Infectious Diseases - Research Publications
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ItemIntrahousehold Transmission of Pandemic (H1N1) 2009 Virus, Victoria, Australia(CENTERS DISEASE CONTROL & PREVENTION, 2011-09)To examine intrahousehold secondary transmission of pandemic (H1N1) 2009 virus in households in Victoria, Australia, we conducted a retrospective cross-sectional study in late 2009. We randomly selected case-patients reported during May-June 2009 and their household contacts. Information collected included household characteristics, use of prevention and control measures, and signs and symptoms. Secondary cases were defined as influenza-like illness in household contacts within the specified period. Secondary transmission was identified for 18 of 122 susceptible household contacts. To identify independent predictors of secondary transmission, we developed a model. Risk factors were concurrent quarantine with the household index case-patient, and a protective factor was antiviral prophylaxis. These findings show that timely provision of antiviral prophylaxis to household contacts, particularly when household members are concurrently quarantined during implementation of pandemic management strategies, delays or contains community transmission of pandemic (H1N1) 2009 virus.
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ItemAnalysis of laboratory testing results collected in an enhanced chlamydia surveillance system in Australia, 2008-2010(BIOMED CENTRAL LTD, 2014-06-12)BACKGROUND: Chlamydial infection is the most common notifiable disease in Australia, Europe and the US. Australian notifications of chlamydia rose four-fold from 20,274 cases in 2002 to 80,846 cases in 2011; the majority of cases were among young people aged less than 29 years. Along with test positivity rates, an understanding of the number of tests performed and the demographics of individuals being tested are key epidemiological indicators. The ACCESS Laboratory Network was established in 2008 to address this issue. METHODS: The ACCESS Laboratory Network collected chlamydia testing data from 15 laboratories around Australia over a three-year period using data extraction software. All chlamydia testing data from participating laboratories were extracted from the laboratory information system; patient identifiers converted to a unique, non-reversible code and de-identified data sent to a single database. Analysis of data by anatomical site included all specimens, but in age and sex specific analysis, only one testing episode was counted. RESULTS: From 2008 to 2010 a total of 628,295 chlamydia tests were referred to the 15 laboratories. Of the 592,626 individual episodes presenting for testing, 70% were from female and 30% from male patients. In female patients, chlamydia positivity rate was 6.4% overall; the highest rate in 14 year olds (14.3%). In male patients, the chlamydia positivity rate was 9.4% overall; the highest in 19 year olds (16.5%). The most common sample type was urine (57%). In 3.2% of testing episodes, multiple anatomical sites were sampled. Urethral swabs gave the highest positivity rate for all anatomical sites in both female (7.7%) and male patients (14%), followed by urine (7.6% and 9.4%, respectively) and eye (6.3% and 7.9%, respectively). CONCLUSIONS: The ACCESS Laboratory Network data are unique in both number and scope and are representative of chlamydia testing in both general practice and high-risk clinics. The findings from these data highlight much lower levels of testing in young people aged 20 years or less; in particular female patients aged less than 16 years, despite being the group with the highest positivity rate. Strategies are needed to increase the uptake of testing in this high-risk group.
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ItemThe Australian national binge drinking campaign: campaign recognition among young people at a music festival who report risky drinking(BMC, 2011-06-20)BACKGROUND: The Australian Government launched a mass media campaign in 2009 to raise awareness of the harms and costs associated risky drinking among young Australians. The aim of this study was to assess if young people attending a music festival who report frequent risky single occasions of drinking (RSOD) recognise the key message of the campaign, "Binge drinking can lead to injuries and regrets", compared to young people who report less frequent RSOD. METHODS: A cross-sectional behavioural survey of young people (aged 16-29 years) attending a music festival in Melbourne, Australia, was conducted in January 2009. We collected basic demographics, information on alcohol and other drug use and sexual health and behaviour during the previous 12 months, and measured recognition of the Australian National Binge Drinking Campaign key message. We calculated the odds of recognition of the key slogan of the Australian National Binge Drinking Campaign among participants who reported frequent RSOD (defined as reported weekly or more frequent RSOD during the previous 12 months) compared to participants who reported less frequent RSOD. RESULTS: Overall, three-quarters (74.7%) of 1072 participants included in this analysis recognised the campaign message. In the adjusted analysis, those reporting frequent RSOD had significantly lower odds of recognising the campaign message compared to those not reporting frequent RSOD (OR 0.7, 95% CI 0.5-0.9), whilst females had significantly greater odds of recognising the campaign message compared to males (OR 1.8, 95% CI 1.4-2.1). CONCLUSIONS: Whilst a high proportion of the target group recognised the campaign, our analysis suggests that participants that reported frequent RSOD - and thus the most important group to target - had statistically significantly lower odds of recognising the campaign message.
