Training our future specialist pathologists

February 13, 2023 by Tina Sorenso Leave a Comment

NSW Heath Pathology is pleased to welcome 31 new Junior Medical Officers starting their pathology traineeships with us in the 2023 Clinical year.

Pathology trainees are the future of our medical workforce and a crucial part of our organisation.

There is a shortage of specialist pathologists internationally and across Australia and we are working with NSW Health and the Royal College of Pathologists of Australasia (RCPA) to recruit, train and retain the next generation in all disciplines.

Of our new recruits: 25 will train in Anatomical Pathology; 5 in Microbiology; and 1 in Forensic Medicine.

They’ll rotate through our metropolitan laboratories as well as some of our regional labs in Orange, Wagga Wagga and Tamworth, and our Forensic Medicine Lidcombe facility. This year, we were also pleased to secure funding for a second trainee position at Nepean.

Three of our new pathology trainees on an orientation visit to our Forensic Medicine
service at Lidcombe.The trainees will learn how to navigate the exhilarating and challenging world of diagnostic pathology and contribute to ongoing exploration and categorisation of human diseases.

On 8 and 9 February 2023 they attended orientation at the RCPA, a private pathology laboratory and the NSW Ministry of Health. The events were an opportunity to build friendships and support networks that will be needed in the tough but rewarding years ahead.

The NSW Pathology Training Program, run by NSW Health Pathology, the RCPA and NSW Ministry of Health, is one of the most rigorous in Australia. It takes 5 years to qualify for RCPA fellowship, with a strong emphasis on academic and practical learning.

NSW Health Pathology employs approximately 120 junior doctors each year in trainee/registrar positions across NSW, mostly in Anatomical Pathology.

We recently added Resident Medical Officer (RMO) positions to allow junior doctors to have a 12-week experience in Anatomical Pathology before they commit to a career via the Annual Medical Recruitment process.

Anatomical Pathology Training Coordinator Dr Lisa Parker, NSWHP CHief Pathologist and Director of Medical Services Dr Michael Whiley with a JMO. — Our Anatomical Pathology Training Coordinator Dr Lisa Parker and NSWHP Chief Pathologist and Director of Medical Services Dr Michael Whiley with Maria Vassili, our A/Medical Workforce Team Leader.

New Microbiology trainees learned from senior trainees at the RCPA orientation on Wednesday 8 February 2023. — Microbiology trainees learned from senior trainees at the RCPA orientation on Wednesday 8 February 2023.

Our Forensic Pathology trainee Michael Chang.

Chief Pathologist Michael Whiley presenting — Our Chief Pathologist Dr Michael Whiley presenting to trainees at the RCPA orientation event.

What you need to know about the dengue fever outbreak in Singapore

February 6, 2023 by Liz Farquhar Leave a Comment

Singapore is experiencing rising numbers of dengue fever, but what does it mean for Australians travelling to the region and could the outbreak spread here?

Singapore is on alert as dengue fever numbers start to rise again, after case numbers spiked in 2022 and 2020.

The number of dengue cases in Singapore during 2022 reached the second highest on record.

The National Environment Agency has warned that there could be another outbreak this year, as the number of cases remains high.

In the week ending 28 January 2023, Singapore’s National Environment Agency reported 186 dengue cases and there were 274 the previous week.

So what are the implications for Australia?

A man in back t-shirt sits in an office with books and medical specimens on shelves. — Mosquito expert, Cameron Webb

NSW Health Pathology medical entomologist, Associate Professor Cameron Webb said there was no risk of the outbreak coming here as the mosquitoes that spread dengue viruses, especially Aedes aegypti and Aedes albopictus, are not found in NSW.

“There are lots of mosquitoes here that can spread viruses of concern, such as Murray Valley encephalitis virus, but not dengue,” he said.

A/Prof Webb said the most important message is for travellers to Singapore to be aware of the need to avoid being bitten, particularly during daylight hours.

“It is important that Australians travelling overseas make sure they use repellent during the day, as that is when the mosquitoes that transmit the virus tend to bite – not during early morning/evening hours as we are used to here in Australia.”

