News
Enterovirus targets children in central United States. According to the Centers for Disease Control and Prevention (CDC), at least 82 cases of respiratory illness caused by enterovirus D68 (EV-D68) have been confirmed among schoolchildren in six states. Testing has identified the virus in samples from Colorado, Illinois, Iowa, Kansas, Kentucky, and Missouri. Testing for EV-D68 is largely done by state health departments and the CDC. The St. Louis, Kansas City, and Denver areas have been among the hardest-hit so far, but the virus may spread across much of the nation. Young people who are most severely affected develop serious breathing difficulties and require emergency care.
NIH reveals that samples of ricin and other pathogens have been found in its labs. In the wake of the discovery in July of vials of smallpox dating from the 1950s in one National Institutes of Health (NIH) lab, the agency has been systematically inspecting all of its labs to find any other mislaid pathogens. The NIH revealed last month that it had found a sealed container of the toxin ricin as well as intact containers of five other dangerous pathogens in several of the laboratory facilities on its Washington, DC, campus. Reportedly, the bottle containing ricin may be as much as a century old. That sample has been destroyed, along with others containing pathogens that cause botulism, plague, tularemia, and melioidosis, a bacterial disease endemic to Southeast Asia and northern Australia.
Ebola
CDC warns that the Ebola epidemic in West Africa is outpacing current response. Center for Disease Control and Prevention (CDC) Director Tom Frieden, MD, MPH, recently reported on his visits to Guinea, Liberia, and Sierra Leone and called for immediate steps across nations to accelerate response to the Ebola epidemic in West Africa. Dr. Frieden described a daunting situation and called for speed, flexibility, and work on the front lines to take precedence in the ongoing battle against Ebola.
The United States has stepped up assistance to the affected countries and to international organizations responding to the outbreak. Multiple U.S. agencies have been involved in the response to the crisis, including the State Department, the Department of Health and Human Services (HHS), U.S. Agency for International Development (USAID), and the Department of Defense (DOD).
Since the CDC ramped up its Ebola response in early July, more than 500 CDC staff members have provided logistics, staffing, communication, analytics, management, and other support functions. As this issue of MLO goes to press, roughly 100 U.S. government personnel have been deployed and are working in the affected countries. This includes more than 70 CDC staff deployed assisting with various vital response efforts such as surveillance, contact tracing, database management, and health education. On September 5, the Obama administration asked Congress to authorize an additional $30 million in federal funds to support the CDC’s efforts.
USAID has committed more than $21 million for the response since the outbreak was first reported in March 2014. This funding is being used to provide health equipment and emergency supplies and food assistance, train and support healthcare workers on infection control and case management, support public outreach campaigns, and build the capacity of local healthcare and emergency response.
Rapid mutation rate of Ebola virus may complicate diagnosis and treatment. The Ebola virus has mutated 300 times since the outbreak began in May, and these transformations lead scientists to conclude it is unlike any past Ebola epidemic. This could make it both harder to treat and harder to diagnose, according to a study published in Science. The outbreak began as a single human infection, the authors write, but the genetic sequences observed in 78 patients sampled showed a rapid spread in both the number of people infected and the geographical regions affected. Clues from the study have scientists hopeful that continuing research on mutations will help researchers develop new diagnostic tests and treatments.
The initial infection came from one of five strains of Ebola known to affect humans, the Zaire strain. It emerged about a decade ago in a related strain from an animal host. Researchers are not sure which animal hosted the virus, but believe that it most likely was a bat in Guinea. At least one species of fruit bat has a geographic range that spreads from Guinea to Sierra Leone. If bats are really the culprit, “about 150 million more people than previously thought are at risk of the disease,” according to a previous study published in Science.
Worth Re-quoting
In this issue’s “Future Buzz” section, Susan Montgomery of the ASCP writes about how the function of pathologists is changing along with broader changes in the healthcare system. “Today’s pathology residents will be practicing in a very different healthcare delivery and financing environment,” she writes, “where the emphasis is on providing the maximum value for patient outcomes while managing costs.” She elaborates: “Today’s pathologist manages the diagnostic process and helps clinicians ask the right questions. That is a very different job than that which pathologists used to perform. As the profession moves toward a system that pays for value, not per volume of tests performed, pathologists are being held accountable; they are being asked to show that they are good stewards of limited resources.”
The editors of MLO wonder what the pathologists and other professionals who work with them among our readers think. Do you agree with this characterization of pathologists’ changing role? Why or why not? Are you enthusiastic about the changes in the profession, and the larger changes in healthcare that may be driving them—or do you face this future with doubts or misgivings? How do you feel about being taken “out of the basement, so to speak”—in another memorable phrase written by Montgomery? Please share your thoughts with [email protected].
