ABSTRACT
OBJECTIVES: To describe the various investigations and responses to multiple outbreaks of dengue serotype 2 that occurred in north Queensland in 2003/04. METHODS: Details about each case were collated so as to target mosquito-control responses including control of mosquito breeding sites, interior spraying of selected premises, and a novel 'lure and kill' approach using lethal ovitraps. Phylogenetic analyses were undertaken to determine the genetic relatedness of viruses isolated during the outbreaks. RESULTS: Except for a two-month hiatus in mid-2003, the outbreaks continued for 16 months and included approximately 900 confirmed cases, with three severe cases and one death. The available evidence suggests that the mosquito-control measures were effective, but delays in recognising the outbreaks in Cairns and the Torres Strait coupled with intense mosquito breeding contributed to the extensive nature of the outbreaks. Phylogenetic analyses showed that there had been only two major outbreaks, one that spread from Cairns to Townsville, the other from the Torres Strait to Cairns; both were initiated by viraemic travellers from Papua New Guinea. CONCLUSIONS: Phylogenetic analyses were essential in understanding how the outbreaks were related to each other, and in demonstrating that dengue had not become endemic. Further innovative approaches to dengue surveillance and mosquito control in north Queensland are necessary. IMPLICATIONS: Dengue outbreaks have become more frequent and more severe in north Queensland in recent years, raising the possibility that dengue viruses could become endemic in the region leading to outbreaks of dengue haemorrhagic fever.
Subject(s)
Dengue Virus/isolation & purification , Dengue/epidemiology , Dengue/virology , Disease Outbreaks/prevention & control , Aedes/virology , Animals , Dengue/transmission , Dengue Virus/classification , Dengue Virus/genetics , Female , Humans , Insect Vectors/virology , Male , Mosquito Control/methods , Phylogeny , Queensland/epidemiology , Sentinel Surveillance , SerotypingSubject(s)
Escherichia coli Infections/epidemiology , Escherichia coli Infections/microbiology , Escherichia coli/classification , Hemolytic-Uremic Syndrome/epidemiology , Hemolytic-Uremic Syndrome/microbiology , Shiga Toxin 2/biosynthesis , Child , Cluster Analysis , Escherichia coli/metabolism , Female , Humans , Infant , Male , Queensland/epidemiologyABSTRACT
The uptake of the vaccine in at-risk Aboriginal and Torres Strait Island adults in north Queensland in 2003 was determined using the state-wide computerised immunisation register. The uptake in Aboriginal and Torres Strait Island adults > or = 50 years was 63 per cent, and assuming that a third of Aboriginal and Torres Strait Island adults 15-49 years of age had a medical risk factor, 85 per cent of those at-risk were vaccinated in 2003. There were considerable improvements in vaccine uptake in both age groups in the Cairns, Charters Towers, Mackay and the Tablelands Health Service Districts (HSDs) in 2003, but there were been considerable declines in both age groups in the Innisfail and Mt Isa HSDs in 2003 compared to 2002. There was also a decline in uptake in adults 15-49 years of age in the Townsville HSD.
