IDSA News - August 2009
Vol. 19 No. 8
(Print All Articles)

Updated Guideline for Immunizations Released

A new IDSA guideline reviews newly licensed vaccines, good clinical practices, methods to overcome barriers, and complementary immunization settings. The updated guideline covers immunization programs for infants, children, adolescents, and adults.

A new IDSA guideline reviews newly licensed vaccines, good clinical practices, methods to overcome barriers, and complementary immunization settings. The updated guideline for immunization programs for infants, children, adolescents, and adults appears in the Sept. 15 issue of Clinical Infectious Diseases and is now available online.

Many of the revised sections provide health care professionals with improved standards of care and immunization practices. The majority of the changes affect immunization schedules and the allowances for vaccine administration, such as:

  • the use of new licensed vaccines (e.g., human papillomavirus (HPV) vaccine; live, attenuated influenza vaccine (LAIV); rotavirus vaccine; herpes zoster vaccine; and combination vaccines)
  • the recommendation that all young children and certain families of international adoptees receive the hepatitis A vaccine
  • the recommendation that all children 6 months through 18 years of age receive influenza vaccine
  • the inclusion of several vaccines in the adult and adolescent immunization platforms

“These IDSA guidelines were prepared for use by all health care professionals who care for people of all ages to ensure they receive optimal protection against vaccine preventable diseases,” said Larry Pickering, MD, FIDSA, lead author of the guideline. Several recommendations address the responsibility and education of health care professionals. Health care professionals should consistently maintain a high level of expertise in the field and also receive recommended immunizations themselves. This is a basic component of health care that offers protection for providers and their patients from vaccine preventable diseases.

The guideline also highlights the importance of educating patients about immunization. For example, the recommendations urge that vaccine information sheets be provided and potential adverse events be explained to patients whenever a vaccine is administered. Also, tables and figures address standards for immunization practices, availability of vaccines, and methods for vaccine administration.

Several performance measures are included in the guideline. Most importantly, new vaccine recommendations should be implemented by providers within 6 months of a published recommendation, each practice should measure the immunization rates of patients on a regular basis, and immunizations should be entered into state-wide immunization information systems. These goals emphasize the need for continued monitoring of immunization standards and practice.

The guideline is available online. Other IDSA guidelines also are available on the Standards, Practice Guidelines, and Statements page of our website.

IDSA/HIVMA Issue New Primary Care Guidelines for HIV

Updated guidelines from IDSA and the HIV Medicine Association (HIVMA) highlight the challenging primary care needs of those living with HIV infection, many of whom are living longer because of advances in treatment.

Updated guidelines from IDSA and the HIV Medicine Association (HIVMA) highlight the challenging primary care needs of those living with HIV infection, many of whom are living longer because of advances in treatment. Last published in 2004, the guidelines appear in the Sept. 1 issue of Clinical Infectious Diseases and are available online.

Among the changes, the evidence-based guidance outlines recommended screening tests for conditions that also affect the general population. “While improvements in antiretroviral therapy have improved the prognosis for many HIV patients, data from recent studies suggest those living with HIV are at higher risk for developing common health problems, such as heart disease, diabetes, or cancer,” said Judith A. Aberg, MD, FIDSA, lead author of the new guidelines. “Now more than ever, it’s imperative that HIV care providers be aware of the primary care needs of their patients, and that includes routine screening for these kinds of conditions.”

Information about recommended immunizations, along with dose and regimen details for HIV patients, is provided as well. Formatting changes will help readers search the guidelines more easily, with specific clinical questions beginning each section, followed by numbered recommendations and a brief evidence-based summary, said Dr. Aberg, director of virology at New York University School of Medicine and Bellevue Hospital Center in New York City.

Other notable changes in the new guidelines include an expanded list of diagnostic HIV tests, tables on immunization and routine follow-up primary care, and updates of recommendations based on other HIV-related guidelines that have also been recently revised. In addition, the guidelines emphasize the importance of patients adhering to a comprehensive program of care rather than focusing solely on a medication regimen.

