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Dominic Dwyer calls time on 40+ year career in virology and public health pathology

Dominic Dwyer calls time on 40+ year career in virology and public health pathology

He became the public face of our pathology services during the COVID-19 pandemic, but now Professor Dominic Dwyer PSM is retiring after more than four decades dedicated to researching, diagnosing, and treating infectious diseases.

Pro­fes­sor Dominic Dwyer PSM is a world-renowned med­ical virol­o­gist and infec­tious dis­eases physi­cian at NSW Health Pathol­o­gy’s Insti­tute of Clin­i­cal Pathol­o­gy and Med­ical Research (ICPMR) at West­mead Hospital.

His long and dis­tin­guished career spans near­ly 42 years and has tak­en him all over the globe to inves­ti­gate viral out­breaks that threat­en the safe­ty of communities.

When he’s not con­sult­ing with inter­na­tion­al experts or shar­ing his insight and expe­ri­ence at health con­fer­ences, he has been a trust­ed spokesper­son on pub­lic health and emerg­ing infections.

A man wearing a white lab coat and face mask swabbing the nose of a woman seated in front of him.
Pro­fes­sor Dwyer on the front lines of COVID test­ing while on sab­bat­i­cal in Paris.

We’ve lost count of how many media inter­views he has enthu­si­as­ti­cal­ly giv­en dur­ing the COVID-19 pan­dem­ic and he is a glob­al­ly renowned researcher with over 500 pub­lished papers.

Dominic under­took post­grad­u­ate research in HIV/AIDS at the Insti­tute Pas­teur in Paris, France, before going on to the lead the World Health Orga­ni­za­tion (WHO) Nation­al Influen­za Cen­tre in Westmead.

He has exten­sive expe­ri­ence in pan­dem­ic respons­es, even pri­or to COVID-19. His work in mol­e­c­u­lar test­ing for HIV spans three decades and he assist­ed the WHO to man­age the SARS out­break in Chi­na near­ly 20 years ago.

“Dominic has been an exem­plary pub­lic ser­vant and a role mod­el for col­lab­o­ra­tive lead­er­ship and inno­v­a­tive ideas,” NSW Health Pathol­o­gy Chief Exec­u­tive Vanes­sa Janis­sen said.

“He’s a trust­ed voice in the lab­o­ra­to­ry, in the clin­ic and the media, but per­haps his biggest test came with the dev­as­tat­ing glob­al COVID-19 pandemic.

“Work­ing around the clock, he mar­shalled our expert ICPMR-West­mead team, devel­op­ing sci­en­tif­ic break­throughs to advance the health response to the COVID-19 pandemic.”

In 2020 Dominic was select­ed by the WHO to be part of an inter­na­tion­al team of physi­cians, sci­en­tists and researchers to explore the ori­gins of the coro­n­avirus in Wuhan, China.

A man wearing a surgical face mask leans on a balcony railing in a high-rise brick building.
Dominic Dwyer in Wuhan, Chi­na. (Pho­to cred­it: Rhett Why­man, SMH)

Dominic’s con­tri­bu­tion to the pan­dem­ic response earned him an Hon­ourable Men­tion in the 2021 NSW Pub­lic Ser­vant of the Year award.

He was award­ed the Pub­lic Ser­vice Medal in the 2022 Aus­tralia Day Hon­ours List for out­stand­ing pub­lic ser­vice as an infec­tious dis­ease expert and pub­lic health advi­sor in NSW, and the French Government’s ‘Cheva­lier de l’Ordre Nation­al du Mérite’ in 2021 for COVID-19 services.

Con­grat­u­la­tions on a stel­lar career Dominic, and we wish you a long and enjoy­able retirement!

A close up of a man's face above a row of test tubes.
Hang­ing up the lab coat after more than 40 years.

 

New Cooma pathology laboratory opens

We’re excited to show off our brand-new pathology laboratory at Cooma Hospital. It features the latest technology and will bring enormous benefits for patients, staff and the wider Cooma community.

The pathol­o­gy lab­o­ra­to­ry has been com­plet­ed as part of the NSW Government’s $26.5 mil­lion invest­ment in the Cooma Hos­pi­tal rede­vel­op­ment that also includes an expand­ed emer­gency depart­ment, ambu­la­to­ry care cen­tre and a new mater­ni­ty department.

