This is the written version of our Hot Topic video presentation available at: MayoMedicalLaboratories.com/hot-topics

Size: px
Start display at page:

Download "This is the written version of our Hot Topic video presentation available at: MayoMedicalLaboratories.com/hot-topics"

Transcription

1 This is the written version of our Hot Topic video presentation available at: MayoMedicalLaboratories.com/hot-topics Welcome to Mayo Medical Laboratories Hot Topics. These presentations provide short discussion of current topics and may be helpful to you in your practice. Today our topic is serologic testing for the diagnosis and monitoring of some of the most common fungal infections in the United States. 1

2 Our speaker for this program is Dr. Elli Theel, Director of the Infectious Disease Serology Laboratory at Mayo Clinic, Rochester, Minnesota. Dr. Theel, thank you for presenting today. Thank you. 2

3 I have nothing to disclose. 3

4 Serologic testing plays an important role in the diagnosis of some of the common fungal infectious agents in the United States, including Blastomyces dermatitidis, Histoplasma capsulatum, Coccidioides and Cryptococcus species. However, the decision of which fungal serologic test to order should be based on the patient s clinical presentation, their exposure history and risk factors for infection, all of which may differ between these fungal organisms. Serologic evaluation for all 4 of these agents simultaneously may lead to falsely positive results in low-risk patients. Therefore, in an effort to minimize inappropriate testing, as of March 2014 Mayo Medical Laboratories will no longer offer the Fungal Antibody Survey on serum and CSF specimens. Instead, fungal serologic testing will be available for each agent individually and as a panel for Histoplasma and Blastomyces due to the overlapping endemicity and similar clinical presentation of these 2 fungi. The focus of this hot topic will be to review the available serologic assays for these fungal agents and to discuss result interpretation. Identification and detection of these fungi by direct staining, culture, and molecular methods has been described in previous Hot Topics. 4

5 We will begin with Blastomyces dermatitidis, which is a dimorphic fungus that grows as a yeast at body temperature and as a filamentous mold at 25 degrees Celsius. Blastomyces is endemic throughout the Ohio and Mississippi river valleys in the US and encroaches into southern parts of Canada as well. The incidence of infection among these regions is low and the primary route of infection is through inhalation of fungal microconidia. While roughly half of those exposed will remain asymptomatic, patients may present with a wide range of clinical manifestations, including pulmonary flulike symptoms, disseminated disease, and more severe complications like acute respiratory distress syndrome. 5

6 Detection of antibodies to Blastomyces can be useful as an aid for the diagnosis of blastomycosis, alongside other laboratory methods and clinical evaluation. Mayo Medical Laboratories currently offers an FDA-cleared, qualitative enzyme immunoassay or EIA for detection of total antibodies to yeast phase Blastomyces antigens from serum and has also validated this assay for testing of cerebrospinal fluid. Compared to patients with culture-positive Blastomyces, this EIA has a sensitivity of approximately 85% in serum and therefore a negative EIA result cannot be used to definitively exclude the diagnosis of blastomycosis. If acute or pulmonary infection is suspected, a new specimen collected 2 to 3 weeks later should be submitted and tested. The specificity of the Blastomyces EIA is high and therefore samples positive by the EIA do not require further confirmatory testing. Finally, a distinct advantage of this assay, compared to more traditional techniques including immunodiffusion which we will discuss next, is its rapid turnaround time. 6

7 Mayo Medical Laboratories also offers the classic immunodiffusion assay for detection of precipitating antibodies to the Blastomyces A antigen, and similar to the Blastomyces EIA, results from the immunodiffusion assay should be used as an aid for the diagnosis of blastomcyosis. Briefly, immunodiffusion assays are performed by adding patient samples to wells in an agar plate which surround a central well that contains a purified fungal antigen, as shown in the image on this slide. During the incubation process, antibodies, if present in the patient sample, and antigen will diffuse out of their respective wells and an antigen-antibody complex will form between the wells and become visible between the wells, as indicated. The presence of a precipitation band is indicative of acute or active infection. Compared to the Blastomyces EIA, the performance characteristics of the ID assay are similar, likewise showing decreased sensitivity in patients with localized infection, and therefore, a single negative immunodiffusion result should not be used to exclude diagnosis. However, the immunodiffusion assay has a prolonged turnaround time compared to the EIA, and therefore we recommend ordering the Blastomyces EIA for routine evaluation of patients with suspected blastomycosis. 7

8 Histoplasma capsulatum, similar to Blastomyces, is a dimorphic fungus which is also endemic along the Ohio and Mississippi River valleys, with infection occurring through inhalation of aerosolized Histoplasma microconidia. Clinically, the vast majority of primary infections are unrecognized or result in mild influenzalike symptoms for which medical attention is not sought out. In a small proportion of individuals however and particularly those who are at the extremes of age or who are immunosuppressed, exposure can lead to acute pulmonary disease characterized by a dry cough, fever, and fatigue and in some cases may progress to disseminated infection with extrapulmonary foci. 8

9 Detection of antibodies to Histoplasma provides additional laboratory evidence of disease when used alongside other laboratory findings and clinical presentation. All specimens submitted for anti-histoplasma antibody detection, are first screened by an EIA. Patients who are nonreactive by this assay may be considered as negative for histoplasmosis, unless their exposure was recent and early acute infection is suspected. In such cases, collection and submission of a new specimen in 2 to 3 weeks is recommended. Alternatively, all samples which are reactive or equivocal by the EIA are automatically reflexed for confirmatory testing by the Histoplasma immunodiffusion and complement fixation assays. It is important to remember that clinical decisions regarding histoplasmosis should not be based on reactive results from the EIA alone. The Histoplasma immunodiffusion assay utilizes 2 different antigens, the H and the M proteins, and we can therefore detect up to 2 different precipitating bands in the agar plate. Antibodies to the M antigen, appear shortly following exposure and can remain detectable by immunodiffusion for up to 3 years following disease resolution. Therefore, presence of the M band alone cannot be used to discriminate between acute or remote infection. On the other hand, the presence of an H band either alone or in combination with the M band is indicative of active or recent histoplasmosis. Importantly, a negative immunodiffusion result should not be used to exclude histoplasmosis as the specimen may have been collected early following exposure and prior to the development of detectable precipitating antibodies. 9

10 Alongside immunodiffusion, we also perform Histoplasma complement fixation testing. Briefly, complement fixation assays are based on the ability of antibodyantigen complexes, formed between antibodies present in the patient sample and added fungal antigens, to fix and inactivate exogenously added complement. Sensitized RBCs are added to this mix and since the complement pathway is inactivated, the red blood cells will remain intact and settle to the bottom of the well as a compact pellet, indicative of a positive reaction and the presence of specific antibodies. 10

