I coordinate the Professional Experience in Biomedical Science Program, in the School of Life Sciences UTS. This subject allows students to gain real world experience in public and private pathology laboratories.
I am also a Postdoctoral Scientist in the School of Medical Sciences at the University of New South Wales, based at the Prince of Wales Hospital. My overall research aim is to determine the importance of respiratory diseases in vulnerable populations, including children with chronic respiratory diseases. This includes projects on investigating the role of picornaviruses in exacerbation of chronic airway diseases including asthma and cystic fibrosis (CF), new point-of-care testing for respiratory viruses, understanding transmission modes of respiratory viruses, and developing novel sampling and diagnostic methods for respiratory viruses.
I work on influenza, rhinovirus (common cold), enteroviruses and other respiratory viruses. I'm particularly interested in the impact of these viruses in vulnerable populations, including children and adults with chronic respiratory diseases.
I have 15 years of experience teaching at the tertiary level, and coordinate the UTS Professional Experiences in Biomedical Science Program.
I give lectures every year on influenza and vaccines at UNSW and have been an invited guest lecturer in infectious diseases including Influenza, Emerging Viruses and General Virology at other universities.
Chughtai, AA, Stelzer-Braid, S, Rawlinson, W, Pontivivo, G, Wang, Q, Pan, Y, Zhang, D, Zhang, Y, Li, L & MacIntyre, CR 2019, 'Contamination by respiratory viruses on outer surface of medical masks used by hospital healthcare workers.', BMC infectious diseases, vol. 19, no. 1.View/Download from: UTS OPUS or Publisher's site
BACKGROUND:Medical masks are commonly used in health care settings to protect healthcare workers (HCWs) from respiratory and other infections. Airborne respiratory pathogens may settle on the surface of used masks layers, resulting in contamination. The main aim of this study was to study the presence of viruses on the surface of medical masks. METHODS:Two pilot studies in laboratory and clinical settings were carried out to determine the areas of masks likely to contain maximum viral particles. A laboratory study using a mannequin and fluorescent spray showed maximum particles concentrated on upper right, middle and left sections of the medical masks. These findings were confirmed through a small clinical study. The main study was then conducted in high-risk wards of three selected hospitals in Beijing China. Participants (n = 148) were asked to wear medical masks for a shift (6-8 h) or as long as they could tolerate. Used samples of medical masks were tested for presence of respiratory viruses in upper sections of the medical masks, in line with the pilot studies. RESULTS:Overall virus positivity rate was 10.1% (15/148). Commonly isolated viruses from masks samples were adenovirus (n = 7), bocavirus (n = 2), respiratory syncytial virus (n = 2) and influenza virus (n = 2). Virus positivity was significantly higher in masks samples worn for > 6 h (14.1%, 14/99 versus 1.2%, 1/49, OR 7.9, 95% CI 1.01-61.99) and in samples used by participants who examined > 25 patients per day (16.9%, 12/71 versus 3.9%, 3/77, OR 5.02, 95% CI 1.35-18.60). Most of the participants (83.8%, 124/148) reported at least one problem associated with mask use. Commonly reported problems were pressure on face (16.9%, 25/148), breathing difficulty (12.2%, 18/148), discomfort (9.5% 14/148), trouble communicating with the patient (7.4%, 11/148) and headache (6.1%, 9/148). CONCLUSION:Respiratory pathogens on the outer surface of the used medical masks may result in self-contamination. The risk is...
