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One by one attendees of the Triangle Global Health Consortium’s awards ceremony stood from their chairs applauding and cheering for Margaret “Peggy” Bentley, MA, PhD, who was honored as the 2017 Global Health Champion on Tuesday evening, May 2.
Bentley, who is the founding Board Director of the Triangle Global Health Consortium, juggles many high level roles at UNC. She is the Carla Smith Chamblee Distinguished Professor of Global Nutrition and the Assistant Dean for Global Health in the Gillings School of Global Public Health. She is also the Associate Director for Education in the UNC Institute for Global Health & Infectious Diseases. Her research focus of women and children’s nutrition has led her to conduct studies around the state as well as in Asia, Africa and South America.
“Winning this award is the capstone of my career,” she said during her acceptance speech.
Watch a video tribute to Bentley.
Building a Career in Nutrition
Upon graduation from high school, Bentley took a break from academics to travel. She worked as a cook on a sailboat in the Caribbean, as a secretary on Wall Street, as a chambermaid in Utah and as a cocktail waitress in California. She returned to school in her early 20s, studying human society and world food issues at Michigan State University. Bentley graduated, married and bought a farm complete with seven cows.
She then began reading the works of cultural anthropologist Margaret Mead, which further sparked her interest in nutrition and anthropology. She moved to Connecticut, earning both her master’s and her doctoral degrees in anthropology. Bentley wanted to explore the relationship between infection and nutrition. Moving to New Delhi, India with her family provided her with the opportunity to investigate the household management of childhood diarrhea for her doctoral dissertation.
Word of her research in India caught the eye of the Department of International Health at Johns Hopkin University in Maryland. She received a cable offering her a job as a research associate, allowing her to work on the dietary management of diarrhea in Peru and Nigeria.
Local is Global
In 1998, Bentley left Johns Hopkins, heading south for a position in the Department of Nutrition at Gillings. At UNC, she has continued her research on women and infants’ nutrition, infant and young child feeding, HIV and breastfeeding, and community-based interventions for improving growth and development of young children. Her work has taken her to UNC Project-Malawi and the Galapagos Science Center.
“Peggy has changed the perception of global health,” said Gillings Dean Barbara Rimer, DrPH. “She has shown the deep connection between local and global health right here in our state. I am thrilled she has been honored as a champion because she is a champion and an asset to the Triangle and the consortium.”
Bentley has balanced a robust research career with teaching and mentoring countless students at Gillings. One of her mentees, Naya Villarreal, attended the awards ceremony.
“Peggy wrote me an email five years ago, offering me a position,” said Villarreal, MPH, program coordinator for the Gillings Global Gateway. “It was the best decision I’ve made and I can’t thank you enough for your mentorship.”
Implementing TLC was a key component of Aaron Fleischauer’s presentation at UNC’s Friday Center on Monday, May 1. But he wasn’t talking about the acronym’s most common definition of tender love and care. He was referring to the test, link and cure strategy for decreasing the rates of hepatitis C virus (HCV).
Fleischauer, PhD, MSPH, is the career epidemiology field officer for the Centers for Disease Control and Prevention (CDC) assigned to the North Carolina Division of Public Health. He was one of several speakers who addressed the crowd of 455 health providers from around the state gathered for the annual HIV update conference sponsored by the UNC Institute for Global Health and Infectious Diseases, the UNC Eshelman School of Pharmacy and the Greensboro Area Health Education Center (AHEC). The meeting is the largest training for HIV providers in the state.
“The majority of our attendees serve the HIV community,” said Tina Latham, assistant director of regional education for the Greensboro AHEC. “Participants can choose from two tracks. One is for clinicians – physicians, pharmacists and nurses. The second track is designed for people who provide mental health, allied health or social services.”
This was the first year the conference included presentations on addiction and injection drug use, Latham said. Fleischauer’s presentation on HCV detailed how injection drug use is fueling an increase in HCV incidences.
“We are dealing with two HCV epidemics – the historic and the emerging,” Fleischauer said. “The historic HCV epidemic focuses on the Baby Boomer generation of people born from 1945-1965 who may have had an organ transplant or blood transfusion prior to the 1980s when we started testing for HCV. These are people living with chronic hepatitis. The emerging epidemic is associated with injection drug use. This is a younger group of people who are usually white and live in rural areas.”
In the United States, 5.7 million people are living with hepatitis B or C virus, Fleischauer said. He said 150,000 people in NC are living with HCV, but he believes that estimate is low, especially since Wilmington was recently named the number one county in the nation for injection drug use. In addition to hepatitis, injection drug users are at risk for contracting HIV. Fleischauer said legislative support of more syringe service programs is one way to prevent a spike in infectious diseases similar to the 142 cases of HIV in Scott County, Indiana, in 2015.
“Last year, the NC General Assembly approved a needle exchange program,” Fleischauer said. “More than one million free needles have been distributed.”
TLC also outlines ways to decrease the number of HCV cases. High-risk populations, including Baby Boomers, people living with HIV and injection drug users, should be tested at least annually for HCV. Anyone who tests positive should be connected with medical care as well as mental health, substance abuse and social services if appropriate. Since HCV is curable, treatment should be offered to those living with HCV to improve their health and prevent onward transmission, Fleischauer said.
Helping clinicians determine which HCV treatment to prescribe was the focus of another session. Presenters Heidi Swygard, MD, MPH, and Lisa Fletcher, PharmD, determine treatment plans for patients in UNC’s Infectious Diseases Clinic. They presented four case studies, coaching participants on what questions to ask patients to prescribe the correct medication.
“You need to keep in mind what other medications your patient is taking, their liver enzyme levels and any insurance restrictions,” Swygard cautioned. “Medicaid will only pay for one round of hepatitis C treatment. You need to ask your patient if he or she is ready to commit to what can be 12 weeks of therapy.”
