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Division of Bacterial Diseases (DBD) News Bulletin

Summer 2015

In This Issue

  1. Exploring Meningococcal Outbreaks & Carriage
  2. White House Forum on Antibiotic Stewardship
  3. New EIS Officers & LLS Fellow
  4. DBD Supports the Ebola Response
  5. MenAfriNet Partners Respond to Niger Outbreak
  6. Laboratory & Communications
  7. Vaccine News & Meetings
  8. Awards
  9. Epi-Aids & Outbreak Investigations
  10. Publication Highlights

White House Forum on Antibiotic Stewardship

Photo: CDC antibiotic resistance subject matter experts attend the White House Forum on Antibiotic Stewardship in Washington, DC on June 2, 2015. From left to right: Jean Patel (NCEZID/DHQP), Arjun Srinivasan (NCEZID/DHQP), Nimalie Stone (NCEZID/DHQP), and Lauri Hicks (NCIRD/DBD)

Photo: CDC antibiotic resistance subject matter experts attend the White House Forum on Antibiotic Stewardship in Washington, DC on June 2, 2015. From left to right: Jean Patel (NCEZID/DHQP), Arjun Srinivasan (NCEZID/DHQP), Nimalie Stone (NCEZID/DHQP), and Lauri Hicks (NCIRD/DBD).

"Antibiotic resistance may be the single most important infectious disease threat of our time," according to CDC Director Tom Frieden. As part of a continued effort to combat antibiotic resistance, the Obama Administration convened a White House Forum on Antibiotic Stewardship on June 2, 2015. Hicks was chosen to attend and moderate a session at the forum.

Antibiotic stewardship means using antibiotics when necessary and appropriate. CDC finds that between a third and a half of all antibiotics used in the United States are either unnecessary or the antibiotic is not the best choice to treat the germ. Antibiotics are not needed, for example, for colds, most sore throats, and many sinus infections. The forum brought together key human and animal health organizations to discuss how they will support antibiotic stewardship. More than 150 food companies, retailers, and human and animal health stakeholders highlighted their commitments to implement changes over the next five years to slow the emergence of resistant bacteria and prevent the spread of resistant infections.

When asked about her experience in participating in the event, Hicks commented, "To be able to participate was an extreme honor and a highlight of my career. So many organizations made major commitments to improve antibiotic use and work with the Get Smart program. The new partnership opportunities have opened many doors and will undoubtedly help us move the needle on the problem of antibiotic misuse."

Get Smart Medical Director Gets a Rare Opportunity

Getting the chance to thank your hero is a rare opportunity. DBD’s Lauri Hicks, medical director of the Get Smart: Know When Antibiotics Work program, was recently lucky enough to do just that.

Following the White House Forum on Antibiotic Stewardship held on June 2, 2015, Hicks was invited to appear on a Connecticut-based health radio show. The show was scheduled to occur live on a Sunday morning, so Hicks needed to first see if she could squeeze this into her busy weekend. But once she learned who else would be on the show with her, the decision to participate became obvious. As luck would have it, another guest doctor on the show that day would be her mentor and “hero” from her time as a medical resident at Connecticut’s Hartford Hospital, Jack Ross. Ross inspired Hicks to go into the field of infectious diseases and encouraged her to apply to the Epidemic Intelligence Service fellowship at CDC, which brought her to the Respiratory Diseases Branch in 2003. If it weren’t for Ross, CDC may not have Hicks as a champion tackling the crisis of antibiotic resistance.

According to HHS Secretary Sylvia Mathews Burwell and USDA Secretary Tom Vilsack, "A world without effective antibiotics is a frightening prospect. But our greatest threat isn’t evolution of bacteria—it’s inaction from people. Through smart policies and cross-sector partnerships, we can make sure effective medicine is there when we need it."

Hicks, with support from Get Smart’s Becky Roberts, the Division of Bacterial Diseases’ policy coordinator, Marsha Houston, and the Division of Healthcare Quality Promotion’s Michael Craig reached out to dozens of partners in preparation for this event. In response, commitments were made by health systems to incorporate goals, such as reducing inappropriate outpatient prescribing. CVS Health and Walgreens announced commitments to educate patients and providers and introduce antibiotic stewardship into their retail health clinics―a rapidly growing segment of the healthcare system.

The forum and commitments follow the March 2015 release of the National Action Plan for Combating Antibiotic-Resistant Bacteria. Commitments made could even impact life at CDC’s cafeterias. At the forum, the White House announced a Presidential Memorandum directing the federal government to buy meat from sources that follow responsible antibiotic use.

All this progress brings tears of joy to members of the Get Smart program, some of whom have been working on these efforts since as far back as 2001.

Learn more about and watch the opening session of the White House Forum.

Note: The Get Smart program joined the Division of Healthcare Quality Promotion in August 2015 as the agency moves to coordinate all human antibiotic stewardship activities from the same office.

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Serogroup B and C Meningococcal Outbreaks Span United States in 2015

Photo: Bacterial Meningitis Laboratory team preparing for one of the carriage evaluations in Feburary 2015. From left to right: Melissa Whaley, Brian Harcourt, Xin Wang, Fang Hu, and Jeni Vuong

Photo: Bacterial Meningitis Laboratory team preparing for one of the carriage evaluations in Feburary 2015. From left to right: Melissa Whaley, Brian Harcourt, Xin Wang, Fang Hu, and Jeni Vuong.

Meningococcal disease outbreaks across the country kept DBD’s Meningitis and Vaccine Preventable Diseases Branch (MVPDB) busy this year.

Many states are now turning to CDC for guidance on how to MenB vaccines to control outbreaks at colleges and universities, in large part due to the division’s experience helping obtain vaccines to respond to two outbreaks in 2013 and 2014 before vaccines were licensed in the United States. Now, two MenB vaccines are licensed and recommended for use in response to serogroup B meningococcal disease outbreaks. Few states have experience with these vaccines, which are quite different from the quadrivalent meningococcal conjugate (MenACWY) vaccine.

In the first quarter of 2015, MVPDB provided epidemiologic and laboratory support for serogroup B meningococcal disease outbreaks at colleges in Rhode Island and Oregon. These outbreaks resulted in nine cases, including one death. As of early August more than 21,000 doses of vaccine had been provided. In addition to support for those outbreaks, MVPDB also provided technical and laboratory assistance to at least six other states regarding sporadic cases of meningococcal disease.

Most recently, MVPDB assisted the Chicago and Illinois Departments of Public Health in tackling a challenging outbreak of serogroup C meningococcal disease among primarily African-American men who have sex with men (MSM). Epidemic Intelligence Service Officer Temitope Folaranmi and colleagues from CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention traveled to Chicago to help the health department determine how to best target their vaccination campaign by conducting a knowledge, behaviors, and practices survey among the target population. Staff from across the National Center for Immunization and Respiratory Diseases also provided vaccine assistance to help the health department promote MenACWY vaccine use in the population at risk. As of July 9, 2015, the Chicago Department of Public Health distributed more than 11,000 doses of MenACWY to community partners and provided 5,190 vaccines directly to residents.

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