key: cord-0721330-ufu76ip7 authors: Smith, David W. title: Tropical viral infections date: 2012-12-31 journal: Pathology DOI: 10.1016/s0031-3025(16)32716-7 sha: 67724dc1a4379f5743db6ea731144ba798b86b8b doc_id: 721330 cord_uid: ufu76ip7 Travel into subtropical and tropical areas is increasing, with a corresponding increase in the number of suspected viral infections acquired while travelling. In addition, legal and illegal immigrants may enter with overseas-acquired infections. Some of these infections are endemic to Australia, but are seen more often in returned travellers because they are more common overseas. These include hepatitis A, hepatitis B, HIV, seasonal influenza, measles, mumps and rubella. In addition there are number of infectious agents that are exotic or uncommon within Australia and are a particular diagnostic concern in people recently arrived from overseas. The most important of these are dengue virus infections, which have been increasing internationally in recent decades. Other arboviruses such as chikungunya and Japanese encephalitis virus also require consideration. Other important but rare viruses include Nipah virus, hantaviruses, rabies virus and the viruses causing viral haemorrhagic fever. Also it is important to consider new pathogens, as Asia has seen the emergence of SARS coronavirus, avian influenza virus, Nipah virus and others in recent years. This talk will focus on the exotic viruses and the diagnostic approach to potential overseas-acquired viral illnesses. traditional methods such as isolation studies to support serology and nucleic acid based testing. To underpin this capability, regional quality assurance programs provide the mechanism for ensuring laboratories are able to deliver testing of the required accuracy for the disease. The enhanced genomic knowledge also allows cautious optimism for the development of a recombinant style vaccine. Globally the surveillance of leptospirosis is limited and the actual incidence of the disease still relatively unknown. It is estimated that over 500 000 severe cases of the disease occur annually around the world. Parasitology, RCPA Microbiology QAP, Sydney, NSW, Australia The parasitology Quality Assurance Program (QAP) provides laboratories with a number of challenges throughout the year. The QAP requires staff to process, prepare and stain a specimen of faeces. The task is then to examine and report the presence of parasites. Numerous difficulties can occur at any step. This presentation reviews the specimens from 2011 and reports on some of the issues raised. Australia settles about 14 000 refugees each year under the Humanitarian program; half are aged 19 years or less. Many more immigrants from 'refugee like' backgrounds arrive under different visa categories. Available evidence suggests that these groups suffer with a heavy burden of often undiagnosed health conditions. These include inadequate immunisation, infectious diseases and nutritional deficiencies. A limited predeparture medical check is undertaken overseas, and so after arrival in Australia this group require comprehensive health assessment. This presentation will outline current evidence-based health screening recommendations, diagnostic considerations for some common and unusual infectious diseases, and an update on their management. Vitamin D deficiency will also be discussed. Robin A. Cooke Department of Anatomical Pathology, Princess Alexandra Hospital, Brisbane, Qld, Australia The initial diagnosis of a fungal infection is very frequently made by an anatomical pathologist on biopsy material. Many fungi have characteristic appearances in histological sections but confirmation of the species of fungus must be made by a mycological identification. Some human pathogenic fungi are only found in particular geographic locations. It is important for laboratory workers to be aware of the diagnostic features of these fungi as well as those that are more frequently found in their own clinical environment. A number of fungal infections will be demonstrated including Cryptococcosis, Chromoblastomycosis, Actinomycosis, Aspergillosis, Candidiasis, North and South American Blastomycosis, Coccidioidomycosis, Histoplasmosis, Rhinosporidiosis. Microbiology and Pathology, Pathology Queensland, Townsville Hospital, Townsville, Qld, Australia Aims: To describe bacterial infections that are overrepresented in Northern Australia. Examples of these would include melioidosis, Q fever, brucellosis, invasive Group A streptococcal infection, non-multiresistant methicillin resistant Staphylococcus aureus (nmMRSA) soft tissue infections, atypical mycobacterial skin infections and leptospirosis. Methods: A review of the epidemiology, risk factors, clinical features and laboratory diagnosis of the above. Results: The possibility of acquiring one of a range of microbiologically fascinating infections is one of the risks of visiting or living in tropical Northern Australia. A variety of factors affect this end result and include rainfall, soil, co-morbidities and native mammals. The early culture of appropriate clinical material remains the mainstay of diagnosis for most of these. Serology, with its limitations in some instances, is still the major diagnostic modality for Q fever and leptosirosis. Molecular diagnostics currently has a limited place. Conclusions: Visitors to Northern Australia are often struck by the spectacular scenery, and lifestyle. This comes at a price though. An awareness of local infectious diseases is essential for all diagnostic laboratories due to the high mobility of the population in general. Early clinical suspicion based on a travel history will ensure appropriate diagnosis and subsequent management. School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, and PathWest Laboratory Medicine WA, Nedlands, WA, Australia Travel into subtropical and tropical areas is increasing, with a corresponding increase in the number of suspected viral infections acquired while travelling. In addition, legal and illegal immigrants may enter with overseas-acquired infections. Some of these infections are endemic to Australia, but are seen more often in returned travellers because they are more common overseas. These include hepatitis A, hepatitis B, HIV, seasonal influenza, measles, mumps and rubella. In addition there are number of infectious agents that are exotic or uncommon within Australia and are a particular diagnostic concern in people recently arrived from overseas. The most important of these are dengue virus infections, which have been increasing internationally in recent decades. Other arboviruses such as chikungunya and Japanese encephalitis virus also require consideration. Other important but rare viruses include Nipah virus, hantaviruses, rabies virus and the viruses causing viral haemorrhagic fever. Also it is important to consider new pathogens, as Asia has seen the emergence of SARS coronavirus, avian influenza virus, Nipah virus and others in recent years. This talk will focus on the exotic viruses and the diagnostic approach to potential overseas-acquired viral illnesses. Within 30 years of Laveran's discovery of human malaria parasites in 1880, four species, Plasmodium falciparum, P. vivax, P. malariae and P. ovale, had been described and their morphological distinguishing features clarified. Although other diagnostic techniques have been developed, 130 years later the gold standard is still examination of thick and thin blood films. Recently a fifth species, the monkey malaria Plasmodium knowlesi, has been found to infect humans in parts of Southeast Asia. With human activities continuing to impinge on the habitats of other primates, it is possible that other malaria species may cross over to humans as well. Iain Abbott 1 , Brendan McMullan 2 , John Merlino 3,4 , Indy Sandaradura 5 , Marjoree Sehu 6 , Yuen Su 7 Evidence-based clinical guidelines for immigrants and refugees Victorian Foundation for Survivors of Torture (VFST) Diagnosis, Management and Prevention of Infections in Recently Arrived Refugees. Sydney: ASID Vitamin D deficiency is associated with tuberculosis and latent tuberculosis infection in immigrants from sub-Saharan Africa Screening practices for infectious diseases among Burmese refugees in Australia Antimicrobial resistance is a major problem for hospitals and the community. This interactive session developed for trainees will explore current antimicrobial resistance issues pertinent to the laboratory, including detection and importance in determining mechanisms of resistance, screening, therapeutic implications and consequences for infection control. Four trainees will present illustrative cases of antimicrobial resistance (MRSA, VRE, multi-resistant Gram-negative organisms and Candida) followed by expert panel discussion. Dr John Merlino will deliver an update on hot topics in antimicrobial susceptibility testing and resistance in a 'show and tell session'. Finally trainees and the expert panel will have an opportunity to discuss prepared questions on antimicrobial resistance issues.