December 18, 2014

Dr. M. Elizabeth Tessier, a pediatric gastroenterology fellow at Texas Children’s, received the 2014 Fellow Research Award from the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN).

Her award-winning study titled, “Bile acid signatures in children confer protection from clostridium difficile infection,” found that changes in the bile acid composition in the stool may predispose patients to Clostridium difficile (C.diff), a bacterial infection that causes intestinal inflammation and diarrhea.

In general, children are less susceptible to C.diff infection than adults and tend to have milder disease. However, Tessier says pediatric cases are on the rise, which may be attributed to a newer more toxigenic strain of C. diff called NAP1.

Antibiotics disrupt the bacterial communities in the colon which can alter bile acid compositions, creating favorable conditions for C.diff spores to germinate. Certain types of bile acids can activate or inhibit the growth of this bacterium.

In their study, Tessier and her colleagues in Tor Savidge’s lab in the Texas Children’s Microbiome Center, collected stool samples to examine the bile acid profiles of healthy children between the ages of 7 and 12, healthy adults, patients with antibiotic-induced diarrhea and C.diff patients.

The healthy control group had higher levels of chenodeoxycholic acid (CDCA) – which inhibits C.diff growth – compared to the other two groups. They found healthy children had more CDCA than healthy adults, which may contribute to children’s decreased susceptibility to C.diff infection.

In contrast, patients with antibiotic-induced diarrhea, who may be prone to C.diff infection, had elevated levels of the spore-germinating bile acid called taurocholate. While C. diff patients had lower levels of both bile acid types, they had high serum levels of fibroblast growth factor 19 (FGF-19), a hormone that regulates bile acid synthesis in the liver.

“Based on our findings, C.difficile toxins may alter bile acid profiles in the gut by inducing FGF-19 production,” said Tessier. “Further studies need to be done to determine if this hormone is a true marker of C.diff infection.”

Tessier’s study also examined the bile acid profiles of four patients who received liver transplants. High levels of taurocholate were found in their stool, which increased their risk of C.diff infection.

October 30, 2014

Dear Colleagues,

For the past few months, many of us here at Texas Children’s have been focused on keeping each other and our patients and families safe in the event of a potential Ebola case at our hospital.

While I am proud of our efforts to ensure we will provide the best care to such patients while keeping our staff safe and healthy, I am concerned we have forgotten about an infection that is much more likely to affect us than Ebola. That infection is the flu.

More than 200,000 people suffering from the flu are admitted to a hospital each year. And more than 20,000 of them die. They die from a virus that a simple vaccination can most times prevent – a shot that takes mere seconds to receive.

Ebola has infected some 7,000 people and killed more than 3,300. Most of those infected with the virus are in West Africa. One person in the United States has died from Ebola, and he contracted the infection in Liberia. Two of the people who cared for that patient and became infected with the virus have been treated and released.

There is no vaccine for Ebola. That is why we have been working so hard to obtain the best personal protective equipment for our staff. There is, however, a vaccine for the flu, and everyone here at Texas Children’s should get one. Getting a flu vaccine is one of the simplest and most basic things we can do to keep ourselves and our patients healthy during flu season. It also is part of Texas Children’s incentive plans.

I implore you to take this responsibility to heart. Get your flu shot. Make sure everyone in your family is vaccinated, and educate those around you about getting vaccinated. It’s truly the best personal protective equipment you can wear during flu season.

Remember influenza vaccinations are free and available in Employee Health at our Main and West Campuses and will be available at the Benefits and Wellness Fair today on the Auxiliary Bridge.  If you receive your vaccination elsewhere, your Texas Children’s insurance will cover the cost.  Please remember to provide documentation to Employee Health & Wellness.

Information about where to get your flu shot is below.


Mark A. Wallace

Get vaccinated!

  • Flu vaccines are available in Employee Health
  • Appointments are recommended, however walk-ins are welcome
  • Department or unit leaders may request a flu cart visit by calling Employee Health at 832-824-2151 or West Campus Employee Health at 832-227-1365
  • If you received your flu vaccine elsewhere, please fax your documentation to 832-824-2141or send via interoffice mail to Employee Health A5527

Main Campus Employee Health 

Hours of Operation: Monday – Friday, 7:30 a.m. – 4:30 p.m.

Location: Employee Health & Wellness Center
5 Tower by the yellow elevators

Phone: 832-824-2150

Fax: 832-825-2141

Emergency: An Employee Health nurse is available after hours by pager 24 hours a day for emergencies. Call the page operator at 832-824-1000 to have an Employee Health nurse paged.

West Campus Employee Health 

Hours of Operation: Monday – Friday, 7:30 a.m. – 4:30 p.m.

Location: West Campus, Human Resources and Employee Health, 2nd floor

Phone: 832-227-1365

October 7, 2014


Although the flu shot has proven to be the best protector against influenza, there still are people who don’t get the vaccine. Many of these hold outs believe the myriad of myths about the flu and its vaccine that circulate each year. Since influenza can be serious, even fatal, it’s crucial these misconceptions and rumors are debunked.

Director of Employee Health and Wellness Jill Fragoso and the Centers for Disease Control and Prevention are working hard to do just that and address three of the most popular myths below.

Myth #1: The flu vaccine can give you the flu.

“That is absolutely a misconception,” Fragoso said. “You cannot get the flu from the flu vaccine.”