“For people living with HIV, it’s not just about adherence to medication, it’s also about adherence to care,” Dr. Aberg said. “These patients must have access to a range of services to help them stay engaged in their medical care and should receive the regular monitoring and medical attention this chronic infection demands.” 

The guideline is available online. Other IDSA guidelines als are available on the Standards, Practice Guidelines, and Statements page of our website.

Seasonal & Pandemic Influenza 2009 Monograph Now Available

A CME-certified monograph based on the proceedings of Seasonal & Pandemic Influenza 2009: A Turning Point is now available online. 

A CME-certified monograph based on the proceedings of Seasonal & Pandemic Influenza 2009: A Turning Point is now available online. The monograph is intended for physicians who care for or may care for patients with influenza during seasonal or pandemic outbreaks, as well as for clinicians, researchers, public health officials, policymakers, and others who are involved in research or policy decisions regarding prevention, treatment, and management of influenza.

After completing this CME activity, participants will be able to:

  • discuss the global spread of seasonal and pandemic influenza, including the role of mammalian and avian hosts
  • describe pharmacological and non-pharmacological interventions in the prevention and management of seasonal and pandemic influenza
  • discuss challenges and potential advances in vaccine production and formulation for seasonal and pandemic influenza
  • summarize data on efficacy and resistance of antivirals in managing seasonal and pandemic influenza
  • discuss scientific, ethical, political, and economic considerations in policy, planning, and preparedness with respect to pandemic influenza
  • implement strategies to more effectively immunize highest-risk individuals, utilize appropriate drugs and dosages, and properly instruct patients and others in preventive methods

This program is approved for a maximum of 2.5 AMA PRA Category 1 Credits™.

Click here to access the CME-certified monograph and learn about seasonal and pandemic influenza.

IDSA Journal Club on Vacation

The Journal Club will return in the next issue of IDSA News. Click here for last month's edition.

The Journal Club will return in the next issue of IDSA News. Click here for last month’s edition.

EIN: H1N1 Vaccine and Guillain-Barré Syndrome

The Emerging Infections Network (EIN) is a forum for infectious diseases consultants and public health officials to report information on clinical phenomena and epidemiological issues with public health significance. Any diagnostic or therapeutic recommendations and all opinions presented are those of the individual contributor. They do not necessarily represent the views of EIN, IDSA (EIN's sponsor), or the Centers for Disease Control and Prevention, which funds the EIN. The reader assumes all risks in using this information.

On the eve of what could be the most challenging influenza immunization season in recent history, EIN members are facing questions about the H1N1 vaccine and Guillain-Barré syndrome (GBS), an uncommon immune-mediated neurologic disorder resulting in limb weakness and paralysis—questions that are likely to be asked repeatedly this fall.

An EIN member from New York posed the initial question: “Is there a potential for the prospective H1N1 swine origin vaccine to cross react with neural tissue and increase Guillain-Barré incidence?” Another member in Illinois put an interesting twist on the question: “We know of a patient who … was admitted to our hospital for variant H1N1 ‘swine flu,’ and then [was] admitted to another area hospital a few days post discharge from our institution with acute onset/rapidly progressive GBS. If [GBS is] secondary to H1N1 infection, I wonder if this forebodes a greater risk of GBS post natural infection and/or immunization.”

This prompted a reply from a member in Virginia who noted, “Given the report in the July 24 MMWR, the possibility of such a cross reaction does arise, reminiscent of the question of GBS (apparently with an expected frequency for any vaccine) after the swine flu vaccine in the mid-1970s.”

Another member in Iowa referenced a recent editorial in The Journal of Infectious Diseases and made these key points:

  • The definite GBS background rate in the general population is unknown but is estimated to be very low (4 in 100,000 per year or 7 to 46 per 10,000,000 vaccinees within six weeks of any vaccination).
  • To refute an association that rare, one would need to vaccinate and follow 53,500 and 1,238,000 subjects to show a ten and twofold increase in the background rate of GBS with a 5 percent error and power of 90 percent.
  • Even if an association could be discounted with proper scientific evidence, erroneous public perception can prevail.