The lab­o­ra­to­ry fea­tures new equip­ment and the lat­est tech­nol­o­gy, includ­ing new chem­i­cal pathol­o­gy analy­sers which NSW Health Pathol­o­gy is rolling out in region­al loca­tions across the state as part of a $29 mil­lion investment.

The chem­i­cal analy­sers can car­ry out a range of com­mon pathol­o­gy tests, includ­ing liv­er and kid­ney func­tion tests and mon­i­tor­ing for diabetes.

Senior Hos­pi­tal Sci­en­tist in Charge at Cooma, Jo-Anne Hag­ger, says the refur­bished lab­o­ra­to­ry will deliv­er sig­nif­i­cant ben­e­fits for both patients and pathol­o­gy staff at Cooma Hospital.

“We have a new col­lec­tions room on Lev­el B at the Cooma Hos­pi­tal where peo­ple can go for blood tests,” she said.

“We bulk bill and accept all refer­rals, and you don’t need an appointment.

“There are also on-site, life­sav­ing blood trans­fu­sion ser­vices available.”

The Cooma pathol­o­gy lab­o­ra­to­ry oper­ates 7 days a week and per­forms more than 40,000 pathol­o­gy tests each year.

A big thank you to Jo-Anne Hag­ger for lead­ing this rede­vel­op­ment with the sup­port of Local Pathol­o­gy Direc­tor Matthew Watts, Oper­a­tions Man­ag­er Peter Tom­lin­son, and the entire Cooma team.

Our Plan­ning team has also been there every step of the way, and a huge thanks goes to Geoff Chan­nels who was involved in the design and Pankaj Gaur who project man­aged the lab­o­ra­to­ry decant and was on-site to help with all the logis­tics for relo­cat­ing equip­ment between hos­pi­tal floors.

We’re proud to be serv­ing the Cooma community!

Will Japanese encephalitis return this summer?

The last two summers have been swarming with mosquitoes thanks to near constant rain and flooding brought on by La Niña.

With the return of El Niño, and a hot, dry sum­mer in store, what’s the out­look for Japan­ese encephali­tis and oth­er mos­qui­to-borne diseases?

First, let’s look back at the last two summers

The boom in mos­qui­toes over the last two springs and sum­mers didn’t just bring an increased annoy­ance of buzzing and bites but also out­breaks of poten­tial­ly fatal mos­qui­to-borne disease.

The first out­break of Japan­ese encephali­tis virus was first detect­ed in south­ern regions of main­land Aus­tralia in Feb­ru­ary 2022.

This was fol­lowed by the return of Mur­ray Val­ley encephali­tis in ear­ly 2023, which turned out to be the biggest out­break in the south­ern states since 1974.

These out­breaks were the result of more than just more mos­qui­toes. Flood­wa­ters pro­vid­ed ide­al breed­ing con­di­tions for water­birds, the key “reser­voirs” of these viruses.

Mos­qui­toes pick up the infec­tion after feed­ing on the birds and then sub­se­quent­ly spread the virus­es to peo­ple when they bite.

What’s different about Japanese encephalitis?

Out­breaks of Japan­ese encephali­tis virus in tem­per­ate regions of Aus­tralia in 2022 came as a sur­prise. There had been activ­i­ty in north­ern Aus­tralia and the Tor­res Strait, but it was gen­er­al­ly only con­sid­ered a risk to over­seas travellers.

In India, South­east Asia, and the West­ern Pacif­ic, Japan­ese encephali­tis is con­sid­ered one of the most dan­ger­ous mos­qui­to-borne dis­eases, with tens of thou­sands of cas­es of severe infec­tion each year.

While the major­i­ty of peo­ple infect­ed suf­fer no or very mild symp­toms, some will expe­ri­ence neck stiff­ness, fever, headache and, in the most severe cas­es, per­ma­nent neu­ro­log­i­cal com­pli­ca­tions or death.

How­ev­er, a vac­cine is avail­able that can sig­nif­i­cant­ly lim­it seri­ous illness.

The dis­cov­ery of Japan­ese encephali­tis virus in Australia’s south­ern states trig­gered a dec­la­ra­tion of a “com­mu­ni­ca­ble dis­ease inci­dent of nation­al sig­nif­i­cance”. This was in place from March 2022 through June 2023. A total of 45 peo­ple were infect­ed, sev­en of whom sad­ly died.

