111. Ms Fraser asked Dr Gover a series of questions concerning a supplementary report of Professor Korman
dated 13 May 2022 – Exhibit 10. The following exchange occurred concerning a possible slow response to
Ross River Virus – Tr. 16.5.2022 pp. 32 – 33:
“Do you see that Professor Korman comments on that and concludes there was no evidence of a
slowed response to the Ross River virus? Just dealing with the comments that seroconversion was
demonstrated on 24 April 2020, what do you understand ‘seroconversion’ to be?---So, a
seroconversion in the sense of this test is, as Dr Korman pointed out, it’s where there becomes
(indistinct) of IgG antibodies, the longer term antibodies against the infection. Yes, so that’s what the
seroconversion actually means.
You understand, Doctor, that Ms Farrow-Smith’s blood was tested I think on the 6th or the 7th, or
certainly the result came back on 7 April, and then again on 24 April. So within that timeframe, what
is the earliest time that there could have been evidence of seroconversion, that is, IgG positivity?---It
follows that it was 10 days, which is the average. It wouldn’t be – it’d – within 10 days of the
inoculation. But there are circumstances where the seroconversion can take a lot longer than is
usual, and so I don’t think we can infer much about – there are a range of individuals who (indistinct)
within a short space of time, within 10 days/two weeks. Some will take a much longer amount of
time.
If I could just stop you there. What do you say is the evidence supporting your assertion of a slowed
response to the Ross River virus infection?---The fact that she had serology pictures as they were;
that Elloise developed symptoms within a couple of weeks of being bitten by mosquitoes in early
February in 2020, she developed, you know, quite consistent signs and symptoms of Ross River
virus infection, you know, after what would be a usual incubation period. The pattern of her
antibodies did change over time, and it was consistent with a Ross River virus infection, but if we
look at the way in which they occurred, it was slow compared to usual, and that’s what my assertion
is.
Do you agree with Professor Korman’s comment below where he said, ‘Timing of infection can’ –
and he’s underlined ‘can’ – ‘be estimated, based on the timing of detection of IgM and IgG?’---Well, I
mean it depends what you call estimates. Estimates are guesses really, and this is the case with a
lot of scientific guess is that they have error. If you look at standard deviations, there’s – a
percentage of that is which will exist out of those standard deviations. So, it’s an estimate; it’s a
guess. It can be used, but is it definitive? Is it forensic? The answer is, well, you know, I don’t think
one can conclude that, and that’s based upon what – you know, what we saw with Elloise’s pattern
of, you know, having symptoms after that flood event where she got bitten by mosquitoes, a couple
of weeks later became symptomatic, and then starts (indistinct) – you know, the pattern of her
antibodies changed appropriately over time, but it seemed to take longer than is usual.
In the next paragraph, Professor Korman said, ‘RRV IgM is able to be detected from day four, post
onset of symptoms.’ Is that invariably the case?---I’m sorry, could you just repeat that question?
Yes. It’s a little over halfway down that page: ‘RRV IgM is able to be detected from day four, post
onset of symptoms.’ We’ll have to ask Professor Korman what he means by that exactly, but to your
understanding, is it invariably the case that - - -? ---No, it’s not. It’s not invariably the case, and it’s
really difficult to tie that down and what I would say.
And - - -?---And, yes, I guess the other thing that I’d say is that with these serological tests, if you
have a patient in front of you and you’ve got the ability to take their blood sequentially over time on
day one, day two, you know when they’ve been inoculated, you can study these things, but we’re
talking about a person who presents a couple of times over the course of months and we don’t have
the opportunity to accurately assess their antibodies as they stay, and these antibodies can appear
on one day and not be there the day prior. It’s based on the nature of these tests, which are
basically (indistinct) cooking tests: they either work or they don’t.
Further down that paragraph, the last sentence, Professor Korman says, ‘RIV IgG nearly always
appears within 10 days of illness onset.’ Do you see that?---Yes.
And I think you started saying something about this earlier, that it wasn’t always the case?---That’s
true. I mean, there’s been case reports which have shown that IgG seroconversion might not
happen for some months after an inoculation in some cases, and you know, I think there is a case
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