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Research Papers
Dawood FS, Dalton CB, Durrheim DN, Hope KG Rates of hospitalisation for acute respiratory illness and the emergence of pandemic (H1N1) 2009 virus in the Hunter New England Area Health Service Medical Journal of Australia; 191(10): 573-574
Using diagnostic codes to identify hospitalisations for acute respiratory illness allowed review of the impact of the pandemic virus on HNE hospitalisation. Compared with 2007 and 2008, there was a rapid, early increase in hospitalisations for acute respiratory illness, coinciding with the emergence of pH1N1. A disproportionate burden of hospitalisations occurred among people aged 5-61 years with a relatively lower burden among those aged 62 years.
Merritt TD, Massey PD. Isoniazid Hypersensitivity in a child. Medical Journal of Australia 2009; 190(7): 397.
We report a likely hypersensitivity reaction to isoniazid in a young child, aged 21 months, that required cessation of treatment. Isoniazid is used extensively for the management of tuberculosis and on this occasion was commenced following a potential exposure to tuberculosis while awaiting definitive evidence of infection. The reaction included a maculopapular skin rash and vesicular tongue lesions. Such reactions are well documented in adults but there is very published on skin reactions in children. The Therapeutic Goods Administration in Australia had received no other reports of suspected hypersensitivity in children under 10 years of age.
Tuyl F "Conditional Probability and HIV Testing: A Real-World Example" The American Statistician 2009; 63(3): 294-295.
"This Letter to the Editor suggests a slight improvement to Bhatti & Wightman (2008), who considered the positive predictive value (PPV) in the context of diagnostic testing, i.e. the probability that a positive test result is correct. The improvement describes the simplicity of updating the PPV when successive tests are applied."
http://0-www.amstat.org.library.newcastle.edu.au/publications/tas.cfm
Paterson B, Durrheim DN, Tuyl F. Influenza: H1N1 Goes to School Science 2009; 325: 1071-1072
A secondary analysis of the influenza A (H1N1) outbreak amongst secondary school students at St. Francis Preparatory School outbreak in the United States allowed calculation of an effective reproduction number in a school-based setting of 2.69 [95% CI: 2.20 to 3.22]. This may explain the apparent amplification role of schools during the first wave of the H1N1 pandemic
http;//0-sciencemag.org.library.newcastle.edu.au/
Massey PD, Pearce G, Taylor KA, Orcher L, Saggers S, Durrheim DN. Reducing the risk of pandemic influenza in Aboriginal communities Rural and Remote Health Published Online 2009; 9 (Article 1290): 1-7.
Aboriginal people have borne the brunt of severe disease during previous pandemics and this has also been the case during the first wave of the H1N109 pandemic in Australia. This paper describes the process and findings from preliminary community consultations into reducing influenza risk, including pandemic H1N1(09) swine influenza, in six Aboriginal communities in the Hunter New England area of northern New South Wales, Australia. The consultations further developed shared understanding between health services and Aboriginal communities about appropriate and culturally safe ways to reduce the influenza risk in communities.
http://www.rrh.org.au/articles/showarticlenew.asp?ArticleID=1290
Eastwood K, Durrheim DN, Massey PD, Kewley C. Australia's pandemic 'Protect' strategy: the tension between prevention and patient management Rural and Remote Health Published Online 2009; 9(Article1288): 1-7
Since the first case of the pandemic influenza strain, H1N109 was identified in Australia on 7 May 2009 there have been valuable opportunities to gain experience and learnings for future emergencies. The early response involved an intense containment effort lasting 7 weeks but this was unable to prevent local community transmission in some areas of Australia. However, despite outbreaks in densely populated areas of New South Wales (NSW) and Victoria, much of the outback was unaffected. By the end of the Containment Phase, most parts of rural NSW had only recorded low rates of confirmed H1N109 infection. As rural areas of Australia often provide poorer access to health services than their urban counterparts, they are likely to be more affected by an extended emergency, even one as moderate as the present H1N109 swine influenza pandemic. It is possible that extending containment measures in less affected areas could have had significant benefits that would have been especially useful for communities where large numbers of vulnerable people such as Indigenous Australians reside. Although containment is worthwhile in limiting the spread of disease in specific situations it is unlikely to change the course of a pandemic unless it can be sustained until a large proportion of the population is vaccinated. Significant advantages can be gained by encouraging strenuous containment efforts in outbreaks of severe disease, particularly those caused by novel infectious agents with a low reproductive rate. As advances in vaccine manufacture reduce the time taken to produce a new vaccine, the benefits of investing in containment will be even more worthwhile.
http://www.rrh.org.au/articles/showarticlenew.asp?ArticleID=1288
Huppatz C, Durrheim DN, Levi C, Dalton C, Williams D, Clements MS, Kelly PM. Etiology of Encephalitis in Australia, 1990-2007. Emerging Infectious Diseases 2009; 15(9): 1359-1365.
Rates of hospitalization for patients with encephalitis in Australia’s most populous state, New South Wales, were reviewed from January 1990 through December 2007 and encephalitis accounted for an average annual hospitalization rate of 5.2/100,000 population. During this period Toxoplasma encephalitis and subacute sclerosing panencephalitis showed notable declines. The high proportion of encephalitis with no known etiology may conceal emergence of novel pathogens. Unexplained encephalitis should be investigated, and encephalitis hospitalizations should be subject to statutory notification in Australia.
http://www.cdc.gov/eid/content/15/9/pdfs/EID_Vol15No9.pdf
Guimont C, Hullick C, Durrheim DN, Ryan N, Ferguson J, Massey P. Invasive meningococcal disease-improving management structured review of cases in the Hunter New England area, Australia. Journal of Public Health Advance Access 2009; 1-6.
