Infectious Disease Faculty Profile

Sumathi Sivapalasingam, M.D.

Junior Faculty Member
NYU Fellow 2002 - 2004

"...fellows get a chance to see not only the immigrant population and their infections, but also the poor New York City population and their infections, the veterans and their infections, and the wealthy New Yorkers and their infections. So it's really quite comprehensive and it keeps consultations your first year very interesting. Practicing ID at a community hospital is vastly different from practicing ID at a city hospital or the VA."

HIVinfoSource.org, the web site for the NYU Center for AIDS Research (CFAR), interviewed Dr. Sumathi Sivapalasingam, an alumna of the Fellowship Program in Infectious Diseases here at NYU School of Medicine. Dr. Sivapalasingam is now an Instructor in the Division of Infectious Diseases & Immunology, and Assistant Director of the International Program of CFAR.

HIVinfoSource:Dr. Sivapalasingam, we're interested in learning about you and your path to NYU. Let's start with some background information about you. Where were you born and where did you go to school?

Sumathi Sivapalasingam: I was born in Sri Lanka, in a little town called Chavakacheri. We left Sri Lanka when I was 6 years old and moved to the Bronx. I went to public school there including the Bronx High School of Science. I then left New York to go to Swarthmore College in Pennsylvania. I returned to the Bronx for Medical School at Albert Einstein, and did my internal medicine residency at New York Hospital.

HIVinfoSource: What made you want to become a doctor?

Sumathi Sivapalasingam: I was a physics major in college and didn't initially want to be a doctor. I wanted to do biophysics research, and I was going to get a PhD. I had second thoughts however my senior year of college and decided instead to apply for a Thomas J Watson Fellowship, which is a travel fellowship to pursue a project for a year outside of the U.S. It was a unique opportunity-they give you a one year stipend for the project and they ask that you not return to the U.S. during that year and to provide periodic updates. What a deal! It was during that year and my work in refugee camps that inspired me to pursue medicine. So when I returned, I applied to medical school.

HIVinfoSource: Why did you go into infectious disease?

Sumathi Sivapalasingam: I was always intrigued by infectious diseases (ID) because in international work, it's the number one, two and three killer in the world. I also realized that ID is not just a disease, but the intersection of many fields including anthropology, entomology , epidemiology, climatology, evolutionary theory and medicine. Something that complex is fascinating to study.

HIVinfoSource: What did you do after you completed your residency?

Sumathi Sivapalasingam: I had decided to apply for an ID fellowship. But one of my mentors, Kent Sepkowitz, at Memorial Sloane Kettering Hospital, encouraged me to apply instead to the Epidemic Intelligence Service (EIS). I thank him every time I see him. I had never heard of EIS before. But after a little research I realized that it was my dream job. So I applied and somehow got accepted. I dragged my husband (boyfriend at the time) down to Atlanta for two years. That was hard because Atlanta was a National League City.

HIVinfoSource: What is EIS?

Sumathi Sivapalasingam: EIS is a 2 year training program at the Centers for Disease Control (CDC) -not the NIH as a recent TV drama series would have you believe! This experience is what made me excited about public health and epidemiology. Before then I thought it was the driest subject ever. I was stationed in Atlanta at the Foodborne and Diarrheal Diseases branch. Two of the most fascinating years of my career really. After an intensive summer course in field epidemiology, scientific writing, and media training I was involved in outbreak investigations which included a Salmonella outbreak which we traced to imported mangoes, an outbreak of E. coli O157:H7 and Campylobacter infections among attendees of a county fair which we linked to drinking contaminated well water, and a cholera outbreak in the Marshall Islands. It was only after I designed, conducted and analyzed my first study in which we were able to epidemiologically link an outbreak of infection to a source and then make that link microbiologically through DNA fingerprinting and then make that link again using environmental studies that I became a believer of epidemiology. Before that-I thought it was a lot of hocus pocus.

My work at the foodborne branch also involved designing and conducting long-term studies. We conducted studies on acute and chronic typhoid fever in Vietnam and on preventing acquisition of Helicobacter pylori infections using an intervention of a safe water vessel in the home in rural Bolivia. How can this not be fun?

HIVinfoSource: And after your 2 years with the CDC, is that when you began your fellowship?

Sumathi Sivapalasingam: Yes

HIVinfoSource: And what led to your doing an ID fellowship at NYU School of Medicine?

Sumathi Sivapalasingam: EIS gives you a very particular type of training. It is not design to teach you about all infectious diseases or everything about biostatistics. So after EIS I really wanted to increase my knowledge of general ID and also to get back to clinical care. My hope was to combine both public health work with clinical care work.

