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Abstract Background A storm-related disaster in New South Wales, Australia in June 2007 caused infrastructure damage, interrupted essential services, and presented major public health risks. We investigated household disaster preparedness and information sources used before and during the disaster. Methods Rapid cluster survey of 320 randomly selected households in Newcastle and Lake Macquarie, New South Wales, Australia. Results 227 households (71%) responded to the survey. By the day before the storm, 48% (95%CI 40–57%) of households were aware of a storm warning, principally through television (67%; 58–75%) and radio (57%; 49–66%) announcements. Storm preparations were made by 42% (28–56%) of these households. Storm information sources included: radio (78%; 68–88%); family, friends, colleagues and neighbours (50%; 40–60%); and television (41%; 30–52%). Radio was considered more useful than television (62%; 51–73% vs. 29%; 18–40%), even in households where electricity supply was uninterrupted (52%; 31–73% vs. 41%; 20–63%). Only 23% (16–30%) of households were aware that the local government-operated radio network has a designated communication role during disasters. A battery-operated household radio and appropriate batteries were available in 42% (34–50%) of households, while only 23% (16–29%) had all of: a torch, battery-operated radio, appropriate batteries, mobile phone, emergency contact list and first aid equipment. Conclusion Broadcast media are important information sources immediately before and during disasters. Health services should promote awareness of broadcast networks' disaster role, especially the role of radio, and encourage general household disaster preparedness. A rapid cluster survey conducted shortly after a natural disaster provided practical, robust information for disaster planning.

The World Health Organization (WHO) declared a public health event of international importance on April 24, 2009, after recognition of a novel pandemic influenza virus strain, pH1N1, now called pandemic [...]

Objective To examine the level of stated compliance with public health pandemic influenza control measures and explore factors influencing cooperation for pandemic influenza control in Australia. Methods A computer-assisted telephone interview survey was conducted by professional interviewers to collect information on the Australian public&apos;s knowledge of pandemic influenza and willingness to comply with public health control measures. The sample was randomly selected using an electronic database and printed telephone directories to ensure sample representativeness from all Australian states and territories. After we described pandemic influenza to the respondents to ensure they understood the significance of the issue, the questions on compliance were repeated and changes in responses were analysed with McNemar&apos;s test for paired data. Findings Only 23% of the 1166 respondents demonstrated a clear understanding of the term "pandemic influenza". Of those interviewed, 94.1% reported being willing to comply with home quarantine; 94.2%, to avoid public events; and 90.7%, to postpone social gatherings. After we explained the meaning of "pandemic" to interviewees, stated compliance increased significantly (to 97.5%, 98.3% and 97.2% respectively). Those who reported being unfamiliar with the term "pandemic influenza," male respondents and employed people not able to work from home were less willing to comply. Conclusion In Australia, should the threat arise, compliance with containment measures against pandemic influenza is likely to be high, yet it could be further enhanced through a public education programme conveying just a few key messages. A basic understanding of pandemic influenza is associated with stated willingness to comply with containment measures. Investing now in promoting measures to prepare for a pandemic or other health emergency will have considerable value. Une traduction en francais de ce resume figure a la fin de l&apos;article. Al final del articulo se facilita una traduccion al espanol. Objectif Etudier le niveau d&apos;observance declare des mesures de sante publique contre la grippe pandemique et les facteurs influant sur la cooperation des Australiens a l&apos;endiguement de cette maladie. Methodes Une enquete par entretien telephonique assistee par ordinateur a ete menee par des enqueteurs professionnels pour recueillir des informations sur les connaissances de la population australienne au sujet de la grippe pandemique et sur sa volonte de respecter les mesures de sante publique contre cette grippe. L&apos;echantillon a ete randomise en utilisant une base de donnees electronique et des annuaires telephoniques imprimes pour garantir la representativite de cet echantillon a l&apos;egard de tousles Etats et tousles territoires australiens. Apres avoir explique aux personnes interrogees ce qu&apos;est la grippe pandemique pour s&apos;assurer qu&apos;elles comprennent l&apos;importance du probleme, nous avons repete les questions relatives a l&apos;observance des mesures et nous avons analyse les variations des reponses par le test de McNemar pour donnees appariees. Resultats 23 % seulement des 1166 personnes interrogees ont manifeste une comprehension claire du terme << grippe pandemique >>. Parmi les personnes interrogees, 94,1% ont indique qu&apos;elles etaient disposees a respecter la quarantaine a domicile, 94,2 % qu&apos;elles eviteraient les evenements publics et 90,7 % qu&apos;elles differeraient les rassemblements sociaux. Apres explication du terme << grippe pandemique >> aux sujets de l&apos;enquete, l&apos;observance declaree a augmente significativement (pour atteindre respectivement 97,5 %, 98,3 % et 97,2 %). Les personnes ayant indique ne pas etre familiarisees avec ce terme, les sujets de sexe masculin et les employes ne pouvant travailler a leur domicile ont manifeste une moindre disposition a respecter les mesures. Conclusion En Australie, si la menace se concretisait, l&apos;observance des mesures d&apos;endiguement contre la grippe pandemique serait probablement bonne, bien qu&apos;elle puisse encore etre amelioree par un programme d&apos;education du public vehiculant juste quelques messages cles. Une comprehension generale de la notion de grippe pandemique est associee a d&apos;une volonte declaree de respecter les mesures d&apos;endiguement. Il y aurait un interet considerable a investir maintenant dans la promotion de mesures pour se preparer a une pandemie ou autre urgence de sante publique. Objetivo Determinar el grado de cumplimiento declarado de las medidas de salud publica contra la gripe pandemica y estudiar los factores que influyen en la cooperacion necesaria para controlar esa pandemia en Australia. Metodos Entrevistadores profesionales llevaron a cabo una encuesta telefonica asistida por ordenador a fin de reunir informacion sobre los conocimientos del publico australiano acerca de la gripe pandemica y su determinacion de observar las medidas de salud publica adoptadas para controlarla. La muestra fue seleccionada aleatoriamente a partir de una base de datos electronica y de guias telefonicas impresas para procurar que fuese representativa de todos los estados y territorios australianos. Tras explicar a los encuestados en que consiste la gripe pandemica para que entendieran la importancia del tema, se repitieron las preguntas sobre el cumplimiento. La variacion sufrida por las respuestas fue analizada mediante la prueba de McNemar para datos apareados. Resultados Solo un 23% de los 1166 encuestados demostraron comprender cabalmente Io que supone una << gripe pandemica >>. Entre los entrevistados, un 94,1% manifesto estar dispuesto a cumplir una cuarentena domiciliaria; et 94,2%, a evitar actos publicos; y el 90,7%, a aplazar encuentros sociales. Despues de haber explicado a los entrevistados el significado del termino << pandemia >>, el cumplimiento declarado aumentoi significativamente (al 97,5%, 98,3% y 97,2% respectivamente). Los que manifestaron no conocer bien el significado de la expresion << gripe pandemica, >> los encuestados varones y los empleados que no podian trabajar desde su domicilio se mostraron mas reacios a seguir las recomendaciones. Conclusion En Australia, si se materializase la amenaza, el cumplimiento de las medidas de contencion contra la gripe pandemica seria probablemente alto, no obstante lo cual podria mejorarse mediante un programa de educacion del publico que transmitiera simpiemente unos cuantos mensajes clave. Unos conocimientos basicos sobre la gripe pandemica se asocian a la voluntad declarada de cumplir las medidas de contencion. Invertir ahora en promover medidas de preparacion para una pandemia u otra emergencia sanitaria constituye una opcion beneficiosa., Introduction To limit the spread of disease during the early containment phase of an influenza pandemic response, WHO recommends the use of non-pharmaceutical interventions (NPIs), including public education, social distancing, [...]

