I am an Internist and Pediatrician trained in Pediatric Infectious Diseases. I provide clinical care on the Pediatric Infectious Diseases consult service and I am a medical officer with the Tuberculosis Control Branch at the California Department of Public Health. There I provide clinical consultation on MDR TB in addition to contributing to outbreak control and policy. My prior research, in the lab of Dr. Catherine Blish, explored anti-viral immunity and the systemic immune changes that occur during pregnancy. Throughout my career I have focused on improving care for underserved populations and have an interest in pediatric HIV and TB in resource-limited settings.
Clinical Instructor, Pediatrics - Infectious Diseases
Pregnancy Does Not Attenuate the Antibody or Plasmablast Response to Inactivated Influenza Vaccine
JOURNAL OF INFECTIOUS DISEASES
2015; 212 (6): 861-870
Inactivated influenza vaccine (IIV) is recommended during pregnancy to prevent influenza infection and its complications in pregnant women and their infants. However, the extent to which pregnancy modifies the antibody response to vaccination remains unclear, and prior studies have focused primarily on hemagglutinin inhibition (HI) titers. A more comprehensive understanding of how pregnancy modifies the humoral immune response to influenza vaccination will aid in maximizing vaccine efficacy. Healthy pregnant women and control women were studied prior to, 7 days after, and 28 days after vaccination with IIV. HI titers, microneutralization (MN) titers, and the frequency of circulating plasmablasts were evaluated in pregnant versus control women. Pregnant women and control women mount similarly robust serologic immune responses to IIV, with no significant differences for any influenza strain in postvaccination geometric mean HI or MN titers. HI and MN titers correlate, though MN titers demonstrate more robust changes pre- versus postvaccination. The induction of circulating plasmablasts is increased in pregnant women versus controls (median fold-change 2.60 vs 1.49 [interquartile range, 0.94-7.53 vs 0.63-2.67]; P = .03). Pregnant women do not have impaired humoral immune responses to IIV and may have increased circulating plasmablast production compared to control women.
View details for DOI 10.1093/infdis/jiv138
View details for Web of Science ID 000361285600004
View details for PubMedID 25740957
- Immunogenicity and clinical efficacy of influenza vaccination in pregnancy FRONTIERS IN IMMUNOLOGY 2015; 6: 1-9
- Pleural Effusion and Fever in an Immunocompromised Patient. Journal of the Pediatric Infectious Diseases Society 2015; 4 (1): e6-9
- Delayed BCG vaccination--time to take a shot. journal of infectious diseases 2015; 211 (3): 335-337
- Enhanced natural killer-cell and T-cell responses to influenza A virus during pregnancy PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA 2014; 111 (40): 14506-14511
- Seizure and Meningoencephalitis in an Adolescent CLINICAL PEDIATRICS 2013; 52 (12): 1181-1183
RENAL AND MILIARY TUBERCULOSIS IN AN INTERNATIONALLY ADOPTED INFANT
PEDIATRIC INFECTIOUS DISEASE JOURNAL
2009; 28 (8): 751-753
Renal tuberculosis is rare in children and particularly in infants. We present a case of miliary tuberculosis with focal renal involvement in a 5-month-old male infant recently adopted from Ethiopia, and review the literature on miliary and renal tuberculosis in infants and children. Salient points regarding tuberculosis screening in internationally adopted patients are also addressed.
View details for DOI 10.1097/INF.0b013e31819c6bfb
View details for Web of Science ID 000268533000023
View details for PubMedID 19633525