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Background: To determine the rabies vaccination status of Queensland veterinarians and veterinary students and their perception of zoonotic risk from Australian bat lyssavirus (ABLV). Design: Cross-sectional questionnaire surveys. Methods: Questionnaires were sent by post in 2011 to veterinary surgeons registered in Queensland, to final-year veterinary students at James Cook University via SurveyMonkey® in 2013 and to final-year veterinary students at James Cook University and University of Queensland via SurveyMonkey® in 2014. Results: The response rate for registered veterinarians was 33.5% and for veterinary students 33.3% and 30% in 2013 and 2014, respectively. Of the 466 registered veterinary surgeons, 147 (31.5%) had been vaccinated, with 72 (15.5%) currently vaccinated. For veterinary students the rabies vaccination rate was 20.0% (4/20) and 13.0% (6/46) in the 2013 and 2014 surveys, respectively. More than 95% of veterinary students had received the mandatory Q fever vaccine. Both veterinarians and students regarded bats and horses as high-risk species for zoonoses. Conclusions: Queensland veterinarians and veterinary students have low levels of protection against ABLV. Although incidents of ABLV spilling over from a bat to a domestic mammal are likely to remain rare, they pose a significant human health and occupational risk given the outcome of infection in humans is high consequence. Principals of veterinary practices and veterinary authorities in Australia should implement a policy of rabies vaccination for clinical staff and veterinary students.

Summary The objective of this review was to identify and critique over forty years of peer‐reviewed literature concerned with the transmission of canine zoonoses to Aboriginal people and determine the zoonotic organisms documented in dogs in Australian Aboriginal communities. A systematic literature search of public health, medical and veterinary databases identified 19 articles suitable for critical appraisal. Thirteen articles documented the occurrence of recognized zoonotic organisms in dogs in Aboriginal communities, including Toxocara canis, Dirofilaria immitis, Streptococcus dysgalactiae, Rickettsia felis, Sarcoptes scabiei and Giardia. Currently, there is definitive evidence indicating that dogs act as a reservoir for human scabies in Aboriginal communities. However, there is a need for large‐scale, high‐quality, comparative studies of dogs and humans from the same household to assess the occurrence and importance of transmission of S. scabiei and other diseases between dogs and humans. These studies should use current genetic and molecular techniques along with traditional techniques to identify and type organisms in order to better understand their epidemiology. This review has revealed that there is a lack of high‐quality comparative studies to determine whether dogs are contributing to human disease by transmitting zoonoses. Our recommendations differ significantly from current public health policy and may have substantial implications for human and dog health.

Although hookworm is highly prevalent in the Solomon Islands, the species involved are unknown. We initiated this study in response to finding Ancylostoma ceylanicum hookworm in a peacekeeper in Australia who had returned from the Solomon Islands. Kato-Katz fecal surveys performed in 2013 and 2014 in 2 village groups in East Malaita, Solomon Islands, identified hookworm-positive samples. These specimens were tested by cytochrome oxidase 1 (cox-1) gene multiplex PCR and sequenced. Of 66 positive specimens, 54 (81.8%) contained only Necator americanus, 11 (16.7%) contained only A. ceylanicum, and 1 (1.5%) contained both species. A. duodenale was not found. Haplotype analysis of cox-1 sequences placed all human isolates (99% bootstrap support) of A. ceylanicum within the zoonotic clade rather than the human-specific clade. This study confirms that A. ceylanicum is endemic in the East Malaita region of this Pacific Island nation. The strain of the A. ceylanicum in this region can be shared among humans, dogs, and cats.

Background Immunity to many vaccine-preventable diseases is inadequate amongst medical student populations internationally. Objectives To identify the factors that influence vaccination behaviour of Australian medical students and to identify appropriate immunisation-promotion interventions for this population. Methods A qualitative study using grounded theory techniques was undertaken in August and September 2014. Eighteen medical students from James Cook University in Townsville, Queensland, Australia participated in one of three focus group interviews. Data analysis incorporated the principles of the constant comparative method. Results Four themes emerged to explain the determinants of immunisation in this population: protection from infectious disease, understanding of the consequences of infectious disease, influence of individual and institutional recommendations, and practical barriers. Strategies to improve immunity were explored in three themes: empowering and educating students, improving access and mandating immunisation. Conclusions The determinants of medical student immunisation are complex and interconnected. A multi-faceted, long-term approach is needed to improve medical student immunity, and should include implementation of vaccination clinics and awareness initiatives, with future consideration of mandatory vaccination and integration into clinical skills programs and sessions. Immunisation policies and duty of care arrangements need clarification.

