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Communicable Diseases Intelligence (CDI) is a peer-reviewed scientific journal published by the Office of Health Protection, Department of Health. The journal aims to disseminate information on the epidemiology, surveillance, prevention and control of communicable diseases of relevance to Australia.
Probable epidemic Mycoplasma pneumoniae disease activity in metropolitan Sydney, 2015: combining surveillance data to cross-validate signal detection
Mycoplasma pneumoniae is a leading cause of encephalitis and pneumonia in children. Active surveillance identified a cluster of children with suspected encephalitis associated with M.pneumoniae in NSW during July, 2015. An investigation that cross validated encephalitis surveillance with ED pneumonia surveillance and senitenal reference laboratory data revealed probable epidemic M.pneumoniae disease activity in Sydney during 2015.
Children with melioidosis in Far North Queensland are commonly bacteraemic and have a high case fatality rate
Paediatric melioidosis is uncommon in Northern Australia and localised skin and soft tissue infections predominate. This study presents data from Far North Queensland and shows that, in this population, children with melioidosis are commonly bacteraemia and have a high case fatality rate.
Diagnostic testing in influenza and pertussis-related paediatric intensive care unit admissions, Queensland, Australia, 1997-2013
Severe respiratory infections make up a large proportion of Australian paediatric intensive care unit (ICU) admissions each year. Identification of the causative pathogen is important and informs clinical management. We investigated the use of polymerase chain reaction (PCR) in the ICU-setting using data collated by the Australian and New Zealand Paediatric Intensive Care (ANZPIC) Registry from five ICUs in Queensland, Australia. We describe diagnostic testing use among pertussis and influenza-related paediatric ICU admissions between 01 January 1997 and 31 December 2013.
Position statement on interferon-γ release assays for the detection of latent tuberculosis infection
Interferon-y release assays (IGRAs), such as the Quantiferon (QIFN) TB-Gold Plus assay (Qiagen, Hilden, Germany) and the T-SPOT.TB test (Oxford Immunotec Limited, Abingdon, United Kingdom), are marketed as a substitute for the tuberculin skin test (TST) for the detection of latent tuberculosis infection (LTBI). The relative merits of IGRAs and TST have been hotly debated over the last decade. The specificity of IGRAs has been optimised by using Mycobacterium tuberculosis-specific antigens. However, IGRAs are functional in vitro T-cell-based assays that may lack reproducibility due to specimen collection, transport, processing and kit manufacturing issues.
Longitudinal studies comparing the ability of IGRAs and TST to predict the future development of active tuberculosis disease (TB) are the ultimate arbiters on the respective utility of these assays. Three meta-analyses addressing this comparison have now been published and clinical experience with IGRAs is accumulating. The systematic reviews show that IGRAs and TST have similar (but poor) ability to identify patients with LTBI at risk of developing active TB disease. The improved specificity of IGRAs however may reduce the number of patients requiring preventative therapy.
Based on these meta-analyses, The National Tuberculosis Advisory Committee (NTAC) now recommends either TST or an IGRA for the investigation of LTBI in most circumstances. Both tests may be used in patients where the risk of progression to active TB disease is high and the disease sequelae potentially severe (eg. LTBI testing in immunocompromised patients or those commencing anti-tumour necrosis factor-α (TNF) therapy). Neither test should be used in the investigation of active TB disease (though TST and/or IGRA may be used as supplementary tests in paediatric cases). The choice of test for serial testing in healthcare workers (HCWs) remains controversial. A preference remains for TST in this circumstance because IGRAs have been bedevilled by higher rates of reversions and conversions when used for serial testing. These recommendations supersede all previous NTAC IGRA statements.
The Australian Sentinel Practices Research Network was established in 1991 to provide a rapid, national, monitoring scheme for infectious diseases that can alert public health officials of epidemics before they arise. The network consists of general practitioners, throughout all 8 states and territories in Australia, who report presentations on a number of defined medical conditions each week. This report presents data from the 1st quarter of 2017 (1 January to 31 March) and includes the syndromic surveillance of influenza-like-illness, gastroenteritis, chicken pox, and shingles, and the virological surveillance of respiratory viruses including influenza A, influenza B, RSV and rhinovirus.
