Member Spotlight: Rangaraj Selvarangan

Rangaraj Selvarangan, PhD, is Director of Medical Microbiology Laboratory at Children’s Mercy Hospital in Kansas City, Missouri where he holds the William R. Brown Missouri Endowed Chair in Medical Genetics and Molecular Medicine and directs the Emerging Infections, Area of Emphasis Research program at Children’s Mercy Research Institute. Dr. Selvarangan earned his doctoral degree in Medical Microbiology at the University of Texas Medical Branch in Galveston, Texas. He completed a postdoctoral fellowship in medical and public health laboratory microbiology at the University of Washington, Seattle.

Dr. Selvarangan is the current Professional Member Liaison to the PIDS Board of Directors. He also serves as an Associate Editor for the Journal of the Pediatric Infectious Diseases Society.

Why pediatric ID? My interest in infectious diseases began when I was doing my graduate studies in Veterinary Medicine. I wanted to pursue a doctoral degree in infectious diseases research, which led me to obtain my graduate degree in medical microbiology and immunology. I wanted to combine both my clinical knowledge from veterinary medicine and the research expertise I gained through my PhD program and went on to do a two-year  fellowship in medical and public health microbiology offered by the American Society of Microbiology. It prepares individuals to be directors of clinical microbiology labs, public health labs, and labs that are specializing in testing human samples for clinical care.

I had the opportunity to work with public health in Jackson, Mississippi, my first year out of fellowship as deputy director of the state laboratory. After two years, I was looking to come back to clinical setting. When I started clinical microbiology, my interests were in finding better ways to do lab testing, looking for the next best test that we could offer for better diagnosis of infectious diseases in children. Since then, I’ve started a program for translational research in pediatric infectious diseases. Initially my research program  was funded by clinical trials and collaborative studies with invitro diagnostic industry partners and later as a principal investigator I established a prospective viral surveillance program at Children’s Mercy in 2009  through a CDC funding mechanism called the New Vaccine Surveillance Network (NVSN),  which is a seven-pediatric institution network. We conduct prospective surveillance for acute gastroenteritis and acute respiratory illness in children to evaluate the effectiveness of rotavirus, influenza, SARS-CoV2 vaccines and RSV prevention products.

Where have you taken your ID focus? I have taken on a role here at Children’s Mercy Research Institute as Director of Emerging Infections. It has multiple areas of emphasis. One is in outbreak investigations, the surveillance and epidemiology of infectious diseases. We had some interesting and major outbreaks we’ve characterized in Kansas City, including one of the largest outbreaks of enterovirus D68 that was later associated with causing acute flaccid myelitis in children. Our hospital was one of the two that recognized this infection in children and reported it to CDC. It would turn out there was a much larger national outbreak and since then there’s been a lot of interest in this virus. Parechovirus is another that I’ve worked on for the last 15 years. We have many translational science projects looking at the epidemiology of the virus: who is at risk, if there are any complications, how do we best diagnose and understand more of the pathogenesis of this viral infection and study organoid model systems.

Through NVSN and the prospective surveillance, we have addressed many of the vaccine preventable diseases such as rotavirus, influenza, RSV. NVSN is one of the flagship programs funded by CDC for the last 25 years. Kansas City joined this network in 2009 and continues to be funded for the past 15 years. My research team also participates in other NIH funded studies to enroll children for enterovirus and parechovirus sepsis and post-acute sequela of COVID-19 in children. In addition to federal funding from NIH and, CDC, my collaboration with industry partners is key. This is where my role as a diagnostician becomes crucial. I identify the latest tests and assist with clinical trials and post-implementation studies to ensure diagnostic stewardship. My goal is to provide the right test for the right patient at the right time.

All of this is possible because of the collaborative work with our colleagues in pediatric ID and fellow laboratorians across the country. The teamwork is really what keeps me going. I enjoy working in networks and working with colleagues to learn how to solve problems. In the event of an outbreak, we are among the first to identify and characterize it, searching for novel viruses or mutations. We see ourselves as disease detectives, working to understand what is happening, how children are being affected, and the causes of severe infections. It’s essential for us to be resourceful and knowledgeable about testing to effectively manage patient care.

What is a recent development in pediatric ID that you are working on? Surveillance efforts from Kansas City and the other NVSN sites have focused our efforts in understanding the RSV burden and effectiveness of RSV prevention products on medically attended RSV in children. The CDC team- NVSN collaborators have published on nirsevimab effectiveness against RSV-associated hospitalization among infants in their first RSV season and documented Nirsevimab effectiveness was 90% (95% CI = 75%-96%) against RSV-associated hospitalization with a median time from receipt to symptom onset of 45 days (IQR = 19-76 days). In a more recent study, the high burden of medically attended RSV-associated acute respiratory illness in children in the US was documented and Nirsevimab effectiveness was documented at 89% (95% CI, 79%-94%) for RSV-associated ARI medical visits and 93% (95% CI, 82%-97%) for RSV-associated hospitalization.

What do you enjoy most about being a PIDS member? What keeps you renewing your membership? I really enjoy working with pediatric infectious diseases physicians. They are among the most collaborative and friendly bunch. They are easy to approach and discuss projects with. One unique aspect of this discipline is the constant evolution of microbes, presenting us with many unknowns. Unlike other specialties, we must continuously adapt our techniques and tools to protect patients in pediatric infectious diseases. Our goal is to manage and safeguard the health of children effectively. As laboratorians, we are dedicated to supporting and collaborating with our infectious disease physician colleagues, making their job easier and more efficient. PIDS has been very welcoming to me and our discipline. For example, I was selected as the Professional Liaison to the Board of Directors. That shows the Society is open to bring in other disciplines who work closely with them. Together, ID physicians and the laboratorians aim to identify infections swiftly and accurately, ensuring the best care for children. By working unitedly, we can achieve these goals. I am committed to developing programs that facilitate and support this vital collaboration.