What intrigued me about doing a fellowship in infectious disease at NYU was the variety of patients you get to take care of here. People can acquire infections diseases anywhere in the world. And the world then comes to Bellevue . If you want training in recognizing and treating a wide range of infectious diseases from the mundane like cellulites to the exotic like cutaneous leishmaniasis Bellevue is where you are likely to find them.

HIVinfoSource: So it's the affiliation that NYU has with the other hospitals, like Bellevue and the VA, that made the fellowship appealing?

Sumathi Sivapalasingam: Yes. It's the diversity of patients here. Different groups of patients have their own set of infectious diseases. So fellows get a chance to see not only the immigrant population and their infections, but also the poor New York City population and their infections, the veterans and their infections, and the wealthy New Yorkers and their infections. So it's really quite comprehensive and it keeps consultations your first year very interesting. Practicing ID at a community hospital is vastly different from practicing ID at a city hospital or the VA. I think that is really one of the strongest aspects of the program.

And with that comes a very strong laboratory and research facility here in diagnosing common and strange diseases. Bellevue also has a close relationship with one of the nation's strongest public health institutions-the New York City Department of Health--which I think is exciting for fellows. It's important for fellows to understand the priorities of public health officials, which are sometimes different from a physician's. Public health is also a great career path for infectious disease physicians and the NYU ID training provides the opportunity to explore it.

HIVinfoSource: How long was your fellowship?

Sumathi Sivapalasingam: 3 years.

HIVinfoSource: How did living in NYC have an impact on you on your fellowship, as being an ID doctor?

Sumathi Sivapalasingam: New York City is an important place to study HIV disease. The clinical exposure to the disease, and the diversity of the HIV-infected population here in New York , make it an excellent learning experience for a fellow. There are gay and heterosexual men and women, intravenous drug users, prisoners, people of different socio-economic backgrounds. The management of HIV disease may be different for different populations, and New York offers that.

HIVinfoSource: How did you end up focusing on HIV?

Sumathi Sivapalasingam: Looking around to see what infections are really impacting our world, one realizes the true devastation of HIV internationally and its interaction with other infections such as TB and diarrhea as well as malnutrition and poverty. To be an infectious disease physician in this era-one feels almost obligated to work in the field of international HIV-there just isn't enough being done.

While NYU is a great place to learn about HIV there are many world renowned ID researchers in other fields- for example international malaria research with Dr. (Karen) Day, diarrheal diseases and Helicobacter research with Drs. Marty Blaser and Guillermo Perez-Perez, and TB research with Dr. (Joel) Ernst. I think we have the top four scourges of the world covered pretty well at NYU.

The strength of the fellowship program is that faculty members here are incredibly supportive of fellows. They really encourage you, and give you time to develop your career, whether it be in clinical infectious disease, basic science research or clinical research.

HIVinfoSource: And what are you doing now?

Sumathi Sivapalasingam: I, as a member of a CFAR team, am initiating several studies in Mombasa Kenya . The NYU CFAR is building on work started by Dr. Shaffiq Essajee, who is an attending physician in the Pediatric Infectious Diseases Division at NYU. He founded a pediatric HIV clinic in Mombasa, Kenya, which is now one of the largest clinics to actually treat HIV infected children with antiretrovirals. We are starting several studies exploring less expensive viral load assays for monitoring HIV infected patients on treatment, and exploring the role of hepatitis G virus in vertical transmission of HIV. We also hope to initiate studies on malaria and diarrheal diseases in the HIV infected patient in Mombasa.

This year, we started a training program for Kenyan physicians at NYU. Through support from Family Health International, an international NGO, we will have trained 19 physicians from all over Kenya on all aspects of HIV care. These are experienced physicians for whom ARV (antiretroviral) therapy is a relatively new concept. NYU faculty have been treating HIV since the beginning of the epidemic and we hope to share our mistakes and successes with our Kenyan collegues.

We also just received a CDC grant to provide HIV treatment to HIV infected persons at our study sites in Mombasa, Kenya . We are very excited about this. Even if our studies flop, we know that we have helped improve access to care to people living with HIV.

HIVinfoSource: What would you say to someone who's thinking of applying to a fellowship at NYU, especially to someone who's not from New York ?

Sumathi Sivapalasingam: Well, there are great restaurants here in New York City! So even if you work long hours, there is always an open kitchen or bar awaiting you at the end of the day! Essentially. I've lived in New York City since I was six and my husband was born here--we are still exploring the city. It's endless and ever changing.

HIVinfoSource: Dr. Sivapalasingam, thank you for taking the time to visit with us. We look forward to hearing more about your project in Mombasa in the coming year.

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