The 2010 influenza season was moderate overall, with more laboratory-confirmed cases than in earlier years, with the exception of 2009. This report brings together a range of data sources under the National Influenza Surveillance Scheme to describe influenza during 2010.
The Australian Government Department of Health established the OzFoodNet network in 2000 to collaborate nationally to investigate foodborne disease. In each Australian state and territory, OzFoodNet epidemiologists investigate outbreaks of enteric infection. In addition, OzFoodNet conducts studies on the burden of illness and coordinates national investigations into outbreaks of foodborne disease. This quarterly report documents investigations of outbreaks of gastrointestinal illness and clusters of disease potentially related to food, which commenced in Australia between 1 July and 30 September 2015.
The Australian Government Department of Health established the OzFoodNet network in 2000 to collaborate nationally to investigate foodborne disease. In each Australian state and territory, OzFoodNet epidemiologists investigate outbreaks of enteric infection. In addition, OzFoodNet conducts studies on the burden of illness and coordinates national investigations into outbreaks of foodborne disease. This quarterly report documents investigations of outbreaks of gastrointestinal illness and clusters of disease potentially related to food, which commenced in Australia between 1 April and 30 June 2015.
The Australian Rotavirus Surveillance Program has characterised the G- and P- genotypes of rotavirus strains causing severe disease in Australian children since 1997. This report describes the genotype distribution of rotavirus strains causing severe gastroenteritis in Australia for the period 1 January to 31 December 2016.
The reference laboratories of the Australian National Neisseria Network (NNN) report data on the number of laboratory confirmed cases of invasive meningococcal disease (IMD) using culture and by non-culture based techniques for the Australian Meningococcal Surveillance Programme (AMSP). In 2016, there were 243 laboratory-confirmed cases of invasive meningococcal disease (IMD) analysed by the (NNN).
This quarterly report provides a summary of invasive pneumococcal disease notifications in Australia during the first quarter of 2017.
This quarterly report provides a summary of invasive pneumococcal disease notifications in Australia during the second quarter of 2017.
An outbreak of Salmonella Muenchen gastroenteritis occurred in a remote coastal Aboriginal community in the Northern Territory (NT) of Australia. There were 22 people sick (attack rate 55%); 7 had laboratory confirmed S. Muenchen infection; 2 required medical evacuation and admission to the intensive care unit (ICU). We conducted a descriptive case series to investigate the outbreak. All cases ate meat from a single green turtle (Chelonia mydas). The animal’s pre-death stress, improper butchering, insufficient cooking and the unsatisfactory storage of meat all likely contributed to the outbreak. Turtle meat should be prepared safely, cooked thoroughly and stored appropriately to avoid Salmonella infection.
Influenza epidemiology in patients admitted to sentinel Australian hospitals in 2016: the Influenza Complications Alert Network (FluCAN)
During the period 1 April to 30 October 2016 (the 2016 influenza season), 1,952 patients were admitted with confirmed influenza to one of 17 FluCAN sentinel hospitals. Of these, 46% were elderly (≥65 years), 18% were children (<16 years), 5% were Aboriginal and Torres Strait Islander peoples, 3% were pregnant and 76% had chronic co-morbidities.
A summary of diseases currently being reported by each jurisdiction is provided in Table 1. There were 75,935 notifications to the National Notifiable Diseases Surveillance System (NNDSS) between 1 April to 30 June 2017 (Table 2). The notification rate of diseases per 100,000 population for each state or territory is presented in Table 3.
A summary of diseases currently being reported by each jurisdiction is provided in Table 1. There were 267,220 notifications to the National Notifiable Diseases Surveillance System (NNDSS) between 1 July to 30 September 2017 (Table 2). The notification rate of diseases per 100,000 population for each state or territory is presented in Table 3.
