PHO In Action: Dr. Jonathan Gubbay
Studying and battling the complexities of respiratory viruses
Watch Dr. Jonathan Gubbay talk about his work.
As a medical microbiologist at Public Health Ontario, Dr. Jonathan Gubbay wears many hats. From leading research projects, to providing advice and guidance on test results, and working with other laboratories and organizations on approaches to emerging viruses like Ebola and MERS-CoV, he’s an expert in the study of respiratory viruses.
Originally from Australia, Gubbay came to Canada to do advanced training in medical microbiology, and found a fit with respiratory viruses. “By training, I’m a pediatric infectious diseases doctor, so I thought it would make sense to develop some expertise in virology, as kids tend to be more affected by viral infections.” He remains connected to clinical work as a pediatric infectious diseases specialist at Sick Kids Hospital, and says that role helps him do his job at the PHO laboratory. “Based on my clinical work, I can see where we might improve on testing procedures at the lab. When I’m faced with a problem with a patient, I can better understand and consider what kinds of research questions I’d like to answer in the laboratory.”
At PHO’s laboratory, a centre of expertise for the detection and identification of infectious diseases, Gubbay studies the complexities of respiratory viruses, like influenza, respiratory syncytial virus and rhinovirus, to name but a few. The author of over 70 publications, he’s currently looking at whether the quantity of virus present in a respiratory infection is clinically important and can be used to predict health outcomes. “In current clinical testing, we only look to see whether a respiratory virus is present or absent, but no one really knows to what degree it’s important to know the quantity of virus that’s there.” This research could also impact recommendations for patient isolation, for example, highlighting whether a certain amount of virus will mean that a patient is more infectious and will require isolation.
Gubbay also applies his unique set of skills to the study of emerging pathogens like MERS-CoV and the recent outbreak of Ebola in West Africa. “With Ebola, we had historical information about how Ebola behaved, but this was a different type of outbreak; we had to balance new information about the virus with what was historically known about it in terms of infection control and how we could handle the virus safely, especially if it came to Canada,” says Gubbay. “With emerging pathogens, our main role at the laboratory is setting up new laboratory tests, either by designing our own protocols or rapidly implementing test protocols from the World Health Organization.” Gubbay was a key member of the laboratory working group that developed Ebola protocols for laboratories across the province.
Technology, he notes, has greatly influenced his work. Leaps in the last decade to molecular technologies and next generation sequencing have helped him do his work more efficiently. PHO’s state-of-the-art laboratory employs both molecular testing and viral culture to test for respiratory viruses, with molecular testing a much more sensitive way of understanding viruses. The lab is starting to deploy next generation sequencing in addition to traditional sequencing methods for influenza surveillance. Further, the laboratory is looking to implement new tests that can pick up 14 different viruses with one sample. Putting his clinician hat back on, Gubbay says having access to tests that will detect multiple pathogens at the same time will streamline diagnosis, as clinicians won’t have to order unique tests for every potential pathogen, as many respiratory viruses have similar clinical symptoms.
Gubbay credits his colleagues for their support. “My team helps me do what I need to do—we are deeply committed to improving the lives of Ontarians,” says Gubbay. “The lab is a very busy place, conducting several million tests per year. We manage to do clinical testing, conduct research and build capacity to respond to emerging threats, all at the same time, and that’s very satisfying.”