It wasn’t just peo­ple who were at risk. The impact on com­mer­cial pig­geries, which farm pigs for pork pro­duc­tion, was dev­as­tat­ing and required urgent strate­gies to con­trol mos­qui­toes.

Pig­geries weren’t the source of the out­break, they were the “canaries in the coalmine” – sig­nalling the spread of the virus ear­ly on and the need to pro­tect the broad­er community.

What caused outbreaks in piggeries?

Our research inves­ti­gat­ed how dif­fer­ent land­scapes and weath­er pat­terns influ­ence inter­ac­tions between wildlife, mos­qui­toes, and out­breaks of Japan­ese encephali­tis virus.

We looked at 62 pig­geries where the virus had been detect­ed and some loca­tions where the virus had also been detect­ed in mos­qui­toes, along with water­bird and fer­al pig habi­tats, rain­fall and temperature.

Some of the results were unex­pect­ed. Pig­geries were at high­est risk of an out­break when the num­ber of dif­fer­ent water­bird species in their loca­tion was “just right”. If there were too few or too many, the risk of an out­break was reduced.

A group of pigs in a muddy yard.
Fer­al and domes­tic pigs can be infect­ed with Japan­ese encephali­tis virus and also infect mos­qui­toes that feed on them. Cameron Webb (NSW Health Pathology)

High rain­fall and flood­ing pro­vid­ed excel­lent con­di­tions for mos­qui­toes, with tem­po­rary wet­lands and flood­ed areas pos­ing a greater risk than per­ma­nent wetlands.

Tem­po­rary wet­lands may have pro­vid­ed habi­tat for water­birds whose nor­mal habi­tat and move­ment pat­terns were dis­rupt­ed due to the exten­sive La Niña flooding.

Or per­haps per­ma­nent wet­lands sup­port a greater diver­si­ty of aquat­ic life (includ­ing ani­mals that eat mos­qui­toes) that helped keep mos­qui­to num­bers low­er than tem­po­rary waterbodies.

So what might happen this summer?

The return of El Niño is expect­ed to bring below aver­age rain­fall and above aver­age tem­per­a­tures. But that can be unpre­dictable. Wet­lands are already dry­ing up. Bush­fires have replaced floods.

Mos­qui­to pop­u­la­tions are expect­ed to decline sharply. Sur­veil­lance pro­grams of state and ter­ri­to­ry health author­i­ties, such as New South Wales and Vic­to­ria, are already report­ing mos­qui­to pop­u­la­tions far low­er than pre­vi­ous seasons.

So we may not see as much Japan­ese encephali­tis this sea­son. But that doesn’t mean it will dis­ap­pear completely.

It doesn’t mat­ter how hot and dry it gets, mos­qui­toes are resilient and will per­sist. They’ll seek out the same envi­ron­ments where water remains. So too will water­birds and fer­al pigs.

Author­i­ties are also on alert for the return of Ross Riv­er virus along the coast. Despite the low­er rain­fall, the mos­qui­toes that live in salt­wa­ter wet­lands will thrive fol­low­ing flood­ing by high tides, espe­cial­ly “king tides”.

Com­bined with extreme weath­er, even dur­ing hot and dry sum­mers, out­breaks of Ross Riv­er virus can occur.

How can you reduce your chance of getting these viruses?

To pro­tect your­self and fam­i­ly from mos­qui­to bites and mos­qui­to-borne disease:

Cameron Webb, Clin­i­cal Asso­ciate Pro­fes­sor and Prin­ci­pal Hos­pi­tal Sci­en­tist, Uni­ver­si­ty of Syd­ney; Michael Walsh, Senior Lec­tur­er of Infec­tious Dis­ease Epi­demi­ol­o­gy, Uni­ver­si­ty of Syd­ney, and Vic­to­ria Brookes, Lec­tur­er in Epi­demi­ol­o­gy and One Health, Uni­ver­si­ty of Sydney

This arti­cle is repub­lished from The Con­ver­sa­tion under a Cre­ative Com­mons license. Read the orig­i­nal arti­cle.

The important work of a dissection scientist in a pathology laboratory

Kajaal Prasad is the team leader in dissection at our Nepean laboratory, playing a key role in the diagnosis and treatment of patients.

