Interested in all things pathology? We’ve got a podcast for that!

August 28, 2024 by Liz Farquhar Leave a Comment

NSW Health Pathology has launched its own podcast – Pathologically Speaking. It’s where you’ll meet some of the best and brightest people working behind the scenes to protect and enhance the health, safety and wellbeing of our communities at all stages of life.

We are releasing new episodes each week and we take some deep dives into some fascinating topics.

We talk forensics, genetics, pandemics, and delve into some of our organisation’s most interesting backstories.

Your host, Liz Farquhar, chats to a fantastic line up of guests about their roles at NSW Health Pathology, their background, interesting stories of their job, discoveries, breakthroughs, career tips, personal and professional triumphs and hurdles, and the power of curiosity when finding the answers that matter to people.

Liz worked as a journalist with the ABC for more than 27 years before joining NSW Health Pathology in 2022 as the media relations manager.

Artwork for the Pathologically Speaking podcast featuring a purple microphone. — Pathologically Speaking brings you the stories of the people at NSW Health Pathology.

“I knew soon after arriving here that this was the perfect place to launch a podcast,” Liz said.

“There is so much incredible work going on throughout the organisation, stories that very rarely get told and this was a chance to bring some of that work and the amazing people behind it into the spotlight,” she said.

“A lot of people in pathology are used to working behind the scenes, but the work they do plays such a vital role in keeping us all safe and healthy as a community, I’m so grateful they’ve taken the time to step out of the lab and the office to share their stories.

“The podcast is about letting people know how vital pathology services are, things you may not even realise are being done in the laboratory of your local hospital.”

A man in a lab coat smiles, with a microscope and image of a virus on a computer monitor in the background. — Virologist and public health physician, Prof Dominic Dwyer.

In the first episode Liz talks to Professor Dominic Dwyer, a world-renowned medical virologist and public health physician about his extraordinary career spanning more than four decades and dedicated to researching, diagnosing and treating infectious diseases.

He became the public face of pathology services during the COVID-19 pandemic and was the only Australian selected by the WHO to travel to China to investigate the origins of the virus.

Prof Dwyer reveals what he considers his most rewarding work and how working in western Sydney changed his perspective on public health.

A woman wearing full PPE stands in a laboratory. — Dr Sairita Maistry, Senior Forensic Pathologist at NSW Health Pathology.

Next, Liz interviews Senior Forensic Pathologist Dr Sairita Maistry about what drew her to forensic pathology as a young woman growing up in South Africa, and why she recommends medical students take time to consider forensic pathology as a career pathway.

Dr Maistry describes how NSW Health Pathology’s Forensic Medicine Service operates within the Coronial system, providing answers when there is an unexpected or unexplained death referred to the Coroner.

A woman sits a desk with a microphone. — Sarah Dimmock talks about how blood donations get to patients at Newcastle’s John Hunter Hospital.

Then we take you into the blood transfusion lab at Newcastle’s John Hunter Hospital. Liz sits down with Kamilaroi woman and Senior Medical Laboratory Scientist in charge of Blood Transfusion, Sarah Dimmock.

Sarah explains what happens to the precious blood donations that arrive daily in our major hospitals, how we determine whether the blood will match each patient, and the extraordinary work that goes into ensuring that it’s ready when it’s needed most – and we don’t waste a drop.

And that’s just the start.

We also speak to renowned melanoma expert and joint Australian of the Year, pathologist Richard Scolyer about his groundbreaking work in the treatment of the deadliest form of skin cancer and his own battle to beat brain cancer.

Medical entomologist and mozzie expert Cameron Webb explains how the Sydney Olympics played a crucial role in determining his career path and reveals a secret talent for creating music.

We find out what being an authentic leader means to our Chief Executive Vanessa Janissen.

We’ll also bring you the incredible stories of what went on at Australia’s largest public pathology service during the COVID pandemic and the latest on genomics and precision, personalised cancer treatment.

Pathologically Speaking is available on Spotify, YouTube, Apple Podcasts, and iHeartRadio and you can find the latest episodes here.

What is ‘sloth fever’? And how can I avoid it when travelling to South America?

August 23, 2024 by Liz Farquhar Leave a Comment

International authorities are issuing warnings about “sloth fever”. Despite the name, it’s not contracted via contact with sloths. Rather, you should avoid contact with mosquitoes and biting midges.

