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Abstract: Australia monitors its polio-free status by conducting surveillance for cases of acute flaccid paralysis (AFP) in children less than 15 years of age, as recommended by the World Health Organization (WHO). Cases of AFP in children are notified to the Australian Paediatric Surveillance Unit or the Paediatric Active Enhanced Disease Surveillance System, and faecal specimens are referred for virological investigation to the National Enterovirus Reference Laboratory. In 2022, no cases of poliomyelitis were reported from clinical surveillance and Australia reported 1.69 non-polio AFP cases per 100,000 children, thereby meeting the WHO's performance criterion for a sensitive surveillance system. The non-polio enteroviruses coxsackievirus A2, coxsackievirus A6, coxsackievirus A10, echovirus 18, enterovirus A71 and enterovirus C96 were identified from clinical specimens collected from AFP cases. Australia also performs enterovirus and environmental surveillance to complement the clinical system focussed on children. In 2022, thirty cases of wild poliovirus were reported from three countries (Afghanistan, Mozambique and Pakistan); 24 countries also reported cases of poliomyelitis due to circulating vaccine-derived poliovirus., (© Commonwealth of Australia CC BY-NC-ND.)

Australia monitors its polio-free status by conducting surveillance for cases of acute flaccid paralysis (AFP) in children less than 15 years of age, as recommended by the World Health Organization (WHO). Cases of AFP in children are notified to the Australian Paediatric Surveillance Unit or the Paediatric Active Enhanced Disease Surveillance System, and faecal specimens are referred for virological investigation to the National Enterovirus Reference Laboratory. In 2021, no cases of poliomyelitis were reported from clinical surveillance and Australia reported 1.31 non-polio AFP cases per 100,000 children, thereby meeting the WHO's performance criterion for a sensitive surveillance system. The non-polio enteroviruses coxsackievirus A4, coxsackievirus A10, coxsackievirus A13 and enterovirus A71 were identified from clinical specimens collected from AFP cases. Australia also performs enterovirus and environmental surveillance to complement the clinical system focussed on children. In 2021, there were five cases of wild poliovirus reported from the two remaining endemic countries: Afghanistan and Pakistan. Including Afghanistan and Pakistan, 22 countries also reported cases of AFP due to circulating vaccine-derived poliovirus., (© Commonwealth of Australia CC BY-NC-ND.)

Nutrition plays an important role in pain management. Healthy eating patterns are associated with reduced systemic inflammation, as well as lower risk and severity of chronic non-cancer pain and associated comorbidities. The role of nutrition in chronic non-cancer pain management is an emerging field with increasing interest from clinicians and patients. Evidence from a number of recent systematic reviews shows that optimising diet quality and incorporating foods containing anti-inflammatory nutrients such as fruits, vegetables, long chain and monounsaturated fats, antioxidants, and fibre leads to reduction in pain severity and interference. This review describes the current state of the art and highlights why nutrition is critical within a person-centred approach to pain management. Recommendations are made to guide clinicians and highlight areas for future research.

Abstract: Australia monitors its polio-free status by conducting surveillance for cases of acute flaccid paralysis (AFP) in children less than 15 years of age, as recommended by the World Health Organization (WHO). Cases of AFP in children are notified to the Australian Paediatric Surveillance Unit or the Paediatric Active Enhanced Disease Surveillance System and faecal specimens are referred for virological investigation to the National Enterovirus Reference Laboratory. In 2020, no cases of poliomyelitis were reported from clinical surveillance; Australia reported 1.09 non-polio AFP cases per 100,000 children, thereby meeting the WHO's performance criterion for a sensitive surveillance system. The non-polio enteroviruses coxsackievirus A10 and coxsackievirus A16 were identified from clinical specimens collected from AFP cases. Australia also performs enterovirus surveillance and environmental surveillance to complement the clinical system focussed on children. In 2020, there were 140 cases of wild poliovirus reported from the two remaining endemic countries: Afghanistan and Pakistan. Another 28 countries reported cases of circulating vaccine-derived poliovirus., (© Commonwealth of Australia CC BY-NC-ND.)