With public perception in mind, a North Carolina EIN member suggested the following talking points:

  • All influenza vaccines are tested in humans prior to approval by the Food and Drug Administration. Clinical trial methods have improved substantially since 1976. We will have good safety data by the time of approval.
  • The 2009 novel H1N1 influenza strain has already caused millions of infections and thousands of deaths worldwide.
  • Influenza vaccines do have risks, but the benefits of both seasonal flu vaccines and the novel H1N1 vaccine greatly outweigh the risks for patients without medical contraindications.

Two responders from the Centers for Disease Control and Prevention (CDC) offered a detailed historical perspective and an assessment of efforts to monitor the safety of the current vaccine.

One CDC official noted that in the 1976 outbreak, epidemiologic investigations demonstrated a “small, but significant, risk” of GBS among adult vaccinees in the eight weeks following immunization. “The attributable risk among vaccinees was just under one case per every 100,000 persons vaccinated. Numerous assessments and re-assessments of the original data from this campaign supported this small, but statistically significant, association of this vaccine formulation with GBS; eight controlled studies supported this association, and none found evidence to the contrary. The underlying reasons for this association remain unknown.”

He referred EIN members to a recent analysis in Drug Safety and noted that “subsequent assessments of other formulations of influenza vaccine have been inconclusive. The biological data directly linking the A/NJ/1976 vaccine with anti-ganglioside antibodies is at present still hypothetical.”

“It is important to keep in mind that when assessing the potential risk of GBS following widespread use of an influenza A(H1N1) swine-origin virus vaccine, one substantial difference between the 1976 campaign and the current situation is that unlike the influenza A/NJ/76 (H1N1) virus, which resulted in an estimated 230 overall cases and one death, the current virus has already been associated with morbidity and mortality,” the responder wrote. Had the 1976 virus caused widespread human illness even on the scope of that associated with seasonal influenza, he continued, it is likely the increased risk of GBS after vaccination would have been viewed as unfortunate but acceptable to avert the considerable morbidity and mortality associated with influenza illness.

“The current 2009 A/H1N1 virus has already been associated with widespread illness and many deaths, and the potential virulence of the virus during the upcoming influenza season is not known,” he wrote. “This potentially influences the assessment of various risks and benefits of vaccination.”

Finally, an officer from CDC’s Immunization Safety Office explained that her office is working with the Emerging Infections Programs (EIP) sites to implement an active GBS case-finding protocol, which is intended to:

  • identify all persons with a diagnosis of GBS who are hospitalized within EIP catchment areas in a timely fashion (ideally within one week of hospitalization)
  • estimate the risk of GBS among vaccinated subjects within the six weeks following receipt of vaccine relative to the risk of GBS among unvaccinated subjects (i.e., the relative risk), adjusted for any confounding influences
  • estimate the attributable risk of GBS following vaccination, should a significant relationship be found
  • assess the proportion of persons with GBS who have other risk factors for subsequent development of GBS, including antecedent respiratory or gastrointestinal illness, and receipt of other vaccines besides influenza A (H1N1)
  • determine the overall incidence of GBS among the population captured by the EIP sites

The CDC official noted that “participation and cooperation by ID physicians and the ID community will be critical in these ongoing surveillance efforts for possible adverse events following H1N1 vaccination.”

Physicians and others can report adverse events following immunization to the Vaccine Adverse Event Reporting System (VAERS).


E-mail the Emerging Infections Network.

The Emerging Infections Network (EIN) is a provider-based sentinel network designed to help the public-health community detect trends in emerging infectious diseases.

A joint project of IDSA and the Pediatric Infectious Diseases Society (PIDS) and supported by funding from the Centers for Disease Control and Prevention, EIN tracks emerging infectious diseases and keeps the public-health community up to date with issues that are currently affecting or may soon affect members’ clinical practices. The Network provides a great opportunity for members to share knowledge quickly across large geographical distances. Both IDSA and PIDS members are eligible to join. The EIN listserve allows members to discuss new disease trends and difficult cases. Click here for more information or to join EIN.

