Seattle Children’s Hospital / University of Washington

TRAINING PROGRAM DIRECTOR
Matthew Kronman, MD, MSCE

CHIEF OF INFECTIOUS DISEASES
Danielle Zerr, MD, MPH

ASSOCIATES/DIVISION MEMBERS:

• Serge Barcy, PhD
• Marta Bull, PhD
• Claudia Crowell, MD
• Horacio Duarte, MD
• Janet Englund, MD
• Lisa Frenkel, MD
• Whitney Harrington, MD, PhD
• Rafael Hernandez, MD, PhD
• Heather Jaspan, MD, PhD
• Jai Lingappa, MD, PhD
• Ann Melvin, MD, MPH
• Chikara Ogimi, MD
• Nicole Poole, MD, MPH
• Lakshmi Rajagopal, PhD
• Timothy Rose, PhD
• Sherilyn Smith, MD
• Glen Tamura, MD, PhD
• Kevin Urdahl, MD, PhD
• Sara Vora, MD, MPH
• Alpana Waghmare, MD
• Thor Wagner, MD
• Scott Weissman, MD

TITLE(S) OF RECENT FELLOWS’ PUBLISHED PAPERS OR RESEARCH PROJECTS:

Microchimerism: Defining and redefining the prepregnancy context – A review. Gammill HS, Harrington WE. Placenta. 2017 Dec;60:130-133. doi: 10.1016/j.placenta.2017.08.071. Epub 2017 Aug 31. PMID: 28911790

Maternal microchimerism is prevalent in cord blood in memory T cells and other cell subsets, and persists post-transplant. Kanaan SB, Gammill HS, Harrington WE, De Rosa SC, Stevenson PA, Forsyth AM, Allen J, Cousin E, van Besien K, Delaney CS, Nelson JL. Oncoimmunology. 2017 Mar 31;6(5):e1311436. doi: 10.1080/2162402X.2017.1311436. eCollection 2017. PMID: 28638735

Maternal Microchimerism Predicts Increased Infection but Decreased Disease due to Plasmodium falciparum During Early Childhood. Harrington WE, Kanaan SB, Muehlenbachs A, Morrison R, Stevenson P, Fried M, Duffy PE, Lee Nelson J. J Infect Dis. 2017 May 1;215(9):1445-1451. doi: 10.1093/infdis/jix129. PMID: 28329160

Defending the Use of Sulfadoxine-Pyrimethamine for Intermittent Preventive Treatment for Malaria in Pregnancy: A Short-Sighted Strategy. Harrington WE, Fried M, Duffy PE. J Infect Dis. 2016 Feb 1;213(3):496-7. doi: 10.1093/infdis/jiv420. Epub 2015 Aug 19. No abstract available.
PMID: 26290607 Free PMC Article

Independent lineages of highly sulfadoxine-resistant Plasmodium falciparum haplotypes, eastern Africa. Taylor SM, Antonia AL, Harrington WE, Goheen MM, Mwapasa V, Chaluluka E, Fried M, Kabyemela E, Madanitsa M, Khairallah C, Kalilani-Phiri L, Tshefu AK, Rogerson SJ, Ter Kuile FO, Duffy PE, Meshnick SR.
Emerg Infect Dis. 2014 Jul;20(7):1140-8. doi: 10.3201/eid2007.131720.
PMID: 24960247 Free PMC Article

Improving Antibiotic Prescribing for Children With Urinary Tract Infection in Emergency and Urgent Care Settings. Poole NM, Kronman MP, Rutman L, Weissman SJ, Migita RT, Caglar D, Zerr DM. Pediatr Emerg Care. 2018 Jan 2. doi: 10.1097/PEC.0000000000001342. [Epub ahead of print] PMID: 29298246

Current Status of Point-of-Care Testing for Human Immunodeficiency Virus Drug Resistance. Duarte HA, Panpradist N, Beck IA, Lutz B, Lai J, Kanthula RM, Kantor R, Tripathi A, Saravanan S, MacLeod IJ, Chung MH, Zhang G, Yang C, Frenkel LM. J Infect Dis. 2017 Dec 1;216(suppl_9):S824-S828. doi: 10.1093/infdis/jix413. Review.

Characteristics and Outcomes of Coronavirus Infection in Children: The Role of Viral Factors and an Immunocompromised State. Ogimi C, Englund JA, Bradford MC, Qin X, Boeckh M, Waghmare A. J Pediatric Infect Dis Soc. 2018 Feb 13. doi: 10.1093/jpids/pix093. [Epub ahead of print] PMID: 29447395

Areolar lymphocytoma in a child: A rare cutaneous presentation of borreliosis. Ogimi C, Crowell C, Boos MD. Pediatr Dermatol. 2018 Jan;35(1):e90-e91. doi: 10.1111/pde.13353. Epub 2017 Dec 4. PMID: 29205927

