Communicable Diseases Intelligence最新文献

A summary of diseases currently being reported by each jurisdiction is provided in Table 1. There were 267,220 notifications to the National Notifiable Diseases Surveillance System (NNDSS) between 1 July to 30 September 2017 (Table 2). The notification rate of diseases per 100,000 population for each state or territory is presented in Table 3.

The 2009 influenza season was considered a significant season triggered by the April 2009 emergence of a novel influenza A virus prompting a World Health Organization (WHO) declaration of a public health emergency of international concern. The overall number of notifications in the Australian 2009 influenza season was the highest since national reporting to the National Notifiable Diseases Surveillance System (NNDSS) began in 2001, and substantially higher than in prior years. Over 59,000 notifications were reported to the NNDSS, almost ten times the five year mean and representing a crude notification rate of 272.1 per 100,000. Australia's first case of confirmed influenza A(H1N1) pdm09 was identified in early May 2009. By the end of 2009, there were 37,755 laboratory confirmed cases, including 5,085 hospitalisations and 188 deaths notified. Traditionally the age distribution of influenza notifications has rates highest in very young children and the elderly, however in 2009 with the predominance of the pandemic virus, notifications were highest in older children and younger adults. Although influenza can cause very severe and fatal illness, particularly in the elderly, the impact of influenza A(H1N1) pdm09 in younger healthy adults, Aboriginal and Torres Strait Islander peoples, pregnant women and people with existing medical co-morbidities was proportionally greater than normal seasonal outbreaks, even though the absolute number of such cases remained low.1 The establishment of a number of surveillance systems during the pandemic enabled an enhanced assessment of the epidemiological, clinical and virological characteristics to inform public health responses.

The number of notified cases of invasive pneumococcal disease (IPD) in the second quarter of 2017 was greater than the previous quarter and also the second quarter of 2016. Following the July 2011 replacement of the 7-valent pneumococcal conjugate vaccine (7vPCV) in the childhood immunisation program with the 13-valent pneumococcal conjugate vaccine (13vPCV), there was an initial relatively rapid decline in disease due to the additional six serotypes covered by the 13vPCV across all age groups, however more recently this rate of decline has slowed. Additionally, over this period the number of cases due to the eleven serotypes additionally covered by the 23-valent pneumococcal polysaccharide vaccine (23vPPV) and also those serotypes not covered by any available vaccine has been increasing steadily across all age groups.

A summary of diseases currently being reported by each jurisdiction is provided in Table 1. There were 80,388 notifications to the National Notifiable Diseases Surveillance System (NNDSS) between 1 October to 31 December 2017 (Table 2). The notification rate of diseases per 100,000 population for each state or territory is presented in Table 3.

In 2016, there were 243 laboratory-confirmed cases of invasive meningococcal disease analysed by the Australian National Neisseria Network. This number was the highest number of laboratory confirmed cases since 2008. Probable and laboratory confirmed invasive meningococcal disease (IMD) are notifiable in Australia, and there were 252 IMD cases notified to the National Notifiable Diseases Surveillance System in 2016, the highest number reported since 2010. Meningococcal serogrouping was able to be determined for 98% (237/243) of laboratory confirmed IMD cases. Serogroup B infections accounted for 87 cases (37%), the lowest number and proportion reported since inception of the Australian Meningococcal Surveillance Programme (AMSP) in 1997. In contrast, the number and proportion of serogroup W infections (44%, 107 cases) in 2016 was the highest since the AMSP began. In addition, the number and proportion of serogroup Y infections (16%, 40 cases) was also the highest recorded by the AMSP. Molecular typing results were available for 225 of the 243 IMD cases. Of the serogroup W IMD strains that were able to be genotyped, 92% (97/105) have the PorA antigen encoding gene type P1.5,2 and of these, 72% (70/97) were sequence type 11, the same type as the hypervirulent serogroup W strain that has been circulating in the UK and South America since 2009. The primary IMD age peak was observed in adults aged 45 years or more, whilst secondary disease peaks were observed in those aged less than 5 years, and in adolescents aged 15-19 years. Serogroup B infections predominated in the age groups less than 1 year and 20-24 years, whereas serogroup W infections predominated in those aged 45 years or more. For all other age groups, distribution of serogroup B and W infections was roughly equal. Of the IMD isolates tested for antimicrobial susceptibility, 6% (11/189) were resistant to penicillin, and decreased susceptibility to penicillin was observed in a further 90% (170/189) of isolates. One Men W isolate demonstrated an elevated minimum inhibitory concentration (MIC) to ceftriaxone (0.125mg/L), the highest reported in Australia. All isolates tested were susceptible to rifampicin and ciprofloxacin.