11 In the absence of patient antibodies however, the added complement will remain active and lead to lysis of the sensitized red blood cells. Therefore, the presence of lysis is indicative of a negative reaction and the absence of specific antibodies. 11

12 The Histoplasma complement fixation assay is performed using 2 different Histoplasma antigens, one purified from the yeast phase and the second purified from the mycelial phase of growth. Serial dilution of patient samples, as shown in the image below, allows us to determine an endpoint titer which can be used to guide diagnosis. For either antigen, serially increasing titers or an endpoint titer greater than or equal to 1:32 is associated with the presence of active histoplasmosis. A titer of 1:8 or 1:16 is considered positive, but only presumptive evidence of infection and additional clinical correlation is necessary. Titers less than 1:8 are not considered to be significant and therefore are not reported. Importantly, low-level titers may be detected in individuals who reside in endemic areas and are otherwise healthy. Finally, declining complement fixation titers over months to years have been associated with disease resolution, but should not be used to monitor response to therapy. The complement fixation assay has a higher sensitivity for histoplasmosis as compared to immunodiffusion assays, particularly during early disease, however their specificity is lower and for this reason complement fixation and immunodiffusion are performed concurrently. Also these assays are fairly labor intensive with long incubation times which leads to an average turnaround time of 48 to 72 hours. 12

13 The final dimorphic fungus we will discuss today is Coccidioides which grows as a filamentous mold in the environment, but forms spherules and endospores in the host. Coccidioides is endemic throughout the southwestern United States and infection occurs through inhalation of aerosolized arthroconidia. In the United States, the incidence of medically significant Coccidioides infections is estimated to be approximately 150,000 individuals annually. Though many more people are exposed to the fungus, in up to 60% of them infection will be inapparent or sufficiently mild to not prompt clinical evaluation. Individuals who succumb to disease typically present with pulmonary symptoms, fever, and fatigue. 13

14 As with the other fungal agents, serologic testing for anti-coccidioides antibodies should be used as an aid to diagnose coccidioidomycosis. Similar to the testing process for anti-histoplasma antibodies, specimens submitted for detection of antibodies to Coccidioides are first screened by an enzyme immunoassay. Patients who are nonreactive by the EIA may be considered as negative for coccidioidomycoses, unless patient exposure was recent and early infection is suspected. In such cases, collection and submission of a new specimen in 2-3 weeks is recommended. Alternately, all samples which are reactive by the EIA are automatically reflexed for confirmatory testing by the Coccidioides immunodiffusion and complement fixation assays. Again, it is important to remember that clinical decisions regarding coccidioidomycosis should not be based on a reactive EIA alone. The Coccidioides immunodiffusion assay detects IgM- and IgG-class antibodies separately, using 2 different purified antigens. Following infection, IgM antibodies develop to the TP antigen and are detectable within 3 weeks of symptom onset in over 80% of infected individuals. IgM-class antibodies will subsequently decline over the next 6 to 7 months following disease resolution. IgG-class antibodies to Coccidioidies develop to the CF antigen, are detectable 3 to 5 weeks following infection and remain detectable following the disappearance of IgM-class antibodies. 14

15 The complement fixation assay for Coccidioides uses antigens derived from a culture filtrate of the organism and similar to the other fungi, endpoint titers can be indicative of disease progression. Specifically, titers of 1:2 to 1:8 are indicative of either prior exposure or acute, focal infection. Discrimination between these 2 clinical entities requires correlation with clinical presentation and other laboratory findings. Additionally, submission of a convalescent sample is recommended as a 4- fold or greater rise in titers between acute and convalescent sera would be indicative of active disease. Traditionally, complement fixation titers greater than or equal to 1:16 have been associated with more severe disease manifestations. Finally however, single time point negative immunodiffusion or complement fixation results should not be used to exclude infection as specimens may have been collected prior to the development of detectable antibodies. 15

16 Cryptococcus neoformans and Cryptococcus gattii are encapsulated yeast which are transmitted following environmental aerosolization and inhalation. Epidemiologically, Cryptococcus neoformans can be isolated throughout the United States, whereas Cryptococcus gattii is primarily isolated from states along the pacific coast and more recently has been reported to be endemic to the southeastern United States. Both of these agents are primarily found in the lungs and have a tropism for the central nervous system. Interestingly though, while Cryptococcus neoformans is considered primarily an opportunistic pathogen among immunocompromised hosts, Cryptococcus gattii is commonly associated with infection in otherwise healthy individuals and has a higher predilection for the central nervous system. While the incidence of cryptococcosis as a whole is low, immunocompromised patients are at increased risk of infection and severe disease. 16

17 Detection of the Cryptococcus polysaccharide antigen can be used as definitive laboratory based evidence of infection. Prior to March of 2014, Mayo Medical Laboratories used a latex agglutination assay to detect this antigen in both serum and CSF specimens. As of then however, MML has transitioned to using a new lateral flow immunoassay or LFA to detect the cryptococcal antigen. 17

18 The LFA is a dip-stick based method and FDA-cleared for use in both serum and CSF specimens. This assay offers increased sensitivity for detection of both Cryptococcus neoformans and Cryptococcus gattii compared to the previous latex agglutination assay and will be used as both a screen and to determine an endpoint titer. It is important to understand however, that endpoint titers between the LFA and latex agglutination assays do not correlate and are not interchangeable. We and others have found that endpoint titers acquired by the LFA are often much higher than those acquired on the same sample by the latex agglutination assay. Therefore, for patients who are being monitored for disease regression by the Cryptococcus antigen test, the same method, either LFA or LA must be used on serial samples. In order to help providers transition to the new LFA method, MML will report both the LFA and latex titers for a 3-month period following implementation of the LFA. The latex titer will be performed and reported at no charge to the patient. 18

19 The following 3 slides are a summary of the available and preferred fungal serologic tests performed at Mayo Medical Laboratories and are included for your reference. 19