UNC ID Clinic physician’s assistant Anh Eichholz and family nurse practitioner Brittany Alexander both attended the session, working together to solve the case studies. Eichholz said she appreciates the annual clinical update in Chapel Hill, since working in the clinic full time and caring for her four children prevents her from traveling to infectious diseases conferences held out of state.
“I wasn’t able to go to CROI (the Conference on Retroviruses and Opportunistic Infections) in Seattle earlier this year. This morning’s speaker recapped the major findings presented there, including injectables for treatment and prevention of HIV, which are important developments to my patients,” Eichholz said.
Since many of the annual HIV update’s speakers are UNC infectious diseases specialists, Alexander said she enjoys watching her coworkers shine.
“I like seeing my colleagues do well and receive recognition for their expertise,” Alexander said. “They also highlight areas where I can improve how I care for my patients.”
A six-member delegation from China paid a visit to the University of North Carolina at Chapel Hill (UNC) and the National Institutes of Health (NIH) in Bethseda, Maryland, from April 4-6, 2017. The delegation included representatives from the Guangdong Provincial Health and Family Planning Commission, Southern Medical University, Dermatology Hospital of Southern Medical University.
During their visit to the UNC, the delegation met with representatives of different units including:
- Ron Strauss, DMD, PhD, Executive Vice Provost and Chief International Officer at UNC,
- Wesley Burks, MD, Executive Dean for the UNC School of Medicine,
- Myron Cohen, MD, Associate Vice Chancellor for Global Health at UNC and Director of the UNC Institute for Global Health and Infectious Diseases,
- Jim Herrington, PhD, Executive Director of the UNC Global Gateway,
- Kate Muessig, PhD, UNC Department of Health Behavior,
- Amanda Corbett, PharmD, Clinical Associate Professor and Global Pharmacology Coordinator, and
- Arlene Seña, MD, MPH, Associate Professor of Medicine in UNC Institute for Global Health and Infectious Diseases.
The main purpose of the meeting was to review the existing partnerships with the UNC Institute for Global Health and Infectious Diseases, to discuss how to maintain and improve the current partnership and to explore new collaborations in the areas of HIV/AIDS prevention between UNC and China.
The delegation also visited the Fogarty International Center (FIC) and National Institute of Allergy and Infectious Diseases (NIAID) of NIH. They met with Ken Bridbord, MD, MPH, Acting Division of International Relations Director of FIC, and Carolyn Deal, PhD, the head of Sexually Transmitted Diseases Branch of NIAID. During the meeting, the Chinese Delegates discussed the potential opportunities for the sustaining of UNC-South China Training Center for STI with representatives of NIH, and discussed potential future collaboration.
It’s not everyday a person is likened to Superman. It’s also not everyday a person retires from their 40-year career in infection prevention.
The William A. Rutala Retirement Infection Prevention Symposium and Celebration was held on Friday afternoon, April 28, at the Paul J. Rizzo Conference Center in Chapel Hill. Rutala, MS, MPH, PhD, is stepping down from his role as director of UNC Health Care’s Hospital Epidemiology, Occupational Health and Safety Program.
“I will continue conducting research,” Rutala said. “But I will also get to spend more time with my family.”
Emily Sickbert-Bennet, MS, PhD, will replace Rutala as director.
“Bill has been an incredible mentor to me and hundreds of thousands of infection preventionists and epidemiologists in North Carolina and beyond,” Sickbert-Bennett said.
Many of those trainees and collaborators were in attendance as the crowd of 150 people gathered to hear Rutala, and several others in the field, present the latest research on healthcare-associated infections. David Weber, MD, MPH, has spent the past 32 years working with Rutala at UNC. The two authored 200 publications together, a time-consuming task that inspired Weber to joke that he was Rutala’s significant other, not Rutala’s wife Donna. Weber began his presentation with a slide featuring Rutala as Superman.
“Bill is the world’s leading authority on sterilization and disinfection. He developed SPICE, the Statewide Program for Infection Control and Epidemiology, which has trained the infection preventionists at more than 90 percent of all NC hospitals,” Weber said. “What I like best about Bill is that he believes in evidence-based interventions.”
Rutala opened the symposium with a presentation aimed at answering the question, “Can we prevent all infections associated with environment and medical devices in five years?” He listed MRSA (methicillin-resistant staphylococcus aureus) and C. difficile (Clostridium difficile) as two bacterial infections that could be prevented if hospital rooms were sufficiently cleaned.
“Bacteria can live for days, weeks and months on hospital room surfaces,” Rutala said. “Only around 40 percent of these surfaces are cleaned upon discharge. And daily cleaning is done even less frequently. We call it trash and dash.”
Yet, several novel ideas to combat environmental pathogens are in the pipeline. Visible light disinfection, dilute hydrogen peroxide technology and self-disinfecting surface coatings are all being tested and tweaked, according to Rutala.
Another way patients contract an infection in a healthcare setting is through contaminated medical devices. Rutala has completed extensive research into the dangers that lurk on endoscopes.
“Endoscopes have billions of microorganisms on them after a procedure and the crevices in the instrument make reprocessing difficult,” Rutala said. “Endoscopes remain contaminated 30 percent of the time after one cleaning. This results in transmission of infection.”
Rutala said sterilization should replace high level disinfection of endoscopes. The need for improved sterilization technology is a solution he shared during a 2015 presentation to a panel from the U.S. Food and Drug Administration (FDA). Rutala also believes the development of single-use scopes that would be disposed of after each patient could also help eliminate infections from contaminated medical devices.
“Can we prevent infections associated with medical devices and the environment in five years?” Rutala asked at the end of his presentation. “Our passion will make this happen.”