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The Pediatric Infectious Diseases Society Annual Awards, 2010

The Pediatric Infectious Disease Journal: September 2010 - Volume 29 - Issue 9 - p 789-793
doi: 10.1097/INF.0b013e3181e7c18d
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This award is in memory of Burtis Burr Breese, MD, who pioneered practice-based research. Dr. Breese found that the epidemiology, diseases, and care of patients within his daily practice were sources of continual fascination, curiosity, and offered a unique opportunity for research that could contribute to the understanding and care of pediatric infectious diseases. This award commemorates his gratification and the value he found in conducting research in a primary care setting. It is presented annually for the article published in The Pediatric Infectious Disease Journal that best demonstrates the importance and worth of primary care research.

The award this year goes to Dr. Keri Cohn, who is currently at Children's Hospital in Boston, and to her colleagues at Children's Hospital of Philadelphia and from the Dominican Republic, Dr. Rodney Finalle, Geraldine O'Hare, Dr. Jesús Feris, Dr. Josefina Fernández, and Dr. Samir Shah for their article “Risk Factors for Intrathoracic Tuberculosis in Children From Economic Migrant Populations of Two Dominican Republic Bateyes.”

First, it should be noted that Dr. Cohn is the first to receive this honor while still in training. Keri is currently in her third year of a 5-year combined fellowship for certification in Pediatric Emergency Medicine and Infectious Diseases at the Children's Hospital in Boston.

Her training, however, actually commenced at birth when she entered the medical and international milieu of her parents. Her mother is a nurse and chef, and her father is a cardiologist. Keri and her 2 younger sisters' lives were broadened and enriched by their many interests and talents, and the travels of her family. Each acquired the “Multiple-Achiever Gene.” Keri was a star athlete in high school, an All-American track and field athlete, and a member of the US National Track and Field Team. She even carried the Olympic Torch as part of the torch relay for the 1996 Summer Olympics.

Keri entered Lehigh University's 6-year BA/MD program to study premedical science, sociology, and psychology, with a minor in French. Between her second and third year, she began her international career with a year in France at the Universite Paul-Valery III to study French and Sociology. Her undergraduate years were notable for her varied pursuits and interests, including history, foreign language, music, and her name on the Dean's List every semester. She was elected to the Phi Beta Kappa Honors Society, won the Williams Prize Writing Award, and graduated with High Honors and Honors with Distinction for her Honors' thesis.

In medical school, Keri increasingly focused her interests on Global Health. The first summer after entering Drexel University College of Medicine, Keri was off to West Africa to study traditional medicine practices in villages in several West African countries. In addition, for 4 years of her 6-year program, Keri was a Medicine-Related Humanities Scholar. This program included the study of medical history, religion, art, literature, and alternative medicine throughout the world. Her work on establishing an international medical program for residents won her an award from the American Medical Women's Association for her achievement in medical scholarship.

After graduating AOA from medical school with Honors in Clinical Medicine, Keri began her pediatric residency at Children's Hospital of Philadelphia. Even residency did not deter her from expanding her experience in Global Health. It was during this time that she began her project of working in the bateyes of the Dominican Republic.

Immediately on completing her residency, Keri joined Doctors without Borders to work at a mission in the Ivory Coast, and before entering her fellowship at Boston Children's, she obtained a Diploma of Tropical Medicine and Hygiene at the London School of Hygiene and Tropical Medicine. Now, in her Fellowship, Keri has continued to expand her research interests with multiple projects which include the development of a clinical decision rule for Lyme meningitis, and studying the health of women and infants in Uganda, especially among children with severe malaria and malnutrition.

Keri and her colleagues' winning article describes a prospective cohort study to identify the predictors of pulmonary tuberculosis among Haitian children living in the poor conditions of the bateyes of the Dominican Republic. Keri's compassion for these Haitian children and her efforts to improve their poor and crowded conditions are better described by the pictures of her work than by words (Fig. 1).



Dr. Shah, Research Director for Global Health at Children's Hospital of Philadelphia, and coauthor, describes Keri's work as “instrumental in building trust in our research endeavors with our patients and colleagues in the Dominican Republic,” and also “as a catalyst for broader institutional support to expand our clinical and research programs in Global Health.” Keri simply summarizes all her time and efforts toward improving the health of children globally as—-“I enjoy it, and I think it is the right thing to do.”

