Closing the Gap

Closing the Gap

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Taking on the challenge of managing an outback laboratory

Taking on the challenge of managing an outback laboratory

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Sunita Goundar says her decision to move from Sydney to Walgett in northern NSW was about giving back to the community but has also changed her life for the better.

Suni­ta took up the role of Lab­o­ra­to­ry Man­ag­er at Wal­gett in Sep­tem­ber 2023.

“I’d been work­ing in pathol­o­gy in Syd­ney for almost 20 years, the last 14 with NSW Health Pathol­o­gy,” Suni­ta explains.

“I’m from Fiji orig­i­nal­ly and when you come to a coun­try like Aus­tralia to study and work, it gives you so many priv­i­leges, and you just want to give back because Aus­tralia has giv­en me so much.”

Suni­ta loves explor­ing region­al and rur­al Aus­tralia. A few years ago, on a trip to region­al Queens­land, she got talk­ing to some locals about how hard it was to access health­care and realised she want­ed to help.

“I actu­al­ly felt that I could do some­thing, this was some­thing I could do to help small­er communities.”

Does she miss liv­ing in a city the size of Syd­ney, where she has a net­work of friends and family?

“Not at all! Wal­gett is a beau­ti­ful place, the peo­ple are very friend­ly. I have col­leagues who arrive every morn­ing at 6am and we all go for a morn­ing walk togeth­er. Every­one here is like a fam­i­ly, not like col­leagues,” Suni­ta says.

“I make friends very quick­ly, and unlike Syd­ney where you don’t even know your neigh­bours, here, every­one knows every­one. My health has also improved. I have asth­ma and the air here is just so much clean­er and fresh­er than Sydney.

“Of course it’s very dif­fer­ent to Syd­ney, but I was very clear in my think­ing that I am here for a pur­pose, and I am hap­py to be here.”

Two men and a woman in a laboratory.
Suni­ta with her col­leagues, Cha­van Goluko­rup­puge and Mosisa Yusuf in the lab.

Suni­ta admits she was afraid of one thing mov­ing to region­al NSW – snakes.

“In my first cou­ple of months I saw a cou­ple of east­ern brown snakes. But you know what? I’m not scared any­more because if you leave them alone they don’t actu­al­ly harm you.”

Suni­ta says she was lucky to get accom­mo­da­tion near the hos­pi­tal, as Wal­gett is no dif­fer­ent to oth­er region­al areas where rental hous­ing is in short supply.

“I’m only one minute away from work – a very short com­mute! We have a gym here as well, so I have every­thing I need close by.”

Suni­ta says the Wal­gett lab­o­ra­to­ry has a range of ser­vices and the work is challenging.

“We’ve got a bio­chem­istry depart­ment, a haema­tol­ogy depart­ment, we also do blood trans­fu­sion and recent­ly we’ve been deal­ing with more com­pli­cat­ed cas­es for the blood bank.

“If there is an MTP (Mas­sive Trans­fu­sion Pro­to­col) we are here dis­pens­ing bloods, not just local­ly, but also for sur­round­ing areas.

“We have a col­lec­tion cen­tre at Light­ning Ridge and we also serve Col­larenabri Dis­trict Hos­pi­tal, the AMS (Abo­rig­i­nal Med­ical Ser­vice) and we are also help­ing Bre­war­ri­na with lab testing.”

Suni­ta says NSW Health Pathol­o­gy has pro­vid­ed a great net­work of men­tors and sup­port­ive man­agers since she arrived in Walgett.

“In six months, I nev­er expect­ed to grow so much and I should give cred­it to Ben Alchin (Senior Oper­a­tions Man­ag­er for West­ern NSW and Far West) for link­ing me with so many great peo­ple in the organ­i­sa­tion who have helped me.”

A group of people smiling with arms around each other.
The Wal­gett lab team: Cha­van Goluko­rup­puge, Ben Alchin (Senior Oper­a­tions Man­ag­er), Yen Hol­land, Suni­ta Goundar, Mar­la Gould.

Sunita’s advice to some­one con­sid­er­ing a tree change?

“They shouldn’t over­think it – just take the leap! Wal­gett is a long way from Syd­ney, but I do not regret one day that I made this deci­sion. I am very grate­ful to be work­ing here, because I love it here.”

Incentives to move to regional NSW

Han­nah Bev­eridge is NSW Health Pathology’s Region­al Tal­ent Acqui­si­tion Spe­cial­ist and says she loves hear­ing about staff who have had a suc­cess­ful career change into the regions.