20 Finally, to conclude, the College of American Pathologists, recently recommended that all CSF specimens submitted for initial diagnostic testing and which are positive by the Cryptococcus antigen assay, must also be submitted for routine fungal culture. CSF specimens submitted for repeat or serial cryptococcal antigen testing do not need to be cultured. To comply with this requirement, MML will offer 3 different test codes for Cryptococcus antigen testing from CSF. First, the LFACX test should be ordered if the specimen is submitted for initial diagnostic purposes and the referring laboratory does not perform routine fungal culture on CSF. If the CSF is positive for cryptococcal antigen in this case, the sample will be reflexed to fungal culture and for determination of an endpoint titer. Alternatively, if the specimen is submitted for initial diagnostic purposes and the referral laboratory performs fungal culture on site, test code CLFA should be requested. In this case, Cryptococcus antigen-positive CSF specimens will be reflexed to titer only. Finally, for CSF specimens submitted to monitor antigen levels, the CLFAT test code should be ordered which will determine an endpoint titer only. 20

21 Thank you. 21

22 22

Some Immunological Test. Presented by Alaa Faeiz Ashwaaq Dyaa Aseel Abd AL-Razaq Supervised by D.Feras

Some Immunological Test. Presented by Alaa Faeiz Ashwaaq Dyaa Aseel Abd AL-Razaq Supervised by D.Feras Some Immunological Test Presented by Alaa Faeiz Ashwaaq Dyaa Aseel Abd AL-Razaq Supervised by D.Feras Alaa Faeiz Antigen -Antibody Reactions. Antigen antibody reactions are performed to determine the presence

More information

Topic: Serological reactions: the purpose and a principle of reactions. Agglutination test. Precipitation test. CFT, IFT, ELISA, RIA.

Topic: Serological reactions: the purpose and a principle of reactions. Agglutination test. Precipitation test. CFT, IFT, ELISA, RIA. Topic: Serological reactions: the purpose and a principle of reactions. Agglutination test. Precipitation test. CFT, IFT, ELISA, RIA. Serology is the study and use of immunological tests to diagnose and

More information

Basic Immunologic Procedures. Complex Serological Tests

Basic Immunologic Procedures. Complex Serological Tests Basic Immunologic Procedures Complex Serological Tests Amal Alghamdi 2014-2015 1 Classification of antigen-antibody interactions: 1. Primary serological tests: (Marker techniques) e.g. Enzyme linked immuonosorben

More information

What is HIV? What is AIDS? The HIV pandemic HIV transmission Window period Stages of HIV infection

What is HIV? What is AIDS? The HIV pandemic HIV transmission Window period Stages of HIV infection Module 1 Overview of HIV Infection Purpose Pre-requisite Modules Learning Objectives To provide you with the basic terms and concepts related to HIV infection. None At the end of this module, you will

More information

4A. Types of Laboratory Tests Available and Specimens Required. Three main types of laboratory tests are used for diagnosing CHIK: virus

4A. Types of Laboratory Tests Available and Specimens Required. Three main types of laboratory tests are used for diagnosing CHIK: virus 4. LABORATORY 4A. Types of Laboratory Tests Available and Specimens Required Three main types of laboratory tests are used for diagnosing CHIK: virus isolation, reverse transcriptase-polymerase chain reaction

More information

Molecular Diagnosis of Hepatitis B and Hepatitis D infections

Molecular Diagnosis of Hepatitis B and Hepatitis D infections Molecular Diagnosis of Hepatitis B and Hepatitis D infections Acute infection Detection of HBsAg in serum is a fundamental diagnostic marker of HBV infection HBsAg shows a strong correlation with HBV replication

More information

Diagnosis and Treatment Regimes for Syphilis By Dr John Bannister

Diagnosis and Treatment Regimes for Syphilis By Dr John Bannister Diagnosis and Treatment Regimes for Syphilis By Dr John Bannister Syphilis: Serological Testing Introduction In an ideal world a practitioner would have assessed a patient s medical history with regards

More information

Chapter 18: Applications of Immunology

Chapter 18: Applications of Immunology Chapter 18: Applications of Immunology 1. Vaccinations 2. Monoclonal vs Polyclonal Ab 3. Diagnostic Immunology 1. Vaccinations What is Vaccination? A method of inducing artificial immunity by exposing

More information

Fact Sheet for Health Care Providers: Interpreting Results from the Aptima Zika Virus Assay. June 17, 2016

Fact Sheet for Health Care Providers: Interpreting Results from the Aptima Zika Virus Assay. June 17, 2016 Dear Health Care Provider: Fact Sheet for Health Care Providers: Interpreting Results from the Aptima Zika Virus Assay June 17, 2016 The U.S. Food and Drug Administration (FDA) has issued an Emergency

More information

Objectives. Immunologic Methods. Objectives. Immunology vs. Serology. Cross Reactivity. Sensitivity and Specificity. Definitions

Objectives. Immunologic Methods. Objectives. Immunology vs. Serology. Cross Reactivity. Sensitivity and Specificity. Definitions Immunologic Methods Part One Definitions Part Two Antigen-Antibody Reactions CLS 420 Clinical Immunology and Molecular Diagnostics Kathy Trudell MLS (ASCP) CM SBB CM ktrudell@nebraskamed.com Discuss the

More information

Appendix B: Provincial Case Definitions for Reportable Diseases

Appendix B: Provincial Case Definitions for Reportable Diseases Infectious Diseases Protocol Appendix B: Provincial Case Definitions for Reportable Diseases Disease: West Nile Virus Illness Revised December 2014 West Nile Virus Illness 1.0 Provincial Reporting Confirmed

More information

Nurse Aide Training Program Application Checklist

Nurse Aide Training Program Application Checklist Nurse Aide Training Program Application Checklist The following checklist must be completed before enrolling in the Nurse Aide Training course: Complete, sign, and date the Application Form Have the physical

More information

Streptococcus pneumoniae IgG AB (13 Serotypes), MAID... 7

Streptococcus pneumoniae IgG AB (13 Serotypes), MAID... 7 Volume 12 December 2011 Table of Contents Summary of Test Changes... 3 Test Changes... 6 Human Anti-Mouse AB (HAMA), ELISA... 6 Hepatitis E Antibody (IgG, IgM)... 6 Hepatitis E Antibody (IgG)... 6 Hepatitis

More information

Guidelines for TB Blood Testing. Minnesota Department of Health TB Prevention and Control Program June 2011

Guidelines for TB Blood Testing. Minnesota Department of Health TB Prevention and Control Program June 2011 Guidelines for TB Blood Testing Minnesota Department of Health TB Prevention and Control Program June 2011 Outline Interferon-Gamma Release Assays aka TB blood tests 1. What are they? 2. What are the current

More information

PENNSYLVANIA DEPARTMENT OF HEALTH 2015 PAHAN 307 04-02-ADV Pertussis in Centre County

PENNSYLVANIA DEPARTMENT OF HEALTH 2015 PAHAN 307 04-02-ADV Pertussis in Centre County PENNSYLVANIA DEPARTMENT OF HEALTH 2015 PAHAN 307 04-02-ADV Pertussis in Centre County DATE: 04/02/2015 TO: Health Alert Network FROM: Karen M. Murphy, PhD, RN, Acting Secretary of Health SUBJECT: DISTRIBUTION:

More information

BRUCELLOSIS. Other animals, including wildlife, may provide a reservoir for brucellae.

