Tuberculosis – recent epidemiological data from PNG

These recent papers will be useful to review/ discuss (especially the first two):

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Measles – always relevant

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:

References

Measles rash, day 3                                                  Koplik spots

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Immunisation schedules and SAQ

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.

PNG IMM 2016

In the news:

Some short questions to consider:

  1. Contrast the PNG and NHS schedules above.  What important gaps are there?
  2. Why has IPV replaced OPV in the NHS schedule?
  3. 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?
  4. How does OPV revert to virulence?
  5. What are the risks of dengue vaccine? What is its efficacy in different groups?
  6. How does one estimate vaccine efficacy?

Reference

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Burkholderia pseudomallei review including laboratory aspects

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

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Virology overview

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.

Reference

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Rabies review

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-

  1. What is the local epidemiology of rabies in SE Asia?  Especially focus on prevalence of cases within Indonesia.
  2. Read up the rabies vaccine advice provided by the Australian NHMRC Immunisation handbook.
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Leprosy – key resources

Continue reading

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Human Papilloma Virus – further resources

References Continue reading

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NAMS Nepal presentations 2018 (R Martin)

Here are the four presentations given to National Academy of Medical Sciences, Bir Hospital Pathology and Medicine Residents over the week commencing 7/5/18  by Emeritus Professor Robert Martin, President of the Diagnostic Microbiology Development Program.

 

Elements of laboratory QMS (WHO)

References

 

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NAMS Nepal presentations 2018 (JK Ferguson)

Here are the three presentations given to National Academy of Medical Sciences, Bir Hospital Medical Residents over the week commencing 7/5/18. Thank you for attending and I hope they were useful. Please feel free to contact me via email if you have questions!  As mentioned, I do encourage you to enrol in the international online AMS MOOC course.    Best wishes, John

References

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