Drug Approvals, Recalls, Adverse Events Update

IDSA offers two e-mail services to help members stay informed of updates from the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). Content normally includes a range of topics, including new drug approvals and warnings. Recent alerts have included:

IDSA members can sign up for these services online. (You must be logged in to have access to this link.)


Is Your Facility Experiencing Antibiotic Shortages?
Report these to FDA and IDSA.

Global Center to Host Leading HIV/AIDS Physician-Scientist From South Africa

The Center for Global Health Policy plans to bring Robin Wood, MD, a leading HIV/AIDS physician-scientist from South Africa, to Washington in September for a series of community forums, policy meetings, and press events. The trip is part of the Global Center’s efforts to make the voices of physicians in developing countries heard in American policy debates.

Dr. Wood is director of the Desmond Tutu HIV Centre at the Institute of Infectious Diseases and Molecular Medicine in Cape Town. The marquee event during Dr. Wood’s visit will be a forum, co-sponsored by the Kaiser Family Foundation, on the U.S. government’s strategy to combat global tuberculosis. With South Africa at the epicenter of HIV/TB co-infection, Dr. Wood will address the unique threat posed by the synergy between these two deadly diseases.

Congressional Efforts to Overhaul Foreign Assistance Raise Concerns

The IDSA/HIVMA’s Center for Global Health Policy has serious concerns about the implications of congressional proposals for overhauling U.S. foreign assistance, fearing the legislation could lead to a diminished U.S. commitment to combating infectious diseases, particularly AIDS and tuberculosis.

Earlier this month, the Global Center submitted a formal response to the House Foreign Affairs Committee’s “concept paper,” which outlined the panel’s plans for revamping foreign aid. The Global Center noted that the committee’s initial outline did not list global health as a priority and argued that health must continue to be one of the “cornerstones of U.S. foreign assistance.”

Read more about the Global Center’s concerns, including the formal response and the House committee’s concept paper, at sciencespeaks.wordpress.com.

SHEA, IDSA Stress Basic Infection Control in Protecting HCWs from Novel H1N1

Surgical Masks are Sufficient for Most Cases

As influenza season draws nearer, public health experts are debating the best ways to protect health care workers (HCWs) from novel H1N1. IDSA joined the Society for Healthcare Epidemiology of America (SHEA) and other groups in calling for an evidence-based approach that emphasizes adherence to basic infection control practices, based on their conclusion that the current strain of novel H1N1 has the same transmission dynamics as seasonal influenza.

IDSA and SHEA made their recommendations in a joint statement presented to a task force of the Institute of Medicine (IOM) in mid-August. The IOM task force is charged with making recommendations to the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA) by Sept. 1. CDC currently recommends that HCWs who enter the room of a patient in isolation for suspected or confirmed novel H1N1 influenza should wear N95 respirators or equivalent protection, but currently the science does not appear to support this approach.  

Prudent measures, according to SHEA and IDSA, require rigorous and consistent application of basic infection control and personal hygiene practices including: adherence to hand hygiene and cough etiquette, rapid identification and separation of patients with the virus, and utilization of appropriate personal protective equipment – surgical masks, in the case of droplet transmissible diseases like H1N1. 

For certain procedures that could potentially “aerosolize” the virus, thereby allowing for airborne transmission, IDSA and SHEA advise that health care workers should wear respirators. Such procedures include: bronchoscopy, open suctioning of airway secretions, resuscitation involving emergency intubation or cardiac pulmonary resuscitation, and endotracheal intubation. 

“Surgical masks provide the level of protection needed for health care workers who may be exposed to the H1N1 virus. Using respirators in situations other than when there is the potential for the virus to become aerosolized is not wise,” said IDSA President Anne Gershon, MD, FIDSA.  “Respirators do not provide increased protection against the H1N1 virus. Inappropriate use could result in a shortage of the respirators, which are essential to the prevention and control of truly airborne pathogens such as tuberculosis. This would put health care workers and patients at even greater risk,” Dr. Gershon added.

Another critical component to an appropriate response to the H1N1 virus, according to the groups, is avoiding implementation of automatic reassignment of high-risk health care workers who could be exposed to the virus. The current protocol provides sufficient protection, and reassignment wrongfully implies this is not the case, IDSA, SHEA, the Association for Professionals in Infection Control and Epidemiology (APIC), and the American College of Occupational and Environmental Medicine (ACOEM) said in a recent joint statement.

Finally, the groups note that transmission of both seasonal and pandemic influenza occurs primarily in the community rather than in health care settings. “Therefore, two other critical control measures are early recognition and separation (isolation) of suspected novel H1N1-infected patients upon presentation to a health care facility and restriction of visitors and health care workers with febrile respiratory illnesses,” said the IDSA-SHEA statement to the IOM, which was presented by Lisa Maragakis, MD, MPH, of the Johns Hopkins Medical Institutions. “Without consistent application of these infection prevention measures in our health care institutions, no level of respiratory protection will offer adequate prevention of influenza transmission,” Dr. Maragakis’s statement said.

For more on the IOM task force, see www.iom.edu/?ID=71769.

For more on IDSA and SHEA’s position, see this June 2009 IDSA News article.

For updated guidance documents from CDC and other sources on diagnostics, infection control, antiviral use, and related matters, see the IDSA web page on seasonal and H1N1 influenza. To receive the latest notices from CDC’s Health Alert Network and the Food and Drug Administration—on H1N1 and other timely topics—click here (you must be logged in to have access to this link).

IDSA, HIVMA Outline Health Care Reform Priorities

IDSA continues to work to ensure that ID and HIV/AIDS priorities are addressed in health care reform. Earlier this month, IDSA sent a letter to all members of Congress outlining priorities it would like included in any final version of reform legislation. These priorities include: a minimum benefits package, expanded access to vaccines, reforms to the physician-payment system, coverage for home infusion therapy, a stronger federal approach to dealing with antimicrobial resistance, requiring national reporting of healthcare-associated infections, a focus on prevention and wellness, and medical liability reform. IDSA also endorsed recommendations from the HIV Medicine Association (HIVMA), which sent a letter to all House and Senate members highlighting HIVMA’s top health care reform priorities. Visit this page on IDSA’s website and this page on HIVMA’s site for more information about the organizations’ health care reform advocacy efforts.

Other IDSA advocacy efforts include:

  • The Society wrote a letter to the heads of the federal agencies that make up the Interagency Task Force on Antimicrobial Resistance urging them to quickly issue a revised action plan to combat the problem of drug-resistant pathogens. The letter called for the inclusion of meaningful benchmarks and for the agencies to make the revised plan’s funding a priority.
  • HIVMA submitted comments supporting a proposal from the Centers for Disease Control and Prevention (CDC) that would start the process of removing HIV infection from the list of diseases that exclude individuals from traveling or immigrating to the United States. As part of the proposal, mandatory HIV testing would no longer be required during the medical screening process that some immigrants must undergo.
  • IDSA and HIVMA submitted comments in response to a proposed rule from the Centers for Medicare and Medicaid Services (CMS). The comments addressed several issues raised in CMS’ proposal, including the proposed elimination of payments for the consultation codes used by many ID physicians, starting in 2010 (see IDSA News article). The final rule is scheduled for release in November.

Vote for the IDSA and HIVMA Boards of Directors

Election Ballots Due Sept. 15

IDSA and HIVMA members will elect new officers and Board members this summer. Your ballot includes biographical statements and personal sketches from each of the candidates. The IDSA slate is as follows:

Vice President:

  • Edward Septimus, MD, FIDSA
    System Medical Director, Infection Prevention and Epidemiology Clinical Services Group, HCA Healthcare System; Academic Chief, Infectious Diseases, Memorial Hermann Southwest Hospital Residency Program; Clinical Professor of Medicine, Texas A&M Health Science Center; and Affiliated Professor, Distinguished Senior Fellow, School of Public Policy, George Mason University
  • Thomas G. Slama, MD, FIDSA
    Clinical Professor of Medicine, Indiana University School of Medicine, and Attending Physician, St. Vincent Hospital, Indianapolis, IN