Guidelines for chronic noncancer pain prioritize behavioral treatments. In clinical practice transition from opioids to behavioral treatments is often not endorsed by patients or providers. Feasible interventions to support opioid tapering are needed, particularly in primary care. The objectives of this paper is to review the feasibility of behavioral interventions to support opioid tapering. Electronic databases (MEDLINE, Embase, PsycINFO, and CINAHL) were searched from inception to June 2019 to identify original studies reporting feasibility (consent rates; completion rates; patient-reported acceptability; integration into clinical practice; and adverse events) of opioid tapering and transition to behavioral treatments for adults experiencing chronic noncancer pain. Google scholar and contents tables of key journals were also searched. Two authors independently extracted data and assessed methodological quality using The Quality Assessment Tool for Quantitative Studies. Eleven publications met inclusion criteria, of which three were conducted in primary care. Consent rates ranged from 27% to 98% and completion rates from 6.6% to 100%. Four studies rated at least one component of patient acceptability: helpfulness from 50%-81%; satisfaction 71%-94%, and "recommend to others" 74%-91%. Three studies reported provider perspectives and two studies reported adverse events. Quality assessment indicated all 11 studies were moderate or weak, primarily due to selection bias and lack of assessor blinding. There was also considerable heterogeneity in study design. The limited available data suggest that attempts to translate opioid tapering interventions into practice are likely to encounter substantial feasibility challenges. One possible way to ameliorate this challenge may be a clear policy context, which facilitates and support opioid reduction., (© Society of Behavioral Medicine 2021. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Noroviruses are a leading cause of acute gastroenteritis (AGE) among adults and children worldwide. NoroSurv is a global network for norovirus strain surveillance among children <5 years of age with AGE. Participants in 16 countries across 6 continents used standardized protocols for dual typing (genotype and polymerase type) and uploaded 1,325 dual-typed sequences to the NoroSurv web portal during 2016-2020. More than 50% of submitted sequences were GII.4 Sydney[P16] or GII.4 Sydney[P31] strains. Other common strains included GII.2[P16], GII.3[P12], GII.6[P7], and GI.3[P3] viruses. In total, 22 genotypes and 36 dual types, including GII.3 and GII.20 viruses with rarely reported polymerase types, were detected, reflecting high strain diversity. Surveillance data captured in NoroSurv enables the monitoring of trends in norovirus strains associated childhood AGE throughout the world on a near real-time basis.

Dietary fiber affects canine physiology in many ways, such as increasing colonic absorption of water and improving gut health, both of which may positively impact exercise performance. The objectives of this study were to investigate the effects of increased dietary soluble fiber and incremental training on respiratory rate (RR), internal body temperature (BT), body composition, and fecal metabolites in mid-distance training sled dogs. Fourteen dogs (12 Siberian and 2 Alaskan Huskies) were blocked by age, sex, and body weight (BW) and then randomly allocated into one of two diet groups. Seven dogs were fed a dry extruded control diet (Ctl) with an insoluble:soluble fiber ratio of 4:1 (0.74% soluble fiber on a dry-matter basis), and seven dogs were fed a dry extruded treatment diet (Trt) with an insoluble:soluble fiber ratio of 3:1 (2.12% soluble fiber on a dry-matter basis). Fecal samples were taken once a week. All dogs underwent 9 weeks of incremental exercise conditioning where the running distance was designed to increase each week. Every 3 weeks, external telemetry equipment was used to non-invasively measure and record RR and internal BT at resting, working, and post-exercise recovery states. Body composition was measured on weeks -1 and 9 using quantitative magnetic resonance. Body composition, RR, BT, and fecal metabolites were analyzed using a mixed model with dog as a random effect and week and diet group as fixed effects. Dogs on Trt had lower working and post-exercise BT than Ctl ( P < 0.05). In addition, Trt dogs had lower recovery BT at weeks 2 and 5 than Ctl dogs ( P < 0.05). Treatment dogs had greater fecal short-chain fatty acid concentrations than Ctl ( P < 0.05). Diet had no effect on RR or body composition ( P > 0.10), but exercise resulted in an overall 7% increase in lean and 3.5% decrease in fat mass ( P < 0.05). These data suggest that increasing dietary soluble fiber may positively influence BT and gut health; however, it has no effect on RR or body composition. Soluble fiber did not negatively impact any measures of overall health and performance and should be considered for use in performance dogs., Competing Interests: MB was employed by the company emka Technologies. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors declare that this study received funding from Champion Petfoods Ltd. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication., (Copyright © 2021 Thornton, Robinson, Templeman, Bruggink, Bower, Cant, Holloway, Swanson, Squires and Shoveller.)

