Tuberculosis notifications in Australia, 2015-2018.

ABSTRACT: In 2018, the National Notifiable Diseases Surveillance System received 1,438 tuberculosis (TB) notifications, representing a rate of 5.8 per 100,000 population, consistent with the preceding three years. Australia has achieved and maintained good tuberculosis (TB) control since the mid-1980s, sustaining a low annual TB incidence rate of approximately five to six cases per 100,000 population. The number of multi-drug-resistant TB (MDR-TB) cases diagnosed in Australia is low by international standards, with approximately 2% of TB notifications per year classified as MDR-TB. Australia's overseas-born population continue to represent the majority of TB notifications (between 86% to 89% across the four reporting years) and the Aboriginal and Torres Strait Islander population continues to record TB rates around four to five times higher than the Australian-born Non-Indigenous population. Whilst Australia has achieved and maintained excellent control of TB in Australia, sustained effort is required to reduce local rates further, especially among Aboriginal and Torres Strait Islander populations, and to contribute to the achievement of the World Health Organization's goal to end the global TB epidemic by 2035.

The effect of COVID-19 public health measures on nationally notifiable diseases in Australia: preliminary analysis.

ABSTRACT: Since the introduction of COVID-19-related public health measures, notifications for most nationally notifiable diseases have declined when compared to previous years. Physical distancing, travel restrictions, and emphasis on hygiene are likely to have affected the number of expected notifications, with the greatest reductions observed among disease spread via person-to-person contact such as influenza, and among overseas-acquired infections such as dengue virus and measles. However, quantifying the magnitude of the effect of COVID-19 public health measures on communicable diseases in Australia will be difficult, due to confounding factors such as: changes in testing priorities in laboratories; diversion of resources to the COVID-19 response; changes in health-seeking behaviours; greater utilisation of telehealth practices; and financial impacts such as income loss and ability to afford healthcare. It is considered likely that these other factors will have also impacted notification numbers.

Humoral response to an equine encephalitis vaccine in healthy alpacas.

OBJECTIVE: To determine humoral responses to an equine encephalitis vaccine in healthy alpacas. DESIGN: Clinical trial. ANIMALS: 39 healthy alpacas on 1 farm and 86 healthy alpacas on a second farm. PROCEDURES: All alpacas were given 3 doses IM of a bivalent, killed-virus equine encephalitis vaccine, with 4 weeks between doses. Eastern equine encephalitis (EEE) virus neutralizing antibody responses were determined with a plaque reduction neutralization assay every 14 days in alpacas on the first farm and 70 days after the first dose of vaccine on the second farm. RESULTS: For alpacas on the first farm, geometric mean virus neutralizing antibody titer peaked 2 weeks after the third vaccine dose was given (ie, day 70). At this time, 29 of 38 (76%) animals were seropositive for antibodies against EEE virus, and percentage of animals 6 years old that were seropositive (1/5). For alpacas on the second farm, 76 (88%) were seropositive on day 70, and percentage of animals 6 years old that were seropositive (27/33). For both farms, geometric mean titer on day 70 was significantly higher in animals < 2 years old than in animals > 6 years old. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that inoculation of alpacas with 3 doses of a bivalent, killed-virus equine encephalitis vaccine induced a humoral antibody response against EEE virus.

Eastern equine encephalitis in 9 South American camelids.

BACKGROUND: Eastern equine encephalitis (EEE) virus is a mosquito-borne togavirus (alphavirus) that causes severe (often fatal) encephalitis in many mammalian species, but it has not been reported previously in South American camelids. HYPOTHESIS: South American camelids can become naturally infected with EEE virus and show encephalitic signs similar to those observed in other affected species. ANIMALS: Nine cases (8 alpacas and 1 llama, aged 3.5 weeks to 12 years) were identified; 4 of 9 were 510 weeks old. All cases were from the East Coast of the United States and presented in late summer and fall. METHODS: A retrospective study was performed to include confirmed cases of EEE in camelids in North America before 2006. RESULTS: Eight of nine (89%) camelids died or were euthanized in extremis, with the mean time to death of 2 days. Clinical signs were consistent with encephalitis and included fever, lethargy, ataxia, seizures, recumbency, torticollis, opisthotonus, and vestibular signs. No consistent hematologic abnormalities were identified, and cerebrospinal fluid contained an increased protein concentration in the single camelid analyzed. No successful therapy was identified. EEE was confirmed by alphavirus detection by using immunohistochemistry (IHC) and polymerase chain reaction (PCR) in the central nervous system (CNS) and by serology. Findings included polioencephalitis with lymphocytic perivascular cuffing; neutrophil infiltration; gliosis; neuron satellitosis; necrosis; and edema, with intracytoplasmic alphavirus within neurons and glial cells. No virus was detected in extraneural tissues. CONCLUSIONS AND CLINICAL IMPORTANCE: In endemic areas, EEE should be considered a differential diagnosis for young and adult camelids with CNS disease. Brain histopathology with indirect IHC or PCR is diagnostic.