It is an honor to present the 2010 Burtis Burr Breese Award to Keri Cohn, Dr. Shah, and their colleagues here and in the Dominican Republic. May this award not only recognize their important work, but stimulate other physicians in this country and globally to conduct research that may directly benefit the care of the world's children. Accepting for Keri is Dr. Samir S. Shah.

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I am pleased to nominate Dr. Natasha B. Halasa for the Pediatric Infectious Diseases Society 2010 Young Investigator Award. Natasha embodies the ideal of a young investigator pursuing excellence and high-impact research in the field of pediatric infectious diseases. Natasha's initial studies focused on evaluating antibiotic prescribing practices in multiple different outpatient settings. She documented important trends in the types of antibiotics prescribed and discovered substantial differences in prescribing practices between community- and university-based physicians and among different races. These findings were published in The Pediatric Infectious Disease Journal and the Journal of Pediatrics.

Natasha then became interested in pertussis while caring for several infants who died of pertussis while receiving extracorporeal membrane oxygenation. She summarized data from the national extracorporeal membrane oxygenation database and reported on the high mortality rate associated with this therapy in young infants with pertussis in Pediatrics. As a result of this experience, she developed the hypothesis that pertussis immunization of neonates would elicit protective immunologic responses that could prevent severe pertussis early in life. To test this hypothesis, Natasha designed and conducted a randomized trial comparing an additional dose of DTaP administered at 2 to 14 days of life, in addition to the recommended DTaP vaccine schedule, with the routine DTaP vaccination alone. Unexpectedly, the birth dose group had lower antibody titers to pertussis antigens at 7 months and 18 months of age when compared with those receiving the standard schedule, suggesting that the birth dose was suppressing the ultimate immune response in these infants. These results were published in the Journal of Pediatrics.

Natasha also studied vaccine responses in infants to influenza. She prepared a National Institutes of Health-funded Vaccine Treatment and Evaluation Unit protocol and evaluated the safety and immunogenicity of inactivated influenza vaccine administered to infants 10 to 22 weeks of age. Although the administration of influenza vaccine was safe in this age group, preexisting maternally derived influenza antibody inhibited the ultimate immune responses in the infants. This work showed that infant immunization is not always effective in stimulating protective responses and was published in the Journal of Infectious Diseases.

Natasha has also participated in a number of epidemiologic studies. She began work with the Tennessee site of the CDC-funded Active Bacterial Core surveillance network during her fellowship when she successfully identified and added to the database all cases of invasive pneumococcal disease (IPD) from one of the large metropolitan sites. This allowed her and her collaborators to determine the rates of IPD in Tennessee following the introduction of the 7-valent pneumococcal conjugate vaccine. These data clearly demonstrated the marked decline in IPD, including infections with antibiotic-resistant strains, in the 2 years after the introduction of conjugate vaccine and resulted in 2 publications. Natasha also defined the effect of the pneumococcal conjugate vaccine on the burden of IPD in children with sickle-cell disease using the TennCare database. A greater than 90% reduction in IPD in children with sickle-cell disease was measured, and the work was published in Clinical Infectious Diseases Journal.

Natasha has recently forged an international collaboration with Dr. Najwa Khuri-Bulos at Jordan University. In 2007, her studies revealed that greater than 60% of the 728 children less than 5 years of age enrolled and hospitalized with fever or respiratory symptoms had polymerase chain reaction confirmation of respiratory syncytial virus, a burden of disease that was far higher than expected. She has also discovered that a substantial number of these children were coinfected with rhinovirus, and human metapneumovirus. The studies in Jordan have resulted in 3 manuscripts defining the burden of respiratory syncytial virus, rhinovirus, and human metapneumovirus with Natasha the senior author of all 3. Natasha received recently an investigator-initiated 3-year award from the UBS Foundation to test the hypothesis that low vitamin D concentrations in Jordanian children contribute to the severity of their respiratory illness.

In summary, Natasha is an ideal candidate for this award. She has an unwavering commitment to a career in investigative medicine. Her focus, her skill at working with others, and her determination are all qualities that serve her well in her career as a physician-scientist.