So how can Australians protect themselves from sloth fever when travelling to South and Central America? And how does “sloth fever” compare with other mosquito-borne diseases, such as Zika?

Sloth fever is caused by Oropouche virus and is formally known as Oropouche virus disease or Oropouche fever.

The virus is an orthobunyavirus. So it’s from a different family of viruses to the flaviviruses (which includes dengue, Japanese encephalitis and Murray Valley encephalitis viruses) and alphaviruses (chikungunya, Ross River and Barmah Forest viruses).

Oropouche virus was first identified in 1955. It takes its name from a village in Trinidad and Tobago, where the person who it was first isolated from lived.

Symptoms include fever, severe headache, chills, muscle aches, joint pain, nausea, vomiting and a rash. This makes it difficult to distinguish it from other viral infections. Around 60% of people infected with the virus become ill.

There is no specific treatment and most people recover in less than one month.

However, serious symptoms, including encephalitis and meningitis (inflammation of the brain and membranes surrounding the brain and spinal cord) have occasionally been reported.

What’s happening with this latest outbreak?

In July, the Pan American Health Organization issued a warning after two women from northeastern Brazil died following infection with Oropouche virus, the first fatalities linked to this virus.

There has also been one fetal death, one miscarriage and four cases of newborns with microcephaly, a condition characterised by an abnormally small head, where infection during pregnancy occurred. The situation is reminiscent of the Zika outbreak in 2015–16.

Oropouche had historically been a significant concern in the Americas. However, the illness had slipped in importance following successive outbreaks of chikungunya and Zika from 2013 to 2016, and more recently, dengue.

How is Oropouche virus spread?

Oropouche virus has not been well studied compared to other insect-borne pathogens. We still don’t fully understand how the virus spreads.

The virus is primarily transmitted by blood-feeding insects, particularly biting midges (especially Culicoides paraensis) and mosquitoes (potentially a number of Aedes, Coquillettidia, and Culex species).

We think the virus circulates in forested areas with non-human primates, sloths and birds as the main suspected hosts. During urban outbreaks, humans are carrying the virus and blood-feeding insects then go on to infect other people.

The involvement of biting midges (blood sucking insects mistakenly known as “sandflies” in Australia) makes the transmission cycle of Oropouche virus a little different to those only spread by mosquitoes. The types of insects spreading the virus may also differ between forested and urban areas.

A close up shot of small brown insects. — Biting midges are much smaller than mosquitoes but can still spread pathogens such as Oropouche virus. A/Prof Cameron Webb (NSW Health Pathology)

Why is Oropouche virus on the rise?

The United States Centres for Disease Control and Prevention (CDC) recently issued a warning about rising cases of Oropouche in the Americas. Cases are rising outside areas where it was previously found, such as the Amazon basin, which has authorities concerned.

More than 8,000 cases of disease have been reported from countries including Brazil, Bolivia, Peru, Colombia and Cuba.

Cases of travellers acquiring infection in Cuba and Brazil have been reported on return to Europe and North America, respectively.

While a changing climate, deforestation and increased movement of people may partly explain the increase and geographic spread of the virus, something more may be at play.

Oropouche virus appears to have a greater potential for genomic reassortment. This means the evolution of the virus may happen faster than other viruses, potentially leading to more significant disease or increased transmissibility.

Other types of orthobunyaviruses have been shown to undergo genetic changes to result in more severe disease.

Should Australia be concerned?

Without more definitive information about the role of local biting midges and mosquitoes in Oropouche virus spread, it is difficult to assess how great the risk is to Australia.

The risk of an infected traveller bringing the virus to Australia is low. Very few cases of Zika were reported in travellers from South or Central America returning to Australia. Dengue is rarely reported from those travellers either.

The biting midges most important to the spread of the virus in the Americas are not present in Australia.

While the risks are low, authorities need to be aware of potentially infected travellers returning from South and Central America and to have appropriate testing protocols to identify infection.

Australia has its own local orthobunyaviruses and while these are known to infect people, the health risks are considered low.

What can travellers do to protect themselves?

There are no vaccines or specific treatments available for Oropouche virus.