Objective: Between May and June 2002 an outbreak of chickenpox (CP) occurred at a child care centre in Perth, Western Australia. An epidemiological study was undertaken in order to determine the characteristics of the outbreak, assess vaccine effectiveness, and to define the direct and indirect costs associated with (CP) infections in young children. Methods: A cohort study of the outbreak utilising attendance records and a telephone survey of parents was conducted. Results: Of the 211 children attending the child care centre at the time of the outbreak, 44 contracted CP (attack rate 25.7%). In addition, two staff members, five secondary household contacts (secondary attack rate 38.5%) and four secondary non-household associated contacts were infected. There were no severe complications or any hospitalisations recorded in infected persons. Two cases had been vaccinated previously. Vaccine effectiveness for CP of any severity was 78.0% (95% (CI 15.4-94.3%) while vaccine effectiveness against severe CP was 100%. Direct costs during this outbreak were estimated to be $54 per case and the total costs, including cost of parental time off work or study, were estimated to be $525.73 per case. Conclusions and Implications: Although morbidity associated with CP in young children is not great, infection in childhood is almost universal. This study found that the average costs associated with each CP case were considerable. Since varicella vaccine affords good protection against CP, the recent inclusion of this vaccine in the Australian childhood vaccination schedule should save the community a considerable amount in direct and indirect costs if high coverage rates can be achieved. Key words: Chickenpox, outbreak, child care centre, costs, vaccination.

