Morbidity associated with heroin overdose presentations to an emergency department: a 10-year record linkage study.

INTRODUCTION: To examine hospitalizations in a cohort of 224 patients who presented with non-fatal heroin overdose to an ED. METHODS: A record linkage study, using the morbidity, mental health and mortality databases in the Data Linkage Unit of the Department of Health, Western Australia. The main outcome measures were hospital separations 5 years before and after entry into the cohort. RESULTS: Before entry into the cohort, 199 (89%) patients had an admission to mental health services. These 199 had a combined total of 1367 separations, most commonly for a mental health condition, injury or poisoning. Women had more than twice the relative risk (RR) of men for all separations (RR 2.35, 95% confidence interval [CI] 1.96-2.82, P < 0.001) and for injury and poisoning separations (RR 2.04, 95% CI 1.56-2.66, P < 0.001). The highest concentrations of separations occurred within 1 year before and 1 year after entry into the cohort. There were 12 (5.4%, 95% CI 2.9-9.4%) deaths, most commonly from overdose. CONCLUSION: Non-fatal heroin overdose ED presentations are associated with a cluster of hospitalizations around that episode, likely to be related to heroin availability. Presentation to hospital by heroin users represents an opportunity to counsel less risky behaviour.

Epidemiology of notified campylobacteriosis in Western Australia.

Campylobacteriosis is one of the most common causes of gastroenteritis in Australia and the rates are thought to be increasing. This study has included all cases of campylobacteriosis that were notified in Western Australia between 1991 and 2001. The data for the study were received from Western Australian Notifiable Infectious Diseases Database located at the Communicable Disease Control Directorate of Western Australia. Rates of notification were calculated using the census data from 1991 for the general population and 1996 census data for the Aboriginal population. The notification rate of campylobacteriosis 89 per 100000 (95.0% confidence interval (CI) 87.6-91.4) for males and for females it was 78 per 100 000 (95.0%CI 87.6-91.4). Increased notification rates were seen in the very young, in males, in non-metropolitan areas and in the spring season. Aboriginal people had a much higher incidence than the rest of the population. Rates increased when laboratory notification was introduced. This study concludes that the rate of campylobacteriosis notification in Western Australia is increasing and is affecting younger children and young adults. The rate is higher in the Aboriginal population. As there were missing data from some cases the study faced some difficulties in interpreting the results. Recommendations for an improved surveillance system are made in order to minimise missing data.