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ItemImproving the identification of priority populations to increase hepatitis B testing rates, 2012(BMC, 2016-02-01)BACKGROUND: It is estimated that over 40 % of the 218,000 people with chronic hepatitis B (CHB) in Australia in 2011 are undiagnosed. A disproportionate number of those with undiagnosed infection were born in the Asia-Pacific region. Undiagnosed CHB can lead to ongoing transmission and late diagnosis limits opportunities to prevent progression to hepatocellular carcinoma (HCC) and cirrhosis. Strategies are needed to increase testing for hepatitis B virus (HBV) (including culturally and linguistically diverse communities, Aboriginal and/or Torres Strait Islander (Indigenous) people and people who inject drugs). General practitioners (GPs) have a vital role in increasing HBV testing and the timely diagnosis CHB. This paper describes the impact of a GP-based screening intervention to improve CHB diagnosis among priority populations in Melbourne, Australia. METHODS: A non-randomised, pre-post intervention study was conducted between 2012 and 2013 with three general practices in Melbourne, Australia. Using clinic electronic health records three priority populations known to be at increased CHB risk in Australia (1: Asian-born patients or patients of Asian ethnicity living in Australia; 2: Indigenous people; or 3): people with a history of injecting drugs were identified and their HBV status recorded. A random sample were then invited to attend their GP for HBV testing and/or vaccination. Baseline and follow-up electronic data collection identified patients that subsequently had a consultation and HBV screening test and/or vaccination. RESULTS: From a total of 33,297 active patients, 2674 (8 %) were identified as a priority population at baseline; 2275 (85.1 %) of these patients had unknown HBV status from which 338 (14.0 %) were randomly sampled. One-fifth (n = 73, 21.6 %) of sampled patients subsequently had a GP consultation during the study period; only four people (5.5 %) were subsequently tested for HBV (CHB detected in n = 1) and none were vaccinated against HBV. CONCLUSION: CHB infection is an important long-term health issue in Australia and strategies to increase appropriate and timely testing are required. The study was effective at identifying whether Asian-born patients and patients of Asian had been tested or vaccinated for HBV; however the intervention was not effective at increasing HBV testing.
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ItemDescription of social contacts among student cases of pandemic influenza during the containment phase, Melbourne, Australia, 2009(WORLD HEALTH ORGANIZATION, REGIONAL OFFICE WESTERN PACIFIC, 2018)INTRODUCTION: Students comprised the majority of early cases of influenza A(H1N1)pdm09 in Melbourne, Australia. Students and school settings were targeted for public health interventions following the emergence of pH1N1. This study was conducted to describe changes in social contacts among the earliest confirmed student cases of pH1N1 in Melbourne, Australia, to inform future pandemic control policy and explore transmission model assumptions. METHODS: A retrospective cross-sectional behavioural study of student cases with laboratory-confirmed pH1N1 between 28 April and 3 June 2009 was conducted in 2009. Demographics, symptom onset dates and detailed information on regular and additional extracurricular activities were collected. Summary measures for activities were calculated, including median group size and median number of close contacts and attendance during the students' exposure and infectious periods or during school closures. A multivariable model was used to assess associations between rates of participation in extracurricular activities and both school closures and students' infectious periods. RESULTS: Among 162 eligible cases, 99 students participated. Students reported social contact in both curricular and extra-curricular activities. Group size and total number of close contacts varied. While participation in activities decreased during the students' infectious periods and during school closures, social contact was common during periods when isolation was advised and during school closures. DISCUSSION: This study demonstrates the potential central role of young people in pandemic disease transmission given the level of non-adherence to prevention and control measures. These finding have public health implications for both informing modelling estimates of future pandemics and targeting prevention and control strategies to young people.