1.Surveillance of hospitalizations with pandemic A(H1N1) 2009 influenza infection in Queensland, Australia
Hai Phung ; Frank Beard ; Christine Selvey ; Ranil Appuhamy ; Frances Birella
Western Pacific Surveillance and Response 2011;2(2):30-35
OBJECTIVE: To describe the demographic and clinical characteristics of patients hospitalized with pandemic A(H1N1) 2009 infection in Queensland, Australia between 25 May and 3 October 2009 and to examine the relationship between timing of antiviral treatment and severity of illness.
METHOD: Using data from the Queensland Health EpiLog information system, descriptive analysis and logistic regression modelling were used to describe and model factors which influence patient outcomes (death, admission to intensive care unit and/or special care unit). Data on patients admitted to hospital in Queensland with confirmed pandemic A(H1N1) 2009 infection were included in this analysis.
RESULTS: 1236 patients with pandemic A(H1N1) 2009 infection were admitted to hospitals in Queensland during the study period. Of the total group: 15% were admitted to an intensive care unit or special care unit; 3% died; 34% were under the age of 18 years and 8% were 65 years of age or older; and 55% had at least one underlying medical condition. Among the 842 patients for whom data were available regarding the use of antiviral drugs, antiviral treatment was initiated in 737 (87.5%) patients, treatment commenced at a median of one day (range 1–33 days) after onset of illness. Admission to an intensive care unit or special care unit (ICU/SCU) or death was significantly associated with increased age, lack of timeliness of antiviral treatment, chronic renal disease and morbid obesity.
DISCUSSON: Early antiviral treatment was significantly associated with lower likelihood of ICU/SCU admission or death. Early antiviral treatment for influenza cases may therefore have important public health implications.
2.Hepatitis E in a food handler – a rapid risk assessment to guide the public health response
Appuhamy Ranil ; Moffatt Cameron ; Davis Stephanie ; Kelly Paul ; Kennedy Karina
Western Pacific Surveillance and Response 2014;5(4):1-4
Objective:The Australian Capital Territory Health Directorate was notified of a food handler with hepatitis E virus (HEV) infection. To guide the public health response, a rapid risk assessment was undertaken to determine the risk of transmission of HEV from the infected food handler to restaurant patrons.Method:The literature on HEV was reviewed and expert advice sought from clinical and public health specialists. This was supplemented by results of a site investigation and a case interview. The risk rating was determined to be the product of the likelihood of transmission and the consequence of the infection.Results:The food handler was likely to have been infectious at the time he was working at the restaurant. He had handled high-risk foods, and the site inspection revealed potential opportunities for transmission. HEV is not common in Australia and it was assumed that the population was non-immune and hence susceptible to the disease. Therefore, there was a low but possible likelihood of transmission of HEV. If infected, HEV has the potential for major consequences in vulnerable populations especially among women who are pregnant. The overall level of risk was considered to be very high.Discussion:The general public and health practitioners were alerted to enable early identification of symptoms and prompt disease management. There were no secondary cases of HEV associated with this event. In the absence of published guidelines and limited evidence, a risk assessment framework was a useful tool to inform public health decision-making.
3.An assessment of risk posed by a Campylobacter -positive puppy living in an Australian residential aged-care facility
Moffatt Cameron ; Appuhamy Ranil ; Andrew Will ; Wynn Sandy ; Roberts Jan ; Kennedy Karina
Western Pacific Surveillance and Response 2014;5(3):1-6
Introduction: In April and June 2012, two outbreaks of