Communicable diseases intelligence (2018)最新文献

Abstract: The Australian National Neisseria Network (NNN) comprises reference laboratories in each state and territory that report data on antimicrobial susceptibility testing to an agreed group of antimicrobial agents for the Australian Gonococcal Surveillance Programme (AGSP). The AGSP data are presented quarterly in tabulated form, as well as in the AGSP annual report. This report presents national gonococcal antimicrobial resistance surveillance data from 1 January to 31 March 2024.

Background and methods: In March 2022, an outbreak of Japanese encephalitis virus (JEV) infection was identified in temperate south-eastern Australia, with detections in humans and animals. The unexpected emergence of JEV prompted a national public health response and a Communicable Disease Incident of National Significance was declared. JEV has previously only been identified in tropical north-eastern Australia in localised outbreaks. This article provides a descriptive analysis of the human case epidemiology of the national outbreak from 1 January 2021 to 30 June 2022.

Results: There were 42 confirmed and probable human cases of JEV identified as acquired in Australia between 1 January 2021 and 30 June 2022. Seven deaths occurred (case fatality rate: 17%). Cases were identified in five Australian jurisdictions (New South Wales, Victoria, Queensland, South Australia and the Northern Territory). The majority of cases were aged 60 years and over (55%; 23/42), with a median age of 61.5 years (range: 0-79 years; interquartile range: 45-70 years); cases were predominantly of non-Indigenous status (90%; 38/42). Sixty-seven percent (28/42) were male. Of the cases with geographical data available (n = 41), all were likely exposed to the virus in 31 unique local government areas across regional and remote Australia.

Conclusions: Cases were detected across Australia in five jurisdictions, requiring a national public health response, to detect and prevent further cases. There was widespread geographical distribution over 18 months. Given the risk of further cases and possible endemicity of JEV being established in Australia, expanded environmental and human surveillance programs are required.

Abstract: The Australian National Neisseria Network (NNN) comprises reference laboratories in each state and territory that report data on antimicrobial susceptibility testing to an agreed group of antimicrobial agents for the Australian Gonococcal Surveillance Programme (AGSP). The AGSP data are presented quarterly in tabulated form, as well as in the AGSP annual report. This report presents national gonococcal antimicrobial resistance surveillance data from 1 April to 30 June 2024.

Abstract: The detection of Japanese encephalitis virus (JEV) in pigs, at four piggeries in the Murray region in February 2022, prompted a public health investigation (PHI) by the New South Wales Department of Health (NSW Health) to identify people at greatest risk of infection. The PHI included three components: a vaccination clinic and accompanying clinic questionnaire; a serological investigation; and a cross-sectional study for consenting Australian-born participants who completed an extended questionnaire after receiving their serological results. The goals were to vaccinate a presumably naïve population to reduce associated risk and to understand the seroprevalence among Australian-born piggery workers. A total of 322 farm workers and/or residents attended clinics organised by NSW Health; 311 received a JEV vaccine (96.6%); and 302 (94%) completed a clinic questionnaire. Of 178 people from whom serology was collected (55.3%), a total of 165 returned Defined Epitope Blocking enzyme-linked immunosorbent assay (DEB ELISA) results; 153/165 of those returning DEB ELISA results were Australian born. The study's cross-sectional component involved 129 participants, ten of whom were seropositive. The overall seropositivity for 153 Australian-born participants across the identified piggeries was 6.5% (95% confidence interval [95% CI]: 3.4-12.0%), suggesting that JEV was circulating in piggeries, and plausibly more broadly, within the Murray region prior to serology collection. Male sex and working on, or visiting, a farm other than their regular workplace were both associated with JEV seropositivity (odds ratio [OR]: 5.4; 95% CI: 0.94-137.1 and OR: 37; 95% CI: 0.92-22.08 respectively). JEV vaccination uptake was high among piggery workers in the Murray region. Further studies are needed to determine if piggery workers have an increased risk of developing JEV compared to people who do not work or live on JEV-affected piggeries. The reasons for the emergence of JEV in pigs in the Murray region remain unclear.

Abstract: Australia is the only high-income country where trachoma has been endemic, defined as an overall trachoma prevalence in Aboriginal and Torres Strait Islander children aged 5-9 years of 5% or more. The Australian Government funds the National Trachoma Surveillance and Reporting Unit to collate and analyse trachoma prevalence data and control strategies annually. This report presents data submitted from 2014 to 2022. In 2022, there were 87 remote communities considered at-risk of endemic trachoma, a decline of 51% since 2014 when 177 communities were considered at-risk. World Health Organization grading criteria are used to diagnose trachoma in at-risk populations. Overall prevalence, which includes estimates from all communities ever considered at-risk, fell below 5% endemicity thresholds for the first time in 2022 in Western Australia (2.9%), the Northern Territory (2.1%), New South Wales (0.5%), and in Queensland and South Australia (0.0% each). New cases of trachomatous trichiasis-a severe consequence of trachoma that causes blindness-were detected in eight out of 10,806 persons, aged 15 years and over, screened in 2022. Jurisdictional trichiasis prevalence was 0.2% in Western and South Australia and 0.0% in the Northern Territory. Australia must maintain overall trachoma and trichiasis prevalence below endemicity levels for a further two years before applying for World Health Organization validation of elimination of trachoma as a public health problem.