To determine how, during the 2013-2016 Ebola outbreak in western Africa, States Parties to the World Health Organization's (WHO) 2005 International Health Regulations (IHR) followed the IHR's international travel recommendations.In 2015, we used the Google search engine to investigate the 196 States Parties to the 2005 IHR. Information detailing Ebola-related travel regulations or restrictions of each State Party was sourced first from official government websites and then from travel and news websites. When limited, conflicting or no relevant information was found on a government website, an email inquiry was sent to a corresponding embassy in an Anglophone country.We collected relevant and non-conflicting data for each of 187 States Parties. Of these, 43 (23.0%) prohibited the entry of foreigners who had recently visited a country with widespread Ebola transmission and another 15 (8.0%) imposed other substantial restrictions on such travellers: the requirement to produce a medical certificate documenting no infection with Ebola (In responding to the 2013-2016 Ebola outbreak, countries had variable levels of adoption of the 2005 IHR's international travel recommendations. We identified 58 (31.0%) States Parties that exceeded or disregarded the recommendations. There is a need for more research to understand and minimize deviations from such recommendations.Déterminer comment, lors de la flambée de maladie à virus Ebola qui a sévi de 2013 à 2016 en Afrique de l'Ouest, les États parties au Règlement sanitaire international (RSI) de 2005 de l'Organisation mondiale de la Santé (OMS) ont suivi les recommandations du RSI concernant les voyages internationaux.En 2015, nous avons utilisé le moteur de recherche Google pour mener une enquête sur les 196 États parties au RSI de 2005. Nous avons d'abord recherché des informations sur la règlementation ou les restrictions relatives aux voyages appliquées par chaque État partie pour faire face à la flambée de maladie à virus Ebola sur les sites Internet officiels des gouvernements, puis sur des sites Internet de voyage et d'information. Lorsque les informations disponibles sur le site Internet d'un gouvernement étaient insuffisantes, contradictoires ou non pertinentes, une demande a été envoyée par e-mail à l'ambassade correspondante dans un pays anglophone.Nous avons recueilli des données pertinentes et non contradictoires sur 187 États parties. Sur ces 187 États parties, 43 (23,0%) ont interdit l'entrée sur leur territoire aux étrangers ayant récemment séjourné dans un pays où la transmission de la maladie à virus Ebola prenait une ampleur considérable et 15 (8,0%) ont imposé d'autres restrictions importantes à ce type de voyageurs: présentation obligatoire d'un certificat médical attestant que le voyageur n’est pas infecté par le virus Ebola (Face à la flambée de maladie à virus Ebola qui a sévi entre 2013 et 2016, les pays ont adopté à différents niveaux les recommandations du RSI de 2005 concernant les voyages internationaux. Nous avons repéré 58 (31,0%) États parties ayant dépassé ou ignoré les recommandations. Il est nécessaire de mener davantage de recherches pour comprendre et réduire les entorses faites à ces recommandations.Determinar cómo los Estados Partes del Reglamento Sanitario Internacional (RSI) de la Organización Mundial de la Salud (OMS) siguieron las recomendaciones sobre viajes internacionales del RSI de 2005 durante el brote de ebola en el oeste africano entre 2013 y 2016.En 2015, se utilizó el motor de búsqueda de Google para investigar los 196 Estados Partes del RSI de 2005. La información que detallaba los reglamentos sobre viajes relacionados con el ebola o las restricciones de cada Estado Parte se obtuvo primero de los sitios web gubernamentales oficiales y, posteriormente, de sitios web sobre viajes y noticias. Cuando la información era escasa, contradictoria o no se encontraba en el sitio web gubernamental, se enviaba un correo electrónico de solicitud a la embajada correspondiente de un país angloparlante.Se recopilaron datos importantes y coherentes de 187 Estados Partes. Entre ellos, 43 (23,0%) prohibieron la entrada de extranjeros que habían visitado recientemente un país con un nivel generalizado de contagio del ebola y otros 15 (8,0%) impusieron otras restricciones importantes para dichos viajeros: el requisito de obtener un certificado médico que documentara que el individuo no estaba infectado con el virus (Como respuesta al brote de ebola entre 2013 y 2016, los países contaban con distintos niveles de adopción de las recomendaciones sobre viajes internacionales del RSI de 2005. Se identificaron 58 (31,0%) Estados Partes que superaron o incumplieron las recomendaciones. Existe la necesidad de una búsqueda más exhaustiva para comprender y minimizar los incumplimientos de dichas recomendaciones.الوقوف على مدى التزام الدول الأطراف في اتفاقية اللوائح الصحية الدولية الصادرة عن منظمة الصحة العالمية لعام 2005 باتباع توصيات السفر الدولية المنصوص عليها في تلك اللوائح وذلك خلال تفشي فيروس الإيبولا في الفترة من 2013-2016 بغرب أفريقيا.في عام 2015، استخدمنا محرك البحث "جوجل" لتحري الدول الأطراف في اتفاقية اللوائح الصحية الدولية الصادرة عام 2005، والبالغ عددها 196 دولة. وتم في البداية استخلاص المعلومات التي تشرح بالتفصيل لوائح أو قيود السفر المتعلقة بفيروس الإيبولا والمفروضة في كل دولة من الدول الأطراف من المواقع الإلكترونية الحكومية الرسمية ثم المواقع الإلكترونية للسفر والأخبار. وعند العثور على معلومات محدودة أو متضاربة أو أي غير متصلة على الموقع الإلكتروني للحكومة، كان يتم إرسال رسالة استفهامية بالبريد الإلكتروني إلى السفارة المناظرة في إحدى البلاد الناطقة بالإنجليزية.لقد جمعنا بيانات ذات صلة لا يشوبها التضارب لكل من 187 دولة من الدول الأطراف. ومن بين تلك الدول كانت 43 (بواقع 23.0‏٪) تحظر دخول الأجانب الذين زاروا مؤخرًا بلدًا يتفشى بها فيروس الإيبولا على نطاق واسع، فيما كانت 15 دولة أخرى (بواقع 8.0‏٪) تفرض قيودًا كبيرة على هؤلاء المسافرين، إذ كانت تشترط تقديم شهادة طبية شهادة طبية تثبت عدم الإصابة بعدوى الإيبولا (في إطار الاستجابة لتفشي فيروس الإيبولا بين عامي 2013-2016، فقد أظهرت البلدان مستويات مختلفة من اعتماد توصيات السفر الصحية الدولية الصادرة عام 2005. وقد حددنا 58 دولة (بواقع 31.0‏٪) من الدول الأطراف التي تجاوزت التوصيات أو تجاهلتها. وهناك حاجة لإجراء المزيد من الأبحاث لفهم الانحرافات عن تلك التوصيات والحد منها.旨在确定 2013—2016 年西非埃博拉病毒爆发期间，世界卫生组织 (WHO) 2005 年《国际卫生条例》 (IHR) 缔约国对《IHR 国际旅行指南》的采用情况。.2015 年，我们使用谷歌 (Google) 搜索引擎调查了 196 个缔约国对 2005 年 IHR 指南的采用情况。 我们首先从各缔约国政府网站上获取了各国与埃博拉病毒相关的旅行规定或限制详情，然后从旅行和新闻网站获取了相关信息。 如有限制，冲突或在政府网站上未找到相关信息，可发电子邮件至讲英语国家的相应大使馆。.我们收集了 187 个缔约国中各个国家的相关和非冲突数据。 其中，43 (23.0%) 个国家禁止近期去过埃博拉病毒大面积传播国家的外籍人士入境，另有 15 (8.0%) 个国家对此类游客采取了其他实质性限制措施： 需要提供未感染埃博拉病毒的医学证明 (为应对 2013–2016 年的埃博拉病毒爆发，各国都不同程度地采用了 2005 年《IHR 国际旅行指南》。 我们发现有 58 (31.0%) 个缔约国过度使用或忽视该指南。 我们还需要做更多的研究以理解此类指南，同时在最大程度上减少对指南的理解偏差。.Определить, как во время вспышки лихорадки Эбола в Западной Африке в 2013–2016 годах страны-участники соблюдали рекомендации по международным поездкам в рамках Международных медико-санитарных правил (ММСП) от 2005 года Всемирной организации здравоохранения (ВОЗ).В 2015 году с помощью поисковой системы Google было проведено исследование 196 стран-участников соблюдения ММСП 2005 года. Из каждой страны-участника была получена информация о постановлениях или ограничениях поездок в связи с лихорадкой Эбола, в первую очередь с официальных правительственных, а затем с туристических и новостных веб-сайтов. В случае если информация на правительственном сайте была неполной, противоречивой или не освещала исследуемую тему, в соответствующее посольство в англоязычной стране направлялся запрос по электронной почте.Релевантные и непротиворечащие данные были получены для каждой из 187 стран-участников соблюдения ММСП. В 43 из них (23,0%) был запрещен въезд иностранных граждан, незадолго до этого посещавших страну, на территории которой были широко распространены случаи заражения вирусом Эбола; в других 15 (8,0%) были введены иные существенные ограничения для совершивших опасную поездку граждан, а именно требование предоставить медицинскую справку об отсутствии заболевания Эбола (В ответ на вспышку эпидемии Эбола в 2013–2016 годах страны в разной степени внедрили рекомендации в отношении международных поездок, предложенные в рамках ММСП 2005 года. Авторы установили, что 58 стран-участников (31,0%) вышли за рамки данных рекомендаций или вовсе проигнорировали их. Требуются дополнительные исследования, чтобы понять и минимизировать данные отклонения. исследования, чтобы понять и минимизировать данные отклонения.