“Suni­ta was able to take advan­tage of NSW Health’s Rur­al Health Work­force Incen­tive Scheme (RWIS) which offers finan­cial bonus­es for health staff and new employ­ees tak­ing up jobs in region­al parts of the state,” Han­nah said.

“It’s designed to attract and retain staff to region­al, rur­al and remote NSW. Our ‘hard to fill’ posi­tions and ‘crit­i­cal vacan­cies’ across these loca­tions are incen­tivised via a fort­night­ly allowance, which is worth between $10,000 and $5,000 per annum depend­ing on the loca­tion, pro-rata for part timers.”

A man and a woman holding eskies standing in front of a NSW Health Pathology-badged car.
Mosisa Yusuf and his NSWHP col­league from Bourke, Jen­nifer Bolton, at Walgett.

Han­nah says one of the biggest chal­lenges in attract­ing new employ­ees to rur­al and region­al areas is the per­cep­tion that you need to live and work in a big­ger metro area to grow and fur­ther your career.

“Sunita’s sto­ry is exact­ly what it’s all about! Her pas­sion to help her com­mu­ni­ty ignites excite­ment and inspires others.

“Career growth, health improve­ments as well as the impacts she is hav­ing to the Wal­gett com­mu­ni­ty, is a suc­cess for every­one. Keep­ing our region­al work­force healthy means our com­mu­ni­ties have access to local health­care and time­ly results.”

Inter­est­ed in a job in rur­al or region­al NSW?

Find your next career move and all our eli­gi­ble RWIS posi­tions here!

Training to be part of the ‘SAS of the medical world’

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This year four NSW Health Pathology staff were selected to undergo training with AUSMAT, the Australian Medical Assistance Team, preparing them to be deployed to disasters or health responses at short notice.

In August 2023, the Nation­al Crit­i­cal Care and Trau­ma Response Cen­tre (NCCTRC) sent out an expres­sion of inter­est seek­ing med­ical sci­ence pro­fes­sion­als for recruit­ment into the Aus­tralian Med­ical Assis­tance Team (AUSMAT) vol­un­teer data­base for future AUSMAT deploy­ment oppor­tu­ni­ties and activities.

Over 40 appli­ca­tions from NSW Health Pathol­o­gy staff were received – with four select­ed to under­take the rig­or­ous train­ing required in the 2024 courses.

Philip Dupal a Hos­pi­tal Sci­en­tist at our Mait­land lab­o­ra­to­ry, Luke Ryan a Hos­pi­tal Sci­en­tist based at our Bathurst lab­o­ra­to­ry, Clau­dia Alvarez Chavar­ria­ga from the Trans­fu­sion team at Rand­wick and Infec­tious Dis­eases physi­cian at Suther­land Hos­pi­tal Dr Ben Knip­pen­berg all recent­ly com­plet­ed the train­ing at the NCCTRC in Darwin.

A man and a woman stand inside a large industrial shed smiling.
Luke Ryan at the train­ing course with Leanne Jones, who heads up the pathol­o­gy lab for AUSMAT.

What is AUSMAT?

The Aus­tralian Med­ical Assis­tance Team is a World Health Orga­ni­za­tion-accred­it­ed Emer­gency Med­ical Team man­aged by NCCTRC for the Aus­tralian Gov­ern­ment Depart­ment of Health and Aged Care. AUSMAT leads the way in civil­ian med­ical team pre­pared­ness and response to sud­den onset dis­as­ter, med­ical or human­i­tar­i­an emer­gency, domes­tic or international.

It’s made up of med­ical pro­fes­sion­als, includ­ing physi­cians, reg­is­tered nurs­es, allied health and para­medics, and non-med­ical mem­bers such as logisticians.

While ini­tial respons­es con­cen­trat­ed on inter­na­tion­al events and dis­as­ters, more recent­ly the focus has shift­ed to pub­lic health emer­gen­cies, such as the measles epi­dem­ic in Samoa (Octo­ber 2019-Jan­u­ary 2020), as well as to domes­tic deploy­ments includ­ing the cat­a­stroph­ic bush fires in Vic­to­ria and New South Wales in Jan­u­ary 2020, and Australia’s COVID-19 response.

A group of people setting up a field tent.
Set­ting up a field tent.

What does AUSMAT training involve?

The train­ing course involves a com­pre­hen­sive six-week online course plus a one week face-to-face res­i­den­cy held in Dar­win at the NCCTRC’s new­ly ren­o­vat­ed train­ing facility.

The stan­dard­ised nation­al train­ing brings togeth­er train­ers from a mix of pro­fes­sions and juris­dic­tions to deliv­er the course.

