ABSTRACT
BACKGROUND: Gonorrhoea is the second most common notifiable sexually transmissible infection (STI) in Queensland. Notifications have been increasing since 2002. Enhanced surveillance was undertaken in this study in order to evaluate clinical management and add to understanding of the epidemiology of gonorrhoea and in South East Queensland. METHODS: Information on clinical management and an enhanced surveillance form were faxed to clinicians who notified gonorrhoea in the Brisbane Southside Population Health Unit area from 2003 to 2008. Ceftriaxone was recommended for treatment of gonorrhoea cases, as was simultaneous treatment for chlamydia, testing for other STIs and management of sexual contacts. Enhanced surveillance focussed on collecting more detailed epidemiological and clinical management information. RESULTS: A total of 909 enhanced surveillance forms were returned (response rate 72.2%). The use of ceftriaxone increased significantly over the study period from 31.3% in 2003 to 68.4% in 2008 (P < 0.05). However, there remained a considerable proportion of cases that did not receive ceftriaxone (31.6% in 2008). Simultaneous treatment for chlamydia was reported for 70.5% of cases and did not increase over the study period. A high proportion of males were not screened for high risk co-infection such as HIV (49.6%) and syphilis (51.7%). Contact tracing was initiated for 76.5% of cases and did not increase during the study period. CONCLUSIONS: Continued education of clinicians on treatment guidelines is needed. Screening of other STIs such as HIV in males with gonorrhoea and increasing contact tracing were identified as aspects of clinical management for future improvement. Overall this study provides useful insights into the clinical management of gonorrhoea in South East Queensland.
Subject(s)
Contact Tracing/statistics & numerical data , Disease Notification/statistics & numerical data , Gonorrhea/epidemiology , Gonorrhea/prevention & control , Population Surveillance , Adult , Ambulatory Care Facilities/organization & administration , Anti-Bacterial Agents/therapeutic use , Comorbidity , Female , Gonorrhea/diagnosis , Gonorrhea/drug therapy , HIV Infections/epidemiology , HIV Infections/prevention & control , Health Promotion/organization & administration , Humans , Male , Middle Aged , Prevalence , Queensland/epidemiology , Syphilis/epidemiology , Syphilis/prevention & control , Young AdultABSTRACT
This study aimed to investigate changes in the notification rate of malaria in refugees over a period of national policy change on pre-departure screening. Notifying clinicians were interviewed to complete a standardised enhanced surveillance form. A decline in refugee malaria notifications occurred after implementation of a national policy to offer pre-departure malaria screening and treatment as necessary to refugees. Surveillance data support the benefit of offering pre-departure screening and treatment as necessary to refugees.
Subject(s)
Antimalarials/therapeutic use , Malaria/drug therapy , Malaria/epidemiology , Mass Screening , Refugees , Adolescent , Adult , Africa/epidemiology , Africa/ethnology , Analysis of Variance , Disease Notification , Female , Health Policy , Humans , Male , Population Surveillance , Queensland/epidemiology , Risk Factors , Surveys and QuestionnairesABSTRACT
In November 2008, a case of Shiga toxin-producing Escherichia coli (STEC) infection was reported to the Brisbane Southside Public Health Unit. The case had participated in a school camp. Subsequent investigations confirmed 5 other asymptomatic cases among camp attendees or visitors. Examination of the camp water supply identified that most water sources had high levels of E. coli and did not meet the Australian Drinking Water Guidelines with STEC isolated from 2 water sources. This outbreak highlights the emerging issue of asymptomatic carriage of STEC and the importance of thorough maintenance and attention to drinking water supplies in the rural and school camp setting.
Subject(s)
Escherichia coli Infections/epidemiology , Shiga-Toxigenic Escherichia coli/isolation & purification , Australia/epidemiology , Child , Disease Outbreaks , Escherichia coli Infections/diagnosis , Female , Humans , Male , Risk Factors , Schools , Surveys and Questionnaires , Water MicrobiologyABSTRACT
AIMS: To determine the proportion of notifiable cases of Q fever attributable to occupational and community exposures and to identify missed opportunities for Q fever vaccination in notifications of occupational exposures. METHODS: A review of Q fever notifications to the BSPHU from January 2000 to September 2006 was undertaken. Notifications were categorised according to probable exposure source. Occupational exposures were further categorised according to reported past exposure to Q fever and Q fever vaccination status. RESULTS: One hundred and ninety-one Q fever notifications were identified, with occupational exposure reported in 106 cases and community exposure reported in 69 cases. In the occupational exposures, 76 cases (71%) were not vaccinated, 15 (14%) reported past exposure to Q fever and eight reported vaccination prior to illness onset, but vaccination status could not be independently verified. Community acquired Q fever was most commonly attributed to living or working near a high-risk industry (26, 38%), incidental exposures such as farm visits, or attending sale yards (27, 39%). CONCLUSIONS: Occupationally acquired cases of Q fever continue to be reported in significant numbers and opportunities for vaccination are being missed. There is an ongoing need to ensure that all employees in high-risk industries are screened and vaccinated. The proportion of community acquired notifications of Q fever has increased since the National Q fever Management Program started, commensurate with the decline in occupationally acquired cases. These proportions may be expected to change with the cessation of the program in Queensland in December 2006.
