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When Disaster Strikes: Part 2 of Close Contact's talk with NTCA's Carol Poszik, RN, MPH


SNTC at a Glance

Nurses Notes

This new section of our Close Contact e-newsletter focuses on issues specific to public health nursing and tuberculosis control and prevention efforts.

Nursing Management of TB and HIV Disease

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June 2009 • Vol. 4 • Issue 4
TB and HIV Co-Infection

The numbers are staggering - 15% of the new TB infections occur in HIV patents: 1 out of 4 TB deaths is HIV related; annual incidence and mortality due to TB globally would be falling if it were not for HIV infection and in some countries, upwards of 8 out of 10 TB patients are co-infected with HIV. Dr. Michael Sidibe (Director of UNAIDS) recently indicated that "we have to stop people living with HIV from dying of tuberculosis." The introduction of a new diagnostic test for latent TB infection, interferon gamma release assays (IGRAs), provide the promise of more rapid and accurate diagnosis of TB. However, there is very little data on the use of IGRAs in HIV-infected patients. In this issue of Close Contact, Dr. Mike Lauzardo explores what we do know and what remains unknown about this topic.

The Use of Interferon Gamma Release Assays in HIV Infected Individuals for the Diagnosis of Latent TB Infection 
by Dr. Michael Lauzardo, MD, MSc

More than fifty years after the development of effective therapy, tuberculosis (TB) remains one of the most important infectious diseases in the world today.  Globally, there are an estimated nine million new cases of TB each year and almost two million people each year die from TB, many of them infected with HIV.  Although the absolute number of cases continues to increase, the rates of TB are leveling off for the first time in history in all areas of the globe except for sub-Saharan Africa where the HIV epidemic continues to fuel the firestorm of TB. In lower incidence areas such as the United States, HIV co-infection remains an important risk factor and detection of latent TB infection (LTBI) in patients with HIV infection remains an important strategy to control TB.  Read more >>
Who You Gonna Call? TB Busters!

It's 4:15 Friday afternoon before a 3-day weekend; you're the last one in the office, as all your colleagues got an early start on their holiday.  The infection control nurse at your community's largest hospital calls to tell you the TB inpatient (who has been on medications for less than a week) has checked out against medical advice to visit his brother two states away.  He didn't take any of his drugs with him, he is traveling by car for the 600-mile trip - fortunately the ICN has the address of the patient's brother. Read more >>

Upcoming Training Events

July 9, 2009
Grand Rounds:  The Global Control of TB - Implications for
TB Elimination in the U.S.

Speaker:  Ken Castro, MD, Director of CDC's Division of TB Elimination, A.G. Holley Hospital, Lantana, Florida. More info >>

July 9, 2009
Morbidity and Mortality Review
A.G. Holley Hospital, Lantana, Florida. More info >>

August 18-19, 2009
Contact Investigation Skills
Montgomery, Alabama. More info >>

September 14-17, 2009
Comprehensive Clinical TB Course
A.G. Holley Hospital, Lantana, Florida.  More info >>

September 18, 2009
Tuberculin Skin Test - Train-the-Trainer  
A.G. Holley Hospital, Lantana, Florida. More info >>
Therapeutic Drug Monitoring Lab Opens at UF 

Under Chuck Peloquin's direction, the new Infections Disease Pharmacokinetics Laboratory (IDPL) at the University of Florida (UF) is now operational. After 20 years of working out of Denver, Colorado, the IDPL re-located to UF and is now open and can receive specimens.

Many of the Close Contact subscribers know Dr. Peloquin and his expertise in developing individualized drug regimens for patients with TB, HIV, and fungal infections. This involves sampling a patient's plasma or serum, and then assaying the samples using HPLC or GC/MS. These assays measure concentrations specific to each drug.

Dr. Peloquin's lab is unique in the world because it offers patient-specific, detailed interpretations of the assay results. These interpretations are based on his 20 years of clinical and research experience with these drugs, and allow physicians to individualize drug regimens in order to achieve therapeutic goals for their patients. Follow-up questions about the results can be directed to Dr. Peloquin for even more detailed adjustments.

For more information about the UF-based IDPL and how to send specimens, download the IPDL Requisition Form & Instructions [PDF, 212 K].
New Online Event Registration System
In an effort to serve our region better, SNTC's partner for continuing education, the Suwannee River Area Health Education Center (SRAHEC), has developed a new online event registration system. The system is now operational and should expedite registration for those who are frequent participants in the SNTC training events.  As you use the system for the first time, you will be asked to provide your contact information which is then stored by the system and used to pre-populate fields when you register for future events.  We appreciate your cooperation and understanding during this transition. If you have questions about the new registration process, please email or call 888-265-7682.

Contact the SNTC
Central Office at the University of Florida
1329 SW 16th Street, Room 5174, Gainesville FL 32608
Telephone 352-265-7682
Fax 352-265-7683
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Clinical Training Campus at A.G. Holley Hospital
1199 Lantana Road, Lantana FL 33462

Medical Consultation Hotline 24/7
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The Southeastern National Tuberculosis Center is one of four Regional Training and Medical Consultation Centers (RTMCCs) funded by the CDC. The SNTC seeks to address the training, education, medical consultation, and technical assistance needs of healthcare providers and TB programs in 11 southeastern states, Puerto Rico and the U.S. Virgin Islands.