July 2023

*Updated Factsheet* What You Need to Know About the TB Skin Test

This CDC fact sheet has been updated this July with information on the TB skin test.

Welcome New TB Program Staff!

Tyra Bell is excited to join the team as an Administrative Assistant. Her career in healthcare started 5 years ago, where she not only worked as a Patient Coordinator in Swedish & Snoqualmie Health, but she also received her bachelor's in healthcare management. Tyra will be focusing on the administrative aspects of the TB team, such as taking meeting notes, performing data entry, workshop planning, and supporting the TB team in day-to-day needs. On a day off, you may catch Tyra reading a novel, snuggling her cat, or going on a hike with her husband.  

Tyra can be reached at Tyra.Bell@doh.wa.gov.

LHJ Spotlight: Katie Dickeson at Spokane Regional Health District

How long have you worked as a public health nurse?

11 years

What do you enjoy most about your work?

Working with such a diverse group of people from all over the world. It also never gets old having a patient thank you for giving them their life back.

Katie (right) and her daughter (left)

What do you wish you knew earlier as a new nurse in public health?

For me nursing school focused on hospital nursing, so as a new nurse I had no idea what public health nurses did. I was fortunate to have an opportunity to work with a public health nurse in Alaska and traveled to two Alaska Native villages in the region she was covering. She taught me the importance of being able to make relationships with each patient and their family but also with those in the community that provide both medical and social support. She also taught me the importance of being flexible, of being a good listener, how to advocate, negotiate, and being consistent. It was also pretty apparent how dedicated public health nurses are to the work they do, with often time doesn’t get recognized.

Tell me about how your program is structured and who you work with to provide care?

Our TB Program consists of Dr. Velazquez (Health Officer), Taruwe Rilometo (Marshallese Community Outreach), and myself. Our program manages both pulmonary and extrapulmonary TB disease and LTBI for contacts who are part of contact investigations led by our program. We work closely with patient’s primary care and any other medical providers to make sure all their medical needs are addressed to get them through their TB treatment safely and effectively. We do not offer general TB screening to the public but depend on primary care for TB screening and LBTI case management. We are fortunate to have several local clinics that perform TB screening and LTBI case management for high-risk individuals who are refugees, immigrants, or part of the Uniting for Ukraine program.

What fills you up in your spare time?

Spending time with my daughter and family, running, music concerts, and gardening.

What is your favorite thing about summer time in your area?

Just getting out and enjoying the warmer weather before the snow flies but I like all the seasons.

*Updated* Provisional CDC Guidance for the Use of Pretomanid as part of a Regimen [Bedaquiline, Pretomanid, and Linezolid (BPaL)] to Treat Drug-Resistant Tuberculosis Disease

On May 4th, updates were made to the provisional CDC guidance:

• A recommendation for an initial linezolid dose of 600 mg when using the BPaL regimen in the treatment of adults,
• Additional information about adverse events, and
• References to studies that were published after the initial release of the guidance.
• Updates have been made to the WA DOH BPaL Guidance Document.

Sirturo/Bedaquiline Patient Assistance program

• Johnson & Johnson is updating their patient assistance program and application form.
• The BPaL Guidance Document has been updated to accommodate this change

Information for Local Health Jurisdictions (LHJs)

Save-the-date for the in-person Washington TB LHJ Workshop!

The workshop will take place on October 30th, 2023 in Wenatchee, WA. More information will be available soon.

TB Partners SharePoint Updates 

The DOH VDOT Policy for LHJs using the tool DOH provides has been updated. Please review this policy if you are using or plan to use this tool.

SureAdhere VDOT platform is launching an upgraded version in August.

This new version will include two-way text chat and live video chat integration. SureAdhere will offer trainings on using these new features after they go live. A new TB staff training video to be posted on SharePoint mid-September.

BPaL Access Guidance Updated

The WA DOH TB program regularly updates this guide for your use. There have been a number of changes to the guide including the Bedaquiline patient assistance program (with a new JJPAF application and application guide).

Please contact tbservices@doh.wa.gov if you are experiencing SharePoint access issues or would like to request SharePoint access.

WDRS System Update



Update: The following issue was FIXED with the last vendor update to WDRS. On Dec. 21, 2022, the WDRS team notified users that a bug has been found in WDRS that may result in data loss when using Wizards for data entry. Read more about this issue here. If you need to remove any main/parent question in a repeatable question, please do it only in the regular question package. Email tbservices@doh.wa.gov with any questions or concerns regarding this issue. 

Phlebotomy Training Available

The DOH TB Program is partnering with the Phlebotomy Training Center at the University of Washington to offer phlebotomy training for LHJ TB program staff to be able to perform TB blood tests.

