Veterinary diagnostic labs (VDLs) are important service agencies providing essential diagnostic testing for a wide variety of domestic animal species as well as wildlife. They serve key roles in disease monitoring and diagnosis as well as surveillance for diseases of consequence. Of the many roles VDLs serve, one is being a member of the larger team of professionals dealing with the management of the bovine respiratory disease (BRD) complex. VDLs provide a number of services related to the management of BRD. These include disease outbreak investigation, abnormal morbidity characterization, routine monitoring, and biosecurity screening for a variety of infectious agents via methods such as necropsy and histopathology, bacterial culture, antimicrobial sensitivity testing, virus isolation, and serological assays. VDLs continue to look for better methods and assays as instrumentation technology also grows and improves. This is reflected in the growing proliferation of molecular-based assays that provide a high degree of sensitivity and specificity. Professional staff in VDLs work in collaboration with those in academia and private industry to conduct basic research focusing on a different aspect of the BRD complex. VDLs remain a primary source of the varied field-origin infectious agents associated with BRD that are used for research purposes.

Changes in respiratory pathogen testing can affect disease burden estimates. Using linked data, we describe changes in respiratory virus testing among children born in Western Australia in 1996–2012. We extracted data on respiratory specimens from these children from birth to age 9 years. We estimated testing rates by age, year, Aboriginal status and geographical location. Predictors of testing among children hospitalised at least once before their 10th birthday were identified using logistic regression. We compared detection methods for respiratory viruses from nasal/nasopharyngeal (NP) specimens by age and year. Of 83 199 virology testing records in 2000–2012, 80% were nasal/NP specimens. Infants aged <1 month had the highest testing rates. Testing rates in all children increased over the study period with considerable yearly fluctuations. Among hospitalised children, premature children <32 weeks gestation had over three times the odds of being tested (95% CI 3·47–4·13) than those born at term. Testing using molecular methods increased from 5% to 87% over the study period. Proportion of positive samples increased from 36·3% to 44·4% (P < 0·01); this change was greatest in children aged 2–9 years. These findings will assist in interpreting results from future epidemiology studies assessing the pathogen-specific burden of disease.

A 55-year-old man presented to the emergency department (ED) following 2 episodes of typical cardiac chest pain and nonspecific electrocardiogram findings. His serial cardiac marker assays revealed an elevated total creatine kinase (CK) and 2 negative cardiac troponin levels. Because of a high clinical suspicion of acute coronary syndrome, a total creatine kinase MB mass was obtained and found to be elevated. Subsequent cardiac angiography demonstrated a significantly flow-limiting coronary artery lesion, and stenting was performed. This case demonstrates that simultaneous CK and troponin measurements may have utility in selected ED patients with chest pain. The interpretation of discordant CK and troponin levels is discussed.

Infection with Entamoeba histolytica, the protozoan parasite that causes amoebic colitis and liver abscess, results in 34 million to 50 million symptomatic cases of amoebiasis (all illnesses caused by E. histolytica, including amoebic dysentery) worldwide each year, causing 40 thousand to 100 thousand deaths annually. As a result of accruing biochemical, genetic and immunological data, E. histolytica was re-defined in 1993 to recognise the existence of two morphologically identical but genetically distinct human parasites: E. histolytica, the aetiological agent of invasive intestinal and extraintestinal amoebiasis, and Entamoeba dispar, a non-pathogenic intestinal parasite. Because microscopy is unable to distinguish between these two organisms, it should no longer be relied upon to diagnose amoebiasis. Sensitive and specific molecular techniques that are able to distinguish E. histolytica from E. dispar have been developed recently; they include (1) the detection of an E. histolytica antigen using an enzyme-linked immunosorbent assay (ELISA), (2) the use of the polymerase chain reaction (PCR) to amplify amoebic DNA, and (3) the culture of stool samples followed by isoenzyme analysis. Of these three test methods, only antigen detection using ELISA can be performed rapidly and easily, making it the diagnostic test method of choice for clinical use in the developing world, where the morbidity and mortality caused by E. histolytica are greatest. However, the PCR method is a powerful tool for the genetic typing of different amoebic strains. Together these two methods should result in both improved clinical diagnosis and treatment of amoebiasis, and a greater understanding of the epidemiology of E. histolytica. Such knowledge will not only assist public health efforts to control amoebiasis, but also facilitate the careful testing of the anti-amoebic vaccines that are currently being developed.