Infectious Disease Report - July 2008
Communicable Disease Report, July 2008
Table 1 shows reports of communicable diseases received through to the end of July 2008 in NSW by Area Health Service. To check the latest reports for a particular disease, scroll down the table to the disease of interest, and click on the column headed "NSW data".
Pertussis
NSW is seeing an increase in cases of pertussis (whooping cough) this year. In July there were 441 cases notified. The largest numbers of cases are occurring in Sydney West (126 cases notified in July) and on the North Coast (81 cases). A number of hospitalisations have occurred in pre-school aged children and infants.
Public Health Units are actively following up cases aged less than 20 years, in collaboration with their treating doctors, and offering assistance to GPs in following up others where there are contacts at risk of severe disease. Relevant information about the disease and its prevention are being provided to GPs, schools and child care centres.
Specific antibiotics are advised for those close contacts of cases, if those contacts are at risk of severe disease (infants under one year) or may transmit infection to those at risk, including contacts working in childcare settings or health care facilities (maternity, nursery), women in the last month of pregnancy, and members of households with incompletely vaccinated young children.
Children need to be routinely immunised at two, four and six months. Boosters containing pertussis vaccine are needed at four years of age and again at 15 years of age.
Enterics
In July 2008, NSW public health units investigated 67 outbreaks of gastroenteritis including 63 where person-to-person spread was implicated and four suspected to be food borne.
The 63 suspected person-to-person outbreaks affected a total of 917 people. Forty-two occurred in aged care facilities and affected 625 people, sixteen occurred in hospitals and affected 246 people, four occurred in child care centres and affected 36 people, and one in a respite centre affecting 10 people.
Clinical specimens were submitted for testing from 37 of 63 suspected person-to-person gastroenteritis outbreaks. Rotavirus was confirmed in stool samples from one aged care facility outbreak, and norovirus was identified in seventeen outbreaks. The causative agent was not confirmed for the remaining outbreaks.
Two of the foodborne gastroenteritis outbreaks affected 13 people in whom illness was associated with having eaten oysters. The NSW Food Authority have investigated the source oyster farm and detected norovirus in oysters; this lease was closed as a result.
Further investigation into a large outbreak of Clostridium perfringens affecting over half of the 130 residents in an aged care facility was conducted. The outbreak had two obvious peaks: the first in mid June and the second in late June. C. perfringens enterotoxin type A was detected in seven of ten stool specimens collected from cases during the period 14 June to 14 July. Residents on pureed diets were more likely to be ill than those who were not on a pureed diet. The NSW Food Authority inspected the food services at the facility on two occasions and found that food handling, personal hygiene and food temperature monitoring were in accordance with good hygiene practices. A number of food and environmental samples collected on 10 July were negative for C. perfringens. A full report of this investigation will be available in the near future.