BRUCELLOSIS. Other animals, including wildlife, may provide a reservoir for brucellae. Infectious Disease Epidemiology Section Office of Public Health, Louisiana Dept of Health & Hospitals 800-256-2748 (24 hr number) (504) 219-4563 www.infectiousdisease.dhh.louisiana.gov BRUCELLOSIS Revised

More information

LAB 1 - Direct agglutination. Serology-the study of the in vitro reactions between antibody and antigen

LAB 1 - Direct agglutination. Serology-the study of the in vitro reactions between antibody and antigen LAB 1 - Direct agglutination Serology-the study of the in vitro reactions between antibody and antigen Serological reaction: - quantitative (weight/volume) - qualitative Agglutination - the aggregation

More information

PERTUSSIS SURVEILLANCE AND RESPONSE PROTOCOL

PERTUSSIS SURVEILLANCE AND RESPONSE PROTOCOL PERTUSSIS SURVEILLANCE AND RESPONSE PROTOCOL Public Health Action 1. Educate the public, particularly parents of infants, about the dangers of whooping cough and the advantages of initiating immunization

More information

1) Siderophores are bacterial proteins that compete with animal A) Antibodies. B) Red blood cells. C) Transferrin. D) White blood cells. E) Receptors.

1) Siderophores are bacterial proteins that compete with animal A) Antibodies. B) Red blood cells. C) Transferrin. D) White blood cells. E) Receptors. Prof. Lester s BIOL 210 Practice Exam 4 (There is no answer key. Please do not email or ask me for answers.) Chapters 15, 16, 17, 19, HIV/AIDS, TB, Quorum Sensing 1) Siderophores are bacterial proteins

More information

Antigens & Antibodies II. Polyclonal antibodies vs Monoclonal antibodies

Antigens & Antibodies II. Polyclonal antibodies vs Monoclonal antibodies A Brief Review of Antibody Structure A Brief Review of Antibody Structure The basic antibody is a dimer of dimer (2 heavy chain-light chain pairs) composed of repeats of a single structural unit known

More information

Diagnosis of HIV-1 Infection. Estelle Piwowar-Manning HPTN Central Laboratory The Johns Hopkins University

Diagnosis of HIV-1 Infection. Estelle Piwowar-Manning HPTN Central Laboratory The Johns Hopkins University Diagnosis of HIV-1 Infection Estelle Piwowar-Manning HPTN Central Laboratory The Johns Hopkins University Tests Used to Diagnose HIV-1 Infection HIV antibody (today s topic) HIV p24 antigen HIV DNA HIV

More information

Direct Antiglobulin Test (DAT)

Direct Antiglobulin Test (DAT) Exercise 8 Exercise 9 Direct Antiglobulin Test (DAT) Elution Study Task Aim Introduction To perform the DAT and elution procedure with correct interpretation of results. To perform with 100% accuracy the

More information

Veterinary Testing. Classes of Test

Veterinary Testing. Classes of Test Veterinary Testing Classes of Test July 2014 Copyright National Association of Testing Authorities, Australia 2014 This publication is protected by copyright under the Commonwealth of Australia Copyright

More information

Blood-Based Cancer Diagnostics

Blood-Based Cancer Diagnostics The Biotechnology Education Company Blood-Based Cancer Diagnostics EDVO-Kit 141 Store entire experiment at room temperature. EXPERIMENT OBJECTIVE: The objective of this experiment is to learn and understand

More information

Syphilis Fast latex Agglutination Test: A Rapid Confirmatory Test for Syphilis

Syphilis Fast latex Agglutination Test: A Rapid Confirmatory Test for Syphilis Syphilis Fast latex Agglutination Test: A Rapid Confirmatory Test for Syphilis Martha B. Fears and Victoria Pope* Division of AIDS, STD, and TB Laboratory Research, National Center for Infectious Diseases,

More information

Diagnosing arbovirus infections (and Bill s holiday snaps) David W Smith Division of Microbiology and Infectious Diseases PathCentre

Diagnosing arbovirus infections (and Bill s holiday snaps) David W Smith Division of Microbiology and Infectious Diseases PathCentre Diagnosing arbovirus infections (and Bill s holiday snaps) David W Smith Division of Microbiology and Infectious Diseases PathCentre Arboviral illnesses relevant to Australia Polyarthralgia Fever and rash

More information

Chapter 6: Antigen-Antibody Interactions

Chapter 6: Antigen-Antibody Interactions Chapter 6: Antigen-Antibody Interactions I. Strength of Ag-Ab interactions A. Antibody Affinity - strength of total noncovalent interactions between single Ag-binding site on an Ab and a single epitope

More information

Serotyping Techniques

Serotyping Techniques Serotyping Techniques Thomas A. Kruzel, M.T., N. D. Southwest College of Naturopathic Medicine & Health Sciences ABO Blood Groups Blood Group RBC Antigens Serum Antibodies Percentage O none Anti A & B

More information

Chapter 3. Immunity and how vaccines work

Chapter 3. Immunity and how vaccines work Chapter 3 Immunity and how vaccines work 3.1 Objectives: To understand and describe the immune system and how vaccines produce immunity To understand the differences between Passive and Active immunity

More information

What is an IGRA? What is an IGRA? Are they available here? How do I use them? Learning Objectives

What is an IGRA? What is an IGRA? Are they available here? How do I use them? Learning Objectives What is an IGRA? Are they available here? How do I use them? Debbie Staley, RN, MPH TB Nurse Consultant VDH Division of Disease Prevention TB Control Program Learning Objectives Participants will be able

More information

Viral Hepatitis. 2009 APHL survey report

Viral Hepatitis. 2009 APHL survey report Issues in Brief: viral hepatitis testing Association of Public Health Laboratories May Viral Hepatitis Testing 9 APHL survey report In order to characterize the role that the nation s public health laboratories

More information

Guidelines for Collection and Transport of Specimen for Laboratory Diagnosis of Pathogenic Leptospira spp.

