1.Sustained outbreak of measles in New South Wales, 2012: risks for measles elimination in Australia
Najjar Zeina ; Hope Kirsty ; Clark Penelope ; Nguyen Oanh ; Rosewell Alexander ; Conaty Stephen
Western Pacific Surveillance and Response 2014;5(1):14-20
Objective:On 7 April 2012, a recently returned traveller from Thailand to Australia was confirmed to have measles. An outbreak of measles subsequently occurred in the state of New South Wales, prompting a sustained and coordinated response by public health authorities. The last confirmed case presented on 29 November 2012. This report describes the outbreak and its characteristics.Methods:Cases were investigated following Australian protocols, including case interviews and assessment of contacts for post-exposure prophylaxis.Results:Of the 168 cases identified, most occurred in south-western and western Sydney (92.9%,
2.Effect of antiviral prophylaxis on influenza outbreaks in aged care facilities in three local health districts in New South Wales, Australia, 2014
Tony Merritt ; Kirsty Hope ; Michelle Butler ; David Durrheim ; Leena Gupta ; Zeina Najjar ; Stephen Conaty ; Leng Boonwaat ; Stephanie Fletcher
Western Pacific Surveillance and Response 2016;7(1):14-20
BACKGROUND: There was a record number (n = 111) of influenza outbreaks in aged care facilities in New South Wales, Australia during 2014. To determine the impact of antiviral prophylaxis recommendations in practice, influenza outbreak data were compared for facilities in which antiviral prophylaxis and treatment were recommended and for those in which antivirals were recommended for treatment only.
METHODS: Routinely collected outbreak data were extracted from the Notifiable Conditions Information Management System for two Local Health Districts where antiviral prophylaxis was routinely recommended and one Local Health District where antivirals were recommended for treatment but not routinely for prophylaxis. Data collected on residents included counts of influenza-like illness, confirmed influenza, hospitalizations and related deaths. Dates of onset, notification, influenza confirmation and antiviral recommendations were also collected for analysis. The Mann–Whitney U test was used to assess the significance of differences between group medians for key parameters.
RESULTS: A total of 41 outbreaks (12 in the prophylaxis group and 29 in the treatment-only group) were included in the analysis. There was no significant difference in overall outbreak duration; outbreak duration after notification; or attack, hospitalization or case fatality rates between the two groups. The prophylaxis group had significantly higher cases with influenza-like illness (P = 0.03) and cases recommended antiviral treatment per facility (P = 0.01).
DISCUSSION: This study found no significant difference in key outbreak parameters between the two groups. However, further high quality evidence is needed to guide the use of antivirals in responding to influenza outbreaks in aged care facilities.