An outbreak of Salmonella Muenchen gastroenteritis occurred in a remote coastal Aboriginal community in the Northern Territory (NT) of Australia. There were 22 people sick (attack rate 55%); 7 had laboratory confirmed S. Muenchen infection; 2 required medical evacuation and admission to the intensive care unit (ICU). We conducted a descriptive case series to investigate the outbreak. All cases ate meat from a single green turtle (Chelonia mydas). The animal's pre-death stress, improper butchering, insufficient cooking and the unsatisfactory storage of meat all likely contributed to the outbreak. Turtle meat should be prepared safely, cooked thoroughly and stored appropriately to avoid Salmonella infection.

The 2010 influenza season was moderate overall, with more laboratory-confirmed cases than in earlier years (with the exception of 2009). That said, self-reported influenza-like illness (ILI) was equal to or lower than 2008 and earlier years. In 2010, the number of laboratory-confirmed notifications for influenza was 0.8 times the 5-year mean. High notification rates were reflected in an increase in presentations with ILI to sentinel general practices and emergency departments. Notification rates were highest in the 0-4 year age group. Infections during the season were predominantly due to influenza A(H1N1)pdm09, with 90% of notifications being influenza A (56% A(H1N)1pdm09, 30% A(unsubtyped) and 4% A(H3N2)) and 10% being influenza B. The A(H1), A(H3) and B influenza viruses circulating during the 2010 season were antigenically similar to the respective 2010 vaccine strains. Almost all (99%) of the circulating influenza B viruses that were analysed were from the B/Victoria lineage.

During the period 1 April to 30 October 2016 (the 2016 influenza season), 1,952 patients were admitted with confirmed influenza to one of 17 FluCAN sentinel hospitals. Of these, 46% were elderly (e65 years), 18% were children (<16 years), 5% were Aboriginal and Torres Strait Islander peoples, 3% were pregnant and 76% had chronic co-morbidities.

Interferon-y release assays (IGRAs), such as the Quantiferon (QIFN) TB-Gold Plus assay (Qiagen, Hilden, Germany) and the T-SPOT.TB test (Oxford Immunotec Limited, Abingdon, United Kingdom), are marketed as a substitute for the tuberculin skin test (TST) for the detection of latent tuberculosis infection (LTBI). The relative merits of IGRAs and TST have been hotly debated over the last decade. The specificity of IGRAs has been optimised by using Mycobacterium tuberculosis-specific antigens. However, IGRAs are functional in vitro T-cell-based assays that may lack reproducibility due to specimen collection, transport, processing and kit manufacturing issues. Longitudinal studies comparing the ability of IGRAs and TST to predict the future development of active tuberculosis disease (TB) are the ultimate arbiters on the respective utility of these assays. Three meta-analyses addressing this comparison have now been published and clinical experience with IGRAs is accumulating. The systematic reviews show that IGRAs and TST have similar (but poor) ability to identify patients with LTBI at risk of developing active TB disease. The improved specificity of IGRAs however may reduce the number of patients requiring preventative therapy. Based on these meta-analyses, The National Tuberculosis Advisory Committee (NTAC) now recommends either TST or an IGRA for the investigation of LTBI in most circumstances. Both tests may be used in patients where the risk of progression to active TB disease is high and the disease sequelae potentially severe (eg. LTBI testing in immunocompromised patients or those commencing anti-tumour necrosis factor-ą (TNF) therapy). Neither test should be used in the investigation of active TB disease (though TST and/or IGRA may be used as supplementary tests in paediatric cases). The choice of test for serial testing in healthcare workers (HCWs) remains controversial. A preference remains for TST in this circumstance because IGRAs have been bedevilled by higher rates of reversions and conversions when used for serial testing. These recommendations supersede all previous NTAC IGRA statements.

Paediatric melioidosis is uncommon in Northern Australia and localised skin and soft tissue infections predominate. This study presents data from Far North Queensland and shows that, in this population, children with melioidosis are commonly bacteraemia and have a high case fatality rate.