In Victoria, Australia, 160 gastroenteritis outbreaks were norovirus positive for the period January-September 2017. A distinctive peak in norovirus outbreaks was seen May-August, with 118 positive outbreaks occurring in the peak period. The peak was primarily due to the emergence of a GII.P4&#95;NewOrleans&#95;2009/GII.4&#95;Sydney&#95;2012 recombinant that had genetically changed sufficiently to escape herd immunity. This recombinant was also identified elsewhere in Australia, with highly similar sequences identified in Queensland during the same time period. The recombinant GII.P4&#95;NewOrleans&#95;2009/GII.4&#95;Sydney&#95;2012 has not been reported to cause norovirus epidemics outside Australia, suggesting regional factors play a role in determining norovirus genotype incidence., (© 2018 Wiley Periodicals, Inc.)

A norovirus recombinant GII.P4&#95;NewOrleans&#95;2009/GII.4&#95;Sydney&#95;2012 was first detected in Victoria, Australia, in August 2015 at low frequency, and then re-emerged in June 2016, having undergone genetic changes. Analysis of 14 years' surveillance data from Victoria suggests a typical delay of two to seven months between first detection of a new variant and occurrence of a subsequent epidemic linked to that variant. We consider that the current recombinant strain has the potential to become a pandemic variant., Competing Interests: Conflicts of Interest: None declared., (This article is copyright of ECDC, 2016.)

The current study examined the efficacy of the RIDAGENE norovirus (NoV) real-time polymerase chain reaction assay (R-Biopharm, Darmstadt, Germany) for use in a routine diagnostic laboratory. The RIDAGENE assay had an overall sensitivity of 98% but was more sensitive for GII than GI NoV. The assay had a specificity of 98%. The RIDAGENE assay could detect a variety of GI and GII open reading frame 2 genotypes including GI.1, GI.3, GI.8, GI.13, GII.2, GII.3, GII.4 (including the following variants: 2006b, 2009, 2012, and 3 others that have not been assigned), GII.6, GII.12, and GII.13. The assay did not cross react with a number of gastroenteritis viruses including adenovirus, astrovirus, rotavirus, and sapovirus. The assay was straightforward to perform, and for a run of 50 specimens, a result was obtainable in roughly 4 hours. The RIDAGENE assay can be recommended as a valuable detection method for NoV., (Copyright © 2014 Elsevier Inc. All rights reserved.)

The noroviruses are a major cause of outbreaks of gastroenteritis. The norovirus genotype "GII.e", identified by ORF (Open Reading Frame) 1 nucleotide sequencing, appears to be an obligatory recombinant, in that no unique GII.e ORF 2 genotype has been identified. In 2012 GII.e norovirus became the predominant ORF 1 genotype in norovirus outbreaks in Victoria, Australia, and the current study documents changes in the ORF 1 region of GII.e norovirus since it first emerged in 2008, as well as in the ORF 2 genotypes associated with GII.e norovirus. GII.e norovirus underwent significant genetic change in ORF 1 between 2010 and 2012 and this genetic change corresponded to a significant increase in the prevalence of the virus. Nucleotide sequencing of the ORF 2 region of GII.e specimens showed that in 2008-2009, all the ORF 2 sequences corresponded to the GII.4 (2007) variant, in 2010 all the ORF 2 sequences corresponded to the GII.4 (2012-like) variant and in 2012 all the ORF 2 sequences corresponded to the GII.4 (2012) variant, the GII.4 (2012-like) variant, or the GII.4 (2009-like) variant. The evidence indicated that the development of the 2012 GII.e epidemic strains was due to evolutionary change rather than a novel recombination event. The results also support the notion that ORF 1 is critical in determining the virulence of a norovirus strain., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Background: There is evidence that norovirus genotype is an important factor in determining norovirus epidemiology, but detailed information is lacking. This report examined this question by studying whether the mix of norovirus genotypes associated with norovirus outbreaks in health care settings was different to that in nonhealth care settings., Methods: Norovirus outbreaks tested in Victoria, Australia, 2002-2005 were classified as either health care or nonhealth care. Open reading frame 1 nucleotide sequencing analysis was then used to determine the mix of norovirus genotypes in health care and nonhealth care norovirus outbreaks., Results: For the three most common genotypes detected (GI.2, GII.4, and GIIb), the differences between health care and nonhealth care settings were significant. GII.4 was significantly more common in health care settings than in nonhealth care settings, whereas the genotypes GI.2 and GIIb were significantly more common in nonhealth care settings than in health care settings., Conclusion: Norovirus genotype was found to be an important factor associated with norovirus outbreak setting., (Copyright © 2011. Published by Elsevier B.V.)