Course con­tent includes:
• Sur­vival in aus­tere environments
• Equip­ment familiarisation/management
• Hos­tile negotiation
• Trip planning
• Cul­tur­al awareness
• Med­ical man­age­ment of mul­ti casu­al­ties in the field
• Human­i­tar­i­an operations
• Crowd management
• Water purification

Luke Ryan says the course has been devel­oped to expose par­tic­i­pants to a range of essen­tial tech­niques and sur­vival skills need­ed for suc­cess­ful man­age­ment in the field dur­ing a health emergency.

“It’s par­tic­u­lar­ly focused on test­ing the par­tic­i­pants’ capac­i­ty to sur­vive in dif­fi­cult and hos­tile envi­ron­ments as a val­ued team mem­ber,” he explained.

“It involves both class­room and prac­ti­cal exer­cis­es includ­ing an overnight field deployment.”

Clau­dia Alvarez Chavar­ria­ga described the train­ing as tough but life-changing.

A woman in a uniform and hat in a forested area.
Clau­dia Alvarez Chavar­ria­ga from our Rand­wick Trans­fu­sion team dur­ing the AUSMAT train­ing session.

“Phys­i­cal­ly and men­tal­ly, it was a lot to take on board,” she said.

“Unlike oth­er deploy­ment organ­i­sa­tions, AUSMAT required us to under­go prac­ti­cal sim­u­la­tions as though we had been deployed to a real mass casu­al­ty event.

“We had to deal with and impro­vise as though we were under heat stress and in hard-to-access loca­tions. But it was immense­ly rewarding!”

Philip Dupal said it was a priv­i­lege to have been invit­ed to attend the pre-deploy­ment training.

“It was a fan­tas­tic oppor­tu­ni­ty to work with a diverse group of pro­fes­sion­als and devel­op new skills togeth­er,” he said.

“I look for­ward to using these new skills and work­ing with the AUSMAT team in the future if I am required to respond to a crisis.”

Two men in blue shirts with AUSMAT logos, looking tired and dirty.
Luke Ryan and Phil Dupal at the AUSMAT train­ing course.

NSW Health Pathology’s Emergency/Disaster Man­ag­er Scott Pearce said the organ­i­sa­tion was excit­ed to be boost­ing the num­ber of its staff involved with AUSMAT.

“We cur­rent­ly have two trained and deploy­able med­ical staff list­ed in the AUSMAT data­base, and we are proud to have anoth­er four staff in train­ing,” he said.

“The train­ing is about mak­ing sure they are pre­pared for what­ev­er sit­u­a­tion they may find them­selves in, whether that is a dis­as­ter sit­u­a­tion here in Aus­tralia or overseas.

“They need to be able to deploy rapid­ly, with the assis­tance of the Aus­tralian Defence Force, and can be self-suf­fi­cient once they reach a dis­as­ter zone.

“It’s all about help­ing peo­ple and com­mu­ni­ties affect­ed by dis­as­ters in des­per­ate need of med­ical assistance.”

Built-in robots a key feature of new system at Liverpool Laboratory

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NSW Health Pathology’s Liverpool laboratory is getting a major upgrade with the arrival of the brand new state-of-the-art laboratory automation system.

A brand new pathol­o­gy depart­ment at Liv­er­pool Hos­pi­tal is near­ing com­ple­tion as part of the Liv­er­pool Health and Aca­d­e­m­ic Precinct – a $790 mil­lion rede­vel­op­ment of Liv­er­pool Hos­pi­tal and a new edu­ca­tion and research hub.

Dr Michael Maley, Local Pathol­o­gy Direc­tor – South West­ern Syd­ney said this was a fan­tas­tic mile­stone worth celebrating.

“Our micro­bi­ol­o­gy team are excit­ed to work in the new lab­o­ra­to­ry – it’s been many years in the plan­ning, and they look for­ward to imple­ment­ing new work­flows as we con­fig­ure and opti­mise the automa­tion instruments.

We hope to com­bine the ben­e­fits of automa­tion with the ben­e­fits of Fusion, which will deliv­er our statewide lab­o­ra­to­ry infor­ma­tion sys­tem. All of these excit­ing devel­op­ments will improve patient out­comes, dri­ve effi­cien­cy, and deliv­er greater sat­is­fac­tion for our hard-work­ing lab­o­ra­to­ry staff”, Dr Maley said.

NSW Health Pathology’s Senior Oper­a­tions Man­ag­er South West­ern Syd­ney, Parth Nana­vati said the inte­grat­ed mul­ti­dis­ci­pli­nary lab­o­ra­to­ry has been built to meet the com­mu­ni­ty’s needs using next-gen­er­a­tion automa­tion and robot­ic technology.

