Trachoma surveillance in Australia, 2009. A report by the National Trachoma Surveillance and Reporting Unit

Trachoma is highly prevalent in remote Indigenous communities in Australia. The National Trachoma Surveillance and Reporting Unit was established in 2006 as a result of a Federal Government initiative to provide comprehensive surveillance data from regional and remote Indigenous communities considered by the jurisdictional population health staff to be 'At Risk' for endemic trachoma, defined as a trachoma prevalence of 5% or more. This report details the findings from the 2009 trachoma screening program together with trends in trachoma prevalence and screening coverage since 2006. Aboriginal children aged 1-9 years resident in At Risk communities were examined for trachoma using the World Health Organization (WHO) simplified trachoma grading criteria. In the Northern Territory, screening was conducted by staff from the Healthy School Age Kids program and the Aboriginal Community Controlled Health Services. In South Australia, screening was conducted by the Eye Health and Chronic Disease Specialist Support Program and a team of visiting ophthalmologists and optometrists. In Western Australia, screening was conducted by staff from State Government population health units and Aboriginal Community Controlled Health Services. In the Northern Territory, 53 of 86 At Risk communities were screened and data were reported for 2283 children. In South Australia, 12 of 72 At Risk communities were screened and data were reported for 149 children. In Western Australia, 68 of 74 At Risk communities were screened and data were reported for 1684 children. The prevalence of active trachoma ranged from 1%-44% in the Northern Territory, 0%-57% in South Australia and 13%-15% in Western Australia. Trend analysis across all three jurisdictions combined found that neither the prevalence of trachoma nor community screening coverage changed significantly between 2006 and 2009. When trend analysis was "done by jurisdiction, there was a significant decrease in trachoma prevalence and a significant increase in community screening coverage only for Western Australia over the same 4 year period. The implementation of the and Environmental improvement (SAFE) strategy has been variable. Surgery referral processes for trichiasis were reported as available in all screened communities in the Northern Territory and South Australia but only in 35% of screened communities in Western Australia. Antibiotics were distributed according to Communicable Diseases Network Australia guidelines in 89% of communities where treatment was indicated. Facial cleanliness programs and resources were reported as poorly implemented in South Australia and Western Australia while minimal data were reported for environmental conditions in all jurisdictions. No significant change was found in bacterial resistance to azithromycin from 2007 to 2009. Significant gaps remain in community screening coverage and in the full implementation of the SAFE strategy. However, the parallel increase in community screening coverage and decrease in trachoma prevalence in Western Australia suggests that the SAFE strategy might have had an effect in reducing trachoma prevalence in that jurisdiction.     

Annual report of the National Influenza Surveillance Scheme, 2006

Influenza surveillance in Australia is based on laboratory isolation of influenza viruses, sentinel general practitioner reports of influenza-like illness, and absenteeism data from a major national employer. In 2006, 3,130 cases of laboratory-confirmed influenza were reported to the National Notifiable Diseases Surveillance System, which was one-third lower than in 2005. The influenza season started in mid-June, with peak activity in late August. Influenza A was the predominant type notified (71%), however influenza B activity continued to increase as a proportion of reported cases. Reports of influenza-like illness from sentinel general practitioners showed a slow but steady increase throughout the first half of the year to peak in late August. In 2006, 657 influenza isolates from Australia were antigenically analysed: 402 were A(H3N2), 24 were A(H1N1) and 231 were influenza B viruses. Continued antigenic drift was seen with the A(H3N2) viruses from the previous reference strains (A/California/7/2004 and A/New York/55/2004) and drift was also noted in some of the A(H1N1) strains from the reference/ vaccine strain A/New Caledonia/20/99, although very few A(H1N1) viruses were isolated in Australia in 2006. The B viruses isolated were predominately of the B/Victoria-lineage and similar to the reference/vaccine strain B/Malaysia/2506/2004.     

Australia's notifiable diseases status, 2006: annual report of the National Notifiable Diseases Surveillance System

In 2006, 66 diseases and conditions were nationally notifiable in Australia. States and territories reported a total of 138,511 cases of communicable diseases to the National Notifiable Diseases Surveillance System: an increase of 10.4% on the number of notifications in 2005. In 2006, the most frequently notified diseases were sexually transmissible infections (57,941 notifications, 42% of total notifications), gastrointestinal diseases (27,931 notifications, 20% of total notifications) and vaccine preventable diseases (22,240 notifications, 16% of total notifications). There were 19,111 notifications of bloodborne diseases; 8,606 notifications of vectorborne diseases; 1,900 notifications of other bacterial infections; 767 notifications of zoonoses and 3 notifications of quarantinable diseases.     