Objectives: To identify groups at risk of methicillin-resistant Staphylococcus aureus (MRSA) infection, patterns of antimicrobial resistance, and the proportion of patients with MRSA infections but no history of recent hospitalisation.Design, Setting and Participants: Case series of 39 231 patients with S. aureus isolates from specimens processed by the Hunter New England Local Health District (HNELHD) public pathology provider during 2008-2014.Main Outcome Measures: Proportion of MRSA infections among people with S. aureus isolates; antimicrobial susceptibility of MRSA isolates; origin of MRSA infections (community- or health care-associated); demographic factors associated with community-associated MRSA infections.Results: There were 71 736 S. aureus-positive specimens during the study period and MRSA was isolated from 19.3% of first positive specimens. Most patients (56.9%) from whom MRSA was isolated had not been admitted to a public hospital in the past year. Multiple regression identified that patients with community-associated MRSA were more likely to be younger (under 40), Indigenous Australians (odds ratio [OR], 2.6; 95% CI, 2.3-2.8), or a resident of an aged care facility (OR, 4.7; 95% CI, 3.8-5.8). The proportion of MRSA isolates that included the dominant multi-resistant strain (AUS-2/3-like) declined from 29.6% to 3.4% during the study period (P < 0.001), as did the rates of hospital origin MRSA in two of the major hospitals in the region.Conclusions: The prevalence of MRSA in the HNELHD region decreased during the study period, and was predominantly acquired in the community, particularly by young people, Indigenous Australians, and residents of aged care facilities. While the dominance of the multi-resistant strain decreased, new strategies for controlling infections in the community are needed to reduce the prevalence of non-multi-resistant strains. [ABSTRACT FROM AUTHOR]

Problem: Emergencies resulting from disease outbreaks and extreme environmental events present significant challenges for health services. Context: Preparing to effectively manage emergencies is a core activity in public health units. Field exercises support consolidation of biopreparedness by testing plans, identifying weaknesses, providing training opportunities and developing surge capacity. Action: An extended field exercise to test response to a novel influenza strain was conducted in New South Wales, Australia in September 2008, eight months before the influenza A(H1N1) 2009 pandemic emerged. Lasting four days and involving over 300 participants, the exercise was set in the early response phase with the staggered presentation of 41 cases to 36 emergency departments in the health area. An additional 150 contacts were written into a complex scenario to test the public health response. Outcome: The subsequent pandemic emergence in mid-2009 offered a unique opportunity to assess the field exercise format for disaster preparedness. Most roles were adequately tested with recognized benefit during the actual pandemic response. However, the exercise did not adequately challenge the public health planning team that synthesizes surveillance data and forecasts risk, nor did it identify planning issues that became evident during the subsequent pandemic. Discussion: Field exercises offer the opportunity to rigorously test public health emergency preparedness but can be expensive and labour-intensive. Our exercise provided effective and timely preparation for the influenza A(H1N1) 2009 pandemic but showed that more emphasis needs to be placed on the role and training of the public health planning team. [ABSTRACT FROM AUTHOR]

Introduction: Q fever remains an important notifiable, zoonotic disease in Australia. Previous epidemiological reviews have noted increased importance of non-abattoir contact with livestock and native/feral animals. Changes to surveillance in New South Wales (NSW) have provided enhanced surveillance data with which to examine exposure pathways., Methods: Descriptive analysis of NSW Q fever notification data for the period 2005-2015, with detailed analysis of exposures for the period 2011-2015 (after introduction of improvements to surveillance)., Results: Between 2005 and 2015, 1,653 confirmed cases of Q fever were notified in NSW residents who acquired the disease in this state. For the period 2011-2015, a high-risk occupation was reported in 345/660 (52.3%) of notifications with a known occupation. Of 641 cases with a known animal exposure, 345 (53.8%) had direct contact with livestock, while 62 (9.7%) had indirect contact with livestock (e.g. proximity to livestock, livestock holding areas or trucks). Direct or indirect contact with native/feral animals was reported in 111/641 (17.3%) cases. Mowing and close proximity to kangaroos/wallabies were commonly reported indirect exposure pathways, particularly in urban areas., Conclusions: Enhancements to the state based surveillance database in NSW introduced in 2010 have resulted in improved collection of surveillance data for Q fever. Further refinement of Q fever surveillance can be achieved through continuing to improve data quality, standardising data collection and better elucidating exposure pathways of cases., (This work is copyright. You may download, display, print and reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given the specific written permission from the Commonwealth to do so. Requests and inquiries concerning reproduction and rights are to be sent to the Online, Services and External Relations Branch, Department of Health, GPO Box 9848, Canberra ACT 2601, or by email to copyright@health.gov.au.)

During a recent natural disaster public health staff required timely and comprehensive surveillance of priority health conditions, including injury, mental health disorders and selected infectious diseases, to inform response and recovery activities. Although traditional surveillance is of value in such settings it is constrained by a focus on notifiable conditions and delays in reporting. The application of an electronic emergency department syndromic surveillance system proved valuable and timely in informing public health activities following a natural disaster in New South Wales.

Streptococcus pneumoniae is a common cause of community acquired pneumonia (CAP). Influenza infection increases susceptibility to S. pneumoniae infection in adults but this link is less well described in children. We report on an outbreak of CAP affecting 25 previously well adolescents in a New South Wales boarding school. S. pneumoniae 1 was confirmed in two cases. During this period, the school also experienced an influenza outbreak with an influenza-like illness attack rate peaking at 27% in Year 8 students. A planned school closure may have contributed to controlling the outbreak. Boarding schools are vulnerable to outbreaks of respiratory illness and strategies for limiting this risk are required.