An image of a blue and white lab machine
The high-tech lab­o­ra­to­ry automa­tion sys­tem installed at the new Liv­er­pool pathol­o­gy laboratory.

“The world-class lab­o­ra­to­ry oper­ates 24 hours a day, sev­en days a week and is cru­cial to detect­ing, diag­nos­ing, treat­ing dis­ease and man­ag­ing long-term health con­di­tions,” Parth said.

“The new NSW Health Pathol­o­gy lab at Liv­er­pool Hos­pi­tal will ser­vice a grow­ing pop­u­la­tion in South West­ern Syd­ney, so it needs equip­ment that can deliv­er high-qual­i­ty results for patients and meet increased vol­umes of micro­bi­ol­o­gy diag­nos­tic testing.”

Liv­er­pool Micro­bi­ol­o­gy is an extreme­ly busy depart­ment and the vol­ume of test­ing is ris­ing. In the finan­cial year 2018/19, the micro­bi­ol­o­gy team processed 203,181 sam­ples and dur­ing 2023/24 that increased to 283,203 samples.

“With grow­ing demands on micro­bi­ol­o­gy ser­vices, there is a tremen­dous need for inno­v­a­tive solu­tions to deliv­er time­ly and accu­rate results for a range of infec­tious dis­eases,” Parth said.

The new sys­tem ful­ly auto­mates bac­te­r­i­al cul­ture inves­ti­ga­tion into patient spec­i­mens, work­ing to trans­form lab­o­ra­to­ry oper­a­tions and min­imis­ing time between load­ing the sam­ple and incu­ba­tion of cultures.

“It allows pathol­o­gists, sci­en­tists and tech­ni­cal offi­cers to work seam­less­ly through auto­mat­ed work­flows from plate labelling to inoc­u­la­tion, incu­ba­tion, imag­ing, cul­ture read­ing and results report­ing,” Parth said.

Two men standing in a high-tech laboratory.
Dr Michael Maley and Parth Nana­vati in the lab.

It has a robot­ic track sys­tem which allows plates to trav­el through the sys­tem at a faster rate and acquires up to 22 images of each plate with a high res­o­lu­tion 25-megapix­el cam­era for advanced image qual­i­ty. This pro­vides detail not vis­i­ble to the human eye.

These enhance­ments will allow effi­cient and improved work­flows and enable sci­en­tif­ic and tech­ni­cal staff to per­form oth­er tasks, such as in-depth result review, tech­ni­cal data analy­sis, qual­i­ty con­trol mon­i­tor­ing, trou­bleshoot­ing and the abil­i­ty to remote­ly read cultures.

The impor­tance of hav­ing state-of-the-art lab infra­struc­ture was evi­dent through­out the COVID-19 pan­dem­ic and is a key enabler for the health system’s readi­ness and pre­pared­ness to respond to future pandemics.

The team is set­ting its sights on an envi­ron­men­tal­ly sus­tain­able future, by invest­ing in tech­nolo­gies that reduce ener­gy con­sump­tion and emis­sions and con­tribute to NSW Heath get­ting to net zero.

“The new lab automa­tion sys­tem will help us achieve this green vision because it has a small­er foot­print, uses less pow­er through ener­gy effi­cient prac­tices. With few­er mov­ing parts, we are using less elec­tric­i­ty and have a more effi­cient trans­porta­tion of the plates around the system.

“Pathol­o­gy is an essen­tial sup­port ser­vice for the Liv­er­pool Hos­pi­tal and the upgrade of pathol­o­gy ser­vices is com­ing at a cru­cial time for the hos­pi­tal. NSW Health Pathol­o­gy is proud to be embrac­ing new tech­nolo­gies and set­ting the bench­mark in patient care for South West­ern Syd­ney com­mu­ni­ties, and the peo­ple of NSW,” Parth said.

End of an era – Dr Stephen Braye steps down after four decades of service

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NSW Health Pathology’s Chief Medical Information Officer is retiring, leaving behind a remarkable legacy of leadership.

NSW Health Pathology’s Chief Exec­u­tive Vanes­sa Janis­sen thanked Dr Braye for his years of service.

“It’s with mixed emo­tions of grat­i­tude and sad­ness that we farewell Stephen Braye,” she said.

“He has played a piv­otal role in NSW Health and NSW Health Pathol­o­gy, help­ing to shape clin­i­cal ser­vices and dig­i­tal initiatives.”

