Update in the trends of communicable Disease in SA

Transcription

1 Update in the trends of communicable Disease in SA Emma Denehy Communicable Disease Control Branch (CDCB) September 2018

2 Communicable Disease Control Branch Director Dr Louise Flood Personal Assistant Roberta Forel/ Kelly Thorpe Specialist Services Medical Consultant Epidemiologist/ Dr Brendan Kennedy Data & Corporate Services Manager Steve Kerr Disease Surveillance & Investigation Section Manager Emma Denehy Immunisation Section Manager Noel Lally Infection Control Service Section Manager Irene Wilkinson STI & BBV Manager Danny Gallant HIV Case Coordinator Dean Gloede Principal Public Health Officer/Nurse Rebecca Beazley/Ingrid Tribe/ Emily Fearnley Public Health Officer/ Nurse Hannah Vogt Abbie Akinloye Bernie Edmunds Isabella Johnson Sharon Stendt Jodie Halliday Christian Peut Karen Peterson Caitlin Graham Adriana Milazzo Bernadette Kenny Jana Sisnowski OzFoodNet (C/W funded) Who are we? Also working with Food Policy and Programs section and Health Protection Programs Megge Miller Emily Fearnley

3 Disease Surveillance > Objectives Monitor trends in disease Detect outbreaks Evaluate an intervention Estimate future impact of a disease > Drs and labs notify 80 + diseases and conditions Surveillance is the on-going systematic collection, analysis interpretation and dissemination of data about a health related event for use in public health action to reduce morbidity and mortality and to improve health (CDC, 2001)

4 Notifications : tip of the iceberg Notify Notifiable organism detected Laboratory specimen requested Sees doctor Person becomes ill Exposures in population

5 Timeliness of public health follow-up 5 Time lags defined (T 1 -T 5 ) Source: Research by Christian Peut, CDCB 2016

6 What is an outbreak? > Surveillance outbreak detection > Outbreak: Any unusual or unexpected increase in the number of cases of a particular disease than would normally be expected in a given area, or among a specific group of people, over a particular period of time Observed > Expected

7 How do we investigate? > Epidemiological investigation Confirm diagnosis Interview ill people Determine if there are any common food items from food history interviews with cases Develop hypothesis Test hypothesis with an analytical study

8 Salmonella in a bakery > 73 people with gastroenteritis were associated with an outbreak at a bakery > 66 cases identified as Salmonella Typhimurium phage type 135 > Thirteen cases (19%) were hospitalised > One death (cause of death is unknown at this stage) > 64/68 consumed chicken containing wraps, rolls and sandwiches

9 Outbreak by case status and date of illness onset, 14 December 2017 to 31 December 2017, South Australia Source: Prepared by Dr Megge Miller, CDCB 2018

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11 Salmonella Havana outbreak > Thirty-one cases of Salmonella Havana > 19 females and 12 males, 11 hospitalised > 13 ate at the same hotel (two of these recalled eating alfalfa sprouts) > 8 others reported consuming alfalfa sprouts > A case control study was conducted on the 20 June 2018 > Odds of consuming alfalfa sprouts in cases were 26 times that of the odds of a control

12 No. of Notifications Salmonella Havana, 1 Jan September 2018, SA /1 2015/3 2015/5 2015/7 2015/9 2015/ /1 2016/3 2016/5 2016/7 Onset Date (m onth/year) 2016/9 2016/ /1 2017/3 2017/5 2017/7 2017/9 2017/ /1 2018/3 2018/5 2018/7 2018/9

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15 Cryptosporidium investigation > In June 2017, a cluster of cluster of cryptosporidiosis identified in the Southern Metropolitan > On the 27 June 2017, one case reported consuming unpasteurised milk > On the 6 July 2017, a second case reported consuming unpasteurised milk from the same Dairy > An outbreak investigation was commenced > Seven cases linked

16 No. of Notifications Cryptosporidium investigation Cryptosporidiosis, 1 Jan 2015 to 5 March 2018, SA /1 2015/3 2015/5 2015/7 2015/9 2015/ /1 2016/3 2016/5 2016/7 2016/9 2016/ /1 2017/3 2017/5 2017/7 2017/9 2017/ /1 2018/3 Calculated Onset Date

17 Influenza notifications for week of notification, , SA

18 Meningococcal disease > From 1 October 2018 the State Government funded Meningococcal B Immunisation Program

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20 Legionella pneumophila 1(LP1) > Legionella pneumophila 1(LP1) is a species of bacteria commonly found in the environment > Symptoms include: Fever, cough, chest pain, breathlessness, pneumonia > Incubation period is 2-10 days, though may be longer

21 Reservoir for the bacteria > LP1 has been isolated from many environmental sources including; ice machines, hot water systems, airconditioning cooling towers, hot and cold water taps, showers, nebulisers, spas, hydrotherapy pools and fountains > Person to person spread does not occur.

22 Who get infected? > People of any age may be infected, but is more common in middle aged and older people and people whose immune system is weak. > Men are affected more frequently than women > Risk is increased by; smoking, heart or lung disease, diabetes, kidney failure, immunosuppression and being >50 years

23 Legionella pneumophila 1(LP1) > The DSIS team currently interview every case within 24 hours of notification > Interview is usually conducted at the hospital > A 15 page questionnaire is used > Interpretation of the laboratory results with the clinical history to determine if this a case > Provide information to Health Protection programs to initiate public health actions

24 2010/1 2010/5 2010/9 2011/1 2011/5 2011/9 2012/1 2012/5 2012/9 2013/1 2013/5 2013/9 2014/1 2014/5 2014/9 2015/1 2015/5 2015/9 2016/1 2016/5 2016/9 2017/1 2017/5 2017/9 2018/1 2018/5 2018/9 No. of Notifications Legionella pneumophila Serogroup 1, 1 Jan Sept 2018, SA Onset Date (year/m onth)

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32 Shigella in the Port Augusta, Ceduna, Far North and West Coast regions, SA Since 15 th April 2017: 226 cases have been identified DOO ranging from 06/04/2017 and 28/08/ (18%) cases are persons of Aboriginal origin 81 cases are male and 145 females Age range is 7 months to 89 years old, median age of 19 years 40 (18%) cases were hospitalised

33 Shigella outbreak cases by residential region, South Australia, April September 2018

34 Diphtheria > An infection of the throat and nose. Can cause skin infections > The bacteria can cause a toxin capable of damaging nerves of the heart > Diphtheria is rare in Australia since the introduction of the vaccination > Two confirmed cases recorded in SA (last cases in 2013) > On 17 September notified of a 46 yo male with recent travel to PNG who had blisters on his feet

35 Diphtheria public health action > Interview the case and identify any others that may be at risk > For case and close contacts: Educate Isolate Test nose and throat for the bacteria Vaccinate (booster given if more than 5 years since last vaccination) Treat with antibiotics for clearance

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