OPEN MEDICAL INSTITUTE

SEMINAR REPORT 2019

INFECTIOUS DISEASES

Table of Contents

1. Faculty & Group Photo

2. Schedule

3. Faculty Biographies

4. Fellows Contact Information

5. Diaries

a Program of the

32 fellows from 26 different countries and regions

12 faculty members from the United States, the United Kingdom, Germany and Austria

20 lectures and 1 case presentation session given by faculty

30 interesting case presentations by fellows

5 excellent case presentations selected by faculty

Faculty Photo (L-R) Reed Magleby, MD; Christoph Steininger, MD (Co-Course Director); Kohta Saito, MD, MPH;

Mirella Salvatore, MD, FIDSA; Roy (Trip) Gulick, MD, MPH (Course Director) and Juergen Rockstroh, MD

Not Pictured: Heinz Burgmann, MD, Univ.-Prof.; Cornelia Lass-Floerl, MD, FESCMID, FECMM, FIDSA; Julia Walochnik, PhD, MSc, Assoc. Prof.; Thomas J. Walsh, MD, PhD (Hon), FIDSA, FAAM, FECMM;

Laura Waters, MD; Guenter Weiss, MD

™

SALZBURG WEILL CORNELL SEMINAR INFECTIOUS DISEASES

May 5 - 11, 2019

Group Photo of Faculty and Fellows

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

05.05.2019 06.05.2019 07.05.2019 08.05.2019 09.05.2019 10.05.2019 11.05.2019

HBV ID in the ICU Antiretroviral Therapy STD #2

Juergen Rockstroh, MD Heinz Burgmann, MD Roy (Trip) M. Gulick, MD, MPH Laura Waters, MD

HIV/AIDSImmunocompromised Host

Infections #1Vaccines - IC Hosts TB #2 Influenza

Roy (Trip) M. Gulick, MD, MPH Thomas J. Walsh, MD, PhD (Hon) Heinz Burgmann, MD Kohta Saito, MD, MPH Mirella Salvatore, MD

HCV Fungal Infections Vaccines - Healthy HostsImmunocompromised

Host Infections #2Bioinformatics

Juergen Rockstroh, MD Cornelia Lass-Floerl, MD Mirella Salvatore, MD Thomas J. Walsh, MD, PhD (Hon) Reed Magleby, MD

TB #1 Leishmaniasis STD #1 Pulmonary Infections GI Infections

Kohta Saito, MD, MPH Julia Walochnik, PhD, MSc Laura Waters, MD Guenter Weiss, MD Christoph Steininger, MD

Emerging Infections

Christoph Steininger, MD

DINNER

FACULTY DINNER

IN PRIVATE HOME

20:00 21:00

FAREWELL RECEPTION

GRADUATION DINNER

Certificates AwardedDINNER

WELCOME RECEPTION

& DINNER

DINNER 19:00 20:00 DINNER

Post-Seminar Test

Evaluation & Discussion

20:30 – 21:30CHAMBER MUSIC CONCERT

FACULTY MEETING TO

REVIEW THE WEEK

BREAKFAST

17:00 - 17:15OMI/AAF PRESENTATION

Workshop

How to Present a Case

Workshop

Case Presentations by Faculty

to Fellows

Introductions

Pre-Seminar Test

Workshop

Fellows' Case Presentations

Workshop

Fellows' Case PresentationsFree Afternoon

LUNCH

09:0008:00

LUNCH12:30 14:00

10:00 10:30 COFFEE BREAK COFFEE BREAK COFFEE BREAK

LUNCH LUNCH LUNCH

DEPARTURESBREAKFASTBREAKFASTBREAKFASTBREAKFAST

14:00 15:00

15:00 16:00

16:00 17:00

2019 Salzburg Weill Cornell Seminar in Infectious Diseases

Sunday 05 May - Saturday 11 May 2019

17:00 18:00

18:00 19:00

09:00 10:00

10:30 11:30

11:30 12:30

COFFEE BREAK COFFEE BREAK

07:00 08:00

WEILL CORNELL SEMINAR

in SALZBURG

"Infectious Diseases"

May 5 – 11, 2019

FACULTY

Wolfgang Aulitzky, MD is the Medical Director of the American Austrian Foundation. He is Associate Dean for International Medicine and Distance Learning, Adjunct Prof. of Clinical Urology and Adjunct Prof. of Clinical Reproductive Medicine at the Weill Medical College of Cornell University/New York Presbyterian Hospital. In 2016, he was appointed Adjunct Professor of Pediatrics in the Associated Faculty of the Perelman School of Medicine at the Children’s Hospital of Philadelphia. He is also Associate Prof. of Urology at the Medical University of Innsbruck and Visiting Professor at the Medical University of Vienna. Amongst others he is a member of the American, German and Austrian Societies of Urology and was awarded the Zuckerkandlpreis of the Austrian Society of Urology in 1989. In 1995 he received the Silver Medal, in 2007 the Golden Medal for Merits to the Republic of Austria and in 2014 the cross of honor of the Land Salzburg. As Director of the Medical Program of the American Austrian Foundation he has initiated the Open Medical Institute, a scientific and educational collaboration of Weill Cornell and the NewYork Presbyterian Hospital, the Children Hospital of Philadelphia, Duke University, Columbia University, the Cleveland Clinic and leading hospitals in Austria. Dr. Aulitzky earned his medical degree at the University of Innsbruck in 1977, was a research associate at the University of Uppsala, Sweden and the Rockefeller University, New York. He received his training as an urologist at the University of Innsbruck and the General Hospital of Salzburg. He is the author of more than 140 publications on Urology, Andrology and Health Care issues and is co-author of books on basic and clinical urology/andrology.