Meanwhile, in Singapore the National Environment Agency says it is carrying out preventive measures to further slow dengue transmission.

Sentinel chickens provide early warning on deadly diseases

February 1, 2023 by Liz Farquhar Leave a Comment

Dotted around a handful of backyards and on farms in regional New South Wales are special flocks of chickens that play a key role in helping NSW Health Pathology protect the community from serious diseases.

They are known as ‘sentinel chickens’ and since the 1970s they have been used to give us an early warning about the presence of potentially deadly viruses such as Murray Valley encephalitis virus, Kunjin virus and Japanese encephalitis virus, which are spread via mosquitoes.

So how does the surveillance program work?

During the wet and warmer months of the year blood samples are taken from the chickens once a week and sent to NSW Health Pathology’s Institute of Clinical Pathology and Medical Research (ICPMR) labs at Westmead for testing.

Two women in hi-vis shirts hold a chicken on a table. — Public health officers from Griffith Council take a blood sample from a chicken.

The head of the Arbovirus Emerging Diseases Unit, Principal Scientist Associate Professor Linda Hueston, explains why chickens are used and what her team is looking for when the blood samples arrive.

“Most of the viruses of interest – Murray Valley encephalitis virus, Kunjin virus, and now Japanese encephalitis virus (JEV) – are circulating in wild bird populations,” she said.

“But chickens are much easier to catch and to test than wild birds.”

“In the 1990’s I developed a series of highly specific defined epitope blocking ELISA tests for Murray Valley encephalitis virus, Kunjin virus and for JEV. These tests are not just highly specific they can be used to detect antibody in any species. This allows us to compare results between animals.”

A woman wearing a mask, protective glasses and a protective gown sits in a lab holding containers of pink liquid. — Linda Hueston in the Westmead lab where samples from the chickens are sent.

Health authorities are also testing mosquito populations for the same viruses, but A/Prof Hueston insists the information from testing the chickens is vital.
“Mosquitoes are trapped one night a week and tested, but that doesn’t give you an idea of how much virus is there, or if there is enough virus to cause transmission, which is where the chickens come in” she said.

“We estimate chickens are bitten by mozzies up to 1,000 times a night, and every time a mosquito bites it injects saliva, and the virus is in that saliva.”

“So, it’s a numbers game. With 15 chickens in each flock, the chances of finding the virus increase. As the number of positive birds in the flock increase so does the risk of virus spillover to humans.”

A/Prof Hueston said experience shows that a positive test in a chicken gives health authorities about two weeks’ notice before the virus spreads to the human population, enough time to implement public health measures in the area.

The viruses don’t harm the birds and all sentinel chicken flocks are subject to animal ethics committee approvals, as well as regular checks by veterinarians to ensure they’re properly housed and well cared for.

“They have to be in peak condition to be the best sentinels for the program, so it’s in everyone’s best interest to make sure the birds are healthy and happy,” A/Prof Hueston said.

Want to see more? One of our flocks in Griffith in the Riverina was visited in January 2023 by British YouTuber Tom Scott who made this awesome video.

Celebrating the inspiring winners of our 2022 NSW Health Pathology Awards

January 30, 2023 by Renee Mantle Leave a Comment

We’re proud to share the latest edition of NSW Health Pathology’s Compass magazine – out now.

It is a bumper special edition celebrating the inspiring winners of our NSW Health Pathology Awards – the people who make our organisation great and go above and beyond for the people of NSW.

Go behind the scenes and learn about some of the amazing public pathology and forensic medicine and science work we do every day. We care. We connect. We pioneer.

It also gives us a peek inside the event with some of our highlight photos included.

Please take some time to read, share and celebrate our publication with your friends, family and colleagues, and join the rest of NSW Health Pathology in once again congratulating our recent NSW Health Pathology Award winners.

Read our magazine in flipbook format here.

Australia Day honours for leading genetic pathologist Professor Edwin Kirk

January 30, 2023 by Liz Farquhar Leave a Comment

A massive congratulations to our very own Professor Edwin Kirk, appointed a Member of the Order of Australia (AM) in the 2023 Australia Day Honours List.

