Timely immunisation is important to protect children from communicable diseases. However, immunisation uptake in Aboriginal and Torres Strait Islander children under the age of two years is often lower than in non-Indigenous children. This contributes to the gap in health outcomes between Aboriginal and Torres Strait Islander children and non-Indigenous children. We have tested the effectiveness of short message service (SMS) reminders in improving timeliness of childhood immunisation in Aboriginal and Torres Strait Islander infants in regional Queensland, Australia. Reminders were sent to parents of Aboriginal and Torres Strait Islander children, at five immunisation age milestones: six weeks, four months, six months, 12 months, and 18 months. There was a significant improvement in the proportion of children vaccinated on-time (within 30 days of the due date), compared to an earlier age cohort, at all milestones except 12 months. The absolute risk difference (ARD) of on-time vaccination between the two cohorts ranged between 4.7% (95% confidence interval [95% CI]: 1.1–8.2%, at six weeks) and 12.9% (95% CI: 7.4–18.5%, at six months). The likelihood of on-time vaccination (rate ratio, RR) in the intervention group compared to the control group ranged from 1.05 (95% CI: 1.01–1.10, at six weeks) to 1.31 (95% CI: 1.14–1.50, at 18 months). SMS reminders were associated with an improvement in immunisation timeliness in Aboriginal and Torres Strait Islander infants at all age milestones measured except 12 months.

FluTracking provided evidence for an early, long, but moderate influenza season in the Australian community compared to prior years. Influenza-like illness (ILI) activity in 2019 peaked earlier (week ending 16 June) than any season on record in FluTracking data. ILI attack rates were above average early in the 2019 season (peak of 2.2%), and the duration of peak activity was longer than most prior years. However, ILI attack rates were lower than the five-year average in the latter half of the season. FluTracking participants reported higher vaccination coverage in 2019 (73.3%) compared with 2018 (65.7%), with the most notable increase in children aged less than five years (69.3% in 2019, compared to 55.6% in 2018). The total 2019 count of laboratory notifications (312,945) was higher than prior years (2007 onwards), and the peak weekly count of 18,429 notifications in 2019 was also higher than all prior years, except 2017. FluTracking makes a comparison to another surveillance system each year. The peak weekly percentage of calls to HealthDirect that were influenza-related was higher in 2019 (12.8%) than for 2014–2018 (range of 8.2–11.4% for peak week of activity each year). FluTracking participants reported a 2.5 times increase in influenza testing from 2018 to 2019 and a 1.5 times increase from 2017. Although 2019 was of higher activity and severity than 2018, Flutracking data indicates that 2019 was a lower activity and severity season than 2017, and notifications and influenza-related calls were heightened by increased community concern and testing.

Objective To determine whether a clinical scoring system (the mPRIEST score) could be used to identify an emerging coronavirus disease 2019 (COVID-19) variant with increased clinical severity. Design Cross sectional study comparing two time periods (Delta and Omicron waves). Setting Public Emergency Departments in Northern Sydney Local Health District. Participants Patients presenting during August 2021 (Delta wave) and January 2022 (Omicron wave) with confirmed COVID-19. Data on age, gender, temperature, heart rate, systolic blood pressure, respiratory rate, oxygen saturation and mental status were extracted from patients’ electronic medical records to assess clinical disease severity at presentation. Main outcome measures Modified Pandemic Respiratory Infection Emergency System Triage (mPRIEST) score calculated using routinely collected data. Results A sample of 262 records of COVID-19 positive patients presenting during the Delta and initial Omicron waves were reviewed with 205 having COVID-19 as their primary diagnosis. During the Delta wave 48.1% had scores above 4 compared to 35.1% for the Omicron wave (p = 0.03). The median score was also significantly higher for the Delta group (4 vs 3; p = 0.01). Hospitalisations, admissions to ICU and deaths during admission were higher among patients presenting during the Delta wave than among those presenting during the Omicron wave. Conclusion The mPRIEST score was significantly higher for patients for whom the predominant circulating variant was Delta than those for whom the predominant circulating variant was Omicron. This finding is consistent with international reporting of severity measured by hospital admission data and demonstrates the score’s possible ability to identify an emergent strain with higher morbidity and mortality.

