ABSTRACT
OBJECTIVES: To describe the profile of people who received post-exposure treatment to prevent lyssavirus infection in Sydney South West Area Health Service between 2005 and 2007 and to assess treatment compliance with the current NSW Health protocol. METHODS: Thirty-eight public health files and a subset of 11 medical records were reviewed to collect demographic, exposure and treatment information for the period. RESULTS: Twenty-nine (76%) potential Lyssavirus exposures occurred overseas. Nine potential exposures occurred within Australia; eight of these resulted from a bat bite or scratch. Thirteen (34%) of all potential exposures resulted from handling an animal. CONCLUSION: Many potential exposures were the result of a bite or scratch from a domesticated animal; the animal's survival or health status was not routinely recorded. While all people who commenced post-exposure treatment completed the prescribed course, this was often not within the stipulated timeframe.
Subject(s)
Rhabdoviridae Infections/prevention & control , Adolescent , Adult , Aged , Aged, 80 and over , Animals , Bites and Stings/epidemiology , Bites and Stings/virology , Child , Child, Preschool , Female , Humans , Immunoglobulins/administration & dosage , Infant , Infant, Newborn , Male , Middle Aged , New South Wales/epidemiology , Rabies/immunology , Rabies Vaccines/administration & dosage , Rhabdoviridae Infections/epidemiology , Rhabdoviridae Infections/transmission , Young Adult , Zoonoses/epidemiology , Zoonoses/transmission , Zoonoses/virologyABSTRACT
In late 2004, NSW Health received several reports of a serious desquamating rash among clients of the methadone program. We sought to identify the extent and likely cause of this outbreak. We initiated active surveillance for cases throughout Australia, a survey of dosing points in NSW, and a case control study of clients receiving methadone syrup (MS) at two clinics. Between October 2004 and March 2005, 388 cases were identified, largely in NSW. The dosing point survey found almost all cases were clients prescribed MS (attack rate 4.5%). In multivariate analysis of data from dosing points that dispensed MS, use of take away doses or location of the dosing point in greater western Sydney were associated with illness. In the case control study, MS injection, use of street MS, high doses of MS, frequent takeaway doses, or use of benzodiazepines were associated with illness. Testing found no abnormality in associated batches of MS. Batches of MS temporally associated with the outbreak were quarantined from use and the outbreak subsided. While a direct causal link could not be established, available evidence suggests that a contaminant may have caused the outbreak. Epidemiological analyses are important for assessing concerns about product safety following marketing approval.
