With vaccine hesitancy, average temperatures, and global travel, on the rise, does the lab need to brace itself for unprecedented challenges in vector-borne disease detection?
At the ASCP Annual Meeting, Rodney E. Rohde will discuss the increasingly important role of laboratory medicine in tracking, recognizing, and responding to both vaccine-preventable and arboviral diseases. Here, he explains the issues that prompted his two upcoming sessions.
The following transcript has been edited for clarity.
Hello everyone. I'm Dr. Rodney E. Rohde, Regents and Distinguished Professor, as well as Chair of the medical laboratory science program here at Texas State University.
At this year's ASCP annual meeting in Montréal, I'll be presenting two topics. The first is entitled “Diseases we thought were gone: the unfolding crisis of vaccine-preventable illness in America.”
For decades, vaccines we know have been one of public health's greatest success stories. Diseases like measles, pertussis, and other vaccine-preventable infections became uncommon – enough so that many health care professionals and much of the public rarely encountered them. But uncommon does not mean gone.
We are now seeing the consequences of declining vaccination coverage, vaccine hesitancy, of course, and misinformation, gaps in healthcare access, and increasing global movement. When that community starts declining in immunity, highly contagious pathogens can and do quickly find susceptible populations. One of the key messages from that presentation will be that vaccine-preventable diseases are not simply a vaccination issue. They are also a diagnostic readiness issue. When a disease becomes uncommon, health care professionals may be less likely to recognize it. Laboratories may encounter organisms or testing scenarios they have not seen routinely for years. That makes awareness, appropriate test selection, specimen collection, biosafety, timely reporting, and overall communication with public health really, really important. And this is where you, the medical laboratory professional, become absolutely essential.
We are often among the first to generate the objective evidence that really transforms a suspected case into a confirmed diagnosis. And that diagnosis by us can trigger isolation, contact tracing, outbreak investigation, and other public health and healthcare interventions. My hope is that when you leave this session, you'll have one thought and one central idea. Diseases do not have to disappear forever from our collective memory. and when they return, diagnostic readiness matters.
The other topic that I'll be presenting on is somewhat related. It is entitled “Neglected no more: uncovering the growing impact of tropical arboviral diseases in a changing world.”
When many of us hear terms like dengue, chikungunya, zika, and even malaria, or some other exotic mosquito or tick or other vector-borne disease, we may still think of them as diseases that are occurring somewhere else around the world. That assumption is really becoming almost impossible and difficult to defend. Our world is changing every day: climate, environmental conditions, international travel, urbanization, humans migrating, and the changing geographic ranges of these vectors like mosquitoes are altering where and when these arboviral diseases can emerge.
For laboratory and pathology professionals, that really creates an important challenge for us. Are we diagnostically prepared for pathogens that historically may not have been high on our radar of differential diagnosis? One of the major themes of this presentation will be that diagnosing arboviral infections requires understanding both the pathogen and the timing of the patient's illness.
Molecular testing, antigen detection, even serology have strengths and limitations depending on when that specimen is collected. And we also all know that cross-reactivity among those related viruses can really complicate our interpretations. That means that you, again, and I, the laboratory professional, we're not simply generating a result. We are helping clinicians understand which test to order, when to order it, and what that result actually means.
The larger one health lesson is also an important reminder here. Human health, animal health, vector ecology, the climate, and the environment are all very much interconnected. Effective surveillance and preparedness require us to think across these traditional boundaries. The key message I hope you take away from this talk is that these tropical arboviral diseases can really no longer be dismissed as somebody else's problems somewhere else around the world. In a changing and highly connected world, diagnostic preparedness must move with the pathogens.
I hope that my ASCP American, and my Canadian Association of Pathologist colleagues and friends will join me and others as we explore these emerging threats in Montréal, and the increasingly important role of laboratory medicine in tracking, recognizing, and responding to them.
Have an amazing annual meeting, and I look forward to meeting you all. Take care, everybody.
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