Wolfgang Aulitzky, MD

Director, Open Medical Institute American Austrian Foundation

Associate Dean and Gerhard Andlinger Professor for International Medicine & Distance Learning Adjunct Professor of Clinical Urology Adjunct Professor of Clinical Reproductive Medicine Weill Medical College of Cornell University

Adjunct Professor of Pediatrics Perelman School of Medicine at the Children’s Hospital of Philadelphia

Associate Professor of Urology Medical University of Innsbruck, Austria

Kärntner Straße 51/II/Top 4 1010 Vienna Austria

Phone: +43-1-533-8658 Fax: +43-1-533-8658-10 Email: w.aulitzky@openmedicalinstitute.org

Roy (Trip) M. Gulick, MD, MPH (Course Director) is Rochelle Belfer Professor in Medicine and Chief of the Division of Infectious Diseases at Weill Cornell Medicine in New York City. Dr. Gulick's research interests include designing, conducting and analyzing clinical trials to refine antiretroviral therapy strategies for HIV treatment and prevention and assess antiretroviral drugs with new mechanisms of action. He currently serves as Principal Investigator of the Cornell-New Jersey Clinical Trials Unit of the AIDS Clinical Trials Group (ACTG), sponsored by the National Institutes of Health. He also serves as Co-Chairman of the Panel on Clinical Practices for Treatment of HIV Infection of the U.S. Department of Health and Human Services (U.S. DHHS Guidelines) and as a Board Member of the International Antiviral Society-USA. He is a member of the American Society of Clinical Investigation, the Association of American Physicians, the Infectious Diseases Society of America, and the International AIDS Society and has presented at national and international meetings and published widely in the field of HIV/AIDS. Roy (Trip) M. Gulick, MD, MPH Professor of Medicine Chief, Division of Infectious Diseases Weill Cornell Medicine 1300 York Avenue, Box 125 New York, NY 10065 USA Phone: +1-212-746-6320 Fax: +1-212-746-8675 Email: rgulick@med.cornell.edu

Christoph Steininger, MD (Co-Course Director) is an infectious diseases specialist who focuses on viral and gastrointestinal infections. Dr. Steininger grew up in Upper Austria and completed his undergraduate studies in Steyr/ Upper Austria. He graduated from the Medical School of Leopold-Franzens University of Innsbruck, Austria. Dr. Steininger received his training as board certified specialist in Clinical Virology at the Department of Virology, Medical University of Vienna and additional training in Tropical Medicine and Hygiene at the Gorgas Memorial Institute, University of Alabama, Birmingham, USA and Cayetano Heredia, Lima, Peru. Thereafter, he started his training in Internal Medicine (Infectious Diseases & Gastroenterology) at the University Clinic Eppendorf, Department of Medicine I, Hamburg, Germany and completed this training at the Medical University of Vienna, Department of Medicine I, Vienna, Austria. Dr. Steininger earned special expertise in Gastroenterology & Hepatology at the Wilhelminenspital, Vienna, Austria and worked as a visiting professor at the University of California, San Diego, USA. Dr. Steininger’s research interests include molecular virology and immunology of Cytomegalovirus, Helicobacter pylori infections and gastrointestinal infections in immunocompromised and oncology patients. Recent publications include reviews on Cytomegalovirus immunology and the human microbiome as well as peer-reviewed publications on Cytomegalovirus immunology and innate immunity to Hepatitis C virus infection. He is a peer reviewer for multiple major medical journals including Lancet, Lancet Infectious Diseases and Clinical Infectious Diseases and is member of the editorial board of Scientific Reports, a Nature Journal. Dr. Steininger's research efforts have earned him grants from multiple renowned organizations including the European Society of Clinical Microbiology and Infectious Diseases, European Society of Virology, and Austrian Science Funds. Dr. Steininger is currently on the faculty of the Medical University of Vienna as Associate Professor of Medicine. Christoph Steininger, MD Associate Professor of Medicine Department of Medicine I Medical University of Vienna Waehringer Guertel 18-20 1090 Vienna Austria Phone: +43-1-40400-44400 Fax: +43-1-40400-44180 Email: christoph.steininger@meduniwien.ac.at

Heinz Burgmann, MD, Univ.-Prof. Education: 2007–2011 Secondary specialisation in Clinical

Pharmacology 1996–2007 Secondary specialisation in Infectious

Diseases and Tropical Medicine 1998–2003 Secondary specialisation in Intensive

Care Medicine 1997 Appointed Außerordentlicher

Universitätsprofessor 1997 Habilitation in Internal Medicine;

Habilitation treatise: Cytokine modulation in complicated Plasmodium falciparum malaria

1996 Qualified as specialist in Internal Medicine

1991–1992 Awarded ECFMG Certificate permitting practice in the USA (Educational Commission for Foreign Medical Graduates)

1982–1988 Studied Medicine at the Faculty of Medicine, University of Vienna Qualified as Dr. med univ. 19.12.1988