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This evening I have the distinct honor of introducing Richard Whitley as the 2010 recipient of the Pediatric Infectious Diseases Society's Distinguished Physician Award. This award is the highest honor that our society bestows, recognizing “a pediatrician with an extensive and distinguished career marked by significant accomplishments and contributions in pediatric infectious diseases including those as a clinician, educator and/or investigator.” In Rich's case, there is no need for the “or” in this listing, as he excels in each of these fundamental pillars of our field. He has authored more than 320 original manuscripts and 220 book chapters, and has edited 18 medical textbooks. He is an associate editor of the Journal of Infectious Diseases, and is editor of the Journal Antiviral Research. He has served on the Committee on Infectious Diseases of the American Academy of Pediatrics, and in the early 1990s was one of a handful of leaders in our field, who was asked to pen the first Pediatric Infectious Diseases Board examination for the American Board of Pediatrics. Rich's influence upon past and present public policy and health care advocacy is reflected in his current role as President of the Infectious Disease Society of America and his leadership of the “10 by 2020” campaign to develop 10 new antibiotics within the next 10 years. In 2009, Rich served as one of 12 members of President Obama's pandemic influenza advisory committee. He has served as the cochair of the National Institute of Allergy and Infectious Diseases(NIAID) Influenza Blue Ribbon Task Force, and after 9/11 cochaired the Blue Ribbon Panel on Bioterrorism for the Virology Section of NIAID. He has served as chair of the NIAID Board of Scientific Counselors, on the Councils of the Infectious Disease Society of America (which is now called the Board of Directors) and the International Society for Infectious Diseases, and as chair of the National Institutes of Health(NIH) Acquired Immunodeficiency Syndrome Data and Safety Monitoring Board.

Although these achievements alone mark an exceptional career of accomplishment, there are 2 more fundamental aspects of Rich Whitley that define him and truly set him apart. These are his vision and his humanity—his intrinsic ability to connect with people. Both are found in Rich's leadership of the NIAID Collaborative Antiviral Study Group, for which Rich has served as the Principal Investigator for close to 40 years. In the early 1970s, Rich and his mentor, Charlie Alford (who was the 2005 recipient of the Pelvic Inflammatory Disease Distinguished Physician Award) traveled to the NIH to advocate for funding to do something completely novel: to establish a multi-institutional network of academic medical centers to evaluate new drugs, which were being developed to treat viral diseases. When I was a medical student in the 1980s the central dogma remained that you really couldn't treat a viral infection with specific drugs because viruses depended too fully on host cellular pathways for their replication—to kill the virus would mean killing the cell. Imagine the field 15 years earlier—both the challenges and the potential opportunities. Rich and Charlie could see that, and they convinced scientists at the NIH of the need to develop a means by which new small molecules could be evaluated. Their first study was of ara-C, which at the time through case reports and case series was believed to improve the outcome of herpes simplex encephalitis. Rich developed a controlled clinical trial (in what is now coined comparative effectiveness research) and proved that not only did ara-C not improve their outcomes, but subjects treated with ara-C had higher mortality than did those treated with placebo. This failed study was anything but. It prevented a nonefficacious drug from being used to treat a life-threatening infection, and it established a multicenter collaborative group to evaluate subsequent drugs, which in fact did improve outcomes. These include vidarabine, acyclovir, ganciclovir, valganciclovir, and others, and countless lives have been saved or improved as a result of Rich's vision—a vision of the potential of an entirely new field within infectious diseases, and an entirely new collaborative mechanism by which the field could be developed and advanced. It is fitting that this man who so defines collaborative research was nominated by a 15-member team of colleagues who have been influenced by his warmth and generosity: Mark Abzug, Ann Arvin, Suresh Boppana, John Bradley, Kathy Edwards, Jan Englund, Chris Harrison, Richard Jacobs, myself, Robert Pass, Mobeen Rathore, Jose Romero, Sunil Sood, Sergio Stagno, and Larry Stanberry.

