Guest posting: Dr Ian Marr, Microbiology Registrar, NSW Health Pathology.
Guest posting with permission from Laureate Professor Rodney Scott : these are his presentations provided to post-graduates in Nepal during his recent visit to inspect the new cytogenetics laboratory at the National Academy of Medical Sciences, Bir Hospital, Kathmandu. Most presentations have annotations.
- BRCA presentation R Scott_Nepal_Aug2018
- ctDNA R Scott_Nepal_Aug2018
- Genomics medicine R Scott _Nepal_Aug2018
- Inherited Predispositions to Bowel Cancer_Lynch Syndrome R Scott_Nepal_August 2018
- Mosaic case report R Scott_Bir Hosp_Aug2018
BRCA1 and BRCA2 Structure:
- Classification of Parasites and Helminths 2018 Marr
- Diagnosis of filarial infections (WHO)
- Kow PNGMJ 2013 – a comparative study of intestinal helminths, PNG
- Owen-IL Parasitic_zoonoses_PNG J Helminthology 2005
- Strongyloides CDC site ; Robertson NT strongyloides PCR test
- CDC Laboratory Identification of Parasites of Public Health Concern: excellent pictures and monthly case reports across all key pathogens. DPDx link on right.
These recent papers will be useful to review/ discuss (especially the first two):
Guest posting: Dr Nilar Lwin, Microbiology Registrar, Pathology North.
Measles overview including laboratory diagnosis: Measles virus Lwin 2018
Reports of recent measles outbreaks in PNG which are worth a close read:
- Vanimo, 2017: https://reliefweb.int/sites/reliefweb.int/files/resources/MDRPG006dfr.pdf
- Madang, 2014: https://ojs.wpro.who.int/ojs/index.php/wpsar/article/view/473/721
Measles rash, day 3 Koplik spots
It’s useful to know your schedules and appreciate something of the rationale for the dosing recommendations. Also be aware of key vaccines that are yet to be introduced – e.g. rotavirus, HPV. Please work through the SAQ below. Correct 2016 version of Immunisation schedule obtained from PNG Paediatric site, 2018.
In the news:
- Recent menC meningococcal disease outbreak, Fiji
- Polio outbreak in PNG – WHO update (July 2018). Enga case detected now!
Some short questions to consider:
- Contrast the PNG and NHS schedules above. What important gaps are there?
- Why has IPV replaced OPV in the NHS schedule?
- What is happening with wild type polio control across the world? Which subtype has been eradicated? Where are the remaining areas of activity for wild type polio?
- How does OPV revert to virulence?
- What are the risks of dengue vaccine? What is its efficacy in different groups?
- How does one estimate vaccine efficacy?
- Australian Immunisation Handbook 10th Edition : great reference on specific immunisation topics
Guest posting: Dr Ian Marr, Microbiology Registrar, Pathology North.
Melioidosis is a cause of severe pneumonia, bacteraemia, urosepsis, prostatic abscess, CNS infection, pyogenic myositis and liver and spleen abscesses. It is found in PNG especially around the Balimo region – see Warner, Currie et al 2018 : Melioidosis in Papua New Guinea and Oceania- an important short read.
Melioidosis is caused by Burkholderia pseudomallei, a Gram-negative rod, straight or slightly curved, with bipolar staining, or safety pin appearance. It is highly motile when viewed under phase contrast microscopy. Continue reading
Consider specific diagnostic approaches to each agent, including where relevant, serological testing, antigen detection and nucleic acid amplification methods. Also know what is locally in use in your laboratory.
Immunisation – need to know about the vaccines that are available – relevant for HPV, HBV, Influenza, Dengue, JEV, Polio, HAV, HEV, MMR, Rotavirus.
Particular attention required for those agents underlined. This is not an exhaustive listing but includes all viruses of current clinical relevance.
Dr Ian Marr has produced a useful summary for our local ID & Micro tutes recently which is shared – Rabies_2018 Marr .
It includes reference to Australian bat lyssavirus which clearly may have an incidence outside of Australia (in bats and/or humans)! Serosurveillance of bat populations in the Philippines has suggested that lyssavirus infection of bats might be more widespread than previously thought.
For the purposes of post-grad UPNG pathology revision, I would suggest you consider these additional questions-
- What is the local epidemiology of rabies in SE Asia? Especially focus on prevalence of cases within Indonesia.
- Read up the rabies vaccine advice provided by the Australian NHMRC Immunisation handbook.
- Steinman et al. Innovative tools and approaches to end the transmission of Mycobacterium leprae. Lancet ID 2017 See full text pdf already sent via email or request from JF
- Northern Territory, Australia Leprosy Guidelines – updated edition 4, May 2018- an acknowledged source of guidance. These sections especially: