Arthropods and the Clinical Laboratory

Author: Julie Ann West, PhD, MLS(ASCP)CMSM(ASCP)CM
Reviewer: Christie A. Grueser, MSS, MLS(ASCP) and Joshua J. Cannon, MS, MLS(ASCP)CMSHCM
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Continuing Education Credits

P.A.C.E.® Contact Hours: 1 hour(s)

Florida Board of Clinical Laboratory Science CE Credit Hours

Florida Board of Clinical Laboratory Science CE - General (Microbiology/Mycology/Parasitology): 1 hour(s)

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This course addresses the significance of medically important arthropods and includes preanalytical, analytical, and postanalytical phases of handling ectoparasites in the clinical laboratory. Other topics, such as myiasis, illusory parasitosis, and handling of artifacts are discussed. Quality control and quality assurance as they pertain to arthropod identification are also addressed.

Objectives

  • Explain the significance of medically important arthropods and what is meant by vector, scalar, and envenomation.
  • Describe collection and transport (preanalytical) aspects of arthropod submission to the laboratory.
  • Differentiate between different medically important ectoparasites (to include bedbugs, lice, mites, ticks, and other arthropods) using pictorial and dichotomous identification keys during the analytical aspect of testing.
  • Explain how to report identifications of partial or whole ectoparasites (during the postanalytical stage of testing).
  • Discuss and explain importance of myiasis, illusory parasitosis, and artifacts.
  • Describe the quality control and quality assurance aspects of arthropod-related activities in the CLIA-certified laboratory.

Course Outline

  • Medically Important Arthropods: Terminology and Significance
    • Introduction to Medically Important Arthropods
    • Vector
    • Scalar
    • Envenomation
    • Important Terminology
    • Significance
    • The medically important arthropods may transmit disease to humans via which two vector routes?
    • True or False: Lyme Disease is the most commonly acquired arboviral disease in the United States (US).
  • Pre-examination Phase: Collection and Transport of Specimens
    • Pre-examination: Proper Collection and Submission of Specimens
    • Pre-examination: Proper Collection and Submission of Scabies Skin Scrapings
    • Pre-examination: Proper Transport of Specimens
    • Why is 70–90% ethanol required when submitting a suspected arthropod to the laboratory?
    • True or False: When scabies is suspected, the large, individual organism is placed into a screw-top cup filled with 70–90% ethanol for submission to the laboratory.
  • Examination Phase: How to Identify Medically Important Arthropods (Ectoparasites)
    • Examination: Tools Used in the Identification Process
    • Examination: How to Identify Medically Important Arthropods - Morphology
    • Examination: Use of Pictorial Identification Atlases and Keys
    • Macroscopic examination of suspect arthropods includes the following:
    • Reduced wings (known as pads) are seen in which medically important arthropods?
  • Most Common Medically Important Ectoparasites in the US
    • Ticks: Soft versus Hard
    • Ticks: Example of a Soft Tick
    • Ticks: Comparison of Important Hard Ticks
    • Ticks: Important Examples of Hard Ticks
    • Ticks: More Important Examples of Hard Ticks
    • Mites
    • Mites: Scabies
    • Bedbugs
    • Lice
    • Kissing Bugs
    • Mosquitoes, Fleas, and Other Arthropods
    • Other arthropods (of the order Diptera) include mosquitoes that look for blood meals. Choose the mosquito genus that is associated with the Zika virus.
    • Match the correct arthropod with its description.
  • Post-examination Phase: How to Report
    • Post-examination: How to Report Findings
    • True or False: Arthropods that are notof medical importance should not be identified and reported to the genus or species level, as the reporting might cause confusion in the process of patient diagnosis.
    • When reporting the presence of scabies on a slide preparation submitted to the laboratory for identification, include:
  • Other Scenarios: Myiasis, Illusory Parasitosis, and Artifacts
    • Other Scenarios
    • Pseudoparasites
    • Myiasis: What is it?
    • Myiasis: Fly Larvae Identification
    • Illusory Parasitosis
    • What non-arthropod scenario might be a cause of itch and rash in a patient?
    • Three types of myiasis include:
  • Quality Control and Quality Assurance of Arthropod Identification in the CLIA-certified Laboratory
    • Aspects of Safety and Quality Control
    • Aspects of Quality Assurance
    • The Future of Arthropod Identification
    • What safety concern is present when performing arthropod identification?
    • Quality assurance may include:
  • References
    • References

Additional Information

Level of Instruction: Intermediate 
Intended Audience: Medical laboratory scientists, medical laboratory technicians, laboratory supervisors, and laboratory managers. This course is also appropriate for MLS and MLT students and pathology residents.
Author Information:  Dr. Julie Ann West is certified by the American Society for Clinical Pathology (ASCP) as a Medical Laboratory Scientist (MLS) and as a Specialist in Microbiology (SM). In addition, Dr. West has earned a PhD in Public Health - Infectious Disease Epidemiology - and is Certified in Public Health (CPH) by the National Board of Public Health Examiners. Dr. West is experienced as a Technical Specialist, Safety Officer, Educator, and Lead in the Veterans Administration Healthcare System and has prior experience as an Administrative Laboratory Director.
The author has no conflict of interest to disclose.  
Reviewer Information:
Christie Grueser received her undergraduate degree from the University of Colorado and her master's in communication from the University of Denver. For 14 years, she served as the Assistant Program Director and Microbiology Instructor for the Medical Technology Program at the University of Colorado School of Medicine. Together with Dr. Elmer Koneman, she has authored several educational software programs in clinical microbiology, including GermWare Mycology, GermWare Bacteriology and GermWare Parasitology, didactic and laboratory courses in Clinical Parasitology and Mycology, and most recently, Image Atlases and Identification Guides for Clinical Bacteriology, Mycology, and Parasitology as well as the Clinical Microbiology Question Bank. She currently provides workshops and webinars for the Denver Health Prevention and Training Center, funded by a grant from the CDC.
Joshua J. Cannon, MS, MLS(ASCP)CMSHCM received his Bachelor of Science and Master of Science in Medical Laboratory Science from Thomas Jefferson University in Philadelphia, PA. He holds Medical Laboratory Scientist and Specialist in Hematology certifications through the ASCP Board of Certification. He was a professor at Thomas Jefferson University for seven years before transitioning into his current role as Education Developer at MediaLab by Vastian. His areas of expertise and professional passions include clinical hematology and interprofessional education.
Course Description: This course addresses the significance of medically important arthropods and includes the pre-examination, examination, and post-examination phases of handling ectoparasites in the clinical laboratory. Other topics, such as myiasis, illusory parasitosis, and handling of artifacts, are discussed. Quality control and quality assurance, as they pertain to arthropod identification, are also addressed.