Search

Influenza is a common cause of acute respiratory infection, and is a major cause of morbidity and mortality. This report summarises the epidemiology of hospitalisations with laboratory-confirmed influenza during the 2019 influenza season. The Influenza Complications Alert Network (FluCAN) is a sentinel hospital-based surveillance program that operates at sites in all jurisdictions in Australia. Cases were defined as patients hospitalised at any of the 17 sentinel hospitals with influenza confirmed by nucleic acid detection. Data were also collected on a frequency matched control group of influenza-negative patients admitted with acute respiratory infection. During the period 1 April to 31 October 2019 (the 2019 influenza season), there were 4,154 patients admitted with confirmed influenza to one of 17 FluCAN sentinel hospitals. Of these, 44% were elderly (≥ 65 years), 21% were children (< 16 years), 7.7% were Aboriginal and Torres Strait Islander peoples, 1.7% were pregnant and 73% had chronic comorbidities. Most admissions were due to influenza A infection (85%). Estimated vaccine coverage was 75% in the elderly, 49% in non-elderly adults with medical comorbidities, and 27% in young children (< 5 years). The estimated vaccine effectiveness in the target adult population was 42% (95% confidence interval [95% CI]: 36%, 49%). There were a larger number of hospital admissions detected with confirmed influenza in this national observational surveillance system in 2019 than in 2018.

Introduction Influenza is a common cause of acute respiratory infection, and is a major cause of morbidity and mortality. Coronavirus disease 2019 (COVID-19) is an acute respiratory infection that emerged as a pandemic worldwide before the start of the 2020 Australian influenza season. This report summarises the epidemiology of hospitalisations with laboratory-confirmed influenza and COVID-19 during the 2020 influenza season in a sentinel surveillance system. Methods The Influenza Complications Alert Network (FluCAN) is a sentinel hospital-based surveillance program that operates at sites in all jurisdictions in Australia. Influenza and COVID-19 cases were defined as patients hospitalised at sentinel hospitals and confirmed by nucleic acid detection. Results There were 448 patients with COVID-19 admitted between 16 March and 31 December 2020, and only 20 patients with influenza admitted between 1 April and 30 November 2020, to one of 22 FluCAN hospitals. Of the COVID-19 cases, 173 (39%) were > 65 years of age, 36 (8%) were children (< 16 years), 6 (1%) were Aboriginal and Torres Strait Islander peoples, 4 (1%) were pregnant and 289 (65%) had chronic comorbidities. COVID-19 hospital admissions peaked between weeks 13 and 15 (first wave) nationally, and again between weeks 31 and 35 (Victoria), with most admissions represented by those above 40 years of age. Discussion There was an unusually low number of hospital admissions with laboratory-confirmed influenza in this season, compared to recent seasons. This is likely to be due to effective public health interventions and international border closures as a result of a rise in COVID-19 respiratory infections and associated hospitalisations.

The reverse sintering effect of Ni particles under thermal treatment has been observed in the Ni/γ-Mo2N catalysts. The ab initio molecular dynamic simulation has demonstrated the redispersion of metallic Ni particles into under-coordinated two-dimensional Ni clusters over γ-Mo2N is a thermodynamically favorable process. Utilizing pre-synthesized 4 nm Ni nanoparticles as the loaded particles, a Ni-4nm/γ-Mo2N model catalyst was synthesized and used to study the reverse sintering effect by the combination of multiple in-situ characterization methods, including in-situ quick XANES and EXAFS, ambient pressure XPS and environmental SE/STEM etc. The theoretical and experimental studies both confirmed the reverse sintering effect in the Ni-γ-Mo2N system is driven by the strong metal-support interaction between Ni and γ-Mo2N. The potential application of the reverse sintering effect in heterogeneous catalysis has been realized using the high temperature favored CO2 hydrogenation reaction. The under-coordinated two-dimensional layered Ni clusters on molybdenum nitride support generated from the Ni-4nm/γ-Mo2N has been demonstrated to be a thermally stable catalyst in 50 h stability test, and exhibits a remarkable catalytic selectivity reverse compared with traditional Ni based catalyst, leading to a chemo-specific CO2 hydrogenation to CO.

Splenic infarction is a rare feature of infectious mononucleosis (IM) due to Epstein-Barr virus (EBV), limited to three case reports. We report the first case of splenic infarction during acute EBV infection associated with the transient induction of antiphospholipid antibodies. We discuss the role of antiphospholipid antibodies in thrombosis in acute viral infections and postulate other mechanisms of thrombosis. Once other more common causes of splenic infarction, such as endocarditis and lymphoma, have been excluded, the possibility of viral-induced antiphospholipid antibodies should be considered.

Adolescents and adults are the main reservoir of pertussis infection in Australia today. Diagnosis in these age groups can be difficult because of atypical clinical presentations and limitations of laboratory investigations.This article discusses the common presentation of pertussis in adults and adolescents, the use and limitations of laboratory testing, and appropriate treatment and prophylaxis.The reason for treating cases and providing chemoprophylaxis for contacts is to prevent infection in infants, who account for 90% of deaths from pertussis. Treatment with the newer macrolides appears to be as effective as erythromycin and with less side effects; however, roxithromycin should not be used as its in vivo efficacy is unproven. The majority of pertussis cases will be seen in general practice - most likely during the infectious period - therefore general practitioners need to consider being vaccinated with dTpa against pertussis.

The number of cases of dengue fever in returning travellers is increasing worldwide. In Australia, two mosquito vectors exist and the Aedes aegypti mosquito has already been responsible for local transmission within Queensland. For these reasons, general practitioners need to be able to recognise dengue fever and its complications: dengue haemorrhagic fever (DHF) and dengue shock syndrome. Infections can vary from severe to asymptomatic. The incubation period, duration of fevers, presence of rash and relative bradycardia can assist in the diagnosis of dengue. Dengue haemorrhagic fever is a severe form of dengue fever associated with plasma leakage and specific risk factors. The risk of DHF to most travellers previously infected with dengue is probably low. Serology and reverse transcriptase polymerase chain reaction are useful tests for diagnosing infection, although both have limitations. Vaccine design is a promising strategy to prevent infection.

The ongoing care of patients requires close communication between general practitioners and hospital specialists. In 2005, the General Practice Liaison Office and Department of Infectious Diseases at The Canberra Hospital designed a pilot module to promote interaction between GPs and hospital specialists and to provide an educational opportunity for GPs to be updated on the hospital practice of managing infectious diseases. The simplicity of the module is the key to its generalisability outside Canberra and Australia.

A patient negative for human immunodeficiency virus (HIV) developed multicentric Castleman's disease (MCD) and Kaposi's sarcoma (KS) associated with active human herpesvirus 8 (HHV-8) infection. He was treated with sequential antiviral therapy, chemotherapy, and corticosteroids. HHV-8 levels were monitored throughout the course of the patient's illness, and were found to rise on relapse. No consistent change in HHV-8 levels was found with antiviral therapy. We demonstrate that in this patient antiviral therapy was clinically ineffective, and did not alter HHV-8 levels, but that corticosteroid and combination chemotherapy led to clinical improvement. Despite the implication of HHV-8 as a cause of MCD, few studies have correlated HHV-8 levels with clinical response.

A 52-year-old woman presented feeling giddy and generally unwell. She complained of episodic upper abdominal pain and...