Abstract: Erratum to Commun Dis Intell (2018) 2024;48. (doi: 10.33321/cdi.2024.48.54).

Abstract: From 1 January to 31 December 2023, fifty-six institutions across Australia participated in the Australian Enterococcal Surveillance Outcome Program (AESOP). The aim of AESOP 2023 was to determine the proportion of enterococcal bacteraemia isolates in Australia that were antimicrobial resistant, and to determine the Enterococcus faecium molecular epidemiology. Of the 1,599 unique episodes of enterococcal bacteraemia investigated, 92.9% were caused by either E. faecalis (51.8%) or E. faecium (41.1%). Ampicillin and vancomycin resistance were not detected in E. faecalis but were detected in 94.2% and 50.8% of E. faecium respectively. Two linezolid-resistant E. faecalis were identified in 2023. Both isolates had linezolid minimum inhibitory concentrations (MICs) of 6.0 mg/L, were vancomycin susceptible, and harboured the optrA gene. Overall, 53.2% of E. faecium harboured either the vanA or the vanB gene; of these, 27.3% harboured vanA, 72.1% harboured vanB, and 0.6% harboured vanA and vanB. The percentage of vancomycin-resistant E. faecium bacteraemia isolates in Australia remains substantially higher than that recorded in most European countries. The E. faecium isolates consisted of 58 multi-locus sequence types (STs); 85.7% of isolates were classified into seven major STs, each containing ten or more isolates. All major STs belonged to clonal complex (CC) 17, a global hospital-adapted polyclonal E. faecium CC. The major STs (ST78, ST1424, ST17, ST80, ST796, ST1421 and ST555) were found across most regions of Australia, with ST78 identified in all regions. Overall, 58.3% of isolates belonging to the seven major STs harboured the vanA or vanB gene. AESOP 2023 has shown that enterococcal bacteraemia episodes in Australia continues to be frequently caused by polyclonal ampicillin-resistant high-level gentamicin-resistant vanA- or vanB-positive E. faecium which have limited treatment options.

Abstract: In early 2024, there were eight confirmed cases of locally acquired dengue on Mer Island in the Torres Strait. This dengue outbreak prompted an in-community public health response which included active case finding, health promotion and vector control. This was the first detected dengue outbreak in the Torres Strait since 2017. It highlights the importance of testing in primary healthcare, vector control and ongoing public health surveillance to minimise the risk of local transmission and establishment of endemic viruses which may cause significant and potentially life-threatening disease within populations in northern Australia.

Abstract: In Australia, both probable and laboratory-confirmed cases of invasive meningococcal disease (IMD) are reported to the National Notifiable Diseases Surveillance System (NNDSS). When compared to 2022, the number of IMD notifications in 2023 increased by 14% to 143. Laboratory confirmation of IMD occurred in 140/143 (98%) of these cases, with 64% (90/140) diagnosed by bacterial culture and 36% (50/140) by nucleic acid amplification testing. The serogroup was determined for 96% of laboratory-confirmed cases (134/140): serogroup B (MenB) accounted for 84% of infections (112/134); MenW for 8% (11/134); MenY for 8% (11/134). There were no infections attributed to MenC disease. Fine typing was available on 75% of the cases for which the serogroup was determined (100/134). In MenB isolates, 25 porA types were detected, the most prevalent of which were P1.7-2,4 (32%; 26/82), P1.7,16-26 (16%; 13/82) and P1.22,14 (9%; 7/82). All eight typed MenW infections identified as porA type P1.5,2, with two different multi-locus sequence types (MLST) present: ST-11 (5) and ST-1287 (3) from the clonal complex 11, the hypervirulent strain reported in outbreaks in Australia and overseas. In MenY, the predominant porA type was P1.5-1,10-1 (90%; 9/10), ST-1655 and from clonal complex 23. Peaks of IMD occurred in children aged less than 5 years and in those aged 15-24 years, accounting for 21% (30/140) and 26% (37/140) of laboratory-confirmed cases respectively. In children aged under 5 years, 93% of IMD (27/29) was MenB; in those aged 15-24 years, 97% of IMD (36/37) was MenB, with serogroup not determined for one case in each of these age groups. Of note, 14-15% of IMD occurred in each of the older age groups reported: adults 25-44 years (14%, 19/140), 45-64 years (14%, 20/140), and in those aged 65 years and older (15%, 21/140). Whilst MenB predominated in all age groups, the majority of MenY and MenW IMD cases were reported in adults aged 45 years and older. All cultured IMD isolates (n = 90) had antimicrobial susceptibility testing performed. Minimum inhibitory concentration (MIC) values were reported using Clinical Laboratory Standards Institute (CLSI) interpretative criteria: 9% (8/90) were defined as penicillin resistant (MIC value: ≥ 0.5 mg/L); 71% (64/90) had intermediate susceptibility to penicillin (MIC values: 0.125 and 0.25 mg/L) and 20% (18/90) were susceptible to penicillin (MIC values: ≤ 0.064 mg/L). All isolates tested susceptible to ceftriaxone, ciprofloxacin and rifampicin.