New South Wales annual vaccine-preventable disease report, 2013

Aim:To describe the epidemiology of selected vaccine-preventable diseases in New South Wales, Australia for 2013.Methods:Data from the New South Wales Notifiable Conditions Information Management System were analysed by local health district of residence, age, Aboriginality, vaccination status and organism. Risk factor and vaccination status data were collected by public health units.Results:Pertussis notification rates in infants were low, and no infant pertussis deaths were reported. Despite a high number of imported measles cases, there was limited secondary transmission. The invasive meningococcal disease notification rate declined, and disease due to serogroup C remained low and stable.Conclusion:Vaccine-preventable diseases were relatively well controlled in New South Wales in 2013, with declining or stable notification rates in most diseases compared with the previous year.

Sustained outbreak of measles in New South Wales, 2012: risks for measles elimination in Australia

Objective：On 7 April 2012, a recently returned traveller from Thailand to Australia was confirmed to have measles. An outbreak of measles subsequently occurred in the state of New South Wales, prompting a sustained and coordinated response by public health authorities. The last confirmed case presented on 29 November 2012. This report describes the outbreak and its characteristics.Methods：Cases were investigated following Australian protocols, including case interviews and assessment of contacts for post-exposure prophylaxis.Results：Of the 168 cases identified, most occurred in south-western and western Sydney (92.9%, n = 156). Notable features of this outbreak were the disproportionately high number of cases in the 10–19-year-old age group (29.2%, n = 49), the overrepresentation among people of Pacific Islander descent (21.4%, n = 36) and acquisition in health-care facilities (21.4%, n = 36). There were no reported cases of encephalitis and no deaths.Discussion: This was the largest outbreak of measles in Australia since 1997. Its occurrence highlights the need to maintain vigilant surveillance systems for early detection and containment of measles cases and to maintain high population immunity to measles through routine childhood immunization. Vaccination campaigns targeting susceptible groups may also be necessary to sustain Australia’s measles elimination status.

Vibrio cholerae antimicrobial drug resistance, Papua New Guinea, 2009–2011

Cholera is an acute infectious disease caused by Vibrio cholerae . The disease occurs in a variety of forms ranging from sporadic cases to outbreaks that may transition to endemic disease. While cholera case management focuses on early, rapid rehydration, antimicrobial therapy can reduce the volume of diarrhoea, duration of carriage and symptoms and is frequently recommended for patients with severe dehydration.

Event-based surveillance in Papua New Guinea: strengthening an International Health Regulations (2005) core capacity

Under the International Health Regulations (2005), Member States are required to develop capacity in event-based surveillance (EBS). The Papua New Guinea National Department of Health established an EBS system during the influenza pandemic in August 2009. We review its performance from August 2009 to November 2012, sharing lessons that may be useful to other low-resource public health practitioners working in surveillance. We examined the EBS system’s event reporting, event verification and response. Characteristics examined included type of event, source of information, timeliness, nature of response and outcome. Sixty-one records were identified. The median delay between onset of the event and date of reporting was 10 days. The largest proportion of reports (39%) came from Provincial Health Offices, followed by direct reports from clinical staff (25%) and reports in the media (11%). Most (84%) of the events were substantiated to be true public health events, and 56% were investigated by the Provincial Health Office alone. A confirmed or probable etiology could not be determined in 69% of true events. EBS is a simple strategy that forms a cornerstone of public health surveillance and response particularly in low-resource settings such as Papua New Guinea. There is a need to reinforce reporting pathways, improve timeliness of reporting, expand sources of information, improve feedback and improve diagnostic support capacity. For it to be successful, EBS should be closely tied to response.

Human resources for health: lessons from the cholera outbreak in Papua New Guinea

Issue：Papua New Guinea is striving to achieve the minimum core requirements under the International Health Regulations in surveillance and outbreak response, and has experienced challenges in the availability and distribution of health professionals.Context：Since mid-2009, a large cholera outbreak spread across lowland regions of the country and has been associated with more than 15 500 notifications at a case fatality ratio of 3.2%. The outbreak placed significant pressure on clinical and public health services.Action：We describe some of the challenges to cholera preparedness and response in this human resource-limited setting, the strategies used to ensure effective cholera management and lessons learnt.Outcome：Cholera task forces were useful to establish a clear system of leadership and accountability for cholera outbreak response and ensure efficiencies in each technical area. Cholera outbreak preparedness and response was strongest when human resource and health systems functioned well before the outbreak. Communication relied on coordination of existing networks and methods for empowering local leaders and villagers to modify behaviours of the population.Discussion：In line with the national health emergencies plan, the successes of human resource strategies during the cholera outbreak should be built upon through emergency exercises, especially in non-affected provinces. Population needs for all public health professionals involved in health emergency preparedness and response should be mapped, and planning should be implemented to increase the numbers in relevant areas. Human resource planning should be integrated with health emergency planning. It is essential to maintain and strengthen the human resource capacities and experiences gained during the cholera outbreak to ensure a more effective response to the next health emergency.

Estudio de caso Alcoholismo y salud de pueblos indígenas en Nicaragua / I study of case Alcoholism and health of indigenous towns in Nicaragua

El presente estudio de casos ha sido realizado por la organización indígnea APRODIN, con apoyo de profesionales de salud con experiencia específica en salud de pueblos indígenas y salud mental, incluyendo la asesoría técnia de los profesionales de OPS vinculados al tema de salud indígena y salud mental. El presen estudio se realizó entre noviembre de 2004 y enero 2005, conforme la guía para los estudios de caso proporcionada por la Sede de OPS. La selección de la comunidad estudiada fue propuesta por los propios líderes indígenas con base al conocimiento empírico de los problemas de alcoholismo en dicha comunidad. el país ha agregado al estudio de la comunidad específica un segundo nivel de información y análisis correspondiente al uso, conocimiento, actitudes y prácticas que tienen los líderes indígenas nacionales que representan a los distintos pueblos originarios del pacífico, centro y norte del país. Después de haber recopilado la información requerida, se incluyeron talleres de capacitación sobre el problema del alcoholismo, tanto a nivel de los líderes nacionales como a nivel de la comunidad de Matagalpa y miembros de la comunidad indígena de San Pablo. Este informe esta estructurado en siete partes principales: descripción de la comunidad, uso pasado y presente, consumo en la comunidad, conocimiento y actitudes, prácticas, problemas, experiencias e ideas para la acción

Estudio de caso alcoholismo y salud de pueblos indígenas en Nicaragua / Case study alcoholism and health of indigenous people in Nicaragua

El presente estudio fue realizado entre noviembre de 2004 y enero 2005 realizado por la Organización Panamericana de la Salud (OPS) y la Organización Indigena APRODIN, con apoyo de profesionales de salud con experiencia especifica en salud de pueblos indigenas y salud mental, con la asesoria tecnica de los profesionales de la Organización Panamericana de la Salud, vinculados al tema de salud indigena y salud mental. En el estudio se caracteriza el consumo y efectos del alcohol en los pueblos indígenas Originarios del Pacìfico, Centro y Norte de Nicaragua, y en forma específica en el pueblo indígena Cacaopera en la Comunidad de San Pablo en el Departamento de Matagalpa. Este estudio esta estructurado en siete partes principales: descripción de la comunidad, uso pasado y presente, consumo en la comunidad, conocimiento, actitudes y prácticas que tienen los líderes indìgenas nacionales que representan a los distintos pueblos, asi como los problemas, experiencias e ideas para la acción