Guidelines for Collection and Transport of Specimen for Laboratory Diagnosis of Pathogenic Leptospira spp. Document: Introduction: Guidelines for Collection and Transport of Specimen for Laboratory Diagnosis of Pathogenic Leptospira spp. Leptospirosis is an acute bacterial infection caused by organism belonging

More information

Saint Louis Encephalitis (SLE)

Saint Louis Encephalitis (SLE) Saint Louis Encephalitis (SLE) Saint Louis Encephalitis is a Class B Disease and must be reported to the state within one business day. St. Louis Encephalitis (SLE), a flavivirus, was first recognized

More information

Immunity and how vaccines work

Immunity and how vaccines work 1 Introduction Immunity is the ability of the human body to protect itself from infectious disease. The defence mechanisms of the body are complex and include innate (non-specific, non-adaptive) mechanisms

More information

Second Edition. Literature Review. Human Parvovirus B19. www.biotrin.com

Second Edition. Literature Review. Human Parvovirus B19. www.biotrin.com Second Edition Literature Review Human Parvovirus B19 www.biotrin.com Treatment of Parvovirus B19-Associated Polyarteritis Nodosa with Intravenous Immune Globulin. Viguier M., Guillevin L., Laroche L.

More information

A P P E N D I X SAMPLE FORMS

A P P E N D I X SAMPLE FORMS A P P E N D I X A SAMPLE FORMS Authorization for Disclosure Consent for HBV/HCV Antigens, HIV Antibody Documentation of Staff Education Employees Eligible for Hepatitis-B Vaccination Hepatitis-A Consent

More information

Saint Louis Encephalitis (SLE)

Saint Louis Encephalitis (SLE) Encephalitis, SLE Annual Report 24 Saint Louis Encephalitis (SLE) Saint Louis Encephalitis is a Class B Disease and must be reported to the state within one business day. St. Louis Encephalitis (SLE),

More information

Transient Hypogammaglobulinemia of Infancy. Chapter 7

Transient Hypogammaglobulinemia of Infancy. Chapter 7 Transient Hypogammaglobulinemia of Infancy Chapter 7 An unborn baby makes no IgG (antibody) and only slowly starts producing it after birth. However, starting at about the sixth month of pregnancy, the

More information

Chapter 6. Antigen-Antibody Properties 10/3/2012. Antigen-Antibody Interactions: Principles and Applications. Precipitin reactions

Chapter 6. Antigen-Antibody Properties 10/3/2012. Antigen-Antibody Interactions: Principles and Applications. Precipitin reactions Chapter 6 Antigen-Antibody Interactions: Principles and Applications Antigen-Antibody Properties You must remember antibody affinity (single) VS avidity (multiple) High affinity: bound tightly and longer!

More information

EVALUATION OF DARK FIELD MICROSCOPY, ISOLATION AND MICROSCOPIC AGGLUTINATION TEST FOR THE DIAGNOSIS OF CANINE LEPTOSPIROSIS

EVALUATION OF DARK FIELD MICROSCOPY, ISOLATION AND MICROSCOPIC AGGLUTINATION TEST FOR THE DIAGNOSIS OF CANINE LEPTOSPIROSIS Page85 Research Article Biological Sciences EVALUATION OF DARK FIELD MICROSCOPY, ISOLATION AND MICROSCOPIC AGGLUTINATION TEST FOR THE DIAGNOSIS OF CANINE LEPTOSPIROSIS S. Vamshi Krishna *, Siju Joseph,

More information

JOINT COMMISSION INTERNATIONAL ACCREDITATION STANDARDS FOR. 2nd Edition

JOINT COMMISSION INTERNATIONAL ACCREDITATION STANDARDS FOR. 2nd Edition JOINT COMMISSION INTERNATIONAL ACCREDITATION STANDARDS FOR CliniCAl laboratories 2nd Edition Effective 1 April 2010 International Patient Safety Goals (IPSG) Goals The following is a list of all goals.

More information

HiPer Blood Grouping Teaching Kit

HiPer Blood Grouping Teaching Kit HiPer Blood Grouping Teaching Kit Product Code: HTI008 Number of experiments that can be performed: 100 Duration of Experiment: Protocol: 15 minutes Storage Instructions: The kit is stable for 6 months

More information

PROPOSED DOCUMENT. Global Harmonization Task Force. Title: Principles of In Vitro Diagnostic (IVD) Medical Devices Classification

PROPOSED DOCUMENT. Global Harmonization Task Force. Title: Principles of In Vitro Diagnostic (IVD) Medical Devices Classification SG1(PD)/N045R12 PROPOSED DOCUMENT Global Harmonization Task Force Title: Principles of In Vitro Diagnostic (IVD) Medical Devices Classification Authoring Group: Study Group 1 of the Global Harmonization

More information

Summary and Conclusions

Summary and Conclusions Summary and Conclusions SUMMARY In children, the most vulnerable group of populatton, the problem of pneumonla IS Immense In terms of morbtd~ty and mortality. Worldwide, around 5 million children younger

More information

Bird and bat droppings

Bird and bat droppings Bird and bat droppings Introduction While the hazards of bird and bat droppings are generally exaggerated, there is some risk of disease wherever there are large populations of roosting birds or bats.

More information

Immunization Information for Blinn College Students

Immunization Information for Blinn College Students 1 Immunization Information for Blinn College Students *Important Information Regarding the Bacterial Meningitis Vaccine* The State passed Senate Bill 1107 in 2011 and recently Senate Bill 62 in 2013, which

More information

WHO Prequalification of Diagnostics Programme PUBLIC REPORT. Product: Genscreen ULTRA HIV Ag-Ab Number: PQDx 0096-031-00. Abstract

WHO Prequalification of Diagnostics Programme PUBLIC REPORT. Product: Genscreen ULTRA HIV Ag-Ab Number: PQDx 0096-031-00. Abstract WHO Prequalification of Diagnostics Programme PUBLIC REPORT Product: Genscreen ULTRA HIV Ag-Ab Number: PQDx 0096-031-00 Abstract Genscreen ULTRA HIV Ag-Ab with product codes 72386 and 72388, manufactured

More information

QUICK REFERENCE TO BLOOD BANK TESTING

QUICK REFERENCE TO BLOOD BANK TESTING QUICK REFERENCE TO BLOOD BANK TESTING All Blood bank Tests are performed on demand 24 hours a day, 7 days a week. Feto/Maternal Bleed Quantitation estimates will be available within 4 hours of blood bank