Heinz Burgmann, MD, Univ.-Prof. Head, Division of Infectious Diseases and Tropical Medicine Department of Medicine I Medical University of Vienna Waehringer Guertel 18-20 1090 Vienna Austria Phone: +43-1-40400-44400 Fax: +43-1-40400 44180 Email: heinz.burgmann@meduniwien.ac.at

Cornelia Lass-Floerl, MD, FESCMID, FECMM, FIDSA is Director of the Division of Hygiene and Medical Microbiology of the Medical University of Innsbruck, graduated from the Faculty of Medicine of Leopold-Franzens-University of Innsbruck/Austria, and has specialised in the field of medical microbiology. Her teaching and clinical service responsibilities focus on the diagnosis of fungal infections in severely immunocompromised patients. Research interests include both clinical and basic medical microbiology, with special interests in the epidemiology, diagnosis, prevention and therapy of fungal infections, and antifungal susceptibility testing. Professor Dr. Lass-Flörl has authored several journal articles, abstracts, and book chapters and is a member of the Subcommittee on Antifungal Susceptibility Testing of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) European Committee for Antimicrobial Susceptibility Testing (EUCAST) and chair of the Executive Board of the European Fungal Infection Study Group (EFISG) of the European Society of Clinical Microbiology and Infectious Diseases. She is a board member of the European Confederation of Medical Mycology (ECMM) Excellence Center Initiative. The tasks of the Division of Hygiene and Medical Microbiology (HMM) of the Medical University of Innsbruck comprise research, teaching, laboratory diagnosis of infectious diseases, environmental and hospital hygiene as well as technical hygiene. The Division HMM is designated Reference Centre for Aspergillus and Aspergillus Infections and since November 2017 ECMM Excellence Centre Diamond Status. Cornelia Lass-Floerl, MD, FESCMID, FECMM, FIDSA Director Division of Hygiene and Medical Microbiology Department of Hygiene, Microbiology and Social Medicine Medical University of Innsbruck Christian-Doppler Laboratory for Invasive Fungal Infections Schoepfstrasse 41 6020 Innsbruck Austria Phone: +43-512-9003-70703 Fax: +43-512-003-73700 Email: cornelia.lass-floerl@i-med.ac.at

Reed Magleby, MD is a current infectious disease fellow and master’s degree candidate in health informatics at New York-Presbyterian Hospital, Weill Cornell Medical College. Dr. Magleby grew up in the New York metropolitan area but spent time living abroad in Hong Kong for four years of his childhood. He obtained a bachelor’s degree in biological engineering at Cornell University in Ithaca, New York and following the completion of his undergraduate studies, studied medicine at New York University Medical School He subsequently completed his internal medicine residency at New York-Presbyterian Hospital, Weill Cornell Medical College during which time he spent 6 weeks of clinical rotations on the infectious disease service at Weill Bugando Hospital in Mwanza, Tanzania. Dr. Magleby’s research interests encompass various approaches to infectious disease problems, especially antimicrobial resistance, using informatics-based approaches. Recent publications include a case report of the first isolation of Staphylococcus delphini from a human patient, and a pre-post analysis of outcomes following the implementation of a tetanus care protocol in an ICU at Weill Bugando Hospital in Tanzania. He currently resides in New York City. Reed Magleby, MD Infectious Disease Fellow Master’s Degree Candidate in Health Informatics Weill Cornell Medical College New York-Presbyterian Hospital 1305 York Avenue New York, NY 10021 USA Phone: +1-646-962-8747 Email: rem9072@nyp.org

Juergen Rockstroh, MD is Professor of Medicine and Head of the HIV Outpatient Clinic at the University of Bonn in Germany. He earned a Doctor of Medicine degree from the Rheinische Friedrich-Wilhelms University of Bonn, and completed his residency in the Department of Medicine also at the University of Bonn. His department treats the world’s largest cohort of HIV-infected hemophiliacs. In addition to his clinical practice, Dr Rockstroh is involved in HIV research on: antiretroviral therapy, including new drug classes; the course of HIV disease in haemophiliacs; and HIV and hepatitis co-infection. He has been an investigator in multiple clinical trials of antiretroviral agents and treatments for HIV and hepatitis co-infection. From 2007-2011 he was elected as the president of the German AIDS Society. He is also since 2009 a member of the executive committee of the European AIDS Clinical Society (EACS) and since 2011 member of the governing council of the International AIDS Society. He currently chairs the hepatitis research activities in NEAT and EuroSIDA. He also was the chair of the National German AIDS Advisory Panel from 2011-2017 and the EACS coinfection guidelines from 2008-2017. In 2015 Professor Rockstroh was elected chair of HIV in Europe and is since 2019 president of EACS. The German Society for Infectious Diseases awarded Dr Rockstroh and his co-authors the prize in clinical infectious diseases in 2002, and the national AIDS research prize in 2005. Dr Rockstroh has authored or co-authored over 500 publications in peer-reviewed journals, and over 70 book chapters. Juergen Rockstroh, MD Professor of Medicine University Hospital Bonn Sigmund-Freudstrasse 25 53105 Bonn Germany Phone: +49-228-28716558 Fax: +49-228-2875034 Email: juergen.rockstroh@ukbonn.de