Treasurer:

  • Janet R. Gilsdorf, MD, FIDSA
    Director, Pediatric Infectious Diseases, C. S. Mott Children’s Hospital; Professor, Department of Pediatrics, University of Michigan Medical School; and Professor, Department of Epidemiology, University of Michigan School of Public Health
  • Cynthia L. Sears, MD, FIDSA
    Professor of Medicine and Oncology, Johns Hopkins University School of Medicine, and Attending Physician, Johns Hopkins Hospital

Director (three slots open):

  • R. Michael Buckley, MD, FIDSA
    Professor of Clinical Medicine, University of Pennsylvania School of Medicine; Chair of Medicine, Pennsylvania Hospital; and Chief Medical Officer, Pennsylvania Hospital
  • Mary E. Klotman, MD
    Irene and Dr. Arthur M. Fishberg Professor of Medicine and Microbiology; Chief, Division of Infectious Diseases; and Co-Director of the Global Health and Emerging Pathogens Institute, Mt. Sinai School of Medicine, New York, NY
  • Andrew T. Pavia, MD, FIDSA
    Chief, Division of Pediatric Infectious Diseases; Professor of Pediatrics and Medicine, University of Utah; and Director, Infectious Disease Fellowship Program
  • Wesley C. Van Voorhis, MD, PhD, FIDSA
    Chief, Division of Allergy and Infectious Diseases, and Professor of Medicine and Adjunct Professor of Microbiology and Global Health, University of Washington

State & Regional Societies seat on the IDSA Board of Directors:

  • Johan S. Bakken, MD, PhD, FIDSA
    Consultant in Infectious Diseases, St. Luke’s Hospital, Duluth, MN, and Clinical Associate Professor of Medicine, University of Minnesota, Duluth, MN
  • Lawrence P. Martinelli, MD, FIDSA
    Clinical Associate Professor of Medicine, Texas Tech University School of Health Sciences, and Attending Staff, University Medical Center, Covenant Medical Center, Covenant Lakeside Hospital, Covenant Specialty Hospital, Lubbock Heart Hospital, Lubbock, Texas

The HIVMA slate is as follows:

Vice President:

  • Judith A. Aberg, MD, FIDSA
    Associate Professor of Medicine and Principal Investigator of the AIDS Clinical Trials Unit at New York University School of Medicine and Director of Virology of the South Manhattan Healthcare Network for the New York City Health and Hospital Corporation (HHC) at Bellevue Hospital Center
  • J. Kevin Carmichael, MD
    Associate Medical Director for Special Populations, El Rio Community Health Center, Tucson, AZ

Board of Directors (three slots open):

Infectious Diseases Slot

  • Judith S. Currier, MD, MS, FIDSA
    Professor of Medicine, Associate Division Chief and Co-Director, Center for Clinical AIDS Research and Education, David Geffen School of Medicine, University of California, Los Angeles (UCLA)
  • Mitchell Goldman, MD
    Associate Professor of Medicine, Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine

Internal Medicine Slot

  • Kathleen A. Clanon, MD
    Director of Alameda County Medical Center Division of HIV Services, Oakland, CA;  Consultant on Quality Improvement for the National Quality Center and the HIVQUAL Program, Assistant Professor of Clinical Medicine, University of California, San Francisco (UCSF)
  • Allen L. Gifford, MD
    Associate Professor of Public Health and Medicine, Boston University; and Co-Director of the Department of Veteran Affairs (VA) Quality Enhancement Research Initiative (QUERI) HIV/Hepatitis Program, and VA New England Health Services Research & Development Service (HSR&D) Center of Excellence, Bedford, MA

Pediatric/Adolescent ID Slot

  • Theresa Barton, MD
    Assistant Professor of Pediatrics, University of Texas Southwestern, and Clinical Director, AIDS Related Medical Services (ARMS) Clinic, Children’s Medical Center Dallas
  • Echezona E. Ezeanolue, MD, MPH
    Assistant Professor of Pediatrics and Public Health, University of Nevada School of Medicine (UNSOM), and Adjunct Assistant Professor of Epidemiology, School of Public Health, University of Nevada, Las Vegas

The deadline for casting your ballot is 5 p.m. EDT, Sept. 15.