A summary of diseases currently being reported by each jurisdiction is provided in Table 1. There were 80,388 notifications to the National Notifiable Diseases Surveillance System (NNDSS) between 1 October to 31 December 2017 (Table 2). The notification rate of diseases per 100,000 population for each state or territory is presented in Table 3.
The primary role of any tuberculosis (TB) control program is to ensure the prompt identification and effective treatment of active disease. The host immune system often succeeds in containing the initial (or primary) infection with Mycobacterium tuberculosis (Mtb), but may fail to eliminate the pathogen. The persistence of viable organisms explains the potential for the development of active disease years or even decades after infection. This is known as latent tuberculosis infection (LTBI) although, rather than a distinct entity, this probably represents part of a dynamic spectrum. Individuals with LTBI are asymptomatic and it is therefore clinically undetectable. The World Health Organization (WHO) estimates that one-third of the global population has been infected with Mtb, with highest prevalence of LTBI in countries/regions with the highest prevalence of active disease. In 2013, 88% of 1322 notifications in Australia were in the overseas-born population (incidence 19.5 per 100,000 v. 1.0 per 100,000), with this proportion rising over the course of the last decade. Combined with epidemiological evidence of low local transmission, this strongly implies that the vast majority resulted from reactivation of latent infection acquired prior to immigration. Contrasting trends in TB incidence in other developed countries probably reflect differences in policy regarding LTBI. Conclusion: The diagnosis and treatment of LTBI represents an important opportunity for intervention by jurisdictional TB control programs.
This paper reviews surveillance data to describe the epidemiology of tuberculosis in the Australian Capital Territory over a 10 year period between 2006 and 2015.
The reference laboratories of the Australian Meningococcal Surveillance Programme (AMSP) report data on the number of cases of invasive meningococcal disease (IMD) confirmed by laboratory testing using culture and by non-culture based techniques. Data contained in quarterly reports are restricted to a description of the number of cases of IMD by jurisdiction and serogroup, where known. A full analysis of laboratory confirmed cases of IMD in each calendar year is contained in the AMSP annual reports.
This report summarises Australian passive surveillance data for adverse events following immunisation (AEFI) reported to the Therapeutic Goods Administration (TGA) for 2015. It also describes reporting trends over the 16-year period 1 January 2000 to 31 December 2015.
This is a retrospective cohort study of tuberculosis contact tracing and screening in an elderly residential facility in Victoria. In the absence of specific guidelines regarding an optimal test for this population, 18 residents were tested with both tuberculin skin test (TST) and interferon-gamma release assay (IGRA), and all underwent symptom assessment and chest x-ray (CXR).
Paediatric Active Enhanced Disease Surveillance (PAEDS) annual report 2015: Prospective hospital-based surveillance for serious paediatric conditions
This is the second of planned annual reports to Communicable Diseases Intelligence for Paediatric Active Enhanced Disease Surveillance (PAEDS), a hospital-based active surveillance system for select serious paediatric conditions of public health importance. PAEDS has a focus on monitoring vaccine preventable diseases and adverse events following immunisation and in 2015 included surveillance for: acute flaccid paralysis; encephalitis; influenza; intussusception; pertussis; and varicella and zoster.
The Australian Paediatric Surveillance Unit (APSU) was established in to facilitate national active surveillance of uncommon rare childhood diseases, complications of common diseases or adverse effects of treatment. Currently APSU undertakes surveillance for rare infectious diseases or rare complications of more common infectious diseases including: acute flaccid paralysis (AFP, a surrogate condition for polio virus infection), congenital rubella, congenital cytomegalovirus, congenital or neonatal varicella, neonatal and infant herpes simplex virus, perinatal exposure to HIV and paediatric HIV infection, and juvenile onset recurrent respiratory papillomatosis which is due to the human papilloma virus infection. Surveillance for severe complications of influenza began in 2008. Surveillance for microcephaly began in 2016 to identify potential case of congenital Zika virus infection. APSU data supports clinical and public health policy and surveillance for AFP contributes to Polio-Free certification by the WHO.