If you’re travelling to countries in South and Central America, take steps to avoid mosquito and biting midge bites.

Mosquito repellents containing diethytoluamide (DEET), picaridin and oil of lemon eucalyptus have been shown to be effective in reducing mosquito bites, and are expected to work against biting midge bites too.

Wearing long-sleeved shirts, long pants and covered shoes will further reduce the risk.

Sleeping and resting under insecticide-treated mosquito bed nets will help, but much finer mesh nets are required as biting midges are much smaller than mosquitoes.

Although no specific warnings have been issued by Australian authorities, the CDC and European Centre for Disease Prevention and Control have warned that pregnant travellers should discuss travel plans and potential risks with their health-care professional.

Cameron Webb, Clinical Associate Professor and Principal Hospital Scientist, University of Sydney and Andrew van den Hurk, Medical Entomologist, The University of Queensland

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

NSW Skills Minister meets our new trainees

August 21, 2024 by Liz Farquhar Leave a Comment

The NSW Minister for Skills, TAFE and Tertiary Education Steve Whan visited our pathology laboratory at Royal North Shore Hospital during Skills Week 2024, where he announced a second round of government traineeships and apprenticeships.

As part of Skills Week celebrations this year, NSW Health Pathology Chief Executive Vanessa Janissen showed the Minister around our laboratory at Royal North Shore Hospital (RNSH) where he met four of our new trainees and talked about how their traineeships are going.

In June 2024 NSW Health Pathology welcomed 21 new trainees under the first round of the state government’s 1,000 NSW Public Sector Apprentices and Trainees Program.

The intake targeted disadvantaged and marginalised communities, including people with disabilities and First Nations people.

Our Director of People and Culture Dr Deanna Paulin explains how this connects to our People Strategy.

“We know that our people are their best when they feel like they belong. These traineeships are one of our key initiatives under our People Strategy Priority Outcome 6: Reflecting the diverse communities we serve,” she said.

“We are very excited to support our trainees who come from a broad range of backgrounds to have a rewarding career in Health when they may not otherwise get an opportunity to work.”

Trainees Richard Rutherford and Jaime Reyes are both based at the Royal North Shore Hospital pathology lab. Richard works at Central Specimen Reception and Jaime in Collections.

In Central Specimen Reception, all the pathology specimens at the hospital are sent through to the team for sorting and identification, data entry and distribution to other pathology testing areas. In Collections, our phlebotomists or collectors, perform venepuncture collections for a wide range of patients and prepare specimens for storage and transportation to different testing laboratories.

Richard lives with several invisible disabilities that have proved challenging while looking for employment.

He says the traineeship has given him his first chance at some work experience.

“This is the first job I’ve had, and it’s been an eye-opening experience,” he said.

“I didn’t think I had the ability to hold down a job before, but it’s given me routine and the confidence to know that I can handle the work. It’s only been a couple of months, but I’ve proven to myself that I can do it.

“I absolutely love the team I am working with here at Central Specimen Reception at NSW Health Pathology at Royal North Shore Hospital. They have been very welcoming and supportive. My boss and a few of the people I work with in the lab have already offered to help me if I am struggling with my TAFE studies, so that has also been a great confidence boost.”

A young man wearing a blue health uniform enters information into a robotic delivery system, while a man wearing a suit watches on. — Richard Rutherford shows the Minister how to operate our specimen delivery robot.

For Jaime in Collections, it’s been a chance to learn more about what blood collectors do.

“Prior to working here as a trainee, my only knowledge of what blood collectors did was that they collected blood for my local GP. I am now learning there is a lot more to the job, but essentially, it’s about working with people and making sure they feel comfortable.”

Jaime also lives with an invisible disability.

“Throughout my time working in casual jobs, I developed a fear of telling people about my disability,” Jaime explains.

“I felt like I was a burden, risking my employment if I said anything.

“I understood that this job was very people-centred and that was something that strongly aligned with my own aspirations to work with people.

“To be able to build relationships where people could see me as someone who was empathetic and helped them through getting their blood collection done, this was someone that I wanted to be.”

A man in a suit speaks to three young health trainees. — Minister Whan speaks to NSW Health Pathology trainees Ernest Brinas, Mariam Wadie and Jaime Reyes.

