#TBSky presenting the available data re high-dose (or dose-optimized) rifampin (HDR/DOR) is anyone trialing HDR/DOR for pulm, non-CNS extrapulm, or CNS TB? if so, which, and when? if not, why? a) awaiting more PK data b) awaiting mortality benefit data c) concerns re tolerance/toxicity d) combo

Patterns of #tuberculosis 🫁 Cr. #devrad #radiology #chestrad @pulmpeeps.bsky.social @laurengroner.bsky.social @mmestas.bsky.social

Important #TBSky paper @lancetmicrobe.bsky.social by @mnoursad.bsky.social & @innate2adaptive.bsky.social Diagnosing TB in lymph nodes or pericarditis a challenge RNA biomarkers better than CRP to trigger confirmatory testing, but still not as good as what WHO specifies for TB triage tests #IDSky

gave an ED provider some very gentle (but important!) clinical feedback today and the person said “we hardly ever get feedback — thank you so much for letting me know!” this is so gracious! we could all take lessons

if you’re a physician yelling about vaccine committee removals but not about flagrant human rights abuses & genocide, check your priorities there are no ‘lanes’ when it comes to the preservation of human life and dignity—we have a moral responsibility to speak out and act to protect the vulnerable

just a quick reminder to the medical community that ~the concept of race has no basis in scientific evidence and should not impact your *medical* decision-making~ race *does have* social implications (which can affect access/quality) bc of the disproportionate global power assigned to ‘whiteness’

as i prepare to present data (epi, pathogenesis, presentation, detection, TB control considerations) on subclinical TB tomorrow for the NYC TB bureau, i have relied on this *incredible* review pubmed.ncbi.nlm.nih.gov/30021818/ thank you, @sgschumacher.bsky.social et al!

#TBSky saw this note today: “M africanum in sputum; pt doesn’t meet criteria for NTM disease, stop all therapy” “MTB complex” includes several closely related human pathogens: - M tb - M bovis - M africanum - (& M microti, caprae, pinnipedii, orygis, canetti) all should be treated as ‘TB disease’!

#TBSky: have any clinical TB folks seen hearing loss with BPaLM? this is not a documented/common adverse effect that i’m aware of, but moxi does have post marketing reports of hearing loss and linezolid could potentially cause it via peripheral neuropathy thoughts?

Are you interested in #TB and have experience in #modelling infectious diseases? Come join us in the TB Modelling Group at #LSHTM! We're advertising for a 1 year Research Fellow position, with a closing date of 30 May 2025 👉 jobs.lshtm.ac.uk/vacancy.aspx...

This wasn’t built by an institution or backed by funding. It was built by clinicians, pharmacists, scientists, & anonymous contributors. No sponsors. No conflicts. Just evidence. I’d log in at midnight and see Anonymous Koala editing rows. That’s public science: open, people-powered, and shared.

Alright folks, the amazing @jakescottmd.bsky.social has set up a google sheets for you to crowd source published RCTs of vaccines. Editable sheet (starter trials seeded): bit.ly/3EuYzqI As data are imported, the website will autoupdate. Have at it! www.bradspellberg.com/vaccine-rcts

in my opinion, *particularly* at a safety net hospital in this current political climate, there is absolutely *no medical necessity* to document citizenship status in a patient’s medical record if this becomes commonplace, its absence could be taken by some to mean “undocumented”

important learning re calcified granulomas vs LTBI (i get asked this Q a lot) — this is nuanced, but here are some important considerations #TBSky

a patient (w/ a complex infection) messaged me saying she’s terrified about what’s happening in the US—said she has to return to her previous country ASAP she begged for an urgent visit so i could give her months of meds in case she can’t find care fact: this admin’s policies are hurting patients

We are pleased to announce the availability of the following archived webinar: The Riddle of TB Drug Resistance www.currytbcenter.ucsf.edu/trainings/ar... #GotCurry #Webinar #Tuberculosis #EndTB @theunion-tblh.bsky.social

>100,000 of us took to the streets of Manhattan (and >400,000 ppl nationwide!) today to stand against dangerous attacks on the federal workforce, immigrants, healthcare, and social safety nets for vulnerable populations #handsoff

New — Here is a running list of Dept. of Health and Human Services (HHS) offices that have either been fully eliminated or gutted into non-functionality as a result of today's mass firings (provided to me directly by a CDC staffer):

graduating ID fellows: if you’re okay with slightly less money in exchange for intrinsically meaningful work, less toxicity, and a higher quality of life, consider public health! i love my job(s) so much

#IDSky: if you order a CBC diff, please remember to look at the diff, even in pts you don’t expect to find certain abnormalities (like in this asymptomatic US-born patient) this level of eosinophilia is dangerously high! this patient needs an urgent eval for infectious and hematologic etiologies

the NYC DOH Bureau of TB Control just released our data for 2024 — another staggering increase in TB cases in NYC NYC’s current prevalence is 9.5/100k US national prevalence is ~3/100k at a time when global and national TB control resources are extremely vulnerable #TBsky

Monday is #worldtuberculosisday and a vaccine developed by the Gates Medical Research Institute is being studied in a phase 3 trial. If approved, the vaccine could potentially prevent pulmonary TB in adults and adolescents. #IDsky

public health & city hospital doctors march for medicaid! medicaid provides health insurance to over 80 million americans (nearly 1 in 4 people / almost 25% of the population!), including low-income families, pregnant people, children, elderly individuals, & people with disabilities

if you can’t bring yourself to care about people who live far away from you in their own right, remember that more TB in the world means more TB here, too — in a globalized society, countries don’t exist in a vacuum www.nytimes.com/2025/03/11/h...