Kohta Saito, MD, MPH is an infectious diseases doctor and instructor of medicine at Weill Cornell Medicine. Dr. Saito completed undergraduate studies at Yale University. He received his M.D. from Harvard Medical School before going on to complete an Internal Medicine-Pediatrics combined residency program at the Icahn School of Medicine at Mt. Sinai. He concurrently completed a Masters of Public Health along the Global Health Track, and was Chief Resident of Internal Medicine-Pediatrics in his final year. He then went on to complete a fellowship in adult infectious diseases at Weill Cornell Medicine. He is currently working at WCM in both inpatient and outpatient infectious diseases capacities. When not providing clinical services, his research interests lie in better understanding Mycobacterium tuberculosis, the causative agent of tuberculosis. He studies different phenotypic states of the bacterium that allow it to tolerate current antimicrobials, and aims to find new treatment options for tuberculosis. Kohta Saito, MD, MPH Instructor of Medicine Weill Cornell Medicine, Division of Infectious Diseases New York-Presbyterian Hospital 1305 York Avenue 4th Floor New York, NY 10021 USA Phone: +1-646-962-8747 Fax: +1-646-962-0152 Email: kos9010@med.cornell.edu

Mirella Salvatore, MD, FIDSA is an Assistant Professor of Medicine at the Sanford I. Weill Medical College of Cornell University and an Attending Physician at the New York-Presbyterian Hospital Cornell campus. She obtained her M.D. degree from the Catholic University in Rome, Italy and completed her Internal Medicine Residency and Fellowship in Infectious Diseases at the Mount Sinai School of Medicine in New York City. At Mount Sinai she also completed a postdoctoral fellowship training studying influenza virus under the supervision of Profs Peter Palese and Adolfo Garcia-Sastre. As a physician scientist, Dr. Salvatore has focused her NIH funded research on the development of novel platforms for influenza vaccines. She is also participating in the study of influenza virus pathogenesis and therapy in the immunocompromised human host and with animal models. Her research has been published in peer-reviewed journals, including Journal of Clinical Microbiology, Vaccine, PLoS One, Human Gene Therapy, Journal of Virology, Journal of Hepatology, Journal of Infectious Diseases, Proceedings of the National Academy of Science among others. She is a member of the International Society for Influenza and other Respiratory Virus Diseases (ISIRV), International Society for Travel Medicine (ISTM) and the Infectious Diseases Society of America (IDSA). Dr. Salvatore has served on NIH study sections and is a reviewer for many scientific journals. Mirella Salvatore, MD, FIDSA Assistant Professor of Medicine Assistant Professor of Healthcare Policy and Research Weill Cornell Medicine Department of Medicine and Healthcare Policy and Research 1300 York Avenue Rm A479, BOX 125 New York, NY 10065 USA Phone: +1-646-318-8506 Fax: +1-212-746-8675 Email: mis2053@med.cornell.edu

Julia Walochnik, PhD, MSc, Assoc. Prof. is associate professor and head of the research unit Molecular Parasitology at the Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Austria. She studied Biology with a focus on Microbiology and Parasitology at the University of Vienna and habilitated for Medical Parasitology at the Medical University of Vienna in 2004. Her major research interest is the pathomechanism of acanthamoebae. Also, she has been working on the role of amoebae as vehicles for pathogenic bacteria and other microorganisms. The second focus of her work lies on vector-borne pathogens, particularly on sand flies and their role as vectors for Leishmania spp. Julia Walochnik currently is the president of the German Society for Protozoology and she was the president of the Austrian Society of Tropical Medicine, Parasitology and Migration Medicine from 2013-2015. She published more than 150 peer-reviewed publications, also numerous text book chapters and reviews and currently is Editor in Chief of Parasitology Research. Julia Walochnik, PhD, MSc, Assoc. Prof. Group Leader Molecular Parasitology Institute of Specific Prophylaxis and Tropical Medicine Medical University of Vienna Kinderspitalgasse 15 1090 Vienna Austria Phone: +43-1-40-160-38240 Fax: +43-1-40-160-938233 Email: julia.walochnik@meduniwien.ac.at Web: https://www.meduniwien.ac.at/hp/tropenmedizin

Thomas J. Walsh, MD, PhD (Hon), FIDSA, FAAM, FECMM serves as Professor of Medicine, Pediatrics, and Microbiology & Immunology at Weill Cornell Medicine of Cornell University and founding Director of the Transplantation-Oncology Infectious Diseases Program and the Infectious Diseases Translational Research Laboratory, as Sharp Family Foundation Scholar, Henry Schueler Foundation Scholar in Mucormycosis, and Investigator of Emerging Infectious Diseases of the Save Our Sick Kids Foundation. Having served with distinction as the Chief of the Immunocompromised Host Section of the Pediatric Oncology Branch of National Cancer Institute for 23 years, Dr. Walsh was recruited to build the first Transplantation-Oncology Infectious Diseases Program in Weill Cornell Medicine and New York Presbyterian Hospital. He directs a combined clinical and laboratory research program dedicated to improving the lives and care of immunocompromised children and adults. The objective of the Program’s translational research is to develop new strategies for molecular diagnosis, immunopharmacology, pharmacokinetics / pharmacodynamics, treatment, and prevention of life-threatening invasive mycoses in immunocompromised children and adults. These objectives are achieved through laboratory investigations using parallel in vitro systems, and robustly predictive in vivo animal model systems, leading to phase-I, phase-II, and phase-III clinical trials. The Program’s current targeted laboratory investigations and clinical trials in medical mycology include invasive candidiasis, pulmonary aspergillosis, mucormycosis, fusariosis, and phaeohyphomycosis. In addition to patient care and translational research, Dr. Walsh has also mentored more than 180 students, fellows, and faculty, many of whom are emerging leaders in the field of medical mycology and infections in immunocompromised patients throughout the world. Thomas J. Walsh, MD, PhD (Hon), FIDSA, FAAM, FECMM Founding Director, Transplantation-Oncology Infectious Diseases Program Chief, Infectious Diseases Translational Research Laboratory Professor of Medicine, Pediatrics, and Microbiology & Immunology Weill Cornell Medicine of Cornell University, New York Presbyterian Hospital, and Hospital for Special Surgery 1300 York Ave., Rm A-421 New York, NY 10065 USA Phone: +1-212-746-6320 Fax: +1-212-746-8675 Email: thw2003@med.cornell.edu

