Pan American Society for Clinical Virology

Newsletter

Volume 25 No. 1 January 1998

WWW Version
The Officers and councillors welcome suggestions and comments concerning the PASCV. It is intended that the Newsletter be a forum for exchange of views and information that will be beneficial to the membership. In particular, the experiences of members with reagents, techniques, and new products applicable to rapid viral diagnosis are solicited and will be published in the Newsletter.

Congratulations!

Dr. Danny Wiedbrauk, Ph.D. has been elected to the vacant PASCV councilor position. Dr. Wiedbrauk is the Chief of Virology and Serology at William Beaumont Hospital, Royal Oak, MI.

WISCONSIN LABORATORY INFORMATION NETWORK

Carol Kirk, Program Director, Virology and Peter A. Shult, Director, Communicable Disease Division

Wisconsin State Laboratory of Hygiene

Virologists traditionally fulfill a dual role, as laboratorian, performing testing, and as consultant or educator, advising clinicians on test selection and interpretation, based in part on their knowledge of which viruses are currently circulating in their communities. This information on currently circulating viruses is, in turn, dependent on the results generated by testing performed in their own laboratory, and is, therefore, largely limited to a single laboratory's current specimen base.

Constraints on Virology Laboratories

Pressures on the clinical virology laboratory to streamline operations and reduce costs, however, have often resulted in a more restricted approach to specimen testing, e.g., testing specimens using rapid methods for only influenza A or RSV, instead of the broader multiple cell culture approach to detect many respiratory viruses. In addition, increases in the number of clinical microbiology laboratories that offer virological testing has produced more virology testing sites, which limits the number of specimens available at each site for testing.

Concurrently, public health laboratories have been challenged to redefine their roles, focusing on integrated public health programs to assess and assure the health of the community, rather than the diagnosis of individual patient illnesses. For public health virology laboratories, de-emphasizing their role as primary diagnostic laboratories has resulted in a reduction in the number of specimens to test for those viruses which are deemed a public health concern. Furthermore, public health virology laboratories face the same pressures to streamline and reduce costs and thus limit testing.

The net result of these changes is the potential lack of adequate statewide or even regional information on currently circulating viruses. The private health community requires this information to effectively manage resources and provide relevant information to clinicians. The public health community requires this same information to recognize unusual patterns of virus occurrence, especially when the illness or agent is not a specifically designated public health concern. Both the public health community and the private health community would benefit from a communication network which would provide a broad view of current viral illness in the community.

Information Sharing in Wisconsin

In Wisconsin, virology laboratories in the private and public sector have joined together to form an information-sharing network. This

laboratory-based cooperative network provides benefits to the participating public health and private diagnostic virology laboratories, public health agencies, and clinicians in Wisconsin.

The development of the Wisconsin Laboratory Information Network (LIN) was an outcome of the fifth annual statewide meeting of Wisconsin virologists, which the Wisconsin State Laboratory of Hygiene (WSLH) began hosting in 1991. The annual meetings have provided an opportunity for virologists to share technical information and experiences regarding new diagnostic methodologies or reagents, laboratory problems, epidemiologic findings, etc., while also providing an essential step in the development of communication between laboratories.

In 1995, meeting participants agreed to pilot a weekly reporting system for respiratory viruses. In 1996, the system was expanded to include year-round reporting of respiratory virus, rotavirus, and enterovirus testing, as well as cases of arbovirus and vaccine-preventable viruses.

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Public health virology labs

face the same pressures to streamline and reduce costs and thus limit testing

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Wisconsin virologists weekly report the number of specimens tested, and the number and type of viruses identified. The WSLH collates the information and distributes summary reports and graphs via fax to the participating laboratories the same week. Comments from participants regarding unusual cases or other occurrences, updates from the Centers for Disease Control and Prevention (CDC) and other sources are also appended.

A summarized report of statewide virology testing during any given week is available by Friday of the following week. In addition to sharing the information with participating laboratories, the information is shared with Wisconsin Division of Health epidemiologists and state clinicians.

Laboratory Benefits

Timely laboratory information exchange such as this provides multiple benefits to the clinical laboratory. Knowledge of workload trends in other laboratories in the state can aid each laboratory in planning for changes in its workload. In addition, knowledge of the viruses detected statewide can aid in management of reagents and personnel time or allow proper timing for new method evaluations. Comparison of one's own laboratory data with statewide data on the types of viruses detected can comprise a valuable component of laboratory quality assurance. Finally, the information provides each virologist statewide data which they can utilize as an educational tool for clinicians.

Clinical Benefits

In addition to the direct benefits for the laboratory, this information exchange provides potential benefits for clinicians. The data can aid in the differential diagnosis, improve decision-making for use of rapid laboratory diagnostic testing and antimicrobial usage, and serve as an educational tool for the patient.

Public Health Benefits

For public health agency personnel, the network provides more complete data to monitor viral disease activity in the state. The data also provide a baseline for emerging infectious disease recognition and for outbreak investigations and serve as a resource for response to public and media inquiries.

This network, based on the cooperative exchange of testing information among virology laboratories, provides a simple, effective means of providing each laboratory with more complete information than was previously available to them. The weekly reporting process relies on voluntary participation by Wisconsin virology laboratories, but requires only minimal expenditure of personnel time for the clinical laboratory. As a result, reporting levels have remained consistently high over the past two years and participants have expressed widespread support for the network and the information provided.

Evolution in the future

This network continues to evolve, with future potential to expand the availability of data via the internet, include "stat" testing results obtained in physician offices and smaller laboratories, and include testing for non-viral agents.

While the involvement of the public health laboratory is not required, collating and redistributing the data with relevant graphics and information from other sources is a natural role for the public health laboratory to assume. State public health laboratories have always played an important role as a conduit of information between private laboratories and the public and private health community. In today's changing health care environment, new partnerships between the public health laboratory, private laboratories, and clinicians will maximize the information exchange while benefiting from the expertise represented by each partner. Through these partnerships and networks, public and private laboratories can play a unique role in public health.

Specialist in Virology Examination

Health care professionals who practice virology can earn professional certification with the American Society of Clinical Pathologist Board of Registry, proclaiming their competency as a Specialist in Virology with the initials SV(ASCP) behind their name.

Beginning January 2, 1998, the ASCP Board of Registry has offered the Specialist in Virology examination. The examination will be offered year-round at computerized testing centers.

The application fee is $125. More information and a schedule for applying can be obtained by

Writing:
ASCP Board of Registry
P.O. Box 12277
Chicago, Il 60612-0277


Calling: (800) 621-4142, press 1, ext 1345

FAX: (312) 738-5808

E-mail: bor@ascp.org

Lapsed Memberships

PASCV membership renewals are due on the year noted on the newsletter mailing label. Those who have an "L" after their name are paid lifetime members.

The society bylaws state that "A member who has not paid dues within one year after billing shall, upon being billed for the succeeding year, and receiving appropriate notice, cease to be a member of the Corporation unless all indebtedness to the Corporation is met within 60 days."

The secretary has sent out such a mailing this past October. Following this newsletter, members who last paid their renewal in 1996 will be deleted.

An application form is provided for the convenience of those who need to renew, or for that matter, who want to join!