Background: The One Health (OH) approach, which seeks to bring together human and animal health, is particularly suited to the effective management of zoonotic diseases across both sectors. To overcome professional silos, OH needs to be taught at the undergraduate level. Here, we describe a problem-based learning activity using the OH approach that was conducted outdoors for 3rd-year veterinary students in Malaysia. Materials and Methods: A total of 118 students, divided into two groups, completed the activity which spanned 11/2 days at a deer park adjacent to a wilderness area. Students were asked to evaluate the activity using an online survey that had quantitative and qualitative components. Results: Response rate was 69.5%. The activity was rated excellent by 69.5% and good by 30.4%. Levels of satisfaction were high on a range of criteria. 97.5% of students intended to take action in their studies as a result of what they had learned. Conclusions: Delivery of an outdoor problem-based learning activity using OH approach was very successful in terms of participation, knowledge delivery and understanding, and the willingness of students to integrate OH into their future practice. For the improvement of future programs, the involvement of other disciplines (such as Medical, Biology, Biotechnology, Biomedical, and Public Health) is being considered.

ObjectiveClimate change is expected to cause extensive shifts in the epidemiology of infectious and vector-borne diseases. Scenarios on the effects of climate change typically attribute altered distribution of communicable diseases to a rise in average temperature and altered incidence of infectious diseases to weather extremes.MethodsRecent evaluations of the effects of climate change on Hawaii have not explored this link. It may be expected that Hawaii’s natural geography and robust water, sanitation, and health care infrastructure renders residents less vulnerable to many threats that are the focus on smaller, lesser developed, and more vulnerable Pacific islands. In addition, Hawaii’s communicable disease surveillance and response system can act rapidly to counter increases in any disease above baseline and to redirect resources to deal with changes, particularly outbreaks due to exotic pathogens.ResultsThe evidence base examined in this article consistently revealed very low climate sensitivity with respect to infectious and mosquito-borne diseases.ConclusionsA community resilience model is recommended to increase adaptive capacity for all possible climate change impacts rather an approach that focuses specifically on communicable diseases. (Disaster Med Public Health Preparedness. 2016;10:797–804)

A 26-year-old male member of the Australian Defense Force presented with a history of central abdominal pain of 4 weeks duration and peripheral eosinophilia consistent with eosinophilic enteritis. Acute hookworm disease was diagnosed as the cause. Adult worms recovered from feces after therapy with albendazole were morphologically consistent with Ancylostoma ceylanicum. As the patient had been deployed with the Regional Assistance Mission to Solomon Islands for 6 months prior to this presentation, it is very likely that the A. ceylanicum was acquired in Solomon Islands. Until now, it has been assumed that any Ancylostoma spp. recovered from humans in Solomon Islands is A. duodenale. However, this case demonstrates that human hookworm infection acquired in the Solomon Islands could be caused by A. ceylanicum.

Objective: There is little published research about mental health and climate change in the Pacific, including Solomon Islands. Solomon Islands has one of the highest rates of sea-level rise globally. The aim of this research was to document mental health issues related to sea-level rise for people in East Malaita, Solomon Islands. Method: A cross-sectional study was carried out in six low-lying villages in East Malaita, Solomon Islands. The researcher travelled to villages by dugout canoe. In addition to quantitative, closed-ended questions, open-ended questions with villagers explored individual and community responses to rising sea level. Results: Of 60 people asked, 57 completed the questionnaire. Of these, 90% reported having seen a change in the weather patterns. Nearly all participants reported that sea-level rise is affecting them and their family and is causing fear and worry on a personal and community level. Four themes emerged from the qualitative analysis: experience of physical impacts of climate change; worry about the future; adaptation to climate change; government response needed. Conclusion: Given predictions of ongoing sea-level rise in the Pacific it is essential that more research is conducted to further understand the human impact of climate change for small island states which will inform local, provincial and national-level mental health responses.

[Extract] Strongyloidiasis, caused by the intestinal helminth Strongyloides stercoralis, is commonly found in developing nations in tropical and subtropical regions. Strongyloidiasis was omitted by the World Health Organization (WHO) as one of the Soil Transmitted Helminths in their Neglected Tropical Diseases Roadmap and can therefore be considered one of the most neglected tropical diseases. Despite its reputation as a disease of developing countries, strongyloidiasis remains an important disease in Australia, particularly for Aboriginal and Torres Strait Islanders, and those living in remote communities.

This paper describes two phases of a community-directed intervention to address strongyloidiasis in the remote Aboriginal community of Woorabinda in central Queensland, Australia. The first phase provides the narrative of a community-driven ‘treat-and-test’ mass drug administration (MDA) intervention that was co-designed by the Community Health Service and the community. The second phase is a description of the re-engagement of the community in order to disseminate the key factors for success in the previous MDA for Strongyloides stercoralis, as this information was not shared or captured in the first phase. During the first phase in 2004, there was a high prevalence of strongyloidiasis (12% faecal examination, 30% serology; n = 944 community members tested) that resulted in increased morbidity and at least one death in the community. Between 2004–2005, the community worked in partnership with the Community Health Service to implement a S. stercoralis control program, where all of the residents were treated with oral ivermectin, and repeat doses were given for those with positive S. stercoralis serology. The community also developed their own health promotion campaign using locally-made resources targeting relevant environmental health problems and concerns. Ninety-two percent of the community residents participated in the program, and the prevalence of strongyloidiasis at the time of the ‘treat-and-test’ intervention was 16.6% [95% confidence interval 14.2–19.3]. The cure rate after two doses of ivermectin was 79.8%, based on pre-serology and post-serology tests. The purpose of this paper is to highlight the importance of local Aboriginal leadership and governance and a high level of community involvement in this successful mass drug administration program to address S. stercoralis. The commitment required of these leaders was demanding, and involved intense work over a period of several months. Apart from controlling strongyloidiasis, the community also takes pride in having developed and implemented this program. This appears to be the first community-directed S. stercoralis control program in Australia, and is an important part of the national story of controlling infectious diseases in Indigenous communities.