Objectives: The molecular and epidemiological features of community-based norovirus-associated sporadic gastroenteritis incidents (NASGIs) are poorly understood. This study examined these features and compared the findings with studies of community-based and institutional norovirus-associated gastroenteritis outbreaks (NAGOs)., Methods: Fecal specimens from NASGIs and NAGOs that occurred in Victoria, Australia (2002-2007) were tested for norovirus by reverse transcription-polymerase chain reaction methodology. Norovirus genotype was determined by nucleotide sequence analysis., Results: 106 community-based NASGIs, 116 community-based NAGOs and 902 institutional NAGOs were identified. The mean age and gender ratio of individuals associated with community-based NASGIs and community-based NAGOs were similar but differed from that found for institutional NAGOs. Although GII.4 was the predominant genotype associated with all three incident types, the mix of genotypes was similar for community-based NASGIs and community-based NAGOs but that for institutional NAGOs was different. All three incident types had a similar seasonal periodicity due to the pronounced seasonal periodicity of GII.4 incidents., Conclusions: The molecular and epidemiological features of noroviruses associated with community-based NASGIs and community-based NAGOs are similar but are different from those found for institutional NAGOs., (2010 S. Karger AG, Basel.)

The epidemiology of GIIb norovirus outbreaks and the characteristics of GIIb open reading frame (ORF) 2 recombinant forms are poorly understood and this study examined these questions using norovirus-associated gastroenteritis outbreaks in Victoria, Australia, during 2002-2005. Twenty-one GIIb outbreaks were detected and were the second most common ORF 1 norovirus outbreak genotype (5%) after GII.4 (90%). Both GIIb and GII.4 outbreaks peaked in warmer months of the year but their periodicity was different. ORF 2 sequencing analysis was carried out in the two regions previously designated C and D. RT-PCR region D primers were less sensitive than region C primers. No evidence of recombination between regions C and D was found. ORF 2 genotypes for the 21 GIIb outbreaks were: GII.1 (10 outbreaks), GII.3 (10 outbreaks) and, apparently for the first time, GII.13 (1 outbreak). GIIb outbreaks could occur in a broad range of settings and there was no correlation between ORF 2 genotype and setting except that all 5 outbreaks involving mainly young children were associated with GIIb/GII.3.

Noroviruses are considered the most common cause of outbreaks of non-bacterial gastroenteritis in humans and the GII.4 genotype the most common norovirus genotype. Previous studies have shown that two adjacent codons acted as markers of the severity of GII.4 norovirus outbreak epidemics. In this study, a further such codon was identified at nucleotide position 4670-4672 relative to the norovirus strain Lordsdale virus (GenBank accession no. X86557). Taken together, the data indicate these epidemic marker sites occur, on average, about once in 30 amino acids (aa) in the polymerase region. None of the variant forms associated with the three codons resulted in an aa change. The three codons were not associated with the active sites of the polymerase gene. It is possible changes in these marker sites may influence norovirus virulence by altering the timing of co-translational folding in the norovirus genome.

The aim of the study was to compare the sensitivity of a norovirus RT-PCR method using two manual RNA extraction methods (Qiagen and Roche) and two automated RNA extraction methods (Qiagen and Corbett). All four RNA extraction methods gave similar sensitivities although the automated methods, especially the Corbett, required significantly less labour than the manual methods. The automated methods also enabled RNA extraction of approximately two to three times the number of specimens in a given time period compared to manual methods.

This study examined whether a specific (six-nucleotide) sequence in the norovirus polymerase (POL) gene could act as a marker of GII.4 epidemics in Australia in 2001-2005. The predominant variant (pv) in an epidemic year (2002, 2004) changed relative to the pv in the previous year (AACTTG in 2001 to AATCTG in 2002, AATCTG in 2003 to AACTTG in 2004). The pv in a non-epidemic year (2003, 2005) was the same as in the preceding year (AATCTG in 2002 and 2003, AACTTG in 2004 and 2005). Thus, specific short nucleotide sequences could act as markers of major GII.4 norovirus epidemics.