National Tuberculosis Advisory Committee Guideline: Management of Tuberculosis Risk in Healthcare Workers in Australia
Tuberculosis (TB) is uncommon in Australia and not commonly managed by most healthcare workers (HCWs). However, even in a low incidence setting, occasional exposure of HCWs is inevitable and transmission of TB to HCWs leading to disease does occur. In addition, HCWs may have been recruited to Australia from countries with high TB incidence. These HCWs are more likely to be infected with TB before arrival and subsequently develop active disease while working in health settings in Australia. In 2001, there were 20 TB notifications in HCWs in Australia, of which 10 were born overseas, whereas in 2013, 70 of 77 notified cases (91%) were people born overseas.1, 2 Managing the risk of TB in HCWs is multifaceted. A combination of staff education, awareness, early diagnosis, appropriate use of personal protective equipment (PPE), environmental controls and screening procedures is required to minimise the risk of transmission to HCWs and from HCWs to patients. Prevention of nosocomial transmission from HCWs is particularly important in patients that are more vulnerable, for example children and the immunocompromised. This document aims to describe the components that are considered essential for all healthcare facilities in Australia to minimise this risk. It is not intended to be operational, and reference should be made to specific state and territory TB Control Program policies for this detail. Each facility should develop its own policy for the management of TB risk in HCWs according to this jurisdictional policy and the facility specific factors that determine risk, but it should include at least the following components.
This paper describes the diagnoses of gonorrhoea, syphilis and chancroid attending a single sexual health service in Melbourne and fills a 40-year gap (1929-1969) in STI notifications for Australia.
In 2014, the National Notifiable Diseases Surveillance System received 1,339 tuberculosis (TB) notifications, representing a rate of 5.7 per 100,000 population. Australia has achieved and maintained good tuber¬culosis (TB) control since the mid-1980s, sustaining a low annual TB incidence rate of approximately 5 to 6 cases per 100,000 population. The number of multi-drug resistant TB (MDR-TB) cases diagnosed in Australia is low by international standards, with approximately 1-2% of notifications per year being classified as MDR-TB. Australia’s overseas-born pop¬ulation continued to represent the majority (86%) of TB notifications and Australia’s Aboriginal and Torres Strait Islander population continue to record TB rates around 6 times higher than the Australian born non Indigenous population. Whilst Australia has achieved excellent and sustained control of TB in Australia, sustained effort is still required to reduce rates further and contribute to the achievement of the World Health Organization’s goal to end the global TB epidemic by 2035.
The effects of culture independent diagnostic testing on the diagnosis and reporting of enteric bacterial pathogens in Queensland, 2010 to 2014
This article discusses how the introduction of culture independent diagnostic testing into pathology laboratories in Queensland has impacted diagnosis and reporting of gastrointestinal illness. The article focuses on Salmonella, Campylobacter, Shigella and Yersinia, and shows that the incidence of all four pathogens increased after the introduction of culture independent diagnostic testing. While this change in testing improves detection of pathogens, it doesn’t provide a bacterial culture for further characterisation or antimicrobial susceptibility testing. It is recommended that laboratories continue to perform culture of specimens in addition to culture independent diagnostic testing.
Tuberculosis (TB) remains a disease of high morbidity in Australia, with implications for both public health and the individual. There is minimal published TB cost data in the Australian setting. We found the costs of managing latent TB to be far lower than in cases of active TB. A program designed to detect and treat latent TB (LTBI) to prevent subsequent disease may be cost effective in appropriately selected patients.
This article describes the results of an audit investigating the hepatitis B vaccination completion outcomes and serological testing of infants in the Northern Territory who were born to mothers with hepatitis B infection. The results demonstrate that although adherence to the vaccination schedule in this group of infants was good, mechanisms for ensuring that infants receive serology testing need to be strengthened.
This page contains a report of the Public Health Laboratory Network (PHLN) expert advisory group on whole genome sequencing.
This page contains information on foodborne illness in Australia.
This document provides recommendations for infection prevention and control procedures to minimise the risk of transmission of Creutzfeldt - Jakob disease (CJD) in health care settings.