The objective of this paper is to document the knowledge and experiences of healthcare professionals and researchers in Australia about the barriers to controlling Strongyloides stercoralis in Australian Indigenous communities. Qualitative research methods were used to conduct in-depth semi-structured interviews, which were digitally recorded, transcribed, and participant-checked. Data were thematically analysed to identify significant themes. Five major themes were identified: 1) Barriers to health/treatment; 2) Access to healthcare; 3) Policy; 4) Learning opportunity; and 5) Ideas for intervention. The findings suggest that Australian Indigenous communities will continue to suffer increased morbidity and mortality due to a lack of control or prevention of Strongyloides stercoralis. Issues such as institutional racism, improvements to health promotion, education, socioeconomic determinants, and health care system policy and procedures need to be addressed. This study identifies several direct implications for Indigenous health: • The need for increased knowledge and understanding of the risks to health for Indigenous community members; • The need for prevention policy development for neglected tropical diseases in Indigenous communities; • The need for increased knowledge and understanding of the treatment, diagnosis, and healthcare access concerning Strongyloides stercoralis for health professionals and policymakers who work within Indigenous health; • The need to raise awareness of systematic institutional racism in the control and prevention of neglected tropical diseases in Indigenous communities; and • The need for a health promotion framework that can provide the basis for multiple-level interventions to control and prevent Strongyloides in Indigenous communities.

Objective: To describe a measles outbreak and health service response in a remote location in Malaita, Solomon Islands. Methods: Epidemiological review of cases who presented to the Atoifi Adventist Hospital (AAH) during the outbreak period from July to December 2014. Rumour surveillance was used to gather information on unreported cases. Results: A total of 117 cases were reported to AAH. The incidence rate was 123 per 10 000 individuals. Fifty-six per cent (66/117) of cases were hospitalized. Children under 5 years had the highest number of cases (n = 41) with 10 cases below 6 months old. The age-specific incidence rate of children under 5 years was 278.5 per 10 000 individuals. Eighty-two per cent of reported cases were 18 years old or younger. Rumour surveillance revealed about three quarters of children in one area of the East Kwaio Mountains had suspected measles not reported to AAH. There were three unreported deaths from measles outside AAH. During the outbreak, a total of 2453 measles-rubella vaccines were given in the AAH catchment area. Conclusion: A high incidence rate was observed in children and young people aged 18 years or younger, reflecting low childhood vaccination coverage. More than 50­% of cases required hospitalization due to disease severity and challenges of accessing health services. The rumour surveillance discovered many unreported cases in the mountain areas and a few deaths possibly linked to the outbreak. Improvement of registration methods and follow-up systems and setting up satellite clinics are planned to improve measles surveillance and vaccination coverage.

Genital manifestations of lymphatic filariasis (genital LF) are a significant cause of disfigurement and disability in the developing world. Surgery is the standard treatment; however, definitive publications are lacking and best practice remains unclear. An exhaustive search strategy using keyword and subject headings was applied to Medline, EMBASE, Web of Science, CINAHL, and Scopus. Additionally citation lists, Google and Google Scholar, archives of relevant journals and websites were searched systematically. Studies with data on one or more human patient(s) who underwent surgery for genital LF were included. Articles were screened and data extracted by the first author with data verification by the second author. Fifty-seven studies were included: 18 series of ablative surgery, four series of non-ablative surgery and 35 case reports. Poor study quality, heterogeneous case definitions, lack of severity grading and limited follow-up precluded meta-analysis. Two series of simple hydrocelectomies performed in resource-limited settings reported early complication rates of 3.0-3.5 % using eversion and 5-7 % using excision, with recurrence of 7 % and 3-5 %, respectively. Complications were minimal for single-surgeon series and greater (12-18 %) when scrotal reconstruction was performed. There is little useful evidence for lymphatic bypass procedures in genital LF. Under-recognition of atypical manifestation of genital LF leads to potentially unnecessary surgeries. Surgery for genital LF is safe in resource-limited settings; however, more well-designed studies with better follow-up are needed. Research priorities include validation of case definitions and severity grading systems, and solutions to improve post-operative follow-up in resource-limited settings.

The therapy of pediculosis remains a common problem in pediatric clinical practice. As resistance to commonly used chemical pediculicides, such as permethrin, is constantly increasing, there is a need for the development of new compounds that are effective in causing mortality in adult lice and their eggs. Natural products have been used in traditional medicine for thousands of years and recently have been of increasing interest, since the costs are usually lower and they are considered less toxic by the public. Here we present a review on plant compounds used for the treatment of head lice. An overview is given on published evidence on the use of natural product pediculicides and ovicides in clinical trials and in vitro studies. We conclude that several plant products offer promise for new compounds to treat head lice infestation. However, the number of clinical studies is very limited, and there is an urgent need to increase research assessing the effectiveness and safety of promising compounds. Over the counter natural products should be supported by in vitro data and by adequately designed comparative trials that evaluate cure rates and safety.

Background: Documenting specific knowledge and attitudes about HIV in the culturally diverse nation of Solomon Islands is essential to inform locally targeted public health responses. As part of a large capacity-strengthening project at Atoifi Adventist Hospital in East Kwaio, Solomon Islands, researchers, using a 'learn-by-doing' process, worked with participants in public health research methods. Methods: Overall, 43 people attended research capacity building workshops in 2011; eight joined the HIV study group. A cross-sectional survey including semi-structured interviews on HIV was conducted by the group. In February 2014, a hospital administrator was interviewed about how the 2011 study informed local HIV responses. Results: Of the 53 survey participants, 64% self-assessed as having little or no HIV knowledge, but 90% knew HIV could be transmitted between men and women during sex. Less than 50% knew HIV could be transmitted between two men having sex, 45% thought HIV could be transmitted by mosquitoes and 55% agreed condoms help protect from HIV. Most participants reported negative attitudes towards people with HIV. Three years later the health administrator reported ad hoc responses to HIV because of low HIV prevalence, increasing noncommunicable diseases, staff turnover and resource shortages. Discussion: This HIV study was used to strengthen research skills in local health professionals and community members in Solomon Islands. It showed that community members require accurate information about HIV transmission and that entrenched stigma is an issue. Although results provided local evidence for local response, ongoing health system challenges and little local HIV transmission meant HIV services remain rudimentary.