More information

Gail Bennett, RN, MSN, CIC

Gail Bennett, RN, MSN, CIC Gail Bennett, RN, MSN, CIC The occurrence of more cases of disease than expected in a given area or among a specific group of people over a particular period of time Cases above your usual endemic rate

More information

3. Blood and blood products such as serum, plasma, and other blood components.

3. Blood and blood products such as serum, plasma, and other blood components. Mississippi Downloaded 01/2011 101.11 Infectious Medical Waste. The term "infectious medical waste" includes solid or liquid wastes which may contain pathogens with sufficient virulence and quantity such

More information

Illinois Influenza Surveillance Report

Illinois Influenza Surveillance Report ILLINOIS DEPARTMENT OF PUBLIC HEALTH Illinois Influenza Surveillance Report Week 8: Week Ending Saturday, February 25, 2012 Division of Infectious Diseases Immunizations Section 3/5/2012 1 Please note

More information

Paediatrica Indonesiana. Limitations of the Indonesian Pediatric Tuberculosis Scoring System in the context of child contact investigation

Paediatrica Indonesiana. Limitations of the Indonesian Pediatric Tuberculosis Scoring System in the context of child contact investigation Paediatrica Indonesiana VOLUME 51 November NUMBER 6 Original Article Limitations of the Indonesian Pediatric Tuberculosis Scoring System in the context of child contact investigation Rina Triasih 1,2,

More information

CHAPTER 13. Quality Control/Quality Assurance

CHAPTER 13. Quality Control/Quality Assurance CHAPTER 13 Quality Control/Quality Assurance Quality Control/Quality Assurance (QC/QA) can be defined as the set of planned and systematic activities focused on providing confidence that quality requirements

More information

Maria Dalbey RN. BSN, MA, MBA March 17 th, 2015

Maria Dalbey RN. BSN, MA, MBA March 17 th, 2015 Maria Dalbey RN. BSN, MA, MBA March 17 th, 2015 2 Objectives Participants will be able to : Understand the Pathogenesis of Tuberculosis (TB) Identify the Goals of Public Health for TB Identify Hierarchy

More information

Tuberculosis. Subject. Goal/Objective. Instructions. Rationale. Operations Directorate, Health Branch Immigration Medical Examination Instructions

Tuberculosis. Subject. Goal/Objective. Instructions. Rationale. Operations Directorate, Health Branch Immigration Medical Examination Instructions Subject Instructions for the screening of clients to detect tuberculosis (TB) in the context of the Canadian immigration medical examination (IME). Goal/Objective These instructions are provided to ensure

More information

West Nile Virus Disease

West Nile Virus Disease 1. DISEASE REPORTING A. Purpose of Reporting and Surveillance West Nile Virus Disease 1. To identify areas in which West Nile virus (WNV) is being transmitted. 2. To target public education about reducing

More information

TUBERCULOSIS (TB) SCREENING GUIDELINES FOR RESIDENTIAL FACILITIES AND DRUG

TUBERCULOSIS (TB) SCREENING GUIDELINES FOR RESIDENTIAL FACILITIES AND DRUG TUBERCULOSIS (TB) SCREENING GUIDELINES FOR RESIDENTIAL FACILITIES AND DRUG Tx CENTERS Tuberculosis Control Program Health and Human Services Agency San Diego County INTRODUCTION Reducing TB disease requires

More information

Outbreak of Legionnaires disease in a hotel in Calpe, Spain December 2011 January 2012 6 February 2012

Outbreak of Legionnaires disease in a hotel in Calpe, Spain December 2011 January 2012 6 February 2012 RAPID RISK ASSESSMENT Outbreak of Legionnaires disease in a hotel in Calpe, Spain December 2011 January 2012 6 February 2012 Main conclusions and recommendations A cluster of 13 cases of travel-associated

More information

Health Protection Agency position statement on the use of Interferon Gamma Release Assay (IGRA) tests for Tuberculosis (TB)

Health Protection Agency position statement on the use of Interferon Gamma Release Assay (IGRA) tests for Tuberculosis (TB) Health Protection Agency position statement on the use of Interferon Gamma Release Assay (IGRA) tests for Tuberculosis (TB) Draft Interim HPA Guidance HPA Tuberculosis Programme Board Health Protection

More information

ECDC INTERIM GUIDANCE

ECDC INTERIM GUIDANCE ECDC INTERIM GUIDANCE Interim ECDC public health guidance on case and contact management for the new influenza A(H1N1) virus infection Version 3, 19 May 2009 ECDC intends to produce a series of interim

More information

Annex to the Accreditation Certificate D-PL-14139-01-00 according to DIN EN ISO/IEC 17025:2005

Annex to the Accreditation Certificate D-PL-14139-01-00 according to DIN EN ISO/IEC 17025:2005 Deutsche Akkreditierungsstelle GmbH Annex to the Accreditation Certificate D-PL-14139-01-00 according to DIN EN ISO/IEC 17025:2005 Period of validity: 26.10.2015 to 25.10.2020 Date of issue: 26.10.2015

More information

Enhancing Respiratory Infection Surveillance on the Arizona-Sonora Border BIDS Program Sentinel Surveillance Data

Enhancing Respiratory Infection Surveillance on the Arizona-Sonora Border BIDS Program Sentinel Surveillance Data Enhancing Respiratory Infection Surveillance on the Arizona-Sonora Border BIDS Program Sentinel Surveillance Data Catherine Golenko, MPH, Arizona Department of Health Services *Arizona border population:

More information

Pertussis Information for GPs and other Health Care Providers on Clinical and Public Health Management. March 2010

Pertussis Information for GPs and other Health Care Providers on Clinical and Public Health Management. March 2010 Pertussis Information for GPs and other Health Care Providers on Clinical and Public Health Management March 2010 Infectious Agent Bordetella pertussis (a bacterium) Clinical Features Infants and Young

More information

ELISA BIO 110 Lab 1. Immunity and Disease

ELISA BIO 110 Lab 1. Immunity and Disease ELISA BIO 110 Lab 1 Immunity and Disease Introduction The principal role of the mammalian immune response is to contain infectious disease agents. This response is mediated by several cellular and molecular

More information

Homework 5: Differential Diagnosis of Multiple Sclerosis

Homework 5: Differential Diagnosis of Multiple Sclerosis Homework 5: Differential Diagnosis of Multiple Sclerosis Due Wednesday, 3/3/99 1.0 Background Multiple Sclerosis affects approximately 350 K Americans and is the leading nontraumatic source of neurologic

