Introduction: This report describes a 2011 seasonal influenza B outbreak in a metropolitan primary school in Australia with 179 students. Methods: Epidemiological, microbiological and environmental investigations were undertaken. A retrospective cohort study was conducted using a questionnaire that included demographic data, details of illness, chronic health conditions and vaccination status. Influenza-like illness (ILI) was defined as fever plus cough and/or sore throat. Analysis of ILI was undertaken with the chi-squared test and Fisher’s exact test. Results: Seventy-two questionnaire respondents (75%) reported illness during the outbreak – 43 with ILI, giving an attack rate of 45%. There was no association between ILI and age or chronic lung disease. Six (6%) students were vaccinated against influenza before the outbreak; although four became ill, none satisfied the ILI case definition. Seven students were positive for influenza B including two confirmed as B/Brisbane/60/2008-like; one student was positive for rhinovirus and another for metapneumovirus. The recommended influenza vaccine matched the circulating influenza strains. Discussion: This cohort study estimated a high ILI attack rate and demonstrated low influenza vaccine coverage within the setting of a primary school. Gastrointestinal symptoms, in addition to constitutional and respiratory symptoms, were common.

Introduction: In South Australia, reporting of live births, stillbirths of at least 20 weeks or 400g birth weight, termination of pregnancies and congenital anomalies is mandated. We describe the investigation of an increase in notifications of neural tube defects (NTDs) in South Australia in 2009 and 2010 using data from several surveillance systems. Methods: NTD trend data from 1966 to 2010 were reviewed. Comparisons of pregnancies affected by an NTD in 2009 and 2010 were made with pregnancies affected by an NTD in the period 2003–2008 and with all pregnancies in 2009 and 2010. Statistical analysis was undertaken using Poisson regression, chi-squared or Fisher’s exact tests. Results: The prevalence of NTD-affected pregnancies was 1.95 per 1000 births (39 cases) in 2010 and 1.91 per 1000 births in 2009 (38 cases), the highest annual rates since 1991. Case series comparisons indicated women with NTD-affected pregnancies in 2009 and 2010 were less likely to be Caucasian compared with women who had NTD-affected pregnancies in the period 2003–2008. Women born in the Middle East and African region (n = 7) were significantly more likely to have NTD-affected pregnancies in the years 2009 and 2010 (relative risk: 3.03; 95% confidence interval: 1.39–6.62) compared with women born in the Oceania region. Discussion: The increased notifications of NTDs can only be partially explained by the increase in numbers of women from the Middle East and African region, with no other contributory causes revealed. This analysis highlighted areas where prevention efforts should be strengthened and surveillance data improved.

Problem: From December 2016 to February 2017, two cases of invasive meningococcal disease and one case of meningococcal conjunctivitis, all serogroup W, occurred in Aboriginal children in the Ceduna region of South Australia. The clustering of cases in time and place met the threshold for a community outbreak. Context: The Ceduna region is a remote part of South Australia, with more than 25% of the population identifying as Aboriginal or Torres Strait Islander. Action: As part of the outbreak response, a community-wide meningococcal vaccination programme against serogroups A, C, W and Y was implemented in a collaboration among different agencies of the South Australia Department for Health and Well-being, Aboriginal health and community services providers, and other local service providers and government agencies. The programme comprised an outbreak vaccination schedule, targeting all people aged 3 2 months residing in the cases’ places of residence or in towns with close links. Outcome: Between March and June 2017, 3383 persons were vaccinated, achieving an estimated coverage of 71–85% of the target population, with 31% (n = 1034) of those vaccinated identifying as Aboriginal or Torres Strait Islander. No local cases of serogroup W occurred during the vaccination programme, but two further cases were notified by the end of 2018. Discussion: The participation of a large number of local and non-health-sector stakeholders in programme planning and implementation, a clear response management structure and high community acceptability were identified as key factors that contributed to the programme achieving high vaccination coverage. The need to develop standard operating procedures for community-based outbreak response interventions to ease logistical challenges was considered an important lesson learnt.