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Queensland, Australia

Majowicz S.E.,Public Health Agency of Canada | Musto J.,Communicable Diseases Branch | Scallan E.,Centers for Disease Control and Prevention | Angulo F.J.,Centers for Disease Control and Prevention | And 4 more authors.
Clinical Infectious Diseases

To estimate the global burden of nontyphoidal Salmonella gastroenteritis, we synthesized existing data from laboratory-based surveillance and special studies, with a hierarchical preference to (1) prospective population-based studies, (2) "multiplier studies," (3) disease notifications, (4) returning traveler data, and (5) extrapolation. We applied incidence estimates to population projections for the 21 Global Burden of Disease regions to calculate regional numbers of cases, which were summed to provide a global number of cases. Uncertainty calculations were performed using Monte Carlo simulation. We estimated that 93.8 million cases (5th to 95th percentile, 61.8-131.6 million) of gastroenteritis due to Salmonella species occur globally each year, with 155,000 deaths (5th to 95th percentile, 39,000-303,000 deaths). Of these, we estimated 80.3 million cases were foodborne. Salmonella infection represents a considerable burden in both developing and developed countries. Efforts to reduce transmission of salmonellae by food and other routes must be implemented on a global scale. © 2010 by the Infectious Diseases Society of America. All rights reserved. Source

Waldron L.S.,Macquarie University | Ferrari B.C.,University of New South Wales | Cheung-Kwok-Sang C.,Macquarie University | Beggs P.J.,Macquarie University | And 2 more authors.
Applied and Environmental Microbiology

Cryptosporidiosis is one of the most common waterborne diseases reported worldwide. Outbreaks of this gastrointestinal disease, which is caused by the Cryptosporidium parasite, are often attributed to public swimming pools and municipal water supplies. Between the months of January and April in 2009, New South Wales, Australia, experienced the largest waterborne cryptosporidiosis outbreak reported in Australia to date. Through the course of the contamination event, 1,141 individuals became infected with Cryptosporidium. Health authorities in New South Wales indicated that public swimming pool use was a contributing factor in the outbreak. To identify the Cryptosporidium species responsible for the outbreak, fecal samples from infected patients were collected from hospitals and pathology companies throughout New South Wales for genetic analyses. Genetic characterization of Cryptosporidium oocysts from the fecal samples identified the anthroponotic Cryptosporidium hominis IbA10G2 subtype as the causative parasite. Equal proportions of infections were found in males and females, and an increased susceptibility was observed in the 0- to 4-year age group. Spatiotemporal analysis indicated that the outbreak was primarily confined to the densely populated coastal cities of Sydney and Newcastle. © 2011, American Society for Microbiology. Source

Buttery J.P.,Murdoch Childrens Research Institute | Buttery J.P.,Monash University | Lambert S.B.,University of Melbourne | Grimwood K.,University of Melbourne | And 7 more authors.
Pediatric Infectious Disease Journal

Introduction: Rotavirus vaccines were introduced into the funded Australian National Immunization Program (NIP) in July 2007. Due to purchasing arrangements, individual states and territories chose either a 2-dose RV1 (Rotarix, GSK) regimen or 3-dose RV5 (Rotateq, Merck/CSL) regimen. This allowed comparison of both vaccines in similar populations with high infant vaccination coverage. Methods: Admission and rotavirus identification data from the major pediatric hospitals in 3 states (2 using RV5, 1 RV1), together with state-based hospitalization and vaccination data from Queensland (RV5) were analyzed for the years before, and up to 30 months following rotavirus vaccine introduction. Emergency encounters and short-stay unit admissions for gastroenteritis are also described. Results: Rotavirus vaccine coverage in Australia is high, with 87% of infants receiving at least 1 dose. Hospital admissions for both rotavirus gastroenteritis and nonrotavirus-coded gastroenteritis were reduced following vaccine introduction in all states, not only for the age group eligible for NIP rotavirus vaccination, but also for children born prior. RV5 vaccine efficacy in Queensland has been estimated at 89.3%. Marked reductions in acute gastroenteritis emergency presentations and short-stay unit admissions have also been observed. Conclusions: Early evidence from the NIP in Australia has demonstrated high rotavirus coverage with both RV1 and RV5. The introduction of both vaccines has been associated with a marked reduction in gastroenteritis admissions, supportive of both direct vaccine protection, as well as with indirect herd protection. © 2010 by Lippincott Williams & Wilkins. Source

Field E.J.,Communicable Diseases Branch | Field E.J.,Australian National University | Vally H.,Australian National University | Grimwood K.,Queensland Childrens Medical Research Institute | And 2 more authors.

OBJECTIVE: A publicly funded, universal infant pentavalent rotavirus vaccine (RV5) program was implemented in Queensland, Australia, in mid-2007. We sought to assess vaccine effectiveness (VE) of 3 doses of RV5 at preventing rotavirus and nonrotavirus acute gastroenteritis (AGE) hospitalizations in the first birth cohort and impact on hospitalizations in all age groups. METHODS: Hospitalization rates for rotavirus and nonrotavirus AGE in all age groups before and after RV5 introduction were compared. Population vaccine coverage, hospitalization data, and individual vaccination status were obtained from routinely collected, publicly funded state- and nationally based data sets. Data linkage was performed to calculate 3-dose VE for preventing hospitalization in the eligible age group. RESULTS: RV5 coverage in the first eligible birth cohort was 89.6% for at least 1 dose and 73.1% for 3 doses. Three-dose VE for preventing nonrotavirus AGE hospitalization was 62.3% to 63.9% (any/primary diagnosis) and 89.3% to 93.9% (any/primary diagnosis) for rotavirus hospitalizations. After program implementation, there were immediate and sustained reductions in rotavirus hospitalizations for those who were younger than 20 years and nonrotavirus AGE-coded hospitalizations for those who were younger than 5 years. CONCLUSIONS: RV5 is highly effective at preventing rotavirus hospitalizations in a developed country setting, confirming efficacy figures from the pivotal clinical trial. Additional direct and indirect effects are substantial and include reductions in nonrotavirus AGE hospitalizations in vaccinated age groups and rotavirus and nonrotavirus AGE hospitalization rates in older age groups. Copyright © 2010 by the American Academy of Pediatrics. Source

McPherson M.E.,Communicable Diseases Branch
New South Wales public health bulletin

To review the epidemiology of HIV in NSW and compare HIV rates in NSW with those of other comparable jurisdictions. The rate of newly diagnosed cases of HIV reported in NSW was compared with those published from other Australian and comparable international jurisdictions. Until recent years, NSW has consistently reported the highest rate of newly diagnosed HIV infections in Australia with a peak of 29.1 per 100,000 population in 1987. Since then the notification rate has decreased significantly and has been stable since 2000 at an average annual rate of 5.6 per 100,000. Rates in NSW and in other Australian states and territories are lower than most comparable international jurisdictions, although stability in rates has been observed elsewhere. Between 1984 and 2008, 82% of infections that reported a risk exposure occurred among men who have sex with men. Rates of HIV infection in NSW have been stable over the last decade, remaining among the highest in Australia but lower than those in other comparable industrialised jurisdictions. In NSW, the majority of cases continue to occur among men who have sex with men. Source

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