i work in two different settings which serve predominantly low resource communities and many undocumented folks—fewer & fewer patients are showing up for their in-person medical appointments can you blame them? even without “raids” the fear & uncertainty have real effects on patients’ lives

a dark time for TB control (and the rest of public health…) #TBSky news.un.org/en/story/202...

dear #TBSky please share your favorite articles/reviews/resources about subclinical TB disease! i’m specifically interested in info about differing pathophys/host differences, prevalence, and infectiousness/transmission — i’m prepping a talk from our bureau MDs!

any trainees on the fence about taking a lower-paying job doing something they love with a higher quality of life? i love my job(s)—i could make more doing full time clinical work (even in academia), but i am genuinely happy, my work is meaningful, and my quality of life is excellent—happy to chat!

remember, during Ramadan, you can recommend that patients take their medications at night when the fasting period is over — otherwise, consider deferring nonurgent treatments (HCV, HBV, LTBI) to after

TODAY

“This is absolutely shattering, heartbreaking, and incomprehensible. The termination letters issued by the US state department in the last 24 hours mark the abrupt and devastating end to years — decades — of investment in lifesaving programmes” bhekisisa.org/health-news-...

www.dshs.texas.gov/news-alerts/... - 1st measles death since 2015 - this death was in an unvaccinated, school-aged child - as of February 25, 124 cases have been confirmed; most cases are in children - RFKJ downplayed the severity of the outbreak following the death of the child

Challenge to the #TB community.... what are the RCT's we really need to push things forward in TB? @who.int is putting a call out as part of their Global Clinical Trials Forum. www.thelancet.com/journals/lan... @catherineberry.bsky.social @madhupai.bsky.social @sgschumacher.bsky.social

TB Community Coordination Hub has received more than 100 responses and data looks very grim with testing, treatment adherence, counseling, awareness raising services have been stopped or reduced drastically.If you are witnessing similar situation in your country, please fill the form. #TBSky

random call from manhattan hospital: “hi dr walding this is dr xyz - are you aware of this patient with tb?” “hi there - which patient?” “how many tb patients could there be in nyc?”

I was an EIS officer at CDC. The graduates of that program have saved and improved countless lives through selfless, often dangerous work. The firing of half the EIS force imperils our country and the world. www.statnews.com/2025/02/14/t... #EIS

don’t let this coup happen while the world tells you “log off for your mental health." fascism takes hold when we sit idly by. instead, - protect vulnerable ppl - call/email reps (5 Calls app) - protest, demonstrate - organize w friends - scream online don't believe him; don't accept this. resist.

several CDC employees working at the NYC DOH were abruptly terminated over the weekend public health depts in cities all over the country (especially large cities like NYC) rely on CDC resources (including funding & staff) to complete essential public health functions this is so unfair & dangerous

“This weekly report from the New York State Department of Health presents summaries of select ongoing and emerging infectious disease outbreaks of interest to public health professionals and the public, both globally and in the United States.” (in lieu of CDC) globalhealthreports.health.ny.gov

all institutions who interface heavily with undocumented folks should be providing very clear guidance to their providers/staff re how to protect patients in this current climate if there is silence from your admin, be vocal and tell them to do better — we need to be proactive

Dr. Carole Mitnick of Harvard Medical School discusses the results of the Phase 3 #endTB trial on five all-oral regimens for rifampin-resistant #TB. The aim was to improve treatment outcomes while reducing the toxicity of existing regimens. #IDsky #MEDsky www.contagionlive.com/view/five-al...

a lovely and updated (12/13/24 - updated Jan 2025) review of immunopathology in human tuberculosis #TBSky #IDSky www.science.org/doi/10.1126/...

us02web.zoom.us/webinar/regi... please consider joining tomorrow if relevant to your patient population (it likely is!)

now when obtaining a social history (eg, “in which country were you born?,” “when did you move to the US?”), i have to add “this information just helps me know which infections you may be at risk for; your immigration/documentation status isn’t relevant to my work” otherwise patients are terrified…

Just received this photo from a friend of a warehouse in Kinshasa. These are tuberculosis medications--ALREADY PAID FOR--that aren't being distributed due to the Trump Administration's stop work order. TB treatment is being interrupted in SO many patients around the world. What does that mean? (1/2)

a reminder to all providers that your duty is to your patients’ health and safety, not to be a tool or weapon of a police state don’t ask about and don’t document anyone’s immigration status and convert as many visits as feasible to video visits for those at risk protect patients!

USAID matters. I've often disagreed with their strategy and choices, but their work saves more lives than any philanthropy can. It's a rounding error in the federal budget, and one of the best things we do as a country. To see it destroyed overnight by one unelected man is an unmitigated horror.

We worked for months with USAID to build an $85,000,000 project to end TB in two regions of the Philippines. The project is funded by private money, the Philippine government, and matching USAID funds. It could provide a blueprint for eliminating TB worldwide--except it's...not happening.

if anyone else is feeling overwhelmed/worried about the pace of attempted changes from this current administration, i found this argument convincing & helpful—only 15 mins (on spotify & apple)