The vaccine contains inactivated, or dead, viruses, making it impossible for the vaccine to infect you, Fragoso explained.

The vaccine might cause some side effects – the most common of which are soreness where the shot was given, maybe a low fever or achiness – but it will not cause the flu itself, the CDC reports.

Myth #2: Healthy people don’t need to get the flu vaccine.

It’s true that those most likely to become seriously ill or die from the flu are: 65 and older, younger than 5, pregnant, or have certain medical conditions including asthma, diabetes and chronic lung disease.

But even healthy people can become sick with the flu and experience serious complications from it. That’s why the CDC recommends everyone 6 months and older get an annual flu vaccine, not just those who are at high risk of getting the virus.

“We recommend all employees receive the flu shot,” Fragoso said. “Especially since we are working with vulnerable populations.”

Myth #3: You don’t need to get the flu vaccine every year.

This is not true for two reasons:

  1. Flu viruses are constantly changing, and different flu viruses circulate and cause illness each season. Flu vaccines are made each year to protect against the flu viruses that research indicates will be most common.
  2. A person’s immunity from the flu vaccine declines over time. So, an annual vaccine is needed for optimal protection.

The CDC recommends getting the seasonal vaccine as soon as it’s available since it takes about two weeks after vaccination for antibodies to develop. The agency also recommends offering the vaccine throughout the flu season, which typically begins in October and lasts through January.

Employee Health is administering free seasonal influenza vaccinations to all Texas Children’s employees, Baylor College of Medicine employees working in Texas Children’s facilities, Texas Children’s medical staff and volunteers. Leaders from Texas Children’s Pediatrics, Texas Children’s Health Centers and The Center for Women and Children will inform their staff about seasonal flu vaccination details.

Click here to view vaccination schedules for both Main and West Campuses. Employee Health strongly encourages you to get your vaccine at one of the times listed on the schedule. If you are unable to do so, please schedule an appointment to get the flu vaccine at the Employee Health Clinic.

And, remember, getting an annual flu shot is part of Texas Children’s P3 incentive plan, which is an important component of the total rewards you receive at Texas Children’s Hospital. As part of P3 , we are striving for at least 90 percent of our staff to get vaccinated by Monday, December 1. As of October 3, we were more than half way there.

June 24, 2014


While thousands flock to Brazil for the World Cup games, many health care workers are worried about more than which team will take home the trophy. NTDs like Dengue and Chagas are plaguing the citizens of Brazil – putting a definite damper on the spirit of the games.

“The theme of the 2014 FIFA World Cup Brazil is ‘all in one rhythm.’ So far that rhythm could leave behind millions of Chagas disease sufferers in the Americas,” said Dr. Peter Hotez, Texas Children’s Hospital endowed chair in Tropical Pediatrics. Hotez’ recent article about Chagas disease, which is a leading cause of severe and life-threatening heart disease in the Americas, was published on, and brings to light the fact that more than 1 million people in Brazil suffer from Chagas.

Also of great concern is the surge in cases of dengue fever in Brazil’s largest city, Sao Paulo. Certain strains of the disease, which is carried by female mosquitoes, can be fatal and there is currently no treatment or vaccine. Despite government efforts as of late to control mosquitos with powerful pesticides, the dengue epidemic is sweeping through Brazil, and many worry that international visitors could contract the disease and bring it back to their home countries.

“Several multinational pharmaceutical companies, even Brazil’s Instituto Butantan, are working to make a prototype dengue vaccine, but these will not be ready in time for the World Cup,” said Hotez. “In the meantime, measures aimed at mosquito control and personal protective measures against mosquitos are all that are available.”

Back here in Houston, fear of dengue spreading to the U.S. feels all too real, especially in light of evidence found by our own Dr. Kristy Murray, associate professor of pediatric tropical medicine at Baylor College of Medicine and Texas Children’s Hospital, which suggests that dengue has re-emerged in Houston. Murray and her team investigated the possibility that dengue might be in Houston because the area has the type of mosquitoes known to carry the virus and a dense population full of frequent travelers south of the border. But the study, published this past fall, found that most of the infections were transmitted in Houston.

“This study shows that Houston may be at risk of an outbreak, that people need to be on the lookout,” said Murray.

Beyond NTDs like dengue and Chagas, many in the health care field see Brazil’s hosting of the World Cup as a time to put the spotlight on the various diseases that impact (and often kill) children in Brazil and the Americas – some as simple as diarrhea and pneumonia, which can be prevented through vaccines.

The Global Alliance for Vaccines and Immunization (GAVI) launched a World Cup-themed report last month, designed to draw parallels between the shots, saves and goals made on the field and the shots (vaccines) needed to save lives and help achieve GAVI’s big goals. The report, “Going for Goal: Immunization and the Case for GAVI,” looks at each team playing in this summer’s World Cup (as well as a few others who didn’t make the cut), analyzing their countries’ contributions to global immunization efforts and offering up “pundit’s verdicts” for their future performance.

So while sports fans may be fired up whenever their team scores over the next few weeks, here at Texas Children’s, we’ll be cheering on organizations that are working to ensure children in Brazil, and everywhere, get the vaccines they need – a goal worth celebrating.

Those who are traveling to Brazil this summer, or want to know more about the diseases mentioned in this article, should visit the Travel Clinic at Texas Children’s.