Laura Waters, MD is a GU/HIV consultant and HIV & hepatitis lead at CNWL’s Mortimer Market Centre, London. She is honorary secretary for BHIVA and on the BASHH Board, previous BHIVA conferences chair and involved in several national guidelines. Laura is on the HIV Clinical Reference Group, advising NHS England about HIV care, and on the trials management group of IMPACT, a large PrEP trial. She has published and presented widely, is a regular columnist for Boyz magazine, and is a member of the Terrence Higgins Trust. Laura Waters, MD Consultant GU/HIV Medicine HIV & Hepatitis Lead CNWL Mortimer Market Centre London United Kingdom Phone: +44-20-3317-5241 Fax: +44-20-3317-5190 Email: lwaters@nhs.net

Guenter Weiss, MD studied medicine at the University of Innsbruck, Austria and performed a thesis at the Institute for Medical Chemistry and Biochemistry. He then worked as a post –doctoral fellow the Department of Medical Chemistry and Biochemistry before starting as a resident at the Department of Internal Medicine at the University of Innsbruck where he did his medical training in internal medicine. He became specialist for internal medicine in 1998, for intensive care medicine in 2001 and for infectious diseases in 2006. His clinically training was interrupted by another post-doctoral fellowship at the EMBL in Heidelberg where he was working on translational gene regulation (until 1996). Thereafter he built up his own research group supported by grants from the Austrian Research Funds, the European Union and the National Institutes of Health. Dr. Weiss successfully completed two habilitations (Medical Biochemistry in 1995, Internal Medicine in 1999) and still tries to combine his daily clinical work and duties with scientific laboratory and clinically based projects. Günter Weiss has published more than 340 papers in peer reviewed journals. His research focuses on multiple aspects of cellular and systemic iron homeostasis and their dysregulation in specific pathological conditions including anemia of chronic disease and iron overload. Further, he studies the regulatory network between iron homeostasis, immune function and infection with a specific emphasis to the role of macrophages in host-pathogen interaction and the impact of natural resistance genes and metabolic alterations in the host-pathogen micro-environment on disease outcome Since 2012 Günter Weiss is full professor of medicine at the Medical University of Innsbruck (§98) and director of the Division of Internal Medicine II (infectious diseases, immunology, rheumatology, pneumology), In 2015 he was elected into the Austrian Academy of Science. Guenter Weiss, MD Medical University of Innsbruck Department of Internal Medicine II Infectious Diseases, Immunology, Rheumatology, Pneumology Anichstrasse 35 6020 Innsbruck Austria Email: guenter.weiss@i-med.ac.at Web: https://inneremed2.tirol-kliniken.at

WEILL CORNELL SEMINAR

in SALZBURG

"Infectious Diseases"

May 5 – 11, 2019

FELLOWS

Fellow Booklet 684SWCS19 Infectious Diseases

Abeir Alimam, MDHamad Medical Corporation Ahmed bin Ali3050 DohaQatarabeer154@hotmail.com

Marija Antic, MDGeneral Hospital UziceOtherMilosa Obrenovica 1731000 UziceSerbiadr.marija.antic@gmail.com

Anja Becner, MDUniversity Medical Center MariborOtherLjubljanska 132000 MariborSloveniaanja.becner@gmail.com

Klara Bloksova, MDNa Bulovce HospitalBudiova18081 PrahaCzech Republicklara.bloksova@gmail.com

Gule Cinar, MDAnkara University School of Medicine Department of Infectious Diseases Talatpasa Street06510 AnkaraTurkeygbinjune@gmail.com

Ivan Conteras Coronado Tovar, MDInstituto Mexicano Del Seguro Social, Centro Medico Nacional de OccidenteDepartment of PediatricsBelisario Dominguez 73544340 GuadalajaraMexicoilviazn@yahoo.com

Valeriia Dmytrychenko, MD, PhDState Institution Dnipropetrovsk Madeical Academy of the Ministry of Health of UkraineDepartment of Infectious DiseasesBlyzhnia str. 3149102 DniproUkraineleradmitrichenko@ua.fm

Pamela Garciadiego Fossas, MDInstituto Nacional De PerinatologiaDepartment of Internal MedicineMontes Urales 80011000 Mexico CityMexicodrapamelagf@yahoo.com

Cosmina Gingaras, MD, MPHDr. Matei Bals National Institute For Infectious DiseasesDepartment of Infectious DiseasesStrada Dr. Calistrat Grozovici 1021105 BucharestRomaniacosminagingaras@gmail.com

Kristyna Herrmannova, MDHospital BulovkaDepartment of Infectious DiseasesBudinova 218100 PragueCzech Republick.herrmannova@seznam.cz