Guidelines for the public health management of gastroenteritis outbreaks due to norovirus or suspected viral agents in Australia
The Communicable Disease Network Australia (CDNA) formed a working group in 2005 in order to develop national guidance regarding outbreaks of norovirus and suspected viral gastroenteritis, in response to increasing reports of outbreaks. These Guidelines are designed to complement existing state and territory guidelines.
This document was compiled by the Office of Health Protection in the Department of Health.
A supplementary document to these Guidelines which provides further background to hepatitis C in custodial settings and expands on the evidence base for the Guidelines is available from the Department of Health. The supplementary document also includes appendices, additional reading and references.
These Guidelines have been developed, primarily for Chief Health Officers (CHOs), to ensure consistency in the way all Australian states and territories manage HIV transmission risk behaviours.
The Australian Government Department of Health and Ageing (DoHA or the “Department”) engaged Health Outcomes International (HOI) in February 2007 to undertake a review of the Innovative Health Services for Homeless Youth (IHSHY) program and to recommend future policy directions for the program.
This position statement arises from a discussion session on antiviral use for laboratory staff working with H5/Pandemic Influenza A virus at the October 2006 face-to-face meeting of the Public Health Laboratory Network (PHLN).
Communicable Diseases Intelligence (CDI) is a peer-reviewed scientific journal published by the Office of Health Protection, Department of Health and Aged Care. The journal aims to disseminate information on the epidemiology, surveillance, prevention and control of communicable diseases of relevance to Australia.
The National Hepatitis C Strategy provides a foundation for national action that will guide Australia’s response to hepatitis C over the next three years.
The National STIs Strategy provides a foundation for national action in the prevention and treatment of STIs in Australia.
The National HIV/AIDS Strategy 2005-2008 has identified five priority areas for action to be addressed over the life of the Strategy: development of a targeted prevention education and health promotion program for HIV; improving the health of people living with HIV/AIDS; developing an effective response to the changing care and support needs of people living with HIV/AIDS; a review of the National HIV Testing Policy; and the provision of a clearer direction for HIV/AIDS research.
Guidelines for the control of pertussis in Australia - Communicable Diseases Intelligence Technical Report No. 1
The Communicable Diseases Network Australia advises that this first report in the Communicable Diseases Intelligence Technical Report series is no longer current.
This page has a PDF document and contact details in relation to the Tri-state HIV/STI project (TSP).
This page provides domestic health emergency response plan for a deliberate release of smallpox.
Infection control guidelines for the prevention of transmission of infectious diseases in the health care setting, 2004 edition
THIS DOCUMENT HAS BEEN RESCINDED.
The Australian Government Response to the 2002 Reviews of the National HIV/AIDS and Hepatitis C Strategies
The 2002 Reviews of the National HIV/AIDS and Hepatitis C Strategies evaluated two of the key public health strategies in Australia. The Australian Government Response to the 2002 Reviews of the National HIV/AIDS and Hepatitis C Strategies addresses the recommendations of the Reviews and outlines Government policy in relation to HIV/AIDS, hepatitis C and related issues.
In February 2002, Senator the Hon Kay Patterson, the Commonwealth Minister for Health and Ageing, requested independent reviews of the National HIV/AIDS and Hepatitis C Strategies to be undertaken concurrently with the quinquennial reviews of the NationalCentres in HIV Research.
Laboratory procedures and precautions for samples collected from patients with suspected viral haemorrhagic fevers
The purpose of these guidelines is to allow the necessary on-site testing for other possible causes of the illness, and other testing required for the immediate and ongoing management of the patient.
THIS DOCUMENT HAS BEEN RESCINDED: Eight papers were commissioned to inform of the development of the National Hepatitis C Strategy 1999-2000 to 2003-2004. The papers span the areas of: clinical research, epidemiology, social and behavioural research, and virology and basic scientific research. This publication represents the technical core of the policy development process.