Stelzer-Braid, S, Wynn, M, Chatoor, R, Scotch, M, Ramachandran, V, Teoh, H-L, Farrar, MA, Sampaio, H, Andrews, PI, Craig, ME, MacIntyre, CR, Varadhan, H, Kesson, A, Britton, PN, Newcombe, J & Rawlinson, WD 2019, 'Next generation sequencing of human enterovirus strains from an outbreak of enterovirus A71 shows applicability to outbreak investigations', Journal of Clinical Virology, pp. 104216-104216.View/Download from: Publisher's site
Suresh, S, Rawlinson, WD, Andrews, PI & Stelzer-Braid, S 2019, 'Global epidemiology of nonpolio enteroviruses causing severe neurological complications: A systematic review and meta-analysis.', Reviews in medical virology, p. e2082.View/Download from: Publisher's site
Enteroviruses are RNA viruses found as commensals in the human gut and respiratory system, which may cause a wide spectrum of disease. Enteroviruses may cause severe neurologic complications including acute flaccid paralysis (AFP) and encephalitis and are the most commonly diagnosed agents of viral meningitis. Outbreaks of more severe disease are often associated with particular genotypes, such as enterovirus-A71 causing rhombencephalitis and AFP. There are more than 300 described genotypes of human enterovirus, with overlaps in clinical phenotypes between genotypes, and uncertainty about which genotypes are more prevalent in neurological manifestations. A systematic review of observational studies was conducted to evaluate the most prevalent enterovirus genotypes causing AFP, encephalitis, and meningitis. The genotyping methods and sampling sites were compiled as secondary outcomes. Sources included MEDLINE, Embase (publications until January 2019), and references selected from included studies. Meta-analyses using a random effects model were performed to calculate the pooled proportion of enterovirus genotypes in each disease. Ninety-six publications met the eligibility criteria, comprising 3779 AFP cases, 1140 encephalitis cases, and 32 810 meningitis cases. Enterovirus-A71 was most frequently associated with AFP (pooled proportion 0.12, 95% CI, 0.05-0.20) and encephalitis (0.77, 95% CI, 0.61-0.91). Echovirus 30 (0.35, 95% CI, 0.27-0.42) was the most predominant genotype in meningitis cases. Genotypes were most commonly determined using VP1 RT- reverse transcription-polymerase chain reaction, and most samples assessed were cerebrospinal fluid. With the emergence of enteroviruses as an increasing cause of neurological diseases, surveillance and testing need to increase to identify the aetiology of the most common and most severe disorders.
Dyda, A, Stelzer-Braid, S, Adam, D, Chughtai, AA & MacIntyre, CR 2018, 'The association between acute flaccid myelitis (AFM) and Enterovirus D68 (EV-D68) - what is the evidence for causation?', Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin, vol. 23, no. 3.View/Download from: UTS OPUS or Publisher's site
BackgroundEnterovirus D68 (EV-D68) has historically been a sporadic disease, causing occasional small outbreaks of generally mild infection. In recent years, there has been evidence of an increase in EV-D68 infections globally. Large outbreaks of EV-D68, with thousands of cases, occurred in the United States, Canada and Europe in 2014. The outbreaks were associated temporally and geographically with an increase in clusters of acute flaccid myelitis (AFM). Aims: We aimed to evaluate a causal association between EV-D68 and AFM. Methods: Using data from the published and grey literature, we applied the Bradford Hill criteria, a set of nine principles applied to examine causality, to evaluate the relationship between EV-D68 and AFM. Based on available evidence, we defined the Bradford Hill Criteria as being not met, or met minimally, partially or fully. Results: Available evidence applied to EV-D68 and AFM showed that six of the Bradford Hill criteria were fully met and two were partially met. The criterion of biological gradient was minimally met. The incidence of EV-D68 infections is increasing world-wide. Phylogenetic epidemiology showed diversification from the original Fermon and Rhyne strains since the year 2000, with evolution of a genetically distinct outbreak strain, clade B1. Clade B1, but not older strains, is associated with AFM and is neuropathic in animal models. Conclusion: While more research is needed on dose-response relationship, application of the Bradford Hill criteria supported a causal relationship between EV-D68 and AFM.