Voting is easy and important for setting the priorities and future direction of your Society. Electronic ballots were e-mailed to all members who are eligible to vote and have e-mail addresses on file. Check your e-mail inbox for a message from IDSA’s president, Anne A. Gershon, MD, FIDSA, with a subject line, “2009 IDSA and HIVMA Elections.” Paper ballots were mailed to all members who are eligible to vote but do not have e-mail addresses on file. Members who have not received their ballots by e-mail or mail, or who have lost their ballots, may call the help desk at Election Services at 1-800-720-4357.

Members on the Move

Richard Whitley, MD, FIDSA, has been named to serve on the H1N1 working group of the President’s Council of Advisors on Science and Technology (PCAST), which is providing recommendations to President Barack Obama on federal activities needed to respond to H1N1, including infection data collection, vaccine production, drug stockpile, preparedness plans, and other public-health concerns. Dr. Whitley is director of the Division of Pediatric Infectious Diseases at the University of Alabama at Birmingham (UAB), co-director of UAB’s Center for Emerging Infections and Emergency Preparedness, and vice chair of UAB’s Department of Pediatrics. A UAB professor of pediatrics, microbiology, medicine, and neurosurgery, he also serves on the Advisory Council for the National Institute of Allergy and Infectious Diseases (NIAID). Dr. Whitley is president-elect of IDSA.

Welcome, New Members!

Members

Alvarez-McLeod, Africa, MD
Choffnes, Eileen, PhD
Deutscher, Meredith, MD
Duquaine, Susan, PharmD
Fernandez-Sesma, Ana, PhD
Gomez Alvarez, Carlos Andres, MD
Gonzalez de Schroeder, Maria Mercedes, RN
Gonzalez Lopez, Gilberto
Henderson, Sheryl, MD, PhD
Kenfak Foguena, Alain, MD
Koeth, Laura
Lenis, William, MD
Michael, Joy Sarojini, MD
Minning, Dena, MD, PhD
Myat, Win, MD
Neuman, William, MD, MPH
Pappaioanou, Marguerite, DVM, PhD
Putnam, Shannon, PhD
Rupali, Priscilla, MD
Sawhney, Niraj, MD, MRCP
Seekins, Daniel, MD
Siegel, Lawrence, MD, MPH
Skol, Leia, PharmD
Song, Kyoung-Ho, MD
Sossa Briceno, Monica Patricia, MD
Uehara, Yuki, MD, PhD
Vazquez, Guillermo, MD
Wareham, David, MD, PhD
Williams, Josephine, MD
Yeung, Jean, MD
Yomayusa Gonzalez, Nancy, MD

Associates

Alarcon, Irma, MD
Aymat, Roberto
Carralero, Rita, RPh
Chow, Brian
Clift, Andrew, MBBS, MPH
Dauner, Daniel, PharmD, MSPH
Deck, Daniel, PharmD
Doerr, Heike, PharmD
Hooker, Kevin, PharmD
Howard, Daniel, MD, MPH
Kanatani, Meganne, PharmD
Karstaedt, Alan, MB
Maroko, Robert, MD
Milligan, Shawn
Nguyen, Thai, MD
Pham, Paul, PharmD
Ravyn, Dana, MPH, PhD
Robinson, Chris, BSN
Samuels, Patricia, MD
Self, Wesley, MD
Stern, Eric, MD
Villalba, Jose, MD

