5.Invasive pneumococcal disease in New South Wales, Australia: reporting Aboriginal and Torres Strait Islander status improves epidemiology
Peter D Massey ; Kerry Todd ; Maggi Osborne ; Kylie Taylor ; David N Durrheim
Western Pacific Surveillance and Response 2011;2(3):1-4
The aim of this work was to determine the feasibility of improving Aboriginal and Torres Strait Islander status recording for notifiable diseases using all Invasive Pneumococcal Disease (IPD) notifications in a regional area of New South Wales, Australia.
In Australia people with IPD are nearly always admitted to hospital and their Aboriginal and Torres Strait Islander status is recorded. Aboriginal and Torres Strait Islander status was determined for IPD notifications by referring to the routine hospital admission data in a regional area of New South Wales, Australia.
There were 234 notifications in the regional area of Hunter New England during the period 2007–2009. Initially, 168 (72%) notifications had Aboriginal and Torres Strait Islander status recorded. After referring to the routine hospital admission data, the recorded status increased to 232 (99%). Updating the surveillance data required less than five minutes per notification.
Referring to routine hospital admission data proved a useful and time-efficient surveillance strategy to increase the proportion of notifications with Aboriginal and Torres Strait Islander status. These data can then be used to better understand the current epidemiology of IPD. Aboriginal and Torres Strait Islander children aged 0–4 years have a two- to threefold higher rate of invasive pneumococcal disease than non-Aboriginal children, thus high levels of timely pneumococcal immunization coverage remain important for young Aboriginal and Torres Strait Islander children.
6.Meeting measles elimination indicators: surveillance performance in a regional area of Australia
Julie Kohlhagen ; Peter D Massey ; David N Durrheim
Western Pacific Surveillance and Response 2011;2(3):5-9
The World Health Organization (WHO) Western Pacific Region has established specific measles elimination surveillance indicators. There has been concern in Australia that these indicators may be too stringent and that measles elimination can occur without all surveillance prerequisites being met, in particular the minimum fever and rash clinician-suspected measles reporting rate with subsequent laboratory exclusion of measles. A regional public health unit in northern New South Wales, Australia, prompted local general practitioners to report fever and rash presentations that met the measles case definition or that they considered to be clinical measles. These notifications from July 2006 to June 2008 were reviewed to determine whether measles indicators for monitoring progress towards measles elimination could be achieved in Australia. Results confirmed that the surveillance indicators of “>2 reported suspected measles cases per 100 000 population,” “at least 80% of suspected cases adequately investigated within 48 hours” and “greater than 80% of cases had adequate blood samples collected” could be met. Only half the cases had virology that would allow genotyping of measles virus. Special efforts to engage and convince Australian medical doctors about the public health value of reporting clinically suggestive measles cases and collecting confirmatory blood tests resulted in the current WHO Western Pacific Region indicators for progress towards measles elimination being met in a regional area of Australia.
7.Continued dominance of pandemic A(H1N1) 2009 influenza in Victoria, Australia in 2010
Kristina Grant ; Lucinda Franklin ; Marlena Kaczmarek ; Aeron Hunt ; Renata Kostecki ; Heath Kelly ; James Fielding
Western Pacific Surveillance and Response 2011;2(3):10-18
The 2010 Victorian influenza season was characterized by normal seasonal influenza activity and the dominance of the pandemic A(H1N1) 2009 strain. General Practice Sentinel Surveillance rates peaked at 9.4 ILI cases per 1000 consultations in week 36 for metropolitan practices, and at 10.5 ILI cases per 1000 in the following week for rural practices. Of the 678 ILI cases, 23% were vaccinated, a significantly higher percentage than in previous years. A significantly higher percentage of ILI patients were swabbed in 2010 compared to 2003–2008, but similar to 2009, with a similar percentage being positive for influenza as in previous years. Vaccination rates increased with patient age. Melbourne Medical Deputising Service rates peaked in week 35 at 19.1 ILI cases per 1000 consultations. Of the 1914 cases of influenza notified to the Department of Health, Victoria, 1812 (95%) were influenza A infections – 1001 (55%) pandemic A(H1N1) 2009, 4 (< 1%) A(H3N2) and 807 (45%) not subtyped; 88 (5%) were influenza B; and 14 (< 1%) were influenza A and B co-infections. The World Health Organization Collaborating Centre for Reference and Research on Influenza tested 403 isolates of which 261 were positive for influenza, 250 of which were influenza A and 11 were influenza B. Ninety-two per cent of the influenza A viruses were pandemic A(H1N1) 2009, and following antigenic analysis all of these were found to be similar to the current vaccine strain. Three viruses (0.9%) were found to be oseltamivir resistant due to an H275Y mutation in the neuraminidase gene.
8.Contact tracing of in-flight measles exposures: lessons from an outbreak investigation and case series, Australia, 2010
Frank Beard ; Lucinda Franklin ; Steven Donohue ; Rodney Moran ; Stephen Lambert ; Marion Maloney ; Jan Humphreys ; Jessica Rotty ; Nicolee Martin ; Michael Lyon ; Thomas Tran ; Christine Selvey
Western Pacific Surveillance and Response 2011;2(3):25-33
OBJECTIVE: To describe a 2010 outbreak of nine cases of measles in Australia possibly linked to an index case who travelled on an international flight from South Africa while infectious.
METHODS: Three Australian state health departments, Victoria, Queensland and New South Wales, were responsible for the investigation and management of this outbreak, following Australian public health guidelines. Results: An outbreak of measles occurred in Australia after an infectious case arrived on a 12-hour flight from South Africa. Only one of four cases in the first generation exposed to the index case en route was sitting within the two rows recommended for contact tracing in Australian and other guidelines. The remaining four cases in subsequent generations, including two health care workers, were acquired in health care settings. Seven cases were young adults. Delays in diagnosis and notification hampered disease control and contact tracing efforts.
CONCLUSION: Review of current contact tracing guidelines following in-flight exposure to an infectious measles case is required. Alternative strategies could include expanding routine contact tracing beyond the two rows on either side of the case’s row or expansion on a case-by-case basis depending on cabin layout and case and contact movements in flight. Releasing information about the incident by press release or providing generic information to everyone on the flight using e-mail or text messaging information obtained from the relevant airline, may also be worthy of consideration. Disease importation, inadequately vaccinated young adults and health care-related transmission remain challenges for measles control in an elimination era.
9.Letter to the Editor: Dengue vector surveillance methods in Muntinlupa City, Philippines
Jennifer Duncombe ; Kristian Marrollano
Western Pacific Surveillance and Response 2011;2(3):24-24
This work is part of a larger study that aims to build a low-cost, geographically-enhanced dengue data management system for use by local health authorities. The system will collate data from a range of sources and produce regular reports and maps showing cases, vectors and predicted dengue clusters. Local health authorities can use these outputs to better target dengue control activities, including community education, removal of breeding sites, preventive fogging and improved waste and water management.
10.Preparedness and resilience: the hallmarks of response and recovery
Western Pacific Surveillance and Response 2011;2(4):1-2
The Great East Japan Earthquake struck the north-eastern coast of Honshu on 11 March 2011. With a magnitude of 9.0, it was the largest earthquake ever recorded in Japan. It triggered the largest recorded tsunami in Japan which devastated the lifelines, transportation and communication systems in the Tohoku region. The tsunami caused nuclear accidents and meltdowns of three reactors in Fukushima.