Egilmezer, E, Walker, GJ, Bakthavathsalam, P, Peterson, JR, Gooding, JJ, Rawlinson, W & Stelzer-Braid, S 2018, 'Systematic review of the impact of point-of-care testing for influenza on the outcomes of patients with acute respiratory tract infection.', Reviews in medical virology, vol. 28, no. 5.View/Download from: UTS OPUS or Publisher's site
Acute respiratory tract infections are a major cause of morbidity and mortality and represent a significant burden on the health care system. Laboratory testing is required to definitively distinguish infecting influenza virus from other pathogens, resulting in prolonged emergency department (ED) visits and unnecessary antibiotic use. Recently available rapid point-of-care tests (POCT) may allow for appropriate use of antiviral and antibiotic treatments and decrease patient lengths of stay. We undertook a systematic review to assess the effect of POCT for influenza on three outcomes: (1) antiviral prescription, (2) antibiotic prescription, and (3) patient length of stay in the ED. The databases Medline and Embase were searched using MeSH terms and keywords for influenza, POCT, antivirals, antibiotics, and length of stay. Amongst 245 studies screened, 30 were included. The majority of papers reporting on antiviral prescription found that a positive POCT result significantly increased use of antivirals for influenza compared with negative POCT results and standard supportive care. A positive POCT result also led to decreased antibiotic use. The results of studies assessing the effect of POCT on ED length of stay were not definitive. The studies assessed in this systematic review support the use of POCT for diagnosis of influenza in patients suffering an acute respiratory infection. Diagnosis using POCT may lead to more appropriate prescription of treatments for infectious agents. Further studies are needed to assess the effect of POCT on the length of stay in ED.
Isaacs, SR, Kim, KW, Cheng, JX, Bull, RA, Stelzer-Braid, S, Luciani, F, Rawlinson, WD & Craig, ME 2018, 'Amplification and next generation sequencing of near full-length human enteroviruses for identification and characterisation from clinical samples.', Scientific reports, vol. 8, no. 1, pp. 11889-11889.View/Download from: UTS OPUS or Publisher's site
More than 100 different enterovirus (EV) genotypes infect humans and contribute to substantial morbidity. However, current methods for characterisation of full-length genomes are based on Sanger sequencing of short genomic regions, which are labour-intensive and do not enable comprehensive characterisation of viral populations. Here, we describe a simple and sensitive protocol for the amplification and sequencing of near full-length genomes of human EV species using next generation sequencing. EV genomes were amplified from 89% of samples tested, with Ct values ranging between 15.7 and 39.3. These samples included 7 EV-A genotypes (CVA2, 5-7, 10, 16 and EV71), 19 EV-B genotypes (CVA9, CVB1-6, ECHO3, 4, 6, 7, 9, 11, 16, 18, 25, 29, 30, and EV69), 3 EV-C genotypes (CVA19 and PV2, 3) and 1 EV-D genotype (EV70). We characterised 70 EVs from 58 clinical stool samples and eight reference strains, with a minimum of 100X depth. We found evidence of co-infection in four clinical specimens, each containing two distinct EV genotypes (CVB3/ECHO7, CVB3/ECHO18 and ECHO9/30). Characterisation of the complete genome provided conclusive genotyping of EVs, which can be applied to investigate the intra-host virus evolution of EVs, and allows further identification and investigation of EV outbreaks.
Stelzer-Braid, S, Liu, N, Doumit, M, D'Cunha, R, Belessis, Y, Jaffe, A & Rawlinson, WD 2017, 'Association of rhinovirus with exacerbations in young children affected by cystic fibrosis: Preliminary data.', Journal of Medical Virology, vol. 89, no. 8, pp. 1494-1497.View/Download from: UTS OPUS or Publisher's site
Rhinovirus (RV) is a common respiratory viral infection linked to worsening of chronic respiratory diseases including cystic fibrosis (CF) and asthma. RV was tested by RT-PCR in samples (n = 465) collected from the upper (nasal swab, oropharyngeal suction, and sputum) and lower (bronchoalveolar washings) respiratory tract of 110 children with CF. Air samples (n = 52) collected from the operating theatres and outpatient clinics were tested for RV. RV was found in 43% of children <5 years suffering an exacerbation, and 12% of older children (5-17 years). RV particles were detected in the air of clinic rooms. Detection of RV is important in better understanding viral infections in patients with CF.