Campylobacter is the most common bacterial cause of foodborne gastroenteritis in Australia; however, outbreaks caused by the pathogen are relatively uncommon. In March 2022, the Victorian Department of Health was notified of a gastrointestinal illness in 20 guests following attendance at a wedding reception. Two of these individuals were notified with laboratory-confirmed campylobacteriosis, and an investigation was undertaken to identify the source of the infection and implement strategies to prevent further illness. A case-control study was conducted to determine the likely source of infection. Cases were defined as attendees of the wedding reception, with onset of diarrhoea and/or abdominal cramping 1–10 days after attending the function. Controls were randomly selected from the remaining list of non-ill guests. Cases and controls were interviewed using a standardised, menu-based questionnaire. Food preparation processes were documented, and food samples collected. A total of 29 wedding guests met the case definition. Cases reported onset of illness 2–5 days following the wedding and major symptoms included abdominal cramping (100%), diarrhoea (90%), headache (79%), and fever (62%). Two cases were hospitalised, one with ongoing secondary neurological sequelae. Illness was significantly associated with consumption of a duck breast brioche canapé containing duck liver parfait (odds ratio = 2.85; 95% confidence interval: 1.03–7.86). No leftover food samples were available for testing. The investigation found that the duck canapé was the likely vehicle of infection. Consistent with the literature on Campylobacter transmission, it is likely that inadequate cooking of the duck liver for the parfait was the contributing factor that led to illness. This highlights the risks posed by undercooked poultry dishes, and shows that education of food handlers remains a priority.

Introduction Pathogens can enter the drinking water supply and cause gastroenteritis outbreaks. Such events can affect many people in a short time, making them a high risk for public health. In Australia, the Victoria State Government Department of Health is deploying a syndromic surveillance system for drinking water contamination events. We assessed the utility of segmented regression models for detecting such events and determined the number of excess presentations needed for such methods to signal a detection. Methods The study involved an interrupted time series study of a past lapse in water treatment. The baseline period comprised the four weeks before the minimum incubation period of suspected pathogens, set at two days post-event. The surveillance period comprised the week after. We used segmented linear regression to compare the count of gastroenteritis presentations to public hospital emergency departments (EDs) between the surveillance and baseline periods. We then simulated events resulting in varying excess presentations. These were superimposed onto the ED data over fifty different dates across 2020. Using the same regression, we calculated the detection probability at p < 0.05 for each outbreak size. Results In the retrospective analysis, there was strong evidence for an increase in presentations shortly after the event. In the simulations, with no excess presentations (i.e., with the ED data as is) the models signalled 8% probability of detection. The models returned 50% probability of detection with 28 excess presentations and 100% probability of detection with 78 excess presentations. Conclusions The transient increase in presentations after the event may be attributed to microbiological hazards or increased health-seeking behaviour following the issuing of boil water advisories. The simulations demonstrated the ability for segmented regressions to signal a detection, even without a large excess in presentations. The approach also demonstrated high specificity and should be considered for informing Victoria’s syndromic surveillance system.

Background Syphilis is a nationally notifiable sexually transmitted infection (STI). Rates of syphilis notifications have been on the increase in Australia. Given these increases, we wanted to study the epidemiological trends of syphilis notifications in the Nepean Blue Mountain Local Health District (NBMLHD) over a ten-year period across different healthcare settings. Methods All syphilis notifications in residents in the NBMLHD in the ten-year period between 1 October 2009 and 30 September 2019 were included in the study. Separate analyses were performed for all syphilis notifications, as well as for infectious syphilis and for syphilis acquired > 2 years ago or of unknown duration. We described age distribution and demographic profile and risk factors of all syphilis notifications. Notification trends were studied and crude incidence rates were calculated. Notifications were stratified by stage of syphilis, sex, and geographical location. Results In the study duration, a total of 342 notifications of syphilis were received. Of these, 187 were infectious syphilis and 155 were related to infections acquired > 2 years ago and/or of unknown duration. The majority of notifications were in men: 281 (82%). Overall, syphilis notifications increased over the ten-year study period. The crude incidence rates for infectious syphilis were significantly higher in the second five-year period overall (7.78/100,000 population per year compared to 5.28/100,000 population per year; incidence rate ratio (IRR): 1.47; 95% confidence interval (95% CI): 1.10–1.97; p < 0.01), as well as for males (14.44/100,000 population per year compared to 9.7/100,000 population per year; IRR: 1.49; 95% CI: 1.09–2.03; p < 0.01). There were significant increases in syphilis notifications in males < 35 years of age, from 39 such notifications in the first five-year period (27.5% of all syphilis notifications in this period) to 83 notifications in the second five-year period (42.1% of all notifications in this period), p < 0.05. Conclusion In keeping with national trends, notifications in our study increased. Significant increases were noted in notifications among males under 35 years of age. This supports the continued investment in sexual health promotion activities aimed at young sexually active men. Expansion of screening activities to include women and older people would help detect any increase in cases in these groups. Increase in engagement with general practitioners will support them to provide opportunistic STI screens to sexually-active attendees. National screening recommendations remain applicable to this population.