LIVING THE LAB LIFE
A BLOG FOR ASCLS REGION V
Any who has been paying attention to the news recently knows that Hennepin County in Minnesota has been facing a public health crisis. There is an active outbreak of measles (rubeola) among young children, all who are unvaccinated. So far, no fatalities have been reported, but this event has highlighted the potential dangers associated with failing to vaccinate children as recommended by medical professionals. As laboratory professionals, we must be prepared to handle these outbreaks and appropriately consult other members of the healthcare team.
The measles virus is a member of the Paramyxovirus family, along with the mumps virus, respiratory syncytial virus, parainfluenza viruses, Nipah virus, and Hendra virus. They are single-stranded, enveloped RNA viruses. These viruses are transmitted via the respiratory route, which is what makes them so contagious.
The measles virus has a few tricks up its sleeve that aide in its ability to causes serious infection in hosts. Unlike most respiratory viruses, the measles virus readily disseminates throughout the body by binding to receptors on various somatic cells (a skill few viruses have). By latching on to dendritic cells in the respiratory mucosa, the measles virus scores a free ride the lymphatic system. From there, the virus can spread throughout the body and can cause mischief.
Children are most likely to be infected with measles, particularly under the age of five. The first symptoms to appear in a measles infection include cold-like symptoms (coryza), high fever, cough, sore throat, and conjunctivitis. While these symptoms are present, the patient is most contagious (which is a problem since these symptoms are so nondescript, those around the patient likely have no idea of how serious of an illness they are exposing themselves to).
If you were unable to make it to Duluth for this year's CLC, you can still download the handouts from the event. Visit the ASCLS-MN website.
Confused about how to log your continuing education credits? Allow me to explain.
First, click here to navigate to the ASCLS CE Organizer page.
The site has been updated in the last year, and I am reallly liking the updates.
This morning, we kicked off the day with a moving performance by the Pillsbury House Theatre in Minneapolis. Their performance, “Breaking Ice,” focused on discrimination and inclusion, both in and out of the workplace, and how we can open ourselves up to crucial conversations to address these issues. The performance was very moving, as was the discussion that followed. For a small group breakout session, the performers asked us to participate in an ice breaker exercise where we would present ourselves to each other with phrases that start with “I am from.” This prompt led to very personal responses (most of the people at my table were in tears at the end of the exercise). When we are open and honest about who where are and where we come from, we can really open the door to addressing the social issues that permeate through our society.
So where are you from?
The first breakout session I attended featured a panel of presenters from all walks of the laboratory profession (Industry, Technical Consulting, Education, Lab Administration, Public Health). Each speaker detailed the career path they took to get to where they are today. This was a great presentation to have for a room full of students (Thursday is student day, with over eighty students in attendance). It is very exciting to see all the opportunities available to laboratory professionals who are dedicated to a lifetime of learning.
Greeting from Duluth!
We kicked off the 2017 CLC with a keynote address by ASCLS Executive Vice President Jim Flanigan. Jim’s talk, titled “Disruptive Beliefs, Memes, Mission, and Myths of the Slimy Salesman” is a call to action for all laboratory professionals. As a group, we acknowledge that we do not receive that credit that we deserve for the life-saving care we provide. Additionally, we see, day in and day out, how many errors that occur in the ordering, collecting, and interpretation of laboratory testing. Medical errors like than can be costly. As many as 100,000 people die each year in the United States because of medical errors. Jim’s talk challenges laboratory professionals to be the salespeople of their trade, not only for our sake but for the sake of patient safety. In every encounter with other members of the healthcare team, we need to make the conversation about what we can do for them and for their patients. Patient lives depend on it.
The first breakout session that I attended was given by Dr. Qia Ding, MD, PhD from Ortho Diagnostics. Dr. Ding’s presentation focused on Acute Kidney Injury (AKI) and how current technologies and protocols fall short. Currently, diagnosing and staging of AKI depends on assessing serum creatinine levels and urine volume output. In many patients, this means that diagnosis (and therefore treatment) doesn’t happen until 48 hours after the event triggering the AKI. This has a major effective on patient outcomes, hospital expense, length of stay, readmission rates, etc. It is estimated that about half of all cases of AKI are either misdiagnosed, diagnosed too late, or missed all together. Dr. Ding presented to us a new test available through Ortho Diagnostics, the Nephrocheck, which can diagnose patients with AKI far more rapidly. This test recognized two urinary biomarkers, TIM-2 and IGFBP-7, associated with cellular stress in the renal tubular epithelial cells of the kidneys. A positive result indicates a patient has AKI. The test is supposed to be used within twelve hours of whatever event triggers the AKI (major surgery, nephrotoxic drugs, sepsis, circulatory shock, radiographic dyes). There is clearly an opportunity to influence better patient outcomes with more prompt diagnosis of AKI; I am very interested in seeing what more assay come out in the future to address this issue.