2006-2009年四川国家级监测点人群土源性线虫病监测结果分析

目的了解四川省国家级监测点居民土源性线虫病感染时段变化及影响因素,掌握流行规律,为制定防治对策提供科学依据。方法采用改良加藤厚涂片法和透明胶纸肛拭法对监测点常住居民土源性线虫感染情况进行调查。结果 2006-2009年共检查4 423人,其中男性2 146人,女性2 277人。男、女性蛔虫、鞭虫、钩虫感染率分别为1.68%、0.42%、12.44%和1.98%、0.40%、13.31%。2006-2009年土源性线虫感染率分别为32.06%、14.4%、10.16%和3.21%。2006和2009年蛔虫、鞭虫、钩虫感染率分别为4.10%、1.30%、30.10%和0.25%、0.00%、3.04%。结论四川省国家级监测点2006-2009年人群土源性线虫感染率呈下降趋势,与当地村民服药驱虫密切相关。     

Work-Related Injury Surveillance in Vietnam: A National Reporting System Model

Developing nations bear a substantial portion of the global burden of injury. Public health surveillance models in developing countries should recognize injury risks for all levels of society and all causes and should incorporate various groups of workers and industries, including subsistence agriculture. However, many developing nations do not have an injury registration system; current data collection methods result in gross national undercounts of injuries, failing to distinguish injuries that occur during work. In 2006, we established an active surveillance system in Vietnam’s Xuan Tien commune and investigated potential methods for surveillance of work-related injuries. On the basis of our findings, we recommend a national model for work-related injury surveillance in Vietnam that builds on the existing health surveillance system.Given the International Labor Organization’s estimate that work-related injuries kill 335 000 people each year (a worldwide rate of 14.0 deaths per 100 000 workers), with developing nations having the highest injury fatality rates,1–3 the lack of detailed health statistics on work-related injuries from developing countries is striking. In Vietnam injuries have grown to be a leading cause of mortality, and in 1996 the Vietnam Ministry of Health (MOH) established a national policy that recognized injuries as a public health problem and resolved to implement community programs centered on localized injury prevention.4 The MOH noted the difficulty in obtaining a comprehensive picture of injury determinants, including workplace injuries, from official statistics. Without accurate data to differentiate injury causes (e.g., traffic vs workplace), the burden of injuries on Vietnam’s economy and their influence on the long-term health and well-being of the country’s residents are largely hidden.We established an active injury surveillance system in the Xuan Tien commune of Vietnam in 2006 that allowed us to assess a number of potential improvements in surveillance of work injuries. We collaborated with and received the support of numerous levels of health care and government in Vietnam throughout the project (commune, district, province, ministry). The success of these relationships was dependent on the continuous efforts of the research staff at Vietnam’s National Institute for Occupational and Environmental Health. The results of the surveillance project showed that overall injury incidence rates were well in excess of those identified in any prior study in Vietnam, and a large majority of injuries (80%) were judged to be work related. More detailed information on the project is available elsewhere.5–9Here we apply our findings from the Xuan Tien study to make recommendations on how to improve the means by which existing national health reporting systems in Vietnam track work-related injuries. We use the active surveillance data we collected to examine the likely improvements in data quality that can be realized with incremental changes in the existing health surveillance system. Specifically, we propose adding some of the injury reporting elements we developed in Xuan Tien to the national system and enhancing standard hospital reports to allow more comprehensive collection of data on work-related injuries and their determinants. We describe possible improvements in the sensitivity of data collection on work-related injuries, including collection of information on industries, occupations, and populations at risk; types and causes of injuries; and measures of severity and burden.     

Acute Gastroenteritis Surveillance through the National Outbreak Reporting System,United States

Implemented in 2009, the National Outbreak Reporting System provides surveillance for acute gastroenteritis outbreaks in the United States resulting from any transmission mode. Data from the first 2 years of surveillance highlight the predominant role of norovirus. The pathogen-specific transmission pathways and exposure settings identified can help inform prevention efforts.     

Annual report of the Australian Meningococcal Surveillance Programme, 2006

In 2006 there were 271 laboratory-confirmed cases of invasive meningococcal disease analysed by the National Neisseria Network, a nationwide network of reference laboratories. The phenotypes (serogroup, serotype and serosubtype) and antibiotic susceptibility of 166 isolates of Neisseria meningitidis from invasive cases of meningococcal disease were determined and an additional 105 cases were confirmed by non-culture-based methods. Nationally, 217 (80%) confirmed cases were infected with serogroup B and 26 (9.6%) with serogroup C meningococci. The total number of confirmed cases was 74 (21%) fewer than the 345 cases identified in 2005. Numbers of cases decreased in all jurisdictions except Queensland. The age group showing the greatest decrease in numbers (by about one-third) was in those aged 25 years or more. A typical primary disease peak was observed in those aged 4 years or less with a lower secondary peak in adolescents and young adults. Serogroup B cases were 93% of all cases in those aged 4 years or less and 77% in those aged 15-24 years. The proportion of invasive disease represented by serogroup C disease was highest in the 20-24 years and 25-44 years age groups. The common phenotypes circulating in Australia were B:15:P1.7, B:4:P1.4, C:2a:P1.4 and C:2a:P1.5, but again with significant jurisdictional differences. No evidence of meningococcal capsular 'switching' was detected. About two thirds of all isolates showed decreased susceptibility to the penicillin group of antibiotics (MIC 0.06-0.5 mg/L). All isolates remained susceptible to rifampicin and ciprofloxacin.     