Cancer
New blood test could offer more tailored treatment of ovarian cancer. A new blood test allowing doctors to predict which ovarian cancer patients will respond to particular types of treatment is a step closer following the publication of a new study. Researchers from The University of Manchester and The Christie NHS Foundation Trust say the test could be developed and used in hospitals within the next few years.
It would mean clinicians could see which patients could benefit from blood vessel-targeting drugs—such as bevacizumab—in addition to conventional therapy. Others who are not going to benefit would be spared the time and side effects associated with the drug. The study was published recently in Clinical Cancer Research.
The research team looked at blood samples from patients enrolled in an international trial of bevacizumab, which targets the development of new blood vessels within the tumor. These patients received either standard chemotherapy treatment alone or chemotherapy plus the blood vessel-targeting drug.
The findings show that two particular proteins—Ang1 and Tie2—could be used in combination to predict patient response. Patients with high levels of Ang1 and low levels of Tie2 were most likely to benefit from bevacizumab. Both these proteins are involved in controlling the formation of new blood vessels. Conversely, they found that patients with high levels of both proteins did not benefit from the additional drug.
Industry News
Debra Wood named winner of Cardinal Health urEssential Award for laboratory professionals. Debra Wood, PhD, is the recipient of the Cardinal Health urEssential Award recognizing medical laboratory professionals and their contributions to the field of healthcare. The company is establishing a $20,000 scholarship in her name at the Indiana University School of Medicine for students seeking careers in laboratory medicine.
“Laboratory practitioners are an integral part of the healthcare system, and we are pleased to recognize Debra for exemplifying the qualities of dedication and service that help advance laboratory diagnostics,” says Chris Kerski, senior vice president and general manager of Laboratory Products at Cardinal Health.
Wood is the Histotechnology Program director and clinical assistant professor at the Indiana University School of Medicine in Indianapolis, IN. She is also chairperson for the American Society for Pathologist Histotechnology HT/HTL Exam Committee. Wood’s nominators called her a champion for the patient and profession, specifically noting her volunteerism and contributions toward the accomplishments of others.
Cardinal Health announced the award program in April and accepted nominations through June 20. The award winner, selected based on his or her contributions in the lab, to the community, and to the laboratory profession, was announced during the American Society for Clinical Laboratory Science annual meeting this summer.
AABB’s National Blood Foundation awards Scientific Research Grants to six individuals.The National Blood Foundation, or NBF, Board of Trustees has announced the six recipients of the 2014 NBF Scientific Research Grants: Kyung Hee Chang, PhD, Hoxworth Blood Center, University of Cincinnati, for Angiotensin in Stem Cell Recruitment and Mobilization; Richard Francis, MD, PhD, Columbia University Medical Center, for Effect of Glucose-6-phosphate Dehydrogenase Deficiency on Red Blood Cell Storage; Neil Hanchard, MD, PhD, Baylor College of Medicine, for A Genomics Approach to Transfusion Responders in Sickle Cell Disease; Krystalyn Hudson, PhD, Puget Sound Blood Center Research Institute, for Establishment and Maintenance of Lymphocyte Tolerance to RBC Antigens; Julie Peterson, PhD, Blood Research Institute, BloodCenter of Wisconsin, for Recombinant Glycoprotein Fragments for Improved Detection of Alloantibodies in Neonatal Alloimmune Thrombocytopenia; and Claude Tayou Tagny, MD, MS, MSc, Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Cameroon, for Risk Factors of HIV Infection in Sub-Saharan Africa Blood Donors—a Pilot Phase in Cameroon.
Since 1985, NBF has dispersed almost $8 million in grants to approximately 200 early-career researchers through its Scientific Research Grants Program. Grant proposals are evaluated on the basis of scientific merit and relevance to and impact on transfusion medicine, cellular therapies, and patient blood management.
The NBF is now accepting 2015 scientific research grant applications. Grant applications are available on the NBF Web page (www.aabb.org/nbf), or by contacting the NBF at +1.301.215.6552 or [email protected]. Applications must be received by December 31, 2014. Grant awards will be announced in June 2015 and funded in early July 2015.
Diagnostics
One-minute point-of-care anemia test shows promise in new study. A simple point-of-care testing device for anemia could provide more rapid diagnosis of the common blood disorder and allow inexpensive at-home self-monitoring of persons with chronic forms of the disease.
The disposable self-testing device analyzes a single droplet of blood using a chemical reagent that produces visible color changes corresponding to different levels of anemia. The basic test produces results in about 60 seconds. A companion smartphone application can automatically correlate the visual results to specific blood hemoglobin levels.
Using a two-piece prototype device, the test works this way: A patient sticks a finger with a lance similar to those used by diabetics to produce a droplet of blood. The device’s cap, a small vial, is then touched to the droplet, drawing in a precise amount of blood using capillary action. The cap containing the blood sample is then placed onto the body of the clear plastic test kit, which contains the chemical reagent. After the cap is closed, the device is briefly shaken to mix the blood and reagent.