Halicephalobus gingivalis (previously Micronema deletrix ) is a free-living nematode known to cause opportunistic infections, mainly in horses. Human infections are very rare, but all cases described to date involved fatal meningoencephalitis. Here we report the first case of H. gingivalis infection in an Australian human patient, confirmed by nematode morphology and sequencing of ribosomal DNA. The implications of this case are discussed, particularly, the need to evaluate real-time PCR as a diagnostic tool.

The World Health Organization defined climate change as the most important issue for the 21st century. In 2014, the State of Hawaii called climate change “a matter of security” that directly threatens “economic systems – food, water, energy, biodiversity and health” and has called for “actionable information for local decision making.” According to the Intergovernmental Panel on Climate Change, the burden of human morbidity attributable to climate change is relatively small although not well quantified. Nevertheless, generic climate change impacts are often used to justify actions without adequate supporting local evidence. This paper analyzes Hawaii’s health risks in relation to air pollution, heat extremes, ultraviolet radiation, and weather extremes and finds that Hawaii’s natural geography, robust water, and sanitation infrastructure render the islands less vulnerable to many of the often-mentioned climate change threats. It concludes that the health security threat posed by climate change effects on Hawaii’s physical environment over the next 35 years is slight in most areas and moderate with regard to ecosystem health. Because all global communities tend to be both discrete and unique in their vulnerability, it recommends the collection of grassroots, community-based resilience data to reveal local vulnerabilities that can inform strategic statewide planning.

Background Communication skills are essential for veterinarians who need to discuss animal health related matters with their clients. When dealing with an emerging zoonosis, such as Hendra virus (HeV), veterinarians also have a legal responsibility to inform their clients about the associated risks to human health. Here we report on part of a mixed methods study that examined the preparedness of, and difficulties experienced by, veterinarians communicating about HeV-related risks with their clients. Methods Phase 1 was an exploratory, qualitative study that consisted of a series of face-to-face, semi-structured interviews with veterinary personnel from Queensland, Australia (2009–10) to identify the barriers to HeV management in equine practices. Phase 2a was a quantitative study that surveyed veterinarians from the same region (2011) and explored the veterinarians’ preparedness and willingness to communicate about HeV-related risks, and the reactions of their clients that they experienced. The second study included both multiple choice and open-ended questions. Results The majority of the participants from Phase 2a (83.1%) declared they had access to a HeV management plan and over half (58.6%) had ready-to-use HeV information available for clients within their practice. Most (87%) reported “always or sometimes” informing clients about HeV-related risks when a horse appeared sick. When HeV was suspected, 58.1% of participants reported their clients were receptive to their safety directives and 24.9% of clients were either initially unreceptive, overwhelmed by fear, or in denial of the associated risks. The thematic analysis of the qualitative data from Phases 1 and 2a uncovered similar themes in relation to HeV-related communication issues experienced by veterinarians: “clients’ intent to adhere”; “adherence deemed redundant”; “misunderstanding or denial of risk”; “cost”; “rural culture”; “fear for reputation”. The theme of “emotional state of clients” was only identified during Phase 1. Conclusion Warning horse owners about health and safety issues that may affect them when present in a veterinary work environment is a legal requirement for veterinarians. However, emerging zoonoses are unpredictable events that may require a different communication approach. Future training programs addressing veterinary communication skills should take into account the particular issues inherent to managing an emerging zoonosis and emphasise the importance of maintaining human safety. Veterinary communication skills and approaches required when dealing with emerging zoonoses should be further investigated. Electronic supplementary material The online version of this article (doi:10.1186/s12917-017-0970-2) contains supplementary material, which is available to authorized users.

Highlights • We surveyed private equine veterinarians about their use of personal protective equipment when examining healthy, sick and dead horses. • Practices had official Hendra virus management guidelines and a dedicated field kit available but no standardised management protocols. • Not all participants used all possible personal protective equipment when attending horses, regardless of health status. • Personal protective equipment usage increased when the likelihood of a horse being infected with the zoonosis Hendra virus increased. • Those who had dealt with horses suspected of or were trained in Hendra virus management were more likely to use appropriate protective equipment., Following the emergence of Hendra virus (HeV), private veterinarians have had to adopt additional infection control strategies to manage this zoonosis. Between 1994 and 2010, seven people became infected with HeV, four fatally. All infected people were at a higher risk of exposure from contact with horses as they were either veterinary personnel, assisting veterinarians, or working in the horse industry. The management of emerging zoonoses is best approached from a One Health perspective as it benefits biosecurity as well as a public health, including the health of those most at risk, in this case private veterinarians. In 2011 we conducted a cross-sectional study of private veterinarians registered in Queensland and providing veterinary services to horses. The aim of this study was to gauge if participants had adopted recommendations for improved infection control, including the use of personal protective equipment (PPE), and the development of HeV specific management strategies during the winter of 2011. A majority of participants worked in practices that had a formal HeV management plan, mostly based on the perusal of official guidelines and an HeV field kit. The use of PPE increased as the health status of an equine patient decreased, demonstrating that many participants evaluated the risk of exposure to HeV appropriately; while others remained at risk of HeV infection by not using the appropriate PPE even when attending a sick horse. This study took place after Biosecurity Queensland had sent a comprehensive package about HeV management to all private veterinarians working in Queensland. However, those who had previous HeV experience through the management of suspected cases or had attended a HeV specific professional education programme in the previous 12 months were more likely to use PPE than those who had not. This may indicate that for private veterinarians in Queensland personal experience and face-to-face professional education sessions may be more effective in the improvement of HeV management than passive education via information packages. The role of different education pathways in the sustainable adoption of veterinary infection control measures should be further investigated.

