Impacts of a measles outbreak in Western Sydney on public health resources.

During February and March 2011, an outbreak of 26 confirmed cases of measles was reported to the Parramatta Public Health Unit (PHU) in western Sydney. This paper describes the impact of the outbreak on PHU resources. A retrospective review of information obtained from case notification forms and associated contact tracing records was carried out for each of the confirmed cases. Seven cases (27%) required hospital admission for more than 1 day and 10 (38%) cases required management within a hospital emergency department. There were no cases of encephalitis or death. The number of contacts was determined for each case as well as the number who required post-exposure prophylaxis. In total, 1,395 contacts were identified in this outbreak. Of these, 79 (5.7%) required normal human immunoglobulin and 90 (6.5%) were recommended to receive the measles-mumps-rubella vaccine. A case study detailing the PHU costs associated with the contact management of a hospitalised measles case with 75 identified contacts is also included and the estimated total cost to the PHU of containing this particular case of measles was A$2,433, with staff time comprising the major cost component. Considerable effort and resources are required to manage measles outbreaks. The total cost of this outbreak to the PHU alone is likely to have exceeded A$48,000.

Rotavirus vaccination one year on...

The rotavirus vaccine was incorporated into the Australian National Immunisation Program from 1 July 2007. To measure early impact of the vaccine on rotavirus disease and the burden of gastroenteritis in young children, we examined 2 surveillance data sources, rotavirus isolates from selected New South Wales laboratories, and New South Wales Emergency Department (ED) visits assigned a gastroenteritis-related diagnosis. Between 2001 and 2008, weekly time series were prepared for 2 age groups representing children young enough to have been offered vaccination prior to the 2008 seasonal epidemic (< 15 months) and older children (15 months to 5 years). In 2008, the seasonal increase in laboratory confirmed rotavirus infection and gastroenteritis related ED visits declined substantially in both age groups compared with earlier years. These data provide preliminary evidence of the effectiveness of the rotavirus vaccination program in New South Wales. Immunising the most susceptible population group, infants, against rotavirus may limit wider circulation of the virus in older children.