This is a two day in-person training in Seattle that requires advance notice to schedule. However, there is currently a waiting list of at least a few months. Class space is limited. LHJs who are interested in sending over staff to obtain this certification, should contact tbservices@doh.wa.gov.

Upcoming Events and Education Opportunities

June - September 2023 | Rutgers Global TB Institute TB 101 Series

This 13-part webinar series will provide an introduction to the fundamentals of tuberculosis (TB). The live sessions will be held on Fridays at 7 - 8 am PT. More information here.

August 16-19, 2023 | Afghan Support Center in Seattle

U.S. Citizenship and Immigration Services is holding an Afghan Support Center in Seattle. This no cost event will provide an opportunity for Afghans to talk to staff from U.S., Washington state and Seattle government agencies, a variety of service providers, and others. For more information, view the flyer in English, Dari, and Pashto.

August 23, 2023 | Fundamentals of Medical & Case Management of Drug-Susceptible TB

This Curry International TB Center (CITC) training is intended for nurses and case managers who provide care for TB patients within the public health setting. Register here.

September 15, 2023 | Focus on LTBI

This CITC training in Oakland, CA is intended as an introductory course covering the basics of latent TB infection (LTBI) diagnosis and treatment for physicians, nurses, and other licensed medical care providers who manage patients at risk for TB. Register here by July 31st.

September 26 - 27, 2023 | International Workshop on Clinical Pharmacology of TB Drugs

​Registration is open for the 14th edition of the International Workshop on Clinical Pharmacology of Tuberculosis Drugs. The meeting times will accommodate attendance on most continents. The workshop is free to attend, but you must register to receive access to the sessions. Register here.

Southeastern National TB Center (SNTC) Trainings

These summer and fall training applications will be posted on the website soon.

• August 7- September 1, 2023: LTBI for Clinicians
• August 28 - November 17, 2023: TB Nurse Case Management Fall Cohort
• October 12 - November 2, 2023: LTBI for Nurses

Mycobacterium Interest Group Seminar Series

The Seattle TB Research Advancement Center (SEATRAC) holds monthly Friday sessions (typically on the fourth Friday) which features both basic science and clinical science presentations. More information here.

Washington's TB Project ECHO

On Mondays 12:30-1:30 pm PT, join our lunch-time virtual discussion about real TB cases with your peers. Starting September 12th, the sessions will be occurring weekly on Tuesdays. This free interactive event is guided by a panel of local TB experts. For more information about this local project and our partners who make this ongoing event possible.

Articles

Uniting for Ukraine Tuberculosis Screening Experience, San Francisco, California, USA

Emerging Infectious Diseases Journal | 6/2023 | doi: 10.3201/eid2908.230347

Spatial Epidemiologic Analysis and Risk Factors for Nontuberculous Mycobacteria Infections, Missouri, USA, 2008–2019

Emerging Infectious Diseases Journal | 7/2023 | doi: 10.3201/eid2908.230378

Video Recordings and Education Opportunities



CITC Archived Webinars

CME/CE units will not be offered for these trainings. Access here.

Rutgers TB Institute Webinar Archives

CE units are not available for these archives. Access here.

SNTC Archived Webinars

CME/CE units are not offered for these trainings. Access here.

SNTC Online Courses

CME/CE units are offered for these trainings. Access here.

• When TB is the Least of Their Worries: Mini-Course Series (expires 9/3/2025)

CDC: TB 101 for Health Care Workers

CE units expire on 11/6/2023 and are available at no cost. Access here.

TB ECHO Recorded Archives

Missed a TB ECHO^® session? TB ECHO^® has didactic presentations available for viewing on YouTube. Handouts related to the presentation are included where appropriate. Watch recorded TB ECHO® here

Tools and Resources



Minnesota's Center of Excellence in Newcomer Health

• Access helpful tools, trainings, and updates for newcomers and refugee health here.

CDC

• CDC Learning Connection.
• CDC TRAIN is a comprehensive catalog of free public health training opportunities from the Public Health Foundation. For TB-related trainings, click here.
• FindTBResources.cdc.gov - TB educational materials for patients and providers.
• Visit Everyday Words for Public Health Communication to find plain language alternatives for public health jargon.
• TB Personal Stories patient videos to help raise awareness about TB in the US.
• we are TB offers comprehensive peer support for current TB patients and TB clinics, including weekly live support group sessions.
• Subscribe to the CDC's quarterly newsletter, TB Notes!

DOH Refugee Health Program

• Afghan Health Resources - Fact sheets, webinars, videos, and other health resources (scroll down for TB resources).
• Ukrainian Health Resources - Fact sheets, webinars, videos, and other health resources to support new arrivals from Ukraine (scroll down for TB resources).

Southeastern National TB Center

• Individualized Country Guides

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