Doumit, M, Belessis, Y, Stelzer-Braid, S, Mallitt, K-A, Rawlinson, W & Jaffe, A 2016, 'Diagnostic accuracy and distress associated with oropharyngeal suction in cystic fibrosis', JOURNAL OF CYSTIC FIBROSIS, vol. 15, no. 4, pp. 473-478.View/Download from: UTS OPUS or Publisher's site
Homaira, N, Sheils, J, Stelzer-Braid, S, Lui, K, Oie, J-L, Snelling, T, Jaffe, A & Rawlinson, W 2016, 'Respiratory syncytial virus is present in the neonatal intensive care unit', JOURNAL OF MEDICAL VIROLOGY, vol. 88, no. 2, pp. 196-201.View/Download from: UTS OPUS or Publisher's site
Jensen, TO, Stelzer-Braid, S, Willenborg, C, Cheung, C, Andresen, D, Rawlinson, W & Clezy, K 2016, 'Outbreak of Respiratory Syncytial Virus (RSV) Infection in Immunocompromised Adults on a Hematology Ward', JOURNAL OF MEDICAL VIROLOGY, vol. 88, no. 10, pp. 1827-1831.View/Download from: UTS OPUS or Publisher's site
Stelzer-Braid, S, Tovey, ER, Willenborg, CM, Toelle, BG, Ampon, R, Garden, FL, Oliver, BG, Strachan, R, Belessis, Y, Jaffe, A, Reddel, HK, Crisafulli, D, Marks, GB & Rawlinson, WD 2016, 'Absence of back to school peaks in human rhinovirus detections and respiratory symptoms in a cohort of children with asthma', JOURNAL OF MEDICAL VIROLOGY, vol. 88, no. 4, pp. 578-587.View/Download from: UTS OPUS or Publisher's site
Tovey, ER, Stelzer-Braid, S, Toelle, BG, Oliver, BG, Reddel, HK, Willenborg, CM, Belessis, Y, Garden, FL, Jaffe, A, Strachan, R, Eyles, D, Rawlinson, WD & Marks, GB 2015, 'Rhinoviruses significantly affect day-to-day respiratory symptoms of children with asthma', JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, vol. 135, no. 3, pp. 663-U124.View/Download from: UTS OPUS or Publisher's site
Wong, KKY, Rockman, S, Ong, C, Bull, R, Stelzer-Braid, S & Rawlinson, W 2013, 'Comparison of influenza virus replication fidelity in vitro using selection pressure with monoclonal antibodies', JOURNAL OF MEDICAL VIROLOGY, vol. 85, no. 6, pp. 1090-1094.View/Download from: Publisher's site
Stelzer-Braid, S, Johal, H, Skilbeck, K, Steller, A, Alsubie, H, Tovey, E, Van Asperen, P, McKay, K & Rawlinson, WD 2012, 'Detection of viral and bacterial respiratory pathogens in patients with cystic fibrosis', JOURNAL OF VIROLOGICAL METHODS, vol. 186, no. 1-2, pp. 109-112.View/Download from: UTS OPUS or Publisher's site
Baleriola, C, Rawlinson, WD, Dore, GJ, Chaverot, S, Stelzer-Braid, S, Yoshihara, M, Crawford, D, Sievert, W, McCaughan, G, Weltman, M, Cheng, W, Rizkalla, B, Dubois, D, Thommes, J & Roberts, S 2011, 'Effect of low-level HCV viraemia at week 24 on HCV treatment response in genotype 1 patients', ANTIVIRAL THERAPY, vol. 16, no. 2, pp. 173-180.View/Download from: Publisher's site
Deacon, RM, Wand, H, Stelzer-Braid, S, Treloar, C & Maher, L 2011, 'Improving surveillance for acute hepatitis C.', Communicable diseases intelligence, vol. 35, no. 1, pp. 16-20.