Members-in-Training

Akers, Kevin, MD
Alekal, Prashanti, MD
Aleksoniene, Kristina, MD
Andrade, Rosa, MD
Ashton, Michael, MD
Ataro, Peter, MD
Audcent, Tobey, MD, BSN, DTM&H
Balasubramanian, Prakash, MD
Bobo, Linda
Brennan, Meghan, MD
Brown, Jennifer, MD
Bulik, Catharine, PharmD
Burke, Christopher, PharmD
Caniga, Oliver, MD
Cannella, Anthony, MD, MSc
Chang, Michael, MD
Chapman, Michael, MD
Chasan, Rachel, MD
Chen, Nadine, MD
Chitasombat, Maria, MD
Christensen, Jesica, MD
Cochrane, C. Bruce, MD, MSPH
Crandon, Jared, PharmD
Cuyugan, Mary Gene, MD
Daas, Hanady, MBBS
Darnell, Timothy, DO
De La Cuesta, Carolina, MD
Desai, Sachin, MD
Deschambeault, Andrea, PharmD
Diaz Cotelo, Damian, MD
Doshi, Manish, MD
Doshi, Rupali, MD
D'Souza Singh, Branda, MD, MBBS
Duplessis, Christopher, MD, MPH, MS
Eraso, Jairo, MD
Fitzgibbons, Lynn, MD
Friedman, Rachel, MD
Garcia, Carla, MD
Goldman, Jennifer, MD
Golub, Vitaly, MD
Goodwin-Fernandez, Amina, MD
Goswami, Neela, MD
Grant, Matthew, MD
Hagan, Jose, MD, MS
Han, Zhuolin, MD
Hester, Sydney, MD
Hinkle, Mary, MD
Hoffman, Michelle, MD
Holman, Katherine, MD
Hunte, Tai, MD, MSPH
Hymes, Saul, MD
Iroh Tam, Pui-ying, MD
Jagarlamudi, Rajasekhar, MD
Khaitan, Alka, MD
Khoury, Nabil, MD
Klein, Radoslava, MD
Koethe, John, MD
Kullar, Ravina, PharmD
Kunte, Amit, MD, PhD
Logan, Cathy, MD
Love, John, MD, PhD
Malik, Rushdah, MD
Mariki, Paulina, MD
Mathew, Roshni, MD
McCall, Matthew, MD
McCrary, David, MD
McElwee, Kathleen, MD
Mickail, Nardeen, MD
Miller, Michael, MD
Miranda, Justine Arnessa, MD
Moleski, Rosemary, MD
Molitorisz, Szilvia, MD
Morris, Lee, MD
Murthy, Srinivas, MD
Njoku, Jessica, PharmD
Noyes, Cindy, MD
Oramasionwu, Christine, PharmD, MSc
Pace, William, MD
Palys, Erica, MD
Patel, Nimish, PharmD
Pereira, Edwin, MD
Pragman, Alexa, MD, PhD
Rajaguru, Suresha, MD
Raman, Sivakumar, MD
Rana, Meenakshi, MD
Rathod, Dhanesh, MD
Rebolledo, Paulina, MD
Rellosa, Neil, MD
Richey, Lauren, MD, MPH
Rivera, Cynthia, MD
Sanchez, Kathryn, MD
Sanchez-Rivera, Carlos, MD
Saunders, David, MD
Shah, Jharna, MD
Shah, Pranav, MD
Shaklee, Julia, MD
Sircar, Anita, MD, MPH
Srisupha-Olarn, Warunee, PharmD
Stenehjem, Edward, MD, DTM&H
Swaminathan, Mahesh, MD
Sweet, Michael, PharmD
Szczypinska, Ewa, MD
Tchikounzi, Celestine, DO
Thampi, Nisha, MD
Traugott, Kristi, PharmD
Tiruvury, Hemavarna, MBBS
Tjen-A-Looi, Angelique, MD
Toor, Vajinder, MD
Van Sickels, Nick, MD
Velazquez, Alexander, MD
Verma, Natasha, MD
Visitacion, Mark Paul, MD
Wang, Angel, MD, MPH
Welch, Meredith, MD
Whitaker, Jennifer, MD
Widener, Rebecca, MD
Wigmore, Robin, MD
Willenburg, Kara, MD
Wong, San, MD
Yimen, Mekeleya, MD
Youngblood, Caleb, PA-C
Zangeneh, Tirdad, DO
Zhao, Xiaoyan, PhD