Background People are at greater risk of health problems when travelling and a significant number of travel-related health problems are associated with the effects of travel on pre-existing chronic diseases. Medications play a key role in the management of these conditions. However, there is a notable lack of research evaluating the potential medication-related risks associated with travel. Objective To apply a systematic pharmaceutical care model developed to evaluate potential pharmaceutical risks (PPRs) and pharmaceutical care issues (PCIs) in travellers. Setting Adult travellers leaving Cairns International Airport, Australia, for an international destination. Method A cross-sectional survey using semi-structured interviews, including a systematic medication history, followed by the application of a pharmaceutical care model to evaluate each participant for PPRs and PCIs. Main outcome measure Evaluation of standard clinical and travel-related PPRs and PCIs. Results Medications for chronic diseases were being taken by 47.7 % of the 218 travellers interviewed. Although 75.2 % of participants presented with no PPRs, a total of 274 PCIs were identified across 61.5 % of the participants, with an average of 2.04 PCIs per participant. The most prevalent PCIs related to the inadequate precautions taken by some travellers visiting malaria-endemic regions. Although 91 participants recognised that they were travelling to malaria-endemic regions, 65.9 % of these participants were not using malarial chemoprophylaxis, and only 16.5 % were using chemoprophylaxis that fully complied with standard recommendations. The second most prevalent PCI was the need for 18.8 % of participants to be educated about their medications. Other PCIs identified have the potential to increase the risk of acute, travel-related conditions, and complicate the care of travellers, if they inadvertently became unwell while overseas. Conclusion PPRs and PCIs were not identified in all participants. However, the impact of many of the identified medication-related issues could be substantial to the traveller. This study represents the novel application of a pharmaceutical care model to identify potential PPRs and PCIs in travellers that may not be identified by other pre-travel risk assessment methods.

Because anesthesia of amphibian larvae is currently problematic, the aim of this study was to test if a fish anesthetic containing approximately 500 g/L isoeugenol (Aqui-S) could anesthetize tadpoles. Three concentrations of Aqui-S were tested (of commercial solution 10, 20, and 50 microl/L) with 10 tadpoles of the southern brown tree frog (Litoria ewingii) per concentration. Tadpoles were anesthetized for 15 min in water at 18-20 degrees C. Anesthetic criteria included four time points and two heart rates: time to loss of response to stimulation, loss of righting reflex, and return of spontaneous movement and of righting reflex after removal from Aqui-S, and heart rate after induction and after 15 min of anesthesia. No tadpole showed signs of irritation or excitement, no tadpole died, and all returned to normal behavior. The times for induction of anesthesia (time to loss of righting reflex) decreased significantly (P0.001) with increasing concentration: means of 27.5, 16.8, and 5.7 min for 10, 20, and 50 microl/L, respectively. Heart rate after 15 min of anesthesia was significantly lower (P = 0.006) for concentrations of 20 and 50 microl/L compared to 10 microl/L. At the lowest concentration (10 microl/L), anesthesia was light. Recovery times were significantly delayed (P0.001) for 50 microl/L, approximately double those for the lower concentrations. Spontaneous movements began at 56.9, 51.4, and 119 min for 10, 20, and 50 microl/L Aqui-S, respectively. Although Aqui-S did anesthetize tadpoles at all three concentrations, with 20 microl/L being the most suitable, additional longer-term toxicity testing is required prior to its adoption as an anesthetic agent for this species. Anesthesia, isoeugenol, Litoria ewingii, southern brown tree frog, tadpoles.

Research on pediculosis has focused on treatment strategies and social aspects have been largely ignored. Pediculosis and its treatment in are associated with negative emotional responses while in developing countries pediculosis and its treatment may provide more an opportunity for positive social bonding. Attitudes to pediculosis have been proposed as important to successful control. Previous studies in Australia found that parents of primary school children say they treat pediculosis once it has been detected. This study retrospectively investigated attitudes towards treatment in teenage high school students in an attempt to collect information from those afflicted rather than from parents. Only participants with a history of pediculosis were recruited from a high school in Western Australia and they were asked to complete an anonymous questionnaire. The sample contained 128 Grade 8 and 9 students, aged 13-15 years old with an even gender split. Negative feelings towards being treated for head lice were observed in 41.5% of males and 54.7% of females and 49.5% of Caucasians and 40% of Asians. Anti-treatment sentiment was expressed by 19.7% of males and 10.9% of females. Shampooing with and without combing were the most preferred treatments overall. The results showed that 63.6% male and 52.7% female high school students were in favour of head lice treatments. This low percentage indicates that current treatments for head lice require improvement to be made more acceptable and that alternative treatments that are less unpleasant need to be developed. Strategies need to be explored to make treatment of pediculosis a more positive emotional experience.

Chytridiomycosis caused by the fungal invasive pathogen Batrachochytrium dendrobatidis (Bd) was first detected in 1999 in Christchurch, New Zealand, in the Australian introduced frog species Litoria raniformis. It was detected in wild native frogs in the critically endangered Leiopelma archeyi in 2001 on the Coromandel Peninsula and has been suggested as responsible for a mass decline (88%) in that population between 1994 and 2002. We report the current distribution, host species and prevalence, where known, of Bd in New Zealand, which is essential for conservation management of New Zealand native frogs (Leiopelma spp.). The data set is structured so that it can be readily added to the Australian Bd database for further analyses. Our data included all regions in New Zealand and six offshore islands at 135 sites with 704 records from 23 contributors spanning collection dates 1930–2010. We report 54 positive sites from 132 positive individuals. We also detail negative findings, but declaring an area free from disease should consider the sensitivity of the test used and numbers of individuals tested. The data also included a comprehensive museum survey testing 152 individuals from five species (20 L. archeyi, 50 L. hochstetteri, 15 L. aurea, 40 L. ewingii, and 27 L. raniformis) from 1930–1999 using histology and Bd-specific immunohistochemistry. All museum specimens were negative, so the 1999 positive result is still the earliest record. In the L. archeyi Coromandel Ranges population, the period prevalence of Bd from 2006 to 2010 was relatively stable at 16%, but the number of animals tested remains low (up to N = 19) due to the now depleted population numbers. The period prevalence of Bd in the L. archeyi Whareorino population has remained both consistent and low (6%) between 2005 and 2010. In L. hochstetteri, L. hamiltoni, and L. pakeka all sampling for Bd has been negative. Positive Bd results have been found in all three Litoria spp., but Bd has not been found in the six offshore areas tested. Most data have been previously unpublished and represent the first confirmed reports of Bd in many regions and species in New Zealand.

Surveys were distributed to New Zealand land users in 1998 and 2008 to acquire information about New Zealand frogs with the aim of compiling and mapping their distribution and inferred population trends without costly and time-consuming field surveys. The overall frog population trend was reported as declining, with possible causes reported as an increase in agriculture, an increase in the distribution of predatory fish and disease. The resultant maps could be used for four main purposes: 1) to identify regions where Litoria populations are known to occur, which can be eliminated when considering suitable regions for translocation of Leiopelma; 2) to identify growing or stable populations of Litoria species, which may assist future disease surveys, population monitoring and to identify sources of genetic material that may serve as an Ark for declining Australian populations; 3) to highlight populations that are in decline to enable effective targeting of detailed disease studies; and 4) to approximate the stability of amphibian populations in the absence of more accurate, but costly, scientific monitoring.