Kajaal has been work­ing as a Hos­pi­tal Sci­en­tist (Dis­sec­tion Sci­en­tist) at NSW Health Pathol­o­gy for just over four years and pri­or to that was work­ing in pathol­o­gy in the pri­vate sector.

She worked at West­mead Hos­pi­tal in Anatom­i­cal Pathol­o­gy as a dis­sec­tion tech­ni­cian before pro­gress­ing to work as a Dis­sec­tion Sci­en­tist at Nepean.

“Pathol­o­gy is most def­i­nite­ly the ‘hid­den’ part of med­i­cine,” she says.

“When most peo­ple hear I work in pathol­o­gy – they auto­mat­i­cal­ly think blood col­lec­tion. Pathol­o­gy has so many sub-fields and anatom­i­cal pathol­o­gy is just one of them. We work col­lec­tive­ly behind the scenes to pro­vide patients with cru­cial details regard­ing their diag­no­sis and best treat­ment options.”

As the team leader in dis­sec­tion, Kajaal over­sees the safe and effi­cient dai­ly oper­a­tion of cut-up includ­ing the triage of specimens.

“I also con­duct macro­scop­ic dis­sec­tion (cut-up) and analy­sis of non-com­plex spec­i­mens such as biop­sies, small organs as well as com­plex spec­i­mens includ­ing par­tial and/or whole organs – basi­cal­ly I cut up organs!

“The work I do in dis­sec­tion plays a sig­nif­i­cant role in the diag­no­sis and treat­ment of patients as it pro­vides cru­cial infor­ma­tion required for pathol­o­gy diag­no­sis. For exam­ple, in can­cer cas­es we assess tumours in any giv­en organ and map the tumour to cru­cial anatom­i­cal land­marks to iden­ti­fy whether the tumour is con­fined with­in the organ or has poten­tial­ly spread – which then assists in can­cer stag­ing and treat­ment for patients.”

Kajaal also pro­vides dis­sec­tion train­ing and sup­port to the laboratory’s dis­sec­tion tech­ni­cian, sci­en­tist and pathol­o­gy trainees.

She is pas­sion­ate about anato­my, health­care, and education.

“This role com­bines all these com­po­nents togeth­er as I get to use my anatom­i­cal knowl­edge, play a role in many indi­vid­u­als diag­nos­tic jour­ney and share my knowl­edge to oth­er mem­bers of the team dur­ing train­ing ses­sions. It’s the per­fect role for me.

“There’s always some­thing new – no one day looks the same. We def­i­nite­ly get some inter­est­ing cas­es that come along which always pro­vides an oppor­tu­ni­ty to learn. For me, the most reward­ing part of my role is being able to help patients with their pathol­o­gy diag­no­sis. The next reward­ing aspect of my role would be teach­ing our pathol­o­gy trainees – they are our future pathologists.”

A woman works at a laboratory bench wearing a white lab coat.
Kajaal says pathol­o­gy is the “hid­den” part of med­i­cine but is a very reward­ing career.

In addi­tion to her work at NSW Health Pathol­o­gy, Kajaal is also a PhD candidate.

“My research is look­ing at devel­op­ing high-fideli­ty 3D print­ed breast spec­i­mens for dis­sec­tion train­ing for pathol­o­gy trainees.”

Kajaal says she would def­i­nite­ly rec­om­mend a career in anatom­i­cal pathol­o­gy, say­ing it pro­vides great flex­i­bil­i­ty to work inde­pen­dent­ly and with­in a team.

“It’s a place for con­tin­u­ous learn­ing – if you aren’t afraid of organs or oth­er bod­i­ly flu­ids,” she said.

“I also get to work with a wide range of peo­ple in the med­ical field who share insights about cas­es. We often get to dis­cuss com­plex cas­es with sur­geons who com­plete the surgery of the spec­i­mens we receive, work­ing togeth­er to pro­vide patients with the best pos­si­ble outcome.”

Overdoses linked to illicit vape juice

NSW Health has issued a community drug alert after at least three overdoses, including one death, were linked to potent opioids in black market vape juice used for refillable vapes.

The opi­oid over­dos­es in NSW have been linked to pow­er­ful syn­thet­ic opi­oids called nitazenes (a potent syn­thet­ic opi­oid) in illic­it vape juice.

In one case, the per­son thought the vape refill liq­uid con­tained a syn­thet­ic cannabi­noid (sim­i­lar to THC), but it actu­al­ly con­tained a nitazene.

