member advocates will share their experiences with members of Congress, discuss the ways that advocacy can make a difference, and take questions. Read More.

Educate policymakers on 340B and ID/HIV

In January 2018, the Centers for Medicare and Medicaid Services reduced 340B reimbursement for Medicare Part B drugs to some participating hospitals, potentially cutting support for services provided to uninsured and underinsured patients at these facilities. In addition, Congressional members have indicated an interest in making changes to the program with similar bills being introduced in the House and Senate that would put a moratorium on new participating hospital sites and impose new data reporting requirements. Read More.

IDSA & HIVMA weigh in as House begins work on FY 2019 federal funding bills 

As lawmakers confront a White House budget plan proposing deep cuts to research, public health and global health programs, and consider their priorities for the year to come, IDSA and HIVMA leaders are weighing in. 

HIVMA board member Dr. Marwan Haddad testified April 26 at the House Appropriations Labor, Health and Human Services, and Education subcommittee public witness hearing on the need to increase funding for Ryan White Part C clinics and to leverage Ryan White clinics in responding to national opioid epidemic. His testimony can be found onlineRead More.

The 5th Annual St. Jude-PIDS Pediatric Transplant ID Symposium entitled “Bench to Bedside” was held at the Marlo Thomas Center, St. Jude Children’s Research Hospital in Memphis, TN, on March 9, 2018, with over 160 attendees present. The symposium featured excellent talks by amazing faculty, as well as case presentations, oral abstracts and poster sessions, and 3 clinical breakout sessions discussing bacterial, fungal, and donor question issues.

The morning sessions included lectures on transplant immunology by Allan Kirk, MD, PhD, Duke University School of Medicine; HHV-6 in the transplant recipient by Danielle Zerr, MD, MPH, Seattle Children’s Hospital; cell therapy with genetically modified T cells by Stephen Gottschalk, St. Jude Children’s Hospital, vaccines in transplant patients by Klara Posfay-Barbe, MD, MS, University Hospitals of Geneva, and NIH transplant for primary immmunodeficiencies by Alexandra Freeman, MD, NIH, NIAID. This was followed by a poster session (with a good lunch!) and a session on biomarkers for post-transplant lymphoproliferative disorders by Olivia Martinez, PHD, Stanford University School of Medicine, and three challenging cases in Transplant ID. These cases included a challenging case of CMV resistance and children presenting with RSV and rhinovirus infection pretransplant, which were discussed by panelists Klara Posfay-Barbe, Danielle Zerr, and Michael Green. Following selected oral abstracts by Joy Hazleton, MD, PhD, from University of Colorado and William Muller, MD, PhD, from Northwestern University Feinberg School of Medicine, we had breakout sessions discussing interesting and challenging cases in immunocompromised hosts including evaluation of risk for donor-derived infecitons. Finally, research presentations and proposals by the PIDS Transplant Research Network showing results of multicenter research on respiratory viruses in solid organ transplant recipients (Lara Danziger-Isakov), C. difficile (Gabriela Maron, MD), and a proposed CMV immune biomarker study (Michael Green and Daniel Dulek) were presented and discussed.

The Organizing Committee, Lara Danziger-Isakov, Janet Englund, Brian Fisher, Hayley Gans, Betsy Herold, Gabriela Maron, and Elaine Tuomanen, would like to thank St. Jude and PIDS staff for helping with this meeting. A supplement for JPIDS is being planned featuring some of the topics discussed at this meeting as well as selected abstracts.

SAVE THE DATE: 6th Annual St. Jude-PIDS Pediatric Transplant ID Symposium will be held on March 7, 2019 at the Marlo Thomas Center at St. Jude Children’s Research Hospital. Suggestions for topics for next year’s meeting are welcome – click here to submit your suggestions!

My wife will say that it is when she first knew that I would specialize in pediatric ID. During my final year of medical school in Memphis, I attended the John Erskine Lecture at St. Jude Children’s Research Hospital and I was hooked. Over the last two decades, I have attended nearly every St. Jude/PIDS Pediatric ID Research Conference and each year I am equally enamored by the breadth and depth of research within our field.

The conference is intended to showcase field leading infectious diseases research, highlight luminaries in our field, and honor those whose work transcends disciplines, as with the annual John Erskine Lecture. The meeting focuses principally on basic discovery, with this year’s frontier lecturers ranging from the molecular evolution of Enterococci, to systems serology, HIV therapeutics, and new approaches to S. aureus. As the first morning concluded, Dan Portnoy, PhD, an expert in Listeria pathogenesis was honored as the John Erskine Lecturer in Infectious Diseases.

The afternoon was filled with original research presentations by PIDS Fellowship Award recipients and meeting participants, including a poster presentation and wine/cheese reception. The evening concluded with dinner at the newly renovated National Civil Rights Museum.

The second day of the meeting included insights into RSV pathogenesis and a deeper look into vaccine regulatory considerations, presented by this year’s Luminary in Pediatric Infectious Diseases, Dr. Larry Pickering. These were followed by career development presentations, career pathway talks, and breakout sessions focused on K-awards, loan repayment, grant writing, and understanding how jobs are created. This latter portion is one of the unique aspects of the meeting and follows a 3-year curriculum developed by members of the PIDS Research Committee.

The meeting enjoyed record attendance this year, with over 220 participants. We remain deeply grateful for the generous support that St. Jude provides year after year and for their leadership and organizational commitment to this meeting.

We encourage you to attend next year’s meeting, which will be held March 8-9, 2019. Registration will open in November and we encourage you to attend. Suggestions for topics for next year’s meeting are welcome – click here to submit your suggestions! If you are a fellow, limited funds are available for travel stipends that can offset the cost of travel. The 2019 meeting promises to be a great opportunity for faculty, fellows, residents, and students to attend the only PIDS-specific meeting in the US.

We look forward to seeing you in Memphis next year!

C. Buddy Creech, MD, MPH
Chair, PIDS Research Committee
PIDS Secretary-Treasurer