Ernest Brinas is working in our Central Specimen team at Westmead Hospital in Sydney’s west and sees the traineeship as an important stepping stone in his career.

“I was hit by a car when I was 9 years old and have a traumatic brain injury that means I have trouble with body function on my left side. I find it hard to stand or walk for long periods of time,” he said.

“This has made it hard to hold down a job. This is the first job I’ve seen advertised where people with disabilities were encouraged to apply and I’m really grateful this opportunity has come along.

“This traineeship has been great because I am able to sit and work at a computer doing data entry for most of the time. The team at Westmead laboratory are very supportive and friendly and I am very happy to be working in pathology.”

A woman in a suit points at laboratory equipment while a man and a woman stand nearby. — Vanessa Janissen (right) and Senior Operations Manager Catherine Atkins show the Minister through the NSW Health Pathology laboratory at Royal North Shore Hospital.

Mariam Wadie is based at NSW Health Pathology’s Forensic Medicine Service at Lidcombe completing a traineeship in Health Administration. Mariam’s role includes working at reception at the Forensic Medicine and Coroners Court Complex at Lidcombe, where she assists families who are attending to view their loved one.

She says the experience has encouraged her to further her studies.

“This traineeship helps me expand on existing skills obtained from previous work experience and opens doors of opportunity as it is an entry into different career paths,” Mariam said.

“Whilst working at Forensic Medicine, particularly as a receptionist, I have gained the confidence to make and answer phone calls and deal with different types of people, which is a skill I did not have prior to this traineeship.

“I’ve been inspired by the amazing Forensic Medicine Social Work team in their approach and dealing with distressed families. They are a great help and support to those in need and in seeing their work, I am inspired to be able to provide that same support for families. I can see myself taking on the study of social work.”

NSW Health Pathology is excited to be helping to kickstart the careers of these incredible young people and our other 17 trainees working at our sites across the state and we’re looking forward to welcoming a new cohort of trainees in the near future.

Four young trainees stand in a laboratory. — (L‑R) Trainees Jaime Reyes, Mariam Wadie, Ernest Brinas and Richard Rutherford.

Getting to know the next generation of pathologists – our regional registrars

August 16, 2024 by Liz Farquhar Leave a Comment

Meet Dr Supriya Pradhan who has been working at the Coffs Harbour Anatomical Pathology laboratory since early 2024.

“It was just by chance that I got into pathology,” Supriya admits. “I worked in a cancer registry in India, and that really piqued my interest in the subject.

“I enjoy the process of looking at slides and putting all the pieces together to come to a diagnosis. I’m working in the background but still a part of a patient’s journey.”

Supriya moved to Australia from India in 2018, having finished medical school there in 2008.

“I feel really lucky and privileged to be doing this work and that I get to visualise what is underneath the surface, the cells of body and the many varieties of disease processes that can affect them,” she says.

“I see and learn so many new and interesting things every day. Pathology is not just a ‘boring desk job’ as people sometimes assume.

“I worked with a student here in the lab the other day and she was fascinated with the work we do, because as medical students we look at slides, but we don’t always know much about the process that led up to that slide being under the microscope.”

Supriya says in her spare time, she enjoys being in nature and loves solving puzzles and reading mysteries and detective novels.

“I think that’s part of why I was attracted to working in pathology. It’s all about working out what is going on with a patient and solving that puzzle.”

A laboratory filled with equipment and two people wearing lab coats. — The Coffs Harbour laboratory provides vital pathology services for the wider mid north coast region and beyond.

Supriya says she is enjoying working in the recently refurbished Anatomical Pathology laboratory at Coffs Harbour.

“Having grown up in a small Himalayan town in India within a close-knit community, I always enjoy working in regional settings, where I feel my work has a larger and direct impact on the health services provided to patients.

“Dr Kate Osborne is the other Anatomical Pathology registrar here at Coffs, so we share the work,” Supriya explains.

“But we are working directly with the pathologists and experienced scientists, so learning from the experts themselves, which is fantastic.

“We also attend weekly multi-disciplinary team meetings, that’s where the surgeons, oncologists, radiologists, pathologists and a whole range of experts come together and discuss cases, giving input into the management of a patient.

“It’s also a great lifestyle here in Coffs Harbour. I have two kids and they enjoy being outdoors and going to the beach.