Annual report of the Australian Gonococcal Surveillance Programme, 2006

The Australian Gonococcal Surveillance Programme (AGSP) monitors the antibiotic susceptibility of Neisseria gonorrhoeae isolated in all states and territories. In 2006 the in vitro susceptibility of 3,850 isolates of gonococci from public and private sector sources was determined by standardised methods. Different antibiotic susceptibility patterns were again seen in the various jurisdictions and regions. Resistance to the penicillins nationally was at 34% and, with the exception of the Northern Territory, ranged between 17% and 51%. Quinolone resistance in gonococci increased, especially in Queensland, with resistance to this agent found in all jurisdictions. Nationally, 38% of all isolates were ciprofloxacin-resistant, and most of this resistance was at high minimum inhibitory concentration (MIC) levels. With the exception of the Northern Territory excepted, proportions of quinolone resistant gonococci ranged between 16% and 54%. All isolates remained sensitive to spectinomycin. Less than 1% of isolates showed some decreased susceptibility to ceftriaxone. A high proportion of gonococci examined in larger urban centres were from male patients and rectal and pharyngeal isolates were common. In other centres and in rural Australia the male to female ratio of cases was lower, and most isolates were from the genital tract.     

Annual report of the National Influenza Surveillance Scheme, 2005

Surveillance of influenza in Australia is based on laboratory isolation of influenza viruses, sentinel general-practitioner reports of influenza-like illness, and absenteeism data from a major national employer. In 2005, 4,575 cases of laboratory-confirmed influenza-like illness were reported, which was 115 per cent higher than in 2004. The influenza season started in the first week of June, with peak activity in early August, a month earlier than in 2004. Influenza A was the predominant type notified (73%), while influenza B activity continued to increase compared to previous years. During 2005, the influenza notification rate amongst persons aged over 65 years (22 cases per 100,000 population) was 70 per cent higher than the mean rate of the last four years. One thousand one hundred and seventy-four influenza isolates from Australia were antigenically analysed: 689 were A(H3N2), 210 were A(H1N1) strains and 275 were influenza B viruses. Continued antigenic drift was seen with the A(H3N2) viruses from the previous reference strains with approximately one quarter of isolates being distinguishable from A/Wellington/1/2004-like viruses and more closely matched to A/California/7/2004-like viruses.     

Annual report of the National Influenza Surveillance Scheme, 2007

The year 2007 saw the most severe influenza season since national reporting of influenza began in 2001. Early in the season the National Incident Room was activated to provide effective national surveillance, reporting and management of the 2007 seasonal influenza outbreak. A surveillance team were tasked with establishing enhanced surveillance for the 2007 season and investigating unusual events in this outbreak. Key data required to comprehensively describe the number of cases, morbidity, mortality and virology of the influenza outbreak and the possible sources of these data were identified. In 2007 the number of laboratory-confirmed notifications for influenza was 3.1 times higher than the five-year mean. Forty-four per cent of notifications occurred in Queensland. High notification rates were reflected in an increase in presentations with influenza-like illness to sentinel general practices and Emergency Departments. Notifications and notification rates were highest in the 0-4 and 5-9 years age groups, possibly due to a bias towards testing in these age groups. The clinical morbidity of the infection in terms of complications or most affected groups cannot be determined but anecdotal reports indicate this season may have impacted young adults more than is usual. The available data suggest influenza has caused a significant burden on workplaces and the health care system as indicated by data on absenteeism and presentations for health care. The proportion of H1 strains of influenza circulating varied across Australia but was higher than 2006 in most jurisdictions. In 2007, 1,406 influenza isolates from Australia were antigenically analysed at the World Health Organization Collaborating Centre for Reference and Research on Influenza in Melbourne: 58.7% were A(H3N2), 34.4% were A(H1N1) and 6.9% were influenza B viruses. Antigenic drift away from the vaccine strain A/Wisconsin/67/2005 was observed with the A(H3N2) viruses and was also seen with most of the A(H1N1) viruses when compared with the vaccine strain A/New Caledonia/20/99. The small number of influenza B viruses examined were predominately of the B/Yamagata-lineage. Monitoring influenza through the National Incident Room during the 2007 season offered an excellent opportunity to conduct enhanced surveillance under conditions that were real and potentially serious but not an emergency. It enabled the current state of our surveillance systems to be assessed and opportunities for improvement to be identified.     

Annual report of the National Influenza Surveillance Scheme, 1999

An effective national surveillance system is an essential component of a program for the control of influenza. The National Influenza Surveillance Scheme includes data from sentinel general practice consultations for influenza-like illness, laboratory reports of influenza and absenteeism rates from a national employer. The 1999 season peaked between May and September with maximal activity between July and August. Influenza A was the dominant type in all States and Territories with influenza A H3N2 viruses predominating and influenza A H1N1 occurring sporadically. There was no evidence of significant drift among the H3N2 isolates (A/Sydney-like strains) whereas the H1N1 isolates showed significant antigenic changes from the vaccine strain A/Beijing/262/95 and were closely related to a new variant A/New Caledonia/20/99. A small peak in influenza B activity occurred towards the end of the influenza season and isolates remained closely related to the vaccine reference strain B/Beijing/184/93.