Nitazenes can be stronger and last longer than fen­tanyl. They are far stronger than most oth­er opi­oids and an over­dose can be caused by tak­ing even a small amount.

Nitazenes can also affect a person’s breath­ing more than oth­er opi­oids. Over­dose has occurred in a mat­ter of min­utes, with as lit­tle as 6–8 puffs of a vape if it con­tains a nitazene, even in peo­ple who are used to using opioids.

Fen­tanyl test strips will not detect nitazenes.

A woman in a lab coat and safety glasses using a pipette and test tubes.
Vapes are reg­u­lar­ly test­ed at our Foren­sic & Ana­lyt­i­cal Sci­ence Ser­vice laboratories

Be aware that opi­oids (like nitazenes) and oth­er drugs can be present in illic­it vape juice – and you might be sold some­thing dif­fer­ent than what you think you’re buying.

NSW Health reg­u­lar­ly informs the pub­lic of known high risk drugs in cir­cu­la­tion and has col­lab­o­rat­ed with the NSW Users and AIDS Asso­ci­a­tion (NUAA) to issue a Com­mu­ni­ty Drug Alert.

NSW Health Pathology’s Illic­it Drugs Analy­sis Unit works every day to keep the com­mu­ni­ty safe by con­duct­ing tests on drugs seized by police.

Their work sup­ports the health and jus­tice sys­tems and con­tributes to pub­lic health alerts and drug warn­ings like this one.

Boosting organ donations through lifesaving screening

NSW Health Pathology’s Nucleic Acid Testing Laboratory has won a NSW Premier’s Award for a unique collaboration that provides 24/7 screening of donor organs for infectious diseases.

The team was last night pre­sent­ed with the NSW Premier’s Award for High­est Qual­i­ty Health­care.

When it comes to organ dona­tion, tim­ing is everything.

The abil­i­ty to screen donor organs for infec­tious dis­eases and com­pat­i­bil­i­ty in just a few hours means the dif­fer­ence between life and death for patients await­ing transplant.

With a short­age of organs, more types of donors are being accept­ed fol­low­ing devel­op­ment of new screen­ing meth­ods for infections.

Only one team in NSW does this life­sav­ing work: the NSW Organ and Tis­sue Dona­tion Ser­vice (OTDS) and the NSW Health Pathol­o­gy Nucle­ic Acid Test­ing (NSWHP NAT) Lab­o­ra­to­ry at Prince of Wales Hos­pi­tal in Sydney.

Our ded­i­cat­ed clin­i­cal pathol­o­gists, lab­o­ra­to­ry sci­en­tists and dona­tion spe­cial­ists work a 24/7 ros­ter to respond when­ev­er a donor organ becomes avail­able, deliv­er­ing results with­in a crit­i­cal 8‑hour timeframe.

The lab now tests around 150 organ trans­plant donors – includ­ing 50 high-risk donors – and 650 tis­sue donors each year, ensur­ing safer, healthy organs for transplant.

The team pro­vides viro­log­i­cal screen­ing for pathogens impor­tant in trans­plan­ta­tion, including:

  • Human Immun­od­e­fi­cien­cy Virus type 1 (HIV‑1)
  • Hepati­tis B (HBV)
  • Hepati­tis C (HCV)
  • Cytomegalovirus (CMV)
  • Epstein-Barr virus (EBV)
  • Tox­o­plas­ma, and
  • Strongy­loides.

There are approx­i­mate­ly 1,650 peo­ple on organ trans­plant wait­ing lists in Aus­tralia at any one time. For these chron­i­cal­ly ill peo­ple of all ages, access to a viable organ and tis­sue donor can lead to a longer, health­i­er life.

Cur­rent­ly there are more patients on trans­plan­ta­tion lists than there are avail­able organ and tis­sue donors. This was com­pound­ed dur­ing the COVID-19 pan­dem­ic which saw a 30% decrease in transplants.

But num­bers are increas­ing to pre-pan­dem­ic lev­els and high­er now with con­cert­ed dona­tion dri­ves led by DonateLife and the NSW Organ and Tis­sue Dona­tion Service.

The small but ded­i­cat­ed team is com­mit­ted to help­ing more peo­ple requir­ing trans­plants to access safe organ and tis­sue dona­tions and to sav­ing lives.

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