Post-pandemic increase in invasive group A strep infections in New Zealand.

BACKGROUND: Since October 2022, multiple high-income countries have reported an increase in invasive group A streptococcal (iGAS) infections. This study describes trends in iGAS infections in Aotearoa New Zealand (NZ) between 2017 and 2023, and examines associations of iGAS incidence, COVID-19 eras, and acute respiratory infections (ARI). METHODS: Analyses include national-level surveillance data on iGAS and ARI. Multivariable Poisson regression was used to examine relationships between COVID-19 era and iGAS incidence, and Pearson pairwise correlations were calculated to examine trends between ARI and iGAS. FINDINGS: A sharp increase in iGAS was observed in 2023, with notable increases among children aged under ten years. Indigenous Maori and Pacific peoples were disproportionately affected. emm1 and emm12 were commonly reported in 2022-2023. Compared to pre-pandemic, iGAS decreased significantly during the COVID-19 restrictions era and increased once COVID-19 restrictions were relaxed, after adjusting for ethnicity, sex, and age. ARI was moderately correlated with iGAS (r = 0∙55) in 2022-2023. INTERPRETATION: Though delayed, NZ's recent iGAS trends mirror those seen in the 2022/2023 multi-country iGAS surge. These findings expand existing research, suggesting a link between the easing of COVID-19 measures, increased ARI circulation, and the rise in iGAS. Continued and improved iGAS surveillance, is needed to better understand iGAS epidemiology and support public health response. iGAS in NZ will become notifiable in late 2024, which should help improve iGAS monitoring and support public health response. FUNDING: This research received no specific funding, though iGAS surveillance and typing in NZ is funded by the Ministry of Health, which was not involved in the analysis, interpretation, design, or any aspect of this study. No authors were paid to write this manuscript.

Infectious pulmonary tuberculosis in a New Zealand cancer centre.

This report details the investigation of oncology and haematology patients, as well as cancer centre staff, friends and family who were exposed to an oncology patient with reactivated pulmonary tuberculosis (TB) in a New Zealand cancer centre. A total of 46 patients, seven staff members and 14 family and friends were identified as being exposed to the index case of TB (Mr K). These people were screened for TB infection by the use of a symptom questionnaire, Qiagen QuantiFeron (QFT)® Gold Plus test and, if potentially immunocompromised, a chest x-ray (CXR). There were no confirmed secondary cases of TB in any of the groups screened for infection, but surveillance for signs and symptoms of TB disease in those with significant risk is ongoing. In this article we discuss the public health response to TB in a cancer centre and potential preventative strategies for the future.

Eye health outreach services in the Pacific Islands region: an updated profile.

BACKGROUND: Anecdotal reports indicate a decreasing number of patients presenting for assessment, and in particular a reduction in the number of patients requiring cataract surgery in Pacific Island Countries (PICs). Furthermore, research and routine surveillance is uncommon. AIM: To analyse and describe the records of eye health outreach clinics from a single provider in seven Pacific Islands. METHOD: Routine data collected at the Fred Hollows Foundation eye health outreach clinics in Fiji, Kiribati, Papua New Guinea (PNG), Samoa, the Solomon Islands, Tonga and Vanuatu between 2009 and 2013 were analysed. RESULTS: Over the study period the number of patients treated per clinic fell in Fiji, Samoa and the Solomon Islands. Data from PNG show a higher mean number of patients per clinic and the numbers of patients presenting at PNG outreach clinics appears to be increasing. Cataract was the main eye health condition for between 40%-70% of visits overall, but this range varied between 14% (PNG) and 94% (Fiji). In all countries, males were more likely to receive cataract surgery than females. Refractive error was the most common presenting complaint at PNG outreach clinics; diabetic retinopathy was most common in Tonga. Cases of trachoma or trichiasis were identified in all countries, excepting Kiribati, Samoa and Tonga. CONCLUSION: Data from outreach eye health clinics show marked differences between PICs in the most common presenting conditions. In three countries, it appears there has recently been a reduction in the overall number of patients presenting for treatment. Cautious interpretation of the data is required due to concern about data completeness and quality.