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The article presents the study describing the epidemiology of infectious syphilis among Australian Aboriginals and Torres Strait Islanders. It elaborates on the assessment of trends in national infectious syphilis notification rates from 2005 to 2009 and the comparison of the Indigenous and non-Indigenous rate ratios. The authors reveal the two distinct patterns of infectious syphilis which show a declining incidence in Indigenous remote communities and an increase in urban and regional areas.

Objective: To evaluate the value of notification to public health units (PHUs) in the management of viral gastrointestinal outbreaks in residential care facilities (RCFs) in Queensland., Methods: Routine outbreak characteristics and control measures were collected at notification and conclusion of outbreaks notified between May and August 2008. This was supplemented with detailed interviews with RCFs and PHUs, including perceptions of the value of the RCF-PHU interaction., Results: Norovirus was the confirmed aetiological agent in 39 (68%) of 60 outbreaks. A significant association was found between increased outbreak duration and longer (≥4 days) time to outbreak notification (p<0.01) and larger facility size (≥150 people; p<0.05). Increased attack rate was not significantly associated with either time to outbreak notification or facility size, but was significantly associated with difficulty in cohorting (p<0.05). Most (92%) RCFs considered that outbreak notification was important and that PHU support was useful (97%). Most PHUs (77%) also considered that outbreak notification was important., Conclusions: This study demonstrates an association between prompt notification of viral gastroenteritis outbreaks to PHUs and shorter duration of outbreaks., Implications: This study provides evidence to support recommendations in current Australian guidelines that notification of outbreaks should occur promptly., (© 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia.)

Enhanced surveillance for invasive pneumococcal disease (IPD) was carried out in all Australian states and territories in 2005 with comparative data available since 2001. There were 1,680 cases of IPD notified to the National Notifiable Diseases Surveillance System in Australia in 2005; a notification rate of 8.3 cases per 100,000 population. The rates varied between states and territories and by geographical region with the highest rates in the Northern Territory, the jurisdiction with the largest proportion of Indigenous people. Invasive pneumococcal disease was reported most frequently in those aged 85 years or over (41 cases per 100,000 population) and in 1-year-old children (36.5 cases per 100,000 population). Enhanced data provided additional information on 1,015 (60%) of all notified cases. The overall rate of IPD in Indigenous Australians was 8.6 times the rate in non-Indigenous Australians. There were 126 deaths attributed to IPD resulting in an overall case fatality rate of 7.5%. While the rate of IPD in the Indigenous under 2-year-old population decreased from 219 cases per 100,000 population since targeted introduction of the 7-valent conjugate pneumococcal vaccine (7vPCV) in 2001, the rate in 2005 (94 cases per 100,000 population) was significantly greater than in non-Indigenous children (20.4 cases per 100,000 population). Rates of disease in all children aged less than 2 years, caused by serotypes in the 7vPCV decreased by 75% between 2004 and 2005 as a result of the introduction of a universal childhood 7vPCV immunisation program. Significant decreases in IPD caused by 7vPCV serotypes also occurred in the 2-14 years and 65 years or over age groups. There is no evidence of replacement disease with non-vaccine serotypes. Serotypes were identified in 90% of all notified cases, with 61% of disease caused by serotypes in the 7vPCV and 88% caused by serotypes in the 23-valent polysaccharide pneumococcal vaccine (23vPPV). Reduced penicillin susceptibility remains low and reduced susceptibility to 3rd generation cephalosporins is rare.

There were 2,375 cases of invasive pneumococcal disease (IPD) notified to the National Notifiable Diseases Surveillance System in Australia in 2004; a notification rate of 11.8 cases per 100,000 population. The rate varied between states and territories and by geographical region with the highest rates in the Northern Territory. Invasive pneumococcal disease was reported most frequently in children aged less than 5 years (55.4 cases per 100,000 population). Enhanced surveillance for IPD was carried out in all states and territories, in 2004, providing additional data on 2,023 (85%) cases. The overall rate of IPD in Indigenous Australians was 3.2 times the rate in non-Indigenous Australians. There were 154 deaths attributed to IPD resulting in an overall case fatality rate of 7.6 per cent. Rates of IPD in the Indigenous and non-Indigenous under 2-year-old population were similar in 2004 (91.5 and 93.6 cases per 100,000 population, respectively) following a targeted introduction of the 7-valent pneumococcal conjugate vaccine (7vPCV) in mid-2001 for Indigenous infants and children. Serotypes of isolates were identified from 80 per cent of all notified cases, with 72 per cent of isolates belonging to serotypes represented in the 7vPCV and 91 per cent in the 23-valent polysaccharide pneumococcal vaccine (23vPPV). Comparison of serotypes in the 7vPCV target population showed that the rate of IPD due to 7vPCV serotypes decreased by 74 per cent between 2001-02 and 2003-04. Of 216 isolates with reduced penicillin susceptibility, 83 per cent belonged to pneumococcal serotypes in the 7vPCV and 95 per cent in the 23vPPV.