I first met Rich Whitley in the summer of 1993, when I visited the University of Alabama at Birmingham to interview for a continuing fellowship in clinical virology. I remember 2 things most from that initial encounter: the enthusiasm that he brought to the conversation and the way that this drew me into the discussion, and a caricature over Rich's right shoulder that depicted him in a mad dash to a Delta plane. Little did I realize at the time how representative each of these impressions was. Rich is unable to attend this awards ceremony in person due to a long-standing commitment for a major meeting in France. This kinetic energy, keen mind, and generous heart define the man selected as this year's Pelvic Inflammatory Disease Distinguished Physician.

I'd like to close, though, with reflections on what I believe drew Rich Whitley to medicine in the first place. From everything that I have seen for more than 16 years now, it is still the personal one-on-one care of patients that most energizes Rich. He attends on both the Pediatric ID Consult Service and on the general inpatient service, and can be found at all hours of the day and night sitting in a patient's room, gently helping a family understand a serious medical condition afflicting their child. As the nurse managers on the team, who work with all faculty members in this capacity throughout the year, have said repeatedly, there simply is not anyone who does this better than Rich Whitley. It is this personal connection that Rich accomplishes so effortlessly and naturally that sets him apart, be it in clinical care, research, or teaching. Congratulations, Rich, on receiving the 2010 Distinguished Physician Award!

Figure 3.

Figure 3.

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This is a presentation honoring Stanley A. Plotkin, founder of the Pediatric Infectious Diseases Society. It is my great honor to present the Distinguished Service Award of the Pediatric Infectious Diseases Society to our Founding Father, Stanley Alan Plotkin. If some of you think that this sounds familiar, I gave this presentation last year at the banquet. Stanley was indisposed at the time, and Stanley and Susan could not be here. As a result, I am going to give this presentation again but in a somewhat abbreviated form. I hope this is effective because we owe so much to Stanley.

Stanley is a native New Yorker who was admitted to the Bronx High School of Science at the age of 13. He has written that he was greatly influenced at 15 years of age by Sinclair Lewis' Arrowsmith in an article that he published in 2002 in The Pediatric Infectious Disease Journal:

To be a scientist—it is not just a different job, so that a man should choose between being an explorer or a bond salesman or a king or a farmer... The normal man, he does not care much what he does except that he should eat and sleep and make love. But the scientist is intensely religious—he is so religious that he will not accept quarter-truths, because they are an insult to his faith.”

Stanley's education continued at the New York University where he received his Bachelor of Arts degree and then his MD from the State University of New York, Brooklyn, where he had the opportunity to work in the laboratory of Dr. Robert Austrian. He then left the East Coast and served his internship at the Cleveland Metropolitan Hospital, and then spent 3 years as an Epidemic Intelligence Officer at the CDC. During that service, he had the opportunity to work at the Wistar Institute in Philadelphia with Dr. Hilary Koprowski on polio and did field work in the Belgian Congo.

Stanley's first publication was in the Journal of Pediatrics in 1958, and seemingly had nothing to do with the field of infectious diseases or vaccinology but rather was a study of ABO blood groups, and it should be noted that it was a single-authored publication, which has certainly become rare.

Stanley then did his pediatric residency at The Children's Hospital of Philadelphia and the Hospital for Sick Children, Great Ormand Street in London. From 1959 to 1991, Stanley's academic and clinical career was at the University of Pennsylvania, The Children's Hospital of Philadelphia, and the Wistar Institute in a huge variety of capacities including being the Director of Infectious Diseases, Chief of Infection Control, Associate Chair of Pediatrics, Professor of Pediatrics and Microbiology at University of Pennsylvania, and Professor of Virology at the Wistar Institute, even serving as President of the Medical Staff. He also participated in many national activities including serving as the Chair of the Red Book Committee of the American Academy of Pediatrics, but in 1991, Stanley changed course and assumed the position as Medical and Scientific Director at Pasteur-Mérieux-Connaught Laboratories in Marnes-la-Coquette outside of Paris. In 1997, he became President and Executive Advisor to the CEO of sanofi-pasteur.

The next picture is my favorite because it shows Stanley on the Pont des Art in the heart of Paris, looking to the Pont Neuf with Notre Dame and the tip of the Ile de la Cité in the background. Stanley also wrote the following in the 2002 Pediatric Infectious Disease Journal publication entitled “The Late Sequelae of Arrowsmith”:

“The prospect of leaving academia was not one I had previously considered, and I dithered about it for several months, until one day, during a visit to Paris, I stood on the Pont des Arts, with the river Seine flowing beneath my feet, looking out at Notre Dame and the Ile de la Cité, and like Henry IV decided that Paris was worth the risk.”