More information

Bloodstains. Identification of blood, typing, and splatter

Bloodstains. Identification of blood, typing, and splatter Bloodstains Identification of blood, typing, and splatter 3 questions about an 1. Is it blood? unknown stain 2. From what species did the blood originate? 3. If the blood is of human origin, how closely

More information

Serology: Fluorescent antibody tests and other tests employing conjugated antibodies

Serology: Fluorescent antibody tests and other tests employing conjugated antibodies Serology: Fluorescent antibody tests and other tests employing conjugated antibodies Authors: Adapted by Prof M van Vuuren. Originally compiled by Dr RW Worthington. (Retired) Licensed under a Creative

More information

FILE: EAC 05 002 541 12 Office: VERMONT SERVICE CENTER Date: AUG 2 9 2006

FILE: EAC 05 002 541 12 Office: VERMONT SERVICE CENTER Date: AUG 2 9 2006 U.S. Department of Homeland Security 20 Massachusetts Ave. NW, Rm. 3000 Washington, DC 20529 identifying data deleted to prevent clearly unwarranted invasion of personal privacy U. S. Citizenship and Immigration

More information

HiPer RA Test Teaching Kit

HiPer RA Test Teaching Kit HiPer RA Test Teaching Kit Product Code: HTI019 Number of experiments that can be performed: 20 Duration of Experiment: 1hour Storage Instructions: The kit is stable for 6 months from the date of receipt

More information

WHO Regional Office for Europe update on avian influenza A (H7N9) virus

WHO Regional Office for Europe update on avian influenza A (H7N9) virus WHO Regional Office for Europe update on avian influenza A (H7N9) virus Situation update 2: 30 April 2013 Address requests about publications of the WHO Regional Office for Europe to: Publications WHO

More information

CDC TB Testing Guidelines and Recent Literature Update

CDC TB Testing Guidelines and Recent Literature Update Pocket Guide QuantiFERON -TB Gold CDC TB Testing Guidelines and Recent Literature Update Using IGRAs for TB screening in your patients June 2010 A full copy of the US Centers for Disease Control and Prevention

More information

ProArray Ultra Ligand Binding Assays as a Service

ProArray Ultra Ligand Binding Assays as a Service ProArray Ultra Ligand Binding Assays as a Service Why do ELISAs yourself when you can outsource them for less than your in-house labor and consumable costs miniaturize them to require just microliters

More information

Rheumatology Labs for Primary Care Providers. Robert Monger, M.D., F.A.C.P. 2015 Frontiers in Medicine

Rheumatology Labs for Primary Care Providers. Robert Monger, M.D., F.A.C.P. 2015 Frontiers in Medicine Rheumatology Labs for Primary Care Providers Robert Monger, M.D., F.A.C.P. 2015 Frontiers in Medicine Objectives Review the Indications for and Interpretation of lab testing for the following diseases:

More information

Diagnostic Testing Considerations for Shelters and Rescues Part One: Fundamentals

Diagnostic Testing Considerations for Shelters and Rescues Part One: Fundamentals Diagnostic Testing Considerations for Shelters and Rescues Part One: Fundamentals Sandra Newbury, DVM National Shelter Medicine Extension Veterinarian Koret Shelter Medicine Program University of California,

More information

William Atkinson, MD, MPH Hepatitis B Vaccine Issues June 16, 2016

William Atkinson, MD, MPH Hepatitis B Vaccine Issues June 16, 2016 William Atkinson, MD, MPH Hepatitis B Vaccine Issues June 16, 2016 Advisory Committee on Immunization Practices (ACIP) The recommendations to be discussed are primarily those of the ACIP composed of 15

More information

TB CARE EARLY DETECTION AND PREVENTION OF TUBERCULOSIS (TB) IN CHILDREN. Risk factors in children acquiring TB:

TB CARE EARLY DETECTION AND PREVENTION OF TUBERCULOSIS (TB) IN CHILDREN. Risk factors in children acquiring TB: EARLY DETECTION AND PREVENTION OF TUBERCULOSIS (TB) IN CHILDREN Risk factors in children acquiring TB: Children living in the same household as a lung TB patient (especially children under 5) Children

More information

Table 1.1. Sensitivity, specificity and predictive values of latex agglutination test during the first week of illness

Table 1.1. Sensitivity, specificity and predictive values of latex agglutination test during the first week of illness LEPTOSPIROSIS Evaluation of indigenously developed leptospira latex agglutination test for diagnosis of Leptospirosis A latex agglutination assay was developed for the detection of antibodies to leptospires

More information

JIANGSU CARTMAY INDUSTRIAL CO.,LTD www.labfurniture.asia mail: info@labfurniture.asia

JIANGSU CARTMAY INDUSTRIAL CO.,LTD www.labfurniture.asia mail: info@labfurniture.asia The basic layout, the main functions and instrumentation concept of micro Inspection Division laboratory, 1, Virology Laboratory 1. Functions: for the city to monitor the prevalence of HIV disease, dealing

More information

06-6542 n/a MYSTERY OF THE BLOOD STAIN (RE)

06-6542 n/a MYSTERY OF THE BLOOD STAIN (RE) DATA SHEET Order code Manufacturer code Description 06-6542 n/a MYSTERY OF THE BLOOD STAIN (RE) The enclosed information is believed to be correct, Information may change without notice due to product

More information

P R O D U C T S CATALOG 2011-2012

P R O D U C T S CATALOG 2011-2012 P R O D U C T S CATALOG 2011-2012 INSTITUTE FOR THE APPLICATION OF NUCLEAR ENERGY - INEP Banatska 31b 11080 Zemun Belgrade Serbia Tel: (+381 11) 2619 252, 2618 696, 2199 949 Fax: (+381 11) 2618 724 www.inep.co.rs

More information

MANAGEMENT OF TUBERCULOSIS IN PRISONS: Guidance for prison healthcare teams

MANAGEMENT OF TUBERCULOSIS IN PRISONS: Guidance for prison healthcare teams MANAGEMENT OF TUBERCULOSIS IN PRISONS: Guidance for prison healthcare teams Document control Title Type Author/s Management of tuberculosis in prisons: Guidance for prison healthcare teams Operational

More information

Specimen and Data Repository for TB Diagnostic Research in Children. Sharon Nachman SUNY Stony Brook

Specimen and Data Repository for TB Diagnostic Research in Children. Sharon Nachman SUNY Stony Brook Specimen and Data Repository for TB Diagnostic Research in Children Sharon Nachman SUNY Stony Brook Why have repositories? We need to develop a prospective system that will allow for collection of data

More information

Selective IgA deficiency (slgad) hello@piduk.org 0800 987 8986 www.piduk.org

Selective IgA deficiency (slgad) hello@piduk.org 0800 987 8986 www.piduk.org Selective IgA deficiency (slgad) hello@piduk.org 0800 987 8986 www.piduk.org About this booklet This booklet provides information on selective IgA deficiency (sigad). It has been produced by the PID UK

More information

Viral Hepatitis Case Report

Viral Hepatitis Case Report Page 1 of 9 Viral Hepatitis Case Report Perinatal Hepatitis B Virus Infection Michigan Department of Community Health Communicable Disease Division Investigation Information Investigation ID Onset Date

More information

Time Frame 15 minutes. Student should strive to be able to perform multiple procedures simultaneously.