Karmen Jaaniso, MDTartu University HospitalPuusepa 850406 TartuEstoniakarmen.jaaniso@gmail.com

Dejan Jakimovski, MDUniversity Clinic For Infectious Diseases & Febrile ConditionsOtherMother Teresa 171000 SkopjeMacedonia, Republic ofjakimovskidejan79@gmail.com

Boris Jegorovic, MDInfectious and Tropical Diseases HospitalOtherBulevar Oslobodjenja 1611000 BelgradeSerbiaboris.jegorovic@ymail.com

Csoltkova Katarina, MDSemmelweis EgyetemDepartment of Internal MedicineKoranyi Sandor utca 2/a1083 BudapestHungarycsoltkokati@gmail.com

Lilit Khachatryan, MDCH2MHILL (now Jacobs)Other10 Vasgen Sargsyan0010 YerevanArmenialilit.khachatryan@jacobs.com

Ekaterine Kipiani, MDChildren`s Emergency PediatriDepartment of Emergency MedicineQartvelishvili Str. 32456 TbilisiGeorgiaeka_yifiani@yahoo.com

Kalysbek Kydyshov, MD, MScRepublican Center Quarantine and Highly Dangerouse Infection Diseases Department of Preventive MedicineSkryabina 92720005 Bishkek CityKyrgyzstankalysbekkydyshov@gmail.com

Josephat Magawa, MD, MPHBugando Medical Center/HJFMRIDepartment of Internal MedicineBugando1370 MwanzaTanzania, United Republic ofjmagawa84@yahoo.com

Olena Marchenko, MD, MScUkrainian Medical Stomatological AcademyDepartment of Infectious DiseasesShevchenko Street 2336011 PoltavaUkrainedr.marchenko.o@gmail.com

Jose Arturo Martinez Orozco, MDNational Institute of Respiratory Diseases (Instituto Nacional deEnfermedades Respiratorias)OtherCalzada de Tlalpan09020 Mexico CityMexicojarturoinfectologia@gmail.com

Yerdan Mukhaliyev, MDInstitution Of Pediatric Infectious DiseasesDepartment of PediatricsBayzakov Street050040 AlmatyKazakhstanerdandoctor@gmail.com

Sergei Rakovich,City Clinical Hospital Of Infectious Diseases Kropotkina Str., 76220002 MinskBelarusrakovich_sergey@yahoo.com

Vanya Rangelova, MDMedical University PlovdivDepartment of Infectious DiseasesVasil Aprilov Str. 15A4000 PlovdivBulgariavaniaran1238@gmail.com

Knarik Sargsyan, MDYSMUDepartment of Infectious Diseases2 Koryun Str.0025 ErewanArmeniaknariksargsyan7@gmail.com

Svetlana Semeonova, MDGrodno State Medical UniversityDepartment of Infectious DiseasesBLK, 57230009 GrodnoBelarussvetlayadoc@yandex.ru

Dorice Shangali, MD, MPHBugando Medical CenterDepartment of Internal MedicineBugandoN/A MWANZATanzania, United Republic ofdorice_shangali@yahoo.com

Anna Shin, MScMedical center RahatZhetysu-3050063 AlmatyKazakhstanannashin86@gmail.com

Aniko Szabo, MDUniversity of SzegedDepartment of PediatricsKoranyi Fasor 14-156720 SzegedHungaryszaboa24@gmail.com

Gerelchimeg Tsagaantsooj, MD, MPH, Assoc. Prof Infectious DiseaseOther121 UlaanbaatarMongoliatgeegii@yahoo.com

Mariana Ulinici, MDNicolae Testemitanu State University of Medicine & Pharmacy Department of Infectious DiseasesBd. Stefan cel Mare si Sfint, 1652004 ChisinauMoldovaulmariana@gmail.com

Aija Vilde, MDP.Stradins CUHDepartment of Infectious DiseasesPilsonu 13LV-1002 RigaLatviaaija.vilde@stradini.lv

Samrawit Woldemichael, MDMCM Referal HospitalDepartment of Internal MedicineGerji251 Addis AbebaEthiopiasamrawitgetachew31@yahoo.com