Objective: To identify the perceived barriers to Hendra virus (HeV) management by private equine veterinarians in Queensland. Design: An exploratory qualitative study of private equine veterinarians registered and working in coastal Queensland. Methods: A questionnaire that included eight open-ended questions about the management of HeV was used in face-to-face in-depth interviews with 21 veterinary personnel working in equine or mixed private practice between Far North and South-East Queensland in 2009–10. The qualitative data was entered and analysed thematically using QSR's International's Nvivo 9 qualitative data analysis software. Results: This study revealed key issues associated with HeV testing: (1) inadequate knowledge of testing procedures and laboratory diagnostic pathways; (2) difficulty in accessing laboratory services; (3) responsibility for cost of collection and transport of specimen; and (4) the role of government. Participants perceived these issues as reducing potential HeV case management efficiency. Conclusion: Although HeV management plans have been modified in part since 2009–10, this study highlights the importance of considering the perspectives of private veterinary practitioners in any biosecurity protocols.

Purpose The purpose of this study was to conduct focus groups to operationalise the construct of quality of life (QOL) for people living with lymphatic filariasis (LF) in Bangladesh to develop culturally valid items for a Bangladeshi LF QOL tool. Methods Ten focus groups were conducted with a stratified purposeful sample (n = 60) of LF patients (3 focus groups, n = 17), doctors (1 focus group, n = 5), nurses (1 focus group, n = 6) and other hospital staff (1 focus group, n = 5), community leaders (2 focus groups, n = 14), community volunteer health workers (1 focus group, n = 5) and Bangladeshi LF researchers and planners (1 focus group, n = 8). Focus group methodology was informed by local culture in consultation with cultural mentors and local advisors, often going against standard focus group procedures. Data were collected through note taking, audio taping, transcripts, observational notes and a reflection diary. Open coding of transcript data was completed until data saturation was achieved. Results Forty-three constructs were identified through the focus groups that had not previously been identified in the literature, including constructs relating to environmental supports and barriers, activities, participation and psychological impacts. There were marked differences between the impacts reported by different groups, highlighting the need for a comprehensive purposive sample. In particular, contributions from participants who would not traditionally be viewed as “experts” were vital. Conclusions The use of focus groups strongly contributed to the operationalisation of the concept of QOL in Bangladesh for people living with LF. Use of literature review or expert opinion alone would have missed vital constructs.

The spread of chytridiomycosis, an emerging infectious disease caused by the fungal pathogen Batrachochytrium dendrobatidis (Bd), is one of many threats facing amphibians worldwide. Ascertaining the severity of this threat to particular amphibian species is necessary if managers are to prioritize conservation actions. In New Zealand, Bd has been detected on both threatened endemic (Leiopelma spp.) and widespread introduced (Litoria spp.) anuran species, but Le. archeyi, one of four native species, has demonstrated low susceptibility to chytridiomycosis in captivity. To determine potential impacts of Bd on New Zealand's native anuran fauna, we assessed the susceptibility of two native species, Le. pakeka and Le. hochstetteri, to chytridiomycosis. We exposed Bd-naive individuals to a virulent New Zealand isolate of Bd, and monitored infection status with quantitative real-time polymerase chain reaction. Both species demonstrated low susceptibility and all individuals cleared Bd infection (Le. hochstetteri by week 10, Le. pakeka by week 15). Furthermore, no frogs demonstrated clinical signs of chytridiomycosis. Since Le. archeyi has similarly demonstrated low susceptibility, this appears to be a genus-wide trend, which warrants further study of the mechanism of this response. These findings, in agreement with results from field surveys and analyses of skin peptide defenses, suggest that Bd poses a low risk to leiopelmatids. An investigative study of potential susceptibility to Bd, such as this one, can better equip managers to target imminent threats and focus conservation plans for at-risk amphibian fauna.

To describe the gross and light microscopic characteristics of skin lesions observed on the ventral skin of captive Archey's frogs (Leiopelma archeyi) between 2000 and 2012, and to investigate their occurrence, possible aetiology and association with survival.Postmortem skin samples were obtained for histological evaluation from 37 frogs, with and without skin lesions, that died while in captivity at Auckland Zoo between 2000 and 2012. Four frogs with skin lesions were biopsied under general anaesthesia and samples used for both light and transmission electron microscopy. The records of 94 frogs held at the University of Otago and Auckland Zoo between 2000-2012 were reviewed, which included some frogs recently collected from the wild. Information about the occurrence of skin lesions, and mortality associated with skin lesions was collated.Grossly the skin lesions varied in appearance; most were circular, pale grey papules, which measured from0.5-1.5 mm in diameter with no umbilication. The overlying epidermis was not fragile and there was no associated inflammation. Contents often appeared clear or semi-transparent. Lesions were located predominantly on ventral surfaces including trunk, thighs, lower legs and forearms, and gular region, but not on digits. The number ranged from single to multiple, often confluent lesions covering the entire ventral surface of the frog. Histologically the lesions consisted of enlarged proliferating mucous glands that expanded the dermis and elevated the epidermis. They were semi-organised, solid or occasionally cavitated acinar structures with central lumina which sometimes contained mucus. Nuclei showed moderate anisokaryosis and mitotic figures were uncommon. Transmission electron microscopy did not show any infectious agents. Between 2000 and 2012, skin lesions were recorded in 35/94 (37%) frogs. The size and location of skin lesions varied over time, with some resolving and sometimes reappearing. Skin lesions were not associated with an increased risk of death.The skin lesions had the gross and microscopic characteristics of adenomatous hyperplasia of the dermal mucous glands.The aetiology of this adenomatous hyperplasia is unknown, but factors associated with the captive environment are the most likely cause. This is the first description of adenomatous hyperplasia of the cutaneous mucous glands in amphibians.

Strongyloidiasis is a potentially fatal disease caused by species of Strongyloides (Nematoda). In Oceania, two species infect humans: S. stercoralis and S. kellyi. S. stercoralis is widespread throughout Oceania and causes serious disease in any age group. S. kellyi is localised to Papua New Guinea and causes serious disease in infants. Infective larvae enter the body through the skin and migrate through the tissues. Adult females live in the mucosa of the proximal small intestine. The life cycle of S. stercoralis includes autoinfection, unusual in parasitic worms, whereby some of the offspring of the parasitic adults become infective in the lower intestine and complete the life cycle in the same person. This ensures that the infection persists, and the population of the worms can increase out of control, usually when the person is immunodeficient or immunosuppressed. The worms can be eliminated by oral ivermectin, and the person is probably cured if their serology is negative 6 months after treatment. This chapter contains details of the life cycles, transmission, clinical manifestations, diagnostic tests and how to interpret them, most effective treatment options, how to ensure that treatment has been effective and what to consider when developing effective prevention and control strategies.