Stephen’s career has seen him work across many of NSW Health Pathology’s major lab­o­ra­to­ries, including:

  • Prince Hen­ry and Prince of Wales where he com­menced his train­ing as a Reg­is­trar in Anatom­i­cal Pathol­o­gy and sub­se­quent­ly as Senior Lecturer/Accredited Spe­cial­ist in Anatom­i­cal Pathol­o­gy for UNSW
  • ICPMR West­mead where in 1988 he was appoint­ed as Staff Specialist/Lecturer in Anatom­i­cal Pathology
  • John Hunter from 1990 join­ing the Anatom­i­cal Pathol­o­gy Depart­ment and the Uni­ver­si­ty of New­cas­tle Med­ical School as a Senior Lec­tur­er, a post he held to 2017.

Stephen has main­tained a pas­sion­ate inter­est in Cytol­ogy through­out his career, includ­ing sup­port­ing and devel­op­ing the Depart­ment of Cytol­ogy at the John Hunter Laboratory.

His areas of spe­cial inter­est encom­passed head and neck, thy­roid and breast cytol­ogy. His exper­tise in breast cytol­ogy led to his appoint­ment as the Accred­it­ed Des­ig­nat­ed Pathol­o­gist for Breast Screen NSW, New­cas­tle dur­ing the years 2000 – 2017.

He has held many roles in the Hunter area, includ­ing Senior Staff Spe­cial­ist, Direc­tor of Anatom­i­cal Pathol­o­gy, Assis­tant Direc­tor and, in 2011, he was appoint­ed as Net­work Direc­tor of Pathol­o­gy North. In this capac­i­ty Stephen was a foun­da­tion­al exec­u­tive in the for­ma­tion of NSW Health Pathol­o­gy in 2012. He was lat­er appoint­ed the organisation’s Exec­u­tive Direc­tor of Clin­i­cal Ser­vices and then took on the role of Chief Med­ical Infor­ma­tion Offi­cer and Direc­tor of Statewide Clin­i­cal Services.

From Jan­u­ary 2020, Stephen also led our COVID-19 response as Inci­dent Man­age­ment Con­troller pro­vid­ing guid­ance to NSW Health Pathol­o­gy and the Min­istry of Health.

Stephen says he con­sid­ers the work done dur­ing the ear­ly days of the pan­dem­ic to be some of the most reward­ing of his career.

“You’d like to say it was painful and mis­er­able, and debil­i­tat­ing, but it was none of those things, it was actu­al­ly very, very excit­ing,” he said.

“As a team we were engaged and coop­er­a­tive – it was tru­ly ener­gis­ing. One of the best expe­ri­ences of my work­ing life was work­ing with a team so incred­i­bly focused on deliv­er­ing real, tan­gi­ble and vis­i­ble out­comes for the community.

“I think I would have been absolute­ly mis­er­able if I’d retired five years ear­li­er and missed the oppor­tu­ni­ty of being engaged in NSW Health Pathology’s response to COVID-19.”

A man smiling in front of a pink background.
Stephen Braye led NSW Health Pathol­o­gy’s COVID pan­dem­ic response and says it was some of the most reward­ing work of his career.

Ms Janis­sen acknowl­edged Stephen’s gen­eros­i­ty and com­mit­ment to sup­port­ing oth­er staff at NSW health Pathol­o­gy, through staff devel­op­ment work­shops, plan­ning days, organ­i­sa­tion­al lead­er­ship, and spon­sor­ing many valu­able edu­ca­tion­al opportunities.

“I would like to thank Stephen for his excep­tion­al ser­vice, pro­fes­sion­al­ism and ded­i­ca­tion to NSW Health Pathol­o­gy. We wish him all the best as he steps into what is sure to be a busy and ful­fill­ing retirement.”

Stephen will be fea­tured on the offi­cial NSW Health Pathol­o­gy pod­cast, Pathol­o­gy Speak­ing, in the spe­cial COVID episode. You can check out the pod­cast page on our web­site so you don’t miss an episode. It’s also avail­able here on Spo­ti­fy or wher­ev­er you get your podcasts.

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

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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?

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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.The Conversation

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.

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NSW Health Pathology acknowledges the Traditional Custodians of the land across NSW whose cultures and customs have nurtured and continue to nurture this land. We would like to pay our respects to the Elders past, present and emerging, for they hold the memories, the traditions, the culture and hopes of Aboriginal and Torres Strait Islander peoples across the state.

Aboriginal Workforce Development Closing the Gap

NSW Health Pathology acknowledges the Traditional Custodians of the land across NSW whose cultures and customs have nurtured and continue to nurture this land. We would like to pay our respects to the Elders past, present and emerging, for they hold the memories, the traditions, the culture and hopes of Aboriginal and Torres Strait Islander peoples across the state.

Aboriginal Workforce Development Closing the Gap
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