“If it was up to me, I’d do all my training in a regional area – but I understand that it’s also important to work in a bigger area just to get the experience there as well.”

Two young women in an office, smiling. — Supriya Pradhan and her fellow AP registrar at the Coffs Harbour pathology laboratory, Dr Kate Osborne.

Concord’s new electron microscope arrives to improve the diagnosis of renal disease

August 7, 2024 by Kristy Waddell Leave a Comment

NSW Health Pathology’s Concord laboratory is celebrating the arrival of a brand-new electron microscope, which will help pathologists and scientists more easily and effectively diagnose renal disease.

Clinical Director, Assoc Professor Charles Chan said electron microscopy plays an essential role in the diagnosis of kidney diseases.

“The electron microscope transmits a beam of electrons through ultrathin sections of tissue specimens to produce high-resolution magnified images. With its integrated high-resolution camera, it can “see” with 1,000 to 100,000 times magnification which allows it to look at extremely small structures,” A/Prof Chan said.

“It allows us to take a look inside cells and their surroundings in a kidney biopsy at high magnification and see exactly what the pathologic defect is and its specific location – which means a more definitive diagnosis and treatment options for renal disease patients.”

The Electron Microscopy Unit at Concord Hospital is our statewide referral service for electron microscopy and is the largest diagnostic service of its kind in Australia. NSW Health Pathology labs at Liverpool and Westmead also support this vital statewide service. At Concord, we receive specimens from across NSW and ACT as well as many internationally from New Zealand, New Caledonia and Fiji.

“The highly skilled team processes and report approximately 2,200 cases annually and this number is growing by over nine per cent each year against a background of increased chronic diseases in the population. In fact, our workload has more than doubled over the last 10 years,” A/Prof Chan said.

“The use of electron microscopy has evolved over the years, with advancing medical knowledge and the changing incidence of diseases. The ability of the electron microscope to identify minute structural changes within and around abnormal cells makes it a powerful technique to characterise and diagnose an increasing number of newly recognised diseases,” he said.

Concord now has two electron microscopes, which allows for improved workflow and more efficient turnaround times of diagnoses.

“With two electron microscopes, scientists/pathologists can view cases simultaneously, which will improve our overall turnaround times,” he said.

“We will also be able to continue working and reporting cases in the event that one instrument is undergoing routine maintenance or repair.”

Concord’s Anatomical Pathology Laboratory Manager Andrew Kennedy said another important improvement for staff was the enhanced workstation.

“The space has been ergonomically designed and is more comfortable for lab staff who may be required to sit working at the instrument for many hours each day,” Andrew said.

The new electron microscope was funded by NSW Health Pathology to the tune of $700,000 and minor capital works were undertaken to upgrade the room housing the instrument and attached plant equipment. The space has climate control air conditioning, plumbing, electrical works, flooring and fresh painting.

And no, it doesn’t have a name yet… the team wants to get to know it better first!

Meet the team working behind the Electron Microscope

The role of an electron microscopy scientist requires a unique set of skills. The role covers skills of both a scientific and technical nature and requires great attention to detail and interpretive skills which are acquired predominantly through on-the-job training.

For renal biopsies, it typically takes three years to become proficient in the diagnosis of renal disease using electron microscopy with more complex specimen types requiring longer periods of training.

It can take entire careers to develop the knowledge and skills to interpret many ultrastructural features in many different types of tissues, so our skilled team are forever learning and developing as scientists.

We have five highly trained and dedicated medical laboratory scientists employed in the electron microscopy unit and all seven staff specialists routinely report all renal biopsies.

Stephanie Sampedro is the senior scientist in charge of section in electron microscopy; and three staff specialists, A/Prof Charles Chan (AP Clinical Director), Dr Renee Chan and Dr Ivan Canoy routinely report other specimen types such as skin, muscle, nerve, nasal cilia and platelets.

The team from NSW Health Pathology’s Electron Microscopy Unit at Concord. Left to Right: Roxana Tsui, Stephanie Sampedro, Lauren Lumsden, Beba Attia, Sophi Kc, Dr Ivan Canoy. Front row: A/Prof Charles Chan, Dr Renee Chan.