Background: Few hematologic and biochemical reference intervals for wild amphibians have been established. Reference values would aid in early detection of emerging infectious diseases, which are a significant problem for amphibian conservation efforts. Objective: We aimed to establish reference intervals for a wide range of hematologic and plasma biochemistry variables for 2 species of Australian tree frogs, describe morphologic features of leukocytes, and analyze the effects of season, year, and parasite status on blood values. Methods: Blood specimens were collected from reference populations of wild adult Australian tree frogs, Litoria caerulea and L infrafrenata, for analysis of hematologic (manual) variables, plasma biochemical (automated) analytes, and plasma and serum proteins using automated methods, refractometry, and electrophoresis. Results: Inter- and intraspecies differences were found in L caerulea (n = 80) and L infrafrenata (n = 66) frogs for hematologic and biochemical variables. Intraspecies differences were largely associated with seasonal variations. In the dry season, both species had higher WBC counts, with higher lymphocyte counts in L caerulea and higher neutrophil counts in L infrafrenata, and uric acid concentrations. In the wet season, both species had higher glucose and potassium concentrations, L caerulea frogs had higher neutrophil counts, and L infrafrenata frogs had higher total protein, phosphorus, and sodium concentrations, AST activity, PCV, hemoglobin concentration, and RBC, thrombocyte, and basophil counts. Hemogregarines were identified in 19% of blood samples from L infrafrenata frogs; multiple hematologic and biochemical variables were altered in infected frogs. Conclusions: Wide interspecies and seasonal variations highlight the need to establish species- and season-specific reference intervals for amphibians. Hematologic and plasma biochemical reference values should be useful in assessing the health status and in detecting emerging diseases in wild amphibians.

Understanding how pathogens respond to changing environmental conditions is a central challenge in disease ecology. The environmentally sensitive fungal pathogen Batrachochytrium dendrobatidis (Bd), which causes the amphibian disease chytridiomycosis, has spread globally causing amphibian extirpations in a wide variety of climatic regions. To gain an in-depth understanding of Bd's responses to temperature, we used an integrative approach, combining empirical laboratory experiments with mathematical modeling. First, we selected a single Bd isolate and serially propagated two lineages of the isolate for multiple generations in two stable thermal conditions: 4°C (cold-adapted lineage) and 23°C (warm-adapted lineage). We quantified the production of infectious zoospores (fecundity), the timing of zoospore release, and zoospore activity in reciprocal temperature transplant experiments in which both Bd lineages were grown in either high or low temperature conditions. We then developed population growth models for the Bd lineages under each set of temperature conditions. We found that Bd had lower population growth rates, but longer periods of zoospore activity in the low temperature treatment (4°C) compared to the high temperature treatment (23°C). This effect was more pronounced in Bd lineages that were propagated in the low temperature treatment (4°C), suggesting a shift in Bd's response to low temperature conditions. Our results provide novel insights into the mechanisms by which Bd can thrive in a wide variety of temperature conditions, potentially altering the dynamics of chytridiomycosis and thus, the propensity for Bd to cause amphibian population collapse. We also suggest that the adaptive responses of Bd to thermal conditions warrant further investigation, especially in the face of global climate change.

Chytridiomycosis in amphibians, and mucormycosis in the platypus Ornithorhynchus anatinus and amphibians, are serious fungal diseases affecting these aquatic taxa. In Tasmania, Australia, the fungi that cause these diseases overlap in range along with Phytophthora cinnamomi (Pc), an invasive fungal plant pathogen. To identify disinfectants that may be useful to reduce anthropogenic spread of these fungi to uninfected wilderness areas, for example by bush walkers and forestry or fire-fighting operations, we tested 3 disinfectants and a fire-fighting foam against Mucor amphibiorum (Ma) and tested 1 disinfectant and the foam against Batrachochytrium dendrobatidis (Bd). Combining the present study with previous work we found Bd was more susceptible to all 4 chemicals than Ma. Phytoclean, a disinfectant used at 2 to 10% for 30 s to control Pc, killed cultures of Bd at 0.075% and Ma at 5%, when also applied for 30 s. The disinfectant F10sc was not effective against Ma at standard exposures, but previous work shows Bd is killed at 0.03% with a 1 min exposure. Path-X is effective against Bd at 0.001% with a 30 s exposure and killed Ma at 1% with a 5 min exposure. Forexpan S, a foam added to water at 0.1 to 1% to control forest fires, killed Bd but not Ma when used at 1% for 2 min. Therefore, Phytoclean and Path-X have broader efficacy, although Path-X has not been trialled against Pc. Interestingly a positive mating strain of Ma (from a platypus) was more resistant to disinfectants than a negative strain (from a frog). Current protocols against Pc that involve high concentrations (10%) of Phytoclean are likely to reduce spread of pathogenic wildlife fungi, which is important for protecting biodiversity.

We analyzed submission data from a wildlife care group during amphibian disease surveillance in Queensland, Australia. Between January 1999 and December 2004, 877 white-lipped tree frogs Litoria infrafrenata were classified according to origin, season and presenting category. At least 69% originated from urban Cairns, significantly more than from rural and remote areas. Total submissions increased during the early and late dry seasons compared with the early wet season. Frogs most commonly presented each year with injury, followed by ‘other’, sparganosis and irreversible emaciation of unknown aetiology. This is the first report of Spirometra erinacei infection in this species. A high prevalence (28%) of visible S. erinacei infection was found in emaciated frogs, but this was not statistically different from that in non-emaciated diseased frogs (25%). However, 14 emaciated specimens that were necropsied all had heavy S. erinacei infections, and the odds of visible sparganosis were statistically greater in emaciated frogs compared with injured, non-diseased frogs. We provide a detailed case definition for a new endemic disease manifesting as irreversible emaciation, for which S. erinacei may be the primary aetiological agent. The lack of significant spatial or temporal patterns in case presentation suggests that this is not a currently emerging disease. We show that community wildlife groups can play a valuable role in monitoring disease trends, particularly in urban areas, but identify a number of limitations associated with passive syndromic surveillance. We conclude that it is critical that professionals be involved in establishing syndromic case definitions, diagnostic pathology, complementary active disease surveillance, and data analysis and interpretation in all wildlife disease investigations.