Time Frame 15 minutes. Student should strive to be able to perform multiple procedures simultaneously. Name Direct Antiglobulin Test (DAT) (Direct Coombs) Principle The DAT detects the in vivo sensitization of RBC with IgG incomplete or non-agglutinating antibodies. After thorough washing of RBC with saline

More information

Medical Laboratory Technology Program. Student Learning Outcomes & Course Descriptions with Learning Objectives

Medical Laboratory Technology Program. Student Learning Outcomes & Course Descriptions with Learning Objectives Medical Laboratory Technology Program Student Learning Outcomes & Course Descriptions with Learning Objectives Medical Laboratory Technology Student Learning Outcomes All Colorado Mesa University associate

More information

Nevada State Health Division Technical Bulletin

Nevada State Health Division Technical Bulletin Nevada State Health Division Technical Bulletin Topic: Using QuantiFERON and Tuberculin Skin Test to Screen for TB Section/Program/Contact: Bureau of Community Health / Tuberculosis Program / Susanne Paulson,

More information

Table. Positive Purified Protein Derivative Results (Pediatrics In Review Apr 2008)

Table. Positive Purified Protein Derivative Results (Pediatrics In Review Apr 2008) PPD and TB Sreening COMPETENCY- The resident should know the risk factors for TB exposure, when to screen, and the appropriate criteria for recognizing a positive PPD in children of different age groups

More information

ST. VINCENT'S. MEDICAL CENTER St. Vincent's Healthcare

ST. VINCENT'S. MEDICAL CENTER St. Vincent's Healthcare ST. VINCENT'S MEDICAL CENTER St. Vincent's Healthcare Medical Technology St. Vincent s Schools of Medical Science Throughout Northeast Florida and Southern Georgia, St. Vincent s HealthCare is well known

More information

PROTOCOL FOR THE MANAGEMENT OF CLOSE CONTACTS OF PERTUSSIS INFECTION

PROTOCOL FOR THE MANAGEMENT OF CLOSE CONTACTS OF PERTUSSIS INFECTION PROTOCOL FOR THE MANAGEMENT OF CLOSE CONTACTS OF PERTUSSIS INFECTION Printed copies must not be considered the definitive version DOCUMENT CONTROL PROTOCOL NO. 1.03 Policy Group Infection Control Committee

More information

Assisted Living - TB Risk Assessment

Assisted Living - TB Risk Assessment Montana DPHHS Tuberculosis Program Assisted Living - TB Risk Assessment Assisted Living, Adult Day Care, Adult Foster Care & Transitional Living Centers Today s Date Facility Address Phone County Completed

More information

ALBERTA IMMUNIZATION POLICY GUIDELINES

ALBERTA IMMUNIZATION POLICY GUIDELINES ALBERTA IMMUNIZATION POLICY GUIDELINES Hepatitis Vaccines. Hepatitis A Vaccines Refer to the vaccine product monograph and the Canadian Immunization Guide for further Product monographs are available on

More information

CHAPTER 6 ANTIBODY GENETICS: ISOTYPES, ALLOTYPES, IDIOTYPES

CHAPTER 6 ANTIBODY GENETICS: ISOTYPES, ALLOTYPES, IDIOTYPES CHAPTER 6 ANTIBODY GENETICS: ISOTYPES, ALLOTYPES, IDIOTYPES See APPENDIX: (3) OUCHTERLONY; (4) AFFINITY CHROMATOGRAPHY Human immunoglobulins are made up of LIGHT and HEAVY chains encoded by a total of

More information

Ebola: Teaching Points for Nurse Educators

Ebola: Teaching Points for Nurse Educators Ebola: Teaching Points for Nurse Educators Heightened media attention on emerging disease outbreaks such as Ebola may raise concerns among students. During outbreaks such as Ebola, nursing faculty are

More information

Haemophilus Influenzae (meningitis and invasive

Haemophilus Influenzae (meningitis and invasive Haemophilus Influenzae (meningitis and invasive disease)! Report immediately 24/7 by phone upon initial suspicion or laboratory test order PROTOCOL CHECKLIST Enter available information into Merlin upon

More information

Nursing college, Second stage Microbiology Dr.Nada Khazal K. Hendi L14: Hospital acquired infection, nosocomial infection

Nursing college, Second stage Microbiology Dr.Nada Khazal K. Hendi L14: Hospital acquired infection, nosocomial infection L14: Hospital acquired infection, nosocomial infection Definition A hospital acquired infection, also called a nosocomial infection, is an infection that first appears between 48 hours and four days after

More information

Exploring the Role of Vitamins in Achieving a Healthy Heart

Exploring the Role of Vitamins in Achieving a Healthy Heart Exploring the Role of Vitamins in Achieving a Healthy Heart There are many avenues you can take to keep your heart healthy. The first step you should take is to have a medical professional evaluate the

More information

Viral Safety of Plasma-Derived Products

Viral Safety of Plasma-Derived Products Viral Safety of Plasma-Derived Products SLIDE 1 This presentation will cover viral validation studies for plasma-derived products. FDA requires that the manufacturing process for biopharmaceutical products

More information

HBV DNA < monitoring interferon Rx

HBV DNA < monitoring interferon Rx Hepatitis B Virus Suspected acute hepatitis >>Order: Acute Unknown hepatitis screen Suspected chronic hepatitis >>Order: Chronic unknown hepatitis screen Acute HBV or Delayed Anti HBs response after acute

More information

Level Tow. Level Three

Level Tow. Level Three Level One Code No Title Unit Eng 0012 English Language 2)2+1( Chm 0010 General Chemistry 2)2+1( Zoo 0010 General Biology 2)2+1( Com 0012 Introduction to Computer 2)2+1( Ter 0011 Medical Terminology 1)1+1(

More information