Prolonged Shedding of Human Coronavirus in Hematopoietic Cell Transplant Recipients: Risk Factors and Viral Genome Evolution. Ogimi C, Greninger AL, Waghmare AA, Kuypers JM, Shean RC, Xie H, Leisenring WM, Stevens-Ayers TL, Jerome KR, Englund JA, Boeckh M. J Infect Dis. 2017 Jul 15;216(2):203-209. doi: 10.1093/infdis/jix264. PMID: 28838146

Clinical Significance of Human Coronavirus in Bronchoalveolar Lavage Samples From Hematopoietic Cell Transplant Recipients and Patients With Hematologic Malignancies. Ogimi C, Waghmare AA, Kuypers JM, Xie H, Yeung CC, Leisenring WM, Seo S, Choi SM, Jerome KR, Englund JA, Boeckh M. Clin Infect Dis. 2017 Jun 1;64(11):1532-1539. doi: 10.1093/cid/cix160. PMID: 28329354

Mapping child growth failure in Africa between 2000 and 2015. Osgood-Zimmerman A, Millear AI, Stubbs RW, Shields C, Pickering BV, Earl L, Graetz N, Kinyoki DK, Ray SE, Bhatt S, Browne AJ, Burstein R, Cameron E, Casey DC, Deshpande A, Fullman N, Gething PW, Gibson HS, Henry NJ, Herrero M, Krause LK, Letourneau ID, Levine AJ, Liu PY, Longbottom J, Mayala BK, Mosser JF, Noor AM, Pigott DM, Piwoz EG, Rao P, Rawat R, Reiner RC, Smith DL, Weiss DJ, Wiens KE, Mokdad AH, Lim SS, Murray CJL, Kassebaum NJ, Hay SI. Nature. 2018 Feb 28;555(7694):41-47. doi: 10.1038/nature25760. PMID: 29493591

Mapping local variation in educational attainment across Africa. Graetz N, Friedman J, Osgood-Zimmerman A, Burstein R, Biehl MH, Shields C, Mosser JF, Casey DC, Deshpande A, Earl L, Reiner RC, Ray SE, Fullman N, Levine AJ, Stubbs RW, Mayala BK, Longbottom J, Browne AJ, Bhatt S, Weiss DJ, Gething PW, Mokdad AH, Lim SS, Murray CJL, Gakidou E, Hay SI. Nature. 2018 Feb 28;555(7694):48-53. doi: 10.1038/nature25761. PMID: 29493588

Existing and potential infection risk zones of yellow fever worldwide: a modelling analysis. Shearer FM, Longbottom J, Browne AJ, Pigott DM, Brady OJ, Kraemer MUG, Marinho F, Yactayo S, de Araújo VEM, da Nóbrega AA, Fullman N, Ray SE, Mosser JF, Stanaway JD, Lim SS, Reiner RC Jr, Moyes CL, Hay SI, Golding N. Lancet Glob Health. 2018 Mar;6(3):e270-e278. doi: 10.1016/S2214-109X(18)30024-X. Epub 2018 Feb 2. PMID: 29398634 Free PMC Article

Notes from the Field: Baylisascaris procyonis Encephalomyelitis in a Toddler – King County, Washington, 2017. Kawakami V, Casto A, Natarajan N, Snyder A, Mosser J, Bonwitt J, Kronman MP, Kay M. MMWR Morb Mortal Wkly Rep. 2018 Jan 19;67(2):79-80. doi: 10.15585/mmwr.mm6702a6. No abstract available. PMID: 29346337

Global yellow fever vaccination coverage from 1970 to 2016: an adjusted retrospective analysis. Shearer FM, Moyes CL, Pigott DM, Brady OJ, Marinho F, Deshpande A, Longbottom J, Browne AJ, Kraemer MUG, O’Reilly KM, Hombach J, Yactayo S, de Araújo VEM, da Nóbrega AA, Mosser JF, Stanaway JD, Lim SS, Hay SI, Golding N, Reiner RC Jr. Lancet Infect Dis. 2017 Nov;17(11):1209-1217. doi: 10.1016/S1473-3099(17)30419-X. Epub 2017 Aug 16.

Continued in vitro cefazolin susceptibility in methicillin-susceptible Staphylococcus aureus. Gern BH, Greninger AL, Weissman SJ, Stapp JR, Tao Y, Qin X. Ann Clin Microbiol Antimicrob. 2018 Feb 20;17(1):5. doi: 10.1186/s12941-018-0257-x. PMID: 29463249 Free PMC Article

Case 1: Vomiting and Ventricular Arrhythmia in a 2-year-old Girl. Gern BH, Mehta A, McCammond AN, Holmes KW, Guzman-Cottrill JA. Pediatr Rev. 2018 Feb;39(2):91-92. doi: 10.1542/pir.2016-0133. No abstract available. PMID: 29437128