THIS DOCUMENT HAS BEEN RESCINDED: The National Hepatitis C Strategy 1999-2000 to 2003-2004 was launched in June 2000 by the Federal Minister for Health and Aged Care. The Strategy has two primary aims to reduce the transmission of hepatitis C in Australia, and to minimise the personal and social impacts of hepatitis C infection.
THIS DOCUMENT HAS BEEN RESCINDED: The National HIV/AIDS Strategy 1999-2000 to 2003-2004 builds on an important foundation established under previous HIV/AIDS Strategies - the partnership between and with affected communities, governments at all levels, and medical, scientific and healthcare professionals.
This manual aims to increase awareness amongst health workers in Indigenous primary health care organisations of the needs of Indigenous people infected and affected by HIV/AIDS.
In its concern with preventing the transmission of the hepatitis C virus (HCV), this research report examines Australia’s efforts to date in prevention education particularly among people who inject drugs.
Framework for an Australian Influenza Pandemic Plan - Communicable Diseases Intelligence Technical Report No. 4
The Plan provides a strategic framework for the detection and management of an influenza pandemic in Australia. It provides a national framework and direction for the development of plans at the State/Territory and local level. This is the fourth report in the Communicable Diseases Intelligence Technical Report series.
THIS DOCUMENT HAS BEEN RESCINDED: The review documents the extent of the problem posed by Hepatitis C - in terms of the prevalence and incidence of infection, the economic costs to Australia, and the social impact of the disease; assesses the performance of the National Hepatitis C Action Plan and the Nationally Coordinated Hepatitis C Education and Prevention Approach; provides a broad analysis of the current national and State- and Territory-level responses to the epidemic; and recommendations on directions and priorities for national action.
This report of the epidemiology of Hepatitis C Virus summarises the state of knowledge to the end of 1998. The report is based upon extensive literature reviews and the compilation of a research register that identifies Australian studies. This is the third report in the Communicable Diseases Intelligence Technical Report series.
This paper is a discussion document provided for comment and consultation. The development of a fourth National HIV/AIDS Strategy will involve extensive consultation, which will take place around Australia during the second quarter of 1999.
Building on success 1: a review of gay and other homosexually active men's HIV/AIDS education in Australia
A national review of HIV/AIDS education for gay and other homosexually active men was conducted by the National Centre for Health Promotion. This document reports the findings of the review and was completed in August 1998
Building on success 2: towards a national strategy for HIV/AIDS health promotion for gay and other homosexually active men
This document outlines priorities for maintaining leadership and partnerships in the continued promotion of HIV/AIDS health initiatives for gay and other homosexually active men. It proposes a change from health education to health promotion and provides strategic direction for future developments. It contains 23 recommendations.
Building on success 3: the Commonwealth Government response to towards national strategy for HIV/AIDS health promotion for gay and other homosexually active men
This document outlines the Government's commitment to maintaining the success of HIV/AIDS health promotion for gay and other homosexually active men. It provides a response to each of the recommendations in Building on Success 2 and gives details of specific commitments to new projects and initiatives
Foodborne Disease: Towards reducing foodborne illness in Australia - Communicable Diseases Intelligence Technical Report Series No. 2
The report identifies gaps in knowledge of foodborne disease and assesses the current trends in epidemiology, leading to recommendations to reduce foodborne disease on a national basis. The report encourages a multi-sector approach to the prevention, surveillance and control of foodborne diseases. This is the second report in the Communicable Diseases Intelligence Technical Report series.
The strategy provides a comprehensive approach to preventing the spread of HIV and other sexually transmissible infections in Aboriginal and Torres Strait Islander communities. It recommends action in four priority areas: prevention; treatment, care and support; workforce issues; and research and data collection.
Valuing the past ... investing in the future- Evaluation of the National HIV /AIDS Strategy 1993-94 to 1995-96
The National HIV/AIDS Strategy 1993–94 to 1995–96 is Australia’s second National HIV/AIDS Strategy. The first Strategy operated from 1989 to 1993 and was evaluated in 1992. This evaluation report was requested by Federal Cabinet when it agreed to the National HIV/AIDS Strategy 1993–94 to 1995–96.