Past and present team reunite to check out the new technology

Concord Laboratory’s Electron Microscopy Unit recently hosted a morning tea to celebrate the arrival of the new electron microscope. Past and present staff members were among the special guests.

It was also a chance for all those involved in the ordering, commissioning and building works to come together to see the results of all their hard work.

Many people – from pathologists, scientists, technical officers, planning, eHealth, ICT, procurement and finance have been instrumental in supporting the unit and its emergent role as both a statewide and international referral service for Electron Microscopy.

“Pathology is just magic! I love that we can make such a big difference”

August 6, 2024 by Liz Farquhar Leave a Comment

We’re getting to know some of our regional registrars. Here, we catch up with Dr Kate Osborne to chat about working in Coffs Harbour and why she picked pathology.

Dr Kate Osborne says she wasn’t even considering a career in medicine when she began studying undergraduate science at the University of Sydney but had no hesitation in deciding she wanted to pursue pathology.

“Pathology is just magic! In my undergraduate science degree, I studied Anatomical Pathology, as well as electron microscopy and light microscopy, and I just loved the combination of science and medicine that pathology afforded,” Kate said.

“I thought, I don’t really know what kind of doctor I want to be, but I know I want to do something meaningful, and do research. Pathology is at the heart of medicine in both clinical diagnostics and patient care.

“It is the absolute fundamentals of everything that we do in a hospital. I believe the current statistic is that about 70% of clinical diagnostics are dependent on our pathology laboratories, which is extraordinary.

“If pathology stops, the rest of the hospital stops.

“I love the fact that we can make such a big difference – even though there is this reputation that we live in dark little offices in the basement, it’s a beautiful laboratory here at Coffs and a vibrant team of people.”

Kate began working as a registrar at the Coffs Harbour Anatomical Pathology laboratory in early 2024.

She says it’s been rewarding living and working in a regional setting.

A wide shot of a woman working at a desk with a microscope — Dr Osborne in the recently refurbished offices at the Coffs Harbour AP lab.

“I did some immunohistochemistry and slide preparation as part of my PhD research at Sydney University and RPA and they are huge labs. You might not even know everyone who works there,” she said.

“In Coffs, not only do you know all your colleagues, but you also get to know a lot of the clinicians you work with and attend multi-disciplinary team (MDT) meetings with as well. It’s collegiate and feels warm and inviting.”

Kate said she also feels more connected to patients and the local community at Coffs Harbour.

Although pathologists rarely get to see their patients, Kate says she is very aware of them while working.

“I always try to be really mindful that the tiny bowel biopsy specimen that I get and transfer into a cassette, get processed and then report, that represents up to 3 days of bowel prep for a patient.

“They’ve had to get to the hospital, undergo a general anaesthetic, arrange for time away from family or work and children, and then all the anxiety as they wait for results.

“This 3‑millimetre little specimen represents so much for that person. The job we are doing is so important to give someone a diagnostic picture so they can have better health and appropriate management of disease.”

Kate says she’ll complete her training in a larger metropolitan laboratory but intends to come back to a regional area in the long term.

“There’s so much we can do in regional areas and there’s a general shortage of pathologists of all types, not just anatomical, in regional and rural Australia.

“It’s such a shame because it’s a beautiful place to live, and you get an incredible array of specimens, things you don’t necessarily see in large centres because our patient cohort is so diverse. We regularly diagnose amazing and unusual entities that are quite inspiring to see as a registrar – and our pathologists have so much knowledge to share.”

Her advice to medical students thinking about pathology as an option?

“If you think pathology might be for you – ask to come and visit a lab! See what we do first-hand and experience why it’s such an amazing and privileged part of medicine to work in.

“I’ve had medical students in the AP lab with me and it’s been incredible to teach and mentor them. For example, I’ll open up a bowel that has been removed for malignancy and they’ll say ‘Oh my gosh, is that what all the mucosa really looks like?’ or ‘I had no idea that the mesentery attached like that’.

“They can see a tumour in situ and relate the anatomy in front of them to staging and patient prognosis. Medicine feels so much more tangible when they can see the diagnostic material in front of them.

“They’ll rub the inside of a gallbladder for the first time, and they’ll exclaim that ‘it’s so green and fluffy!’ It’s that sense of wonder that we need to continue to inspire in our medical students and interns.”