Throughout his career, Stanley has made immense scientific contributions. He demonstrated today in the scientific sessions that he is still at the forefront of scientific knowledge related to vaccinology asking the most precise questions and making incisive comments. He has published more than 700 publications and at least 4 books including Vaccines, which is now in its 5th edition. Stanley has developed, as we all know, a variety of vaccines including the RA 27/3 rubella vaccine now used exclusively around the world. He is the codeveloper of the pentavalent rotavirus vaccine and the human diploid rabies vaccine. He also developed the Towne CMV vaccine strain, the further attenuated type 3 polio vaccine, and the Webster varicella vaccine strain. His list of honors would take the rest of the evening to review, but just to highlight a few:

  • The Institute of Medicine of the National Academy of Sciences.
  • French Legion of Honor Medal.
  • French Academy of Medicine.
  • Finland Award of the National Foundation for Infectious Diseases.
  • The first recipient of the Maurice Hilleman Award of the American Society for Microbiology.

This list goes on and on, including honorary degrees from several universities, the Sabin Foundation Medal, the Distinguished Alumnus Award of The Children's Hospital of Philadelphia, the Marshal Award of the European Society for Pediatric Infectious Diseases, and the Distinguished Physician Award of PIDS.

More to the point and highly relevant to our discussion today, Stanley indeed is the father of this Society and he worked tirelessly to help move the Society to this point. I am one of the few people in the room old enough to recall the meetings of the Pediatric Infectious Disease (PID) Club that preceded the founding of the Society, and then the protracted annual debates regarding whether there should be boards in our field; Stanley was the prime mover in these activities.



In addition, Stanley and his wife, Susan, have been extraordinarily generous to our Society. In 2004, sanofi-pasteur established the Stanley A. Plotkin Lecture in Vaccinology in Stan's honor, which Dan Granoff presented earlier today. And, most impressively, Susan and Stanley have established the Plotkin Fellowship for PID with a gift in excess of $1 million, with additional support generated by sanofi-pasteur in his honor, to fully fund this fellowship. The first Plotkin Fellowship awardee will be announced later this evening.

In 2005, in another Pediatric Infectious Disease Journal piece entitled Six Revolutions in Vaccinology, Stanley wrote, “Founding PIDS was perhaps the best thing I ever did. Groucho Marks famously said that he wouldn't want to join a club that would have him as a member. The way around this problem is to found your own club!” He also wrote this: “When I started pediatric infectious diseases was not yet a specialty but it became one. The title of Founding Father of the Pediatric Infectious Diseases Society is something of which I am very proud.” We are all so grateful to Stanley for all of his efforts from the very beginning to the present time.

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Stanley A. Plotkin Sanofi Pasteur Fellowship Award presented to Claire Bocchini, MD, Baylor College of Medicine, Houston, Texas. “Improving State3 folding and function to reverse Job's Syndrome immunodeficiency and reduce staphylococcal skin infections.” David Tweardy and Jesus Vallejo, MD, Mentors (Fig. 5).



PIDS-St. Jude Fellowship Award in Basic Science presented to Anita McElroy, MD, PhD, Emory University School of Medicine, Atlanta, Georgia. “The role of the innate immune response in Rift Valley Fever Virus replication.” Paul Spearman and Stuart Nichol, MD, Mentors (Fig. 6).



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The Stanley A. Plotkin Lecture in Vaccinology was established by the Pediatric Infectious Diseases Society and Sanofi Pasteur to honor Dr. Stanley Plotkin for his contributions in advancing science and the field of vaccinology. This year's award recipient is Dan Granoff, MD—Children's Hospital Oakland Research Institute, Oakland, California. His talk entitled, “Remaining Challenges for Global Control of Meningococcal Disease by Vaccine,” was given at the PAS Meeting in Vancouver. Dr. Granoff was presented with a plaque during the PIDS 32nd Annual Dinner and Awards Banquet for his outstanding contributions to infectious diseases through immunization (Fig. 7).



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