Understanding patterns of newly acquired hepatitis C virus (HCV) infection is fundamental to assessing the impact of prevention and treatment interventions. However, identifying newly acquired cases is difficult, usually requiring documented testing before and after exposure. As the proportion of cases identified as newly acquired by current New South Wales surveillance methodologies is significantly lower than that identified nationally, the impact on the identification of newly acquired cases of systematic reporting of past negative HCV test results from notifying laboratories was assessed. HCV notifications data for 2007 from two New South Wales laboratories were analysed. Cases with a negative HCV antibody test within the past 24 months were classified as newly acquired. These were linked to the NSW Department of Health (NSW Health)-identified cases to assess the effectiveness of accessing laboratory data. The laboratories accounted for approximately half of all new HCV notifications in 2007. Of the 2,206 newly diagnosed cases, 21 (1.0%) were newly acquired, 18 of which had not been identified under the current surveillance system, increasing the total number of newly acquired cases to 83 from 65. This increased the yield by 28% and increased the proportion of newly acquired cases from 65/4,192 (1.6%) to 83/4,196 (2.0%). Laboratory-identified cases were significantly more likely than NSW Health-identified cases to be aged 30 years or over. Combined with current reporting mechanisms, laboratory data on previous HCV test results have the potential to increase the number of newly acquired cases identified through the New South Wales surveillance system and to enhance the identification of cases among those aged 30 years or more.
Smedley, EJ, Stelzer-Braid, S, Ressler, K-A, Melling, P, Bowden, S, McCaw, R, White, PA, Vickers, CR, Rawlinson, WD & Ferson, MJ 2011, 'Transmission of hepatitis C virus to recipients of parenteral vitamin therapy in a primary care facility', JOURNAL OF CLINICAL VIROLOGY, vol. 51, no. 2, pp. 105-109.View/Download from: Publisher's site
Smith, KR, Suppiah, V, O'Connor, K, Berg, T, Weltman, M, Abate, ML, Spengler, U, Bassendine, M, Matthews, G, Irving, WL, Powell, E, Riordan, S, Ahlenstiel, G, Stewart, GJ, Bahlo, M, George, J & Booth, DR 2011, 'Identification of improved IL28B SNPs and haplotypes for prediction of drug response in treatment of hepatitis C using massively parallel sequencing in a cross-sectional European cohort', GENOME MEDICINE, vol. 3.View/Download from: Publisher's site
Tovey, ER, Ng, DSY, Stelzer-Braid, S, Rawlinson, WD & Oliver, BG 2011, 'Children with asthma and no URTI, more commonly have rhinovirus in their exhaled breath, than in mucous (Retraction of vol 123, pg S171, 2009)', JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, vol. 127, no. 2, pp. 551-551.View/Download from: Publisher's site
Wong, KKY, Bull, RA, Rockman, S, Scott, G, Stelzer-Braid, S & Rawlinson, W 2011, 'Correlation of Polymerase Replication Fidelity With Genetic Evolution of Influenza A/Fujian/411/02(H3N2) Viruses', JOURNAL OF MEDICAL VIROLOGY, vol. 83, no. 3, pp. 510-516.View/Download from: Publisher's site
Wong, KKY, Bull, RA, Stelzer-Braid, S, Fennell, M & Rawlinson, W 2011, 'Effect of reassortment on the nucleotide and amino acid changes of human A/H3N2 RNP subunits during 1998-2009', JOURNAL OF CLINICAL VIROLOGY, vol. 51, no. 4, pp. 266-271.View/Download from: Publisher's site
Stelzer-braid, S, Oliver, BG, Blazey, A, Argent, E, Newsome, T, Rawlinson, W & Tovey, E 2009, 'Exhalation of Respiratory Viruses by Breathing, Coughing, and Talking', Journal of Medical Virology, vol. 81, no. 9, pp. 1674-1679.View/Download from: UTS OPUS or Publisher's site