Professor Edwin Kirk was sneaking in a quick check of his work emails while on a family holiday when he found out he was to be appointed a Member of the Order of Australia (AM) in the 2023 Australia Day Honours List.

He said he was startled and delighted in equal measure at the honour.

“I had felt a bit guilty about checking my email – but when I saw that particular message, I was very glad that I had!” he said.

Professor Kirk works in the NSW Health Pathology Genomics Laboratory at Randwick and is both a clinical geneticist and genetic pathologist – a rare combination.

He has been recognised for his significant service to genetic pathology and clinical genetics, and to medical research.

Among his many achievements and appointments, Professor Kirk is currently co-leader in a ground-breaking national reproductive genetic carrier screening study known as Mackenzie’s Mission.

In recent years, thousands of Australian couples taking part in the study have been screened for about 750 severe, childhood-onset genetic conditions, giving them information about their likelihood of having a child with any of these genetic conditions.

Prof Kirk credits Rachael and Jonny Casella for their tireless advocacy in making the project possible. Mackenzie, after whom the project is named, was their daughter.

“When we started Mackenzie’s Mission, the goal was to bring carrier screening to all Australian couples who wish to access it, free of charge,” Prof Kirk said.

“That remains the goal, and we are still working towards it.”

Prof Kirk said he jumped at the chance to work in genetics after completing his initial clinical training in paediatrics.

“I noticed that wherever I was working, any time there was an interesting or challenging diagnostic problem, the geneticists were called in,” he said.

“This was in the early to mid 1990s and even then it was obvious to an outsider that the pace of discovery in genetics was rapid and accelerating. It seemed like a field full of possibilities.”

Prof Kirk has authored or co-authored more than 125 scientific publications during his two-decade long career in genetics.

In 2020 he published a book “The Genes That Make Us: human stories from a revolution in medicine”, in which he shares experiences and anecdotes from his career, while recounting the history of genetic medicine and exploring its future potential.

“Our ability to make diagnoses in children with rare genetic conditions is dramatically better than when I started; this is very rewarding, both in the lab and at the bedside,” he said.

“A diagnosis can have a very large, positive impact for a family in all sorts of ways.”

Forensic science contributes to national recall of poppy seeds

January 12, 2023 by Liz Farquhar Leave a Comment

The Forensic Toxicology team at NSW Health Pathology’s Forensic and Analytical Science Service (FASS) played an important role in discovering why commercially available poppy seeds led to 12 hospitalisations across NSW.

After a series of hospitalisations related to the use of large amounts of poppy seeds in November 2022, FASS scientists conducted forensic toxicology testing on blood samples from several patients and found unusually high levels of a chemical called thebaine.

Thebaine, whilst unharmful at lower doses, has been known to cause severe illness at higher levels. Symptoms of thebaine toxicity include seizures, severe muscle pains, severe muscle spasms, cramping, stiffness, dizziness, abnormal movements, or cardiac arrest.

While the first cases were detected in Queensland, agencies in Victoria led the investigation into the thebaine poisonings. FASS, in conjunction with multiple health agencies in NSW, used their expertise to increase the evidence and provided advocacy which helped lead to major supermarket chains taking poppy seeds off the shelves and issuing a recall.

FASS’s speedy investigation was made possible with cutting-edge analysers called Liquid Chromatography Quadrupole Time-of-Flight Mass Spectrometry (LC-QTOF-MS). These highly sensitive instruments detected high levels of thebaine and allowed the cross referencing with international library databases and certified reference standards available at FASS.

Forensic Toxicology Senior Scientist Catherine McDonald said that a culture of collaboration between different NSW Health agencies contributed to a successful outcome.
“Public Health works closely with food safety departments in food poisoning cases, however it’s unusual for drug investigations to lead to food safety recalls,” she said.

“Collaborative investigations between interstate Public Health departments, food authorities, poisons information centres and forensic toxicology labs was crucial in identifying the cause of illness in 37 patients around Australia.”

This collaboration was fostered by the Prescription, Recreational and Illicit Substance Evaluation (PRISE) program – a network including NSW Health Pathology’s FASS, NSW Poisons Information Centre (PIC) and the NSW Ministry of Health – which allowed for the extensive blood testing vital to the investigation.