RESEARCH TRAINING OPPORTUNITIES:
Respiratory viruses including influenza virus vaccines, respiratory viruses in immunocompromised patients, Viral evolution of HIV during infection and treatment; Clinical studies of HIV infection; Molecular biology of tumor viruses, cytokines, cell growth, differentiation and transformation; Lung infections in Cystic Fibrosis; Immune response to Mycobacterium tuberculosis infection; Evolution and epidemiology of virulence and antimicrobial resistance in extra intestinal pathogens such as Escherichia coli and Kiebsiella pneumonia; geospatial modeling of infectious diseases;

GRANT FUNDING RECEIVED FOR FELLOW RESEARCH PROJECTS:

In addition to the NIH T32 training grant, other grants obtained to fund recent fellow projects include PIDS-St. Jude, Thrasher Foundation Award, PIDS Pediatric Scientist Development Program, and Burroughs-Wellcome Career Award for Medical Scientists

MAJOR FEATURES OF TRAINING PROGRAM:

The overall goal of this program is to train individuals for careers in academic pediatric ID who will be skilled investigators and clinical subspecialists. The usual fellowship training program consists of a three-year period; however modifications are possible depending on the background of the applicant.

Our program seeks to develop skilled investigators and clinicians through:

• Training physicians in the basic scientific study of pediatric infectious disease
• Developing outstanding clinical skills through a wide variety of clinical experiences
• Providing mentorship for both scientific and clinical training
• 2 years of dedicated research time

Research Training
We provide a strong research foundation upon which such a career can be based by providing a minimum of two years of research training related to an ongoing research project. Fellows are free to choose from the large number of outstanding research projects at Seattle Children’s Hospital, the University of Washington, the Fred Hutchinson Cancer Research Institute, and the Seattle Biomedical Research Institute. Strong emphasis is placed on finding a research mentor who will foster the ultimate development of an independent research program.

Clinical Training
The subspecialty trainee will acquire clinical skills through didactic teaching, experience as a consultant in ID at a tertiary care hospital serving a broad geographic catchment area, and participation in conferences. Fellows emerge with extensive experience in management of a wide variety of infections, including bacterial, viral, fungal and parasitic infections in a wide variety of clinical settings including previously healthy children, as well as surgical and immunocompromised patients, including those with solid organ and bone marrow transplantation.

• AFFILIATED HOSPITALS: Children’s Hospital, approximately 400 pediatric beds, with additional training opportunities at Harborview Medical Center, the University of Washington Medical Center, and the Fred Hutchinson Cancer Research Center
• NUMBER OF PEDIATRIC BEDS: 403
• FELLOWS ACCEPTED EACH YEAR: 2 on average
• TRAINING FOR: MD; DO; MD, PhD
• FUNDING IS ENSURED FOR ALL 3 YEARS: YES
• VISAS ACCEPTED: No, U.S. Residents only
• IS COMPLETION OF PEDIATRIC RESIDENCY TRAINING IN THE U.S. OR CANADA A REQUIREMENT? YES

THE PROGRAM OFFERS THE FOLLOWING TRAINING:

• Program provides training in diagnostic microbiology using laboratories on site:
  • Microbiology laboratory: YES
  • Clinical virus isolation laboratory: YES
  • Molecular diagnostics: YES
  • Including newer diagnostic methods such as MALDI-TOF
• Program provides training in infection control and hospital epidemiology as:
  • Didactic lectures: YES
  • Hands on experience: YES
  • Infection Control Meetings/Membership: YES
• Opportunity to fulfill the ABP requirements for scholarly activity is available in the following general areas:
  • Bacteriology/bacterial infections: YES
  • Epidemiology and statistics: YES
  • Infection control/hospital epidemiology: YES
  • Immunizations/Public health: YES
  • Mycology/fungal infections: YES
  • Parasitology/parasitic diseases: YES
  • Virology/viral diseases: YES
  • Antimicrobial agents: YES
• Research opportunities in the section’s program could be described as:
  • Basic: YES
  • Molecular: YES
  • Epidemiologic: YES
  • Clinical: YES
  • International/Public Health: YES
  • HIV, Basic: YES
• Documented liaison exists offering opportunities for research experience n the laboratory of investigator(s) who is (are) not faculty of the section: Yes, with faculty at the University of Washington including adult ID and others
• Program offers the opportunity to obtain a Master’s degree in a field such as Public Health, Education, Clinical Sciences, or Epidemiology (assuming appropriate arrangements are made): YES
• Graduate school courses are available to trainee (assuming appropriate arrangements are made): YES
• Program provides substantial clinical experiences for trainees in special areas/hosts:
  • Bone marrow transplantation
  • Solid organ/transplantation
  • Congenital immune deficiencies
  • Exposure to HIV infections in travelers/adoptees. Adults
• Program includes ABP-required core curricula in scholarly activities in didactic lecture course for fellows (includes epidemiology, statistics, research design, and academic careers): YES
• Program has an NIH-sponsored training grant: YES
• The Infectious Diseases Service is the primary care provider for HIV-infected children and adolescents: YES

Average number of new outpatient consultations per month: 30

Average number of established outpatient follow-up visits per month: 40

Average number of new inpatient consultations per month: 90

Number of trainees completing program in the last 5 years: 11