SEMINAR DIARY FROM FELLOW

Cosmina Gingaras, MD, MPH County Clinical Emergency Hospital

Sibiu, Romania May 5 - 11, 2019

May 5, Sunday evening. I arrived in Salzburg in the afternoon, after a 3-hours, train ride from Vienna. As I rode the bus to Schloss Arenberg, I got a glimpse of the beautiful architecture of the town. I checked into a single room on the top floor, with a view of the snowy surrounding mountains and I was looking forward to exploring my environment. But the weather turned out to be capricious, drizzling rain became snow. Luckily, the snow stopped and I ventured on the streets, crossed one of the many bridges across Salzach and I serendipitously found myself at the Mozart Platz, a charming city square where you can find museums (the Christmas Museum, the Salzburg Museum), the town hall, and chicque stores: selling everything from souvenirs to Christmas decorations, fine chocolate, clothing and books. At 7 pm, the faculty and most of the 32 fellows met in the lobby. The faculty introduced themselves and right from the start established a friendly, welcoming atmosphere. I particularly resonated with Dr. Aulitzky΄s encouragement to share the knowledge we gained and to maintain close collaborations with the fellows we meet here, thus keeping in line with the over 25 years’ tradition of the OMI seminars. A delicious dinner ensued and I met a few wonderful fellows from Qatar, Serbia, and Georgia. May 6, Monday. After breakfast, we started the day at 8 am with every one of the fellows and faculty members officially presenting themselves, their specialties, home institutions and hobbies. There were fellows from three continents (the Americas, Eastern Europe, Asia) with interests as diverse as playing instruments, learning old languages, practicing martial arts or reading classical literature. The faculty was from Weill-Cornell in NY, from Austria and from Germany, experts in the topics to be discussed during the seminar. After introductions, we took a pre-seminar test, giving us a start point from which to learn and improve. The first presentation of the day was Dr. Gulick΄s, on epidemiology, virology, testing, transmission, natural history and prevention strategies of HIV. He insisted on the epidemiology of HIV in Eastern Europe and Central Asia where, unlike the global trend, the number of people living with HIV and the number of new infections is rising. The next presentation was from Dr. Rockstroh, who gave us an update on HCV. Several pieces of information that stood out for me: there is now a genotype 7; recombinations among genotypes are possible; HCV can cause neurocognitive side effects which can be successfully resolved with treatment; treatment failures can in fact be reinfections and that is an important distinction to make; however, true failures need to be treated with three drug combinations; the treatment algorithm in HIV-HCV co-

infected patients. Dr. Saito presented four compare-and-contrast type of clinical cases, illustrating difficulties in interpreting screening tests (TST and IGRA), diagnostic tests (microscopy, culture, molecular testing), unusual presentations in the context of comorbidities, and TB mimics. After lunch, Ms. Stephanie Faschang gave a presentation about the American Austrian Foundation and what it does to promote brain gain and to prevent brain drain: the clinical seminars in a variety of medical fields, 1-3 month observerships and faculty guest lectures in fellows΄ countries. Dr. Steininger -an Austrian clinical virologist, whose life always seemed to bring him at the center of disasters- gave us an update on emerging infectious diseases (measles, hepatitis A, arboviruses-particularly Zika). He emphasized the importance of understanding ecology and how that plays into the distribution of vectors, reservoirs and transmission of disease to humans. The afternoon ended with 12 clinical cases, which were meant to give us a framework for presenting our cases. We were separated into groups of six fellows, each led by a faculty member. I found this part entertaining and it was a well-planned activity for the end of the day. Before dinner, I went with a couple of new friends around Salzburg, Mozart Platz and the wonderful Mirabell gardens. May 7, Tuesday. The first faculty presentation of the day was from Dr. Rockstroh, who gave us an update on HBV epidemiology, diagnostics, treatment and follow-up, according to the newest EASL guidelines. The cure agenda was an element of novelty that I intend to follow more closely in the future. Dr. Walsh then presented on the interplay between immunodeficiency (either of the innate or adaptive immune response) and the risk of various infections. By describing to the molecular level each major player of the immune system and how they can individually or in groups increase susceptibility to certain pathogens, gave us a framework to logically work through when faced with unknown infections in a non-HIV infected immunocompromised patient. For me it was the most impactful and relevant lecture up to this point of the seminar. Dr. Cornelia Lass-Floerl reviewed fungal infections, making the important distinction between true pathogenic fungi (able to infect immunocompetent and immunocompromised hosts) and opportunistic fungi. She raised awareness about the emergence of novel virulent fungi in the hospital setting, because of widespread use of antifungal therapy, either for treatment or prophylaxis. She insisted on accurately making the diagnosis of fungal infections and provided guidance on the appropriate treatment for molds or yeasts. Dr. Walochnik presented on Leishmaniasis, gave us excellent details on the behavior of the vectors, geographic distribution of the disease, methods of diagnosis and treatment. Although I have rarely seen leishmaniasis, that will likely change, considering how much people travel nowadays to and from endemic areas. We finished the day with half of the fellows΄ case presentations. They were all excellent, from Fasciola hepatica to Leishmania, tick-borne encephalitis, complicated VZV, HLH with necrotizing fasciitis, hyperIgM syndrome, invasive fungal infections, NHL in an HIV patient and many more. Unfortunately, I think the time allowed (seven minutes) was not enough for thorough, fruitful discussions. May 8, Wednesday Dr. Burgmann presented on the important topic of infections in the ICU, from making the correct diagnosis of fever to thinking about the causes of fever in the ICU patient, and to the current Sepsis-3 criteria. After a short break he started off with a dramatic case of meningococcemia in an asplenic youth, thus setting the stage for a talk on vaccines in the immunocompromised. He told us there is an outpatient department in Vienna dedicated to vaccinating immunocompromised hosts, a great idea which I would like to see replicated in my country. After a delicious lunch, Dr. Salvatore continued the vaccine lecture series with an update for immunocompetent hosts. And lastly, Dr. Walters gave us an entertaining and informative talk on sexually-transmitted diseases, from taking a good history to making a correct diagnosis and applying newer treatments, given the rising resistance rates in certain ST pathogens. Particularly relevant to me was the section on neurosyphilis in HIV-infected patients. Also, the increased dose of 1g Ceftriaxone for gonorrhea is among the things I intend to change in my practice, given the evidence presented. I spent the rest of the afternoon in the company of a new friend, Abeir, with whom I visited the Hohen-Salzburg castle and the Salzburg Museum, thus becoming more aware of the rich history of the area.