There is a lack of quantitative information about the generation of virus aerosols by infected subjects. The exhaled aerosols generated by coughing, talking, and breathing were sampled in 50 subjects using a novel mask, and analyzed using PCR for nine re
Stelzer-Braid, S, Escott, R, Baleriola, C, Kirkland, P, Robertson, P, Catton, M & Rawlinson, WD 2008, 'Proficiency of nucleic acid tests for avian influenza viruses, Australasia', EMERGING INFECTIOUS DISEASES, vol. 14, no. 7, pp. 1126-1131.View/Download from: Publisher's site
Stelzer-Braid, S, Wong, BB, Robertson, P, Lynch, GW, Laurie, K, Shaw, R, Barr, I, Selleck, PW, Baleriola, C, Escott, R, Katsoulotos, G & Rawlinson, WD 2008, 'A commercial ELISA detects high levels of human H5 antibody but cross-reacts with influenza A antibodies', Journal of Clinical Virology, vol. 43, no. 2, pp. 241-243.View/Download from: UTS OPUS or Publisher's site
Background and objectives: Commercial serological assays to determine influenza A H5N1 infection are available, although the accuracy and reproducibility of these are not reported in detail. This study aimed to assess the validity of a commercial ELISA H5 hemagglutinin (HA) antibody kit. Study design: A commercial ELISA for detection of antibodies towards influenza A H5 HA was evaluated using human sera from vaccinated individuals. The ELISA was used to screen 304 sera with elevated influenza A complement fixation titres collected between the period 1995-2007. Results and conclusions: The ELISA was found to be accurate for sera with high levels of anti-H5 antibodies, and would be useful in clinical settings where a rapid result is required. Thirteen of the stored sera were positive using the ELISA, but were confirmed as negative for H5N1 exposure using further serological tests. Absorption studies suggested that antibodies towards seasonal H3N2 and H1N1 influenza may cross-react with H5 antigen, giving false positive results with the ELISA. © 2008 Elsevier B.V. All rights reserved.
Thomas, T, Evans, FF, Schleheck, D, Mai-Prochnow, A, Burke, C, Penesyan, A, Dalisay, DS, Stelzer-Braid, S, Saunders, N, Johnson, J, Ferriera, S, Kjelleberg, S & Egan, S 2008, 'Analysis of the Pseudoalteromonas tunicata Genome Reveals Properties of a Surface-Associated Life Style in the Marine Environment', PLOS ONE, vol. 3, no. 9.View/Download from: UTS OPUS or Publisher's site
Huynh, K, Oliver, BG, Stelzer, S, Rawlinson, W & Tovey, E 2008, 'A new method for sampling and detection of exhaled respiratory virus aerosols', Clinical Infectious Diseases, vol. 46, no. 1, pp. 93-95.View/Download from: UTS OPUS or Publisher's site
We have developed a mask sampler for exhaled respiratory viruses. Among a group of 9 patients with cold symptoms who had virus-positive nasal mucus specimens, as analyzed by multiplexed polymerase chain reaction, virus-positive mask samples were obtained
Stelzer, S, Egan, S, Larsen, MR, Bartlett, DH & Kjelleberg, S 2006, 'Unravelling the role of the ToxR-like transcriptional regulator WmpR in the marine antifouling bacterium Pseudoalteromonas tunicata', MICROBIOLOGY-SGM, vol. 152, pp. 1385-1394.View/Download from: Publisher's site
Mai-Prochnow, A, Evans, F, Dalisay-Saludes, D, Stelzer, S, Egan, S, James, S, Webb, JS & Kjelleberg, S 2004, 'Biofilm development and cell death in the marine bacterium Pseudoalteromonas tunicata', APPLIED AND ENVIRONMENTAL MICROBIOLOGY, vol. 70, no. 6, pp. 3232-3238.View/Download from: Publisher's site