May 9, Thursday. Dr. Gulick continued lecturing on HIV, this time on treatment and prevention. He reviewed the mechanism of action of different antiretroviral drugs, adverse reactions and new drugs in the pipeline. Dr. Saito presented on treatment of TB, going through five types of clinical cases: latent TB (and how exposure to MDR TB presents a challenge, as well as treating latent TB in pregnancy), drug susceptible TB (and the management of side-effects, understanding the danger signals), MDR-TB (the new WHO guidelines), CNS TB, osteomyelitis (and the role of surgery). Overall, a well thought-out presentation with a lot of clinical pearls. Dr. Walsh’s presentation of the treatment of serious infections in immunocompromised patients did not fall short of the excellent standard he set in the first lecture he gave us earlier this week. Some of the practice-changing advice I can list are: using aminoglycosides in combination with beta-lactams is a historical practice with risks worth considering and with limited utility; one anti-pseudomonal agent is enough for the initial management of febrile neutropenic patients; Aztreonam can be safely used in penicillin and cephalosporin seriously allergic patients; C. glabrata is the most common breakthrough infections in those using Fluconazole prophylaxis; Streptococcus mitis can cause serious infections in BMT patients; never ignore a positive blood culture with Candida and treat it; and many more. Dr. Weiss΄s presentation on community-acquired pneumonia updated us on the evidence behind the diagnosis and treatment of CAP, the changing patterns of resistance of pneumococcus around Europe and how to individualize treatment based on comorbidities and pneumonia severity scores. The second part of the fellows΄ presentations was again a wonderful display of the outstanding quality of young doctors from low and middle-income countries. Besides clinical cases, there were a couple of interesting epidemiological investigations, an outbreak of Norwegian scabies in Estonia, which affected 200 Health-care workers and a water-borne epidemic of tularemia in Armenia. The evening was marked by a beautiful piano concert, at which I had the privilege to meet a couple of young Romanian pianists studying and living in Salzburg: Andrei Gologan and Roxana Circiu. We couldn’t have asked for a more suited end to this week. I am grateful to the Austrian Open Medical Institute for selecting me to participate in this seminar, which was most of all an outstanding opportunity to network with experts from Germany, Austria and the US, and with peers from all around the world. I hope the American Austrian Foundation will continue its noble mission for many more years. I am certain that the friendships formed here in Salzburg will be the foundation of durable and constructive future collaborations. Cosmina Gingaras, MD, MPH (Romania)

SEMINAR DIARY FROM FELLOW

Aija Vilde, MD Pauls Stradins Clinical University Hospital

Riga, Latvia May 5 - 11, 2019

Dear Diary, May 5, Sunday afternoon. I got off of the bus No.6 at the bus stop “Volksgarten”, crossed the street and turned in to the side street “Arenbergstrasse” (narrow and hazy). Walked about 50 meters to the iron gates of Schloss Arenberg and pressed the button. It was raining heavily, I wore a black raincoat and felt as I am in some fairy tell about Dracula. But my worries vanished at the moment I saw this amazingly beautiful and light house. May 6, Monday. The lectures were amazing. After the workshop Dr. Steininger guided our small group of four people up the hill and we took a group picture. That was really nice! I could not imagine the friendliness and warmth coming from the all faculty and fellows! My favorite lecture of the day: Kohta Saito. TB1. (Visionary!) May 7, Tuesday. This was a very stressful day (as for a half of the fellows I presume), because I had to deliver clinical case presentations. At the same time, I was happy for the opportunity to practice my presentation skills, share the clinical case and receive valuable comments from the Faculty (I was aware this is the friendliest auditory, we could imagine but tell this to my nervous system!). Still I was able to enjoy the marvelous lectures. The sentence of the day: Trust but verify! (Wikipedia says it is a Russian proverb, but also President Reagan used to say it (as it was pointed out by Cosmina)) My favorite lecture of the day: Cornelia Lass-Floerl - Fungal Infections. (Practical!) May 8, Wednesday. I could just copy paste from the previous day - marvelous lectures (and I really mean it)! Food is very delicious, and even better for vegetarians! We had a free afternoon. It is very wise to plan a free afternoon on Wednesday. Middle of the week, some are a little tired of the intense communication (I mean myself). Part of the fellows went to Hallstatt. I could not decide to join or not. Finally, I made a decision not to (I forgot that one of my New Year’s resolutions was to become a ‘Yes Man’). Instead I decided in favor of a run (yesterday Dr. Gulick advised to enjoy the road along the river and visit Hallein village. It is possible to rent a bike, however I somehow managed to be not very successful to solve this situation - I could not find the Citybike rental). That was so calming and at the right time to boost endorphins!

The sentence of the day (Mariana’s approximate quotation, with her permission): “Nothing seems to be the way you see it”. My favorite lecture of the day: Laura Waters. STD#1. (Splendid and at the same time very useful!) May 9, Thursday. I am wondering, how it is possible that in such a short time frame people can bound so much! It is a bit sad that there is only one day left! I am very happy for the given opportunity to gain knowledge, to share experience and the most important – to find options!! In the afternoon we went for a walk. It was right before it started raining. Insight of the walk:

The sentence of the day (from Kata’s presentation): “Don’t hesitate, vaccinate!” My favorite lecture of the day: Thomas J. Walsh. Immunocompromised Host Infections2. (Brilliant!) To sum up: Salzburg Weill Cornell Seminar in Infectious Diseases – STRONGLY RECOMMENDED. Aija Vilde, MD (Latvia)