All notified invasive meningococcal disease (IMD) cases over a 2 year period (24 in total) in the HunterNew England Health area were reviewed by an expertpanel to identify key correctable issues in themanagement of IMD. Amongst the avoidable factors identified, length of delay in initiating antibiotic therapywas a particularly important issue to address.
jpubhealth.oxfordjournals.org/cgi/content/abstract/fdp075
Eastwood K, Durrheim DN, Francis JL, Tursan d'Espaignet E, Duncan S, Islam F, Speare R. Knowledge about pandemic influenza and compliance with containment measures among Australians. World Health Organisation Bulletin 2009; 87(8): 588-594
Objective To explore the willingness of the Australian public to comply with public health directives during an influenza pandemic event. Methods Information was gathered from a representative sample of Australians regarding their knowledge of pandemic influenza and willingness to comply with public health control measures. Following initial data collection, respondents were provided with a detailed description of pandemic influenza to ensure they understood the significance of the issue. The questions on compliance were repeated and changes in responses were analysed with McNemar’s test for paired data. Findings Less than a quarter of the 1166 respondents demonstrated a clear understanding of the term “pandemic influenza”. Stated willingness to comply with control measures was high with 94.1% reporting compliance with home quarantine; 94.2% expressed willingness to avoid public events; and 90.7%, were prepared to postpone social gatherings. After the meaning of “pandemic” was explained to all respondents, stated compliance increased significantly (to 97.5%, 98.3% and 97.2% respectively). Those less familiar with the term “pandemic influenza,” males and employed people not able to work from home were less willing to comply. Conclusion In Australia, compliance with containment measures against pandemic influenza is likely to be high, should a pandemic arise, yet it could be further enhanced through a public education programme conveying just a few key messages. A basic understanding of pandemic influenza is associated with reported willingness to comply with containment measures. Investing in promoting measures to prepare for a pandemic or other health emergency will have considerable value for future eventualies.
http://www.who.int/bulletin/volumes/87/08-060772.pdf
Massey PD, Durrheim DN, Way A. Q-fever vaccination-Unfinished business in Australia
PENDING
www.ncbi.nlm.nih.gov/pubmed/19393710
Massey PD, Durrheim DN, Way A. Q-fever vaccination-Unfinished business in Australia Vaccine 2009; 27(29): 3801.
Q fever notifications suggest that the short-lived national Q fever vaccination program in Australia had a positive impact in certain at-risk populations at the time of the program, particularly abattoir workers. However, Australia’s Q fever immunisation challenge is not yet completed. There has been a shift in the epidemiology of Q fever notifications in NSW with the ongoing burden being borne by rural people who live and work in close contact with farm animals. There is a need for a sustainable program in Australia to ensure that non-abattoir workers at risk from this serious disease can access the protection offered by the available vaccine.
www.ncbi.nlm.nih.gov/pubmed/19393710
Massey PD, Irwin M, Durrheim DN Enchanced Q Fever risk exposure surveillance may permit better informed vaccination policy Communicable Diseases Intelligence 2009; 33(1): 41-45.
A review of New South Wales notifications from 1993 to 2007 and a retrospective case series were conducted using acute Q fever cases notified during 2007 from a rural area of New South Wales. Occupation was recorded for less than 50% of Q fever notifications and there was a significant increase in the ‘Farmer/Livestock’ category. In the month prior to illness onset 78% of notified cases reported direct contact with animals. Newly introduced livestock appeared to be of particular importance. 93% of cases required time off work or school, with a median of 21 days due to their Q fever disease. Improved surveillance fields are required to better describe risk exposures to inform vaccine policy.
http://www.ncbi.nlm.nih.gov/pubmed/19618770
Roberts-Witteveen AR, Campbell BA, Merritt TD, Massey PD, Shadbolt CT, Durrheim DN. Egg-associated Salmonella outbreak in an aged care facility, New South Wales, 2008. Communicable Diseases Intelligence 2009; 33(1): 49-52.
An outbreak of Salmonella Typhimurium phage type 44 (Stm 44) in an Aged Care Setting affecting 8/45 residents is described. Onset followed consumption of a dessert containing raw eggs supplied from a local farm. Stm 44 was detected on an egg in an unopened box from this supplier. The raw-egg dessert was epidemiologically implicated as the likely source of the Salmonella. Inadequate cooking of eggs continues to pose a risk for Salmonella infection in settings with vulnerable populations and advocate for food safety regulations and further measures to reduce the risks associated with the distribution, storage and preparation of shell eggs.
www.ncbi.nlm.nih.gov/pubmed/19618772
Osborn M, McPhie KA, Ratnamohan VM, Dwyer DE, Durrheim. Outbreak of Human Metapneumovirus infection in a residential aged care facility. Communicable Diseases Intelligence 2009; 33(1): 38-40.
Human metapneumovirus (hMPV) was detected by polymerase chain reaction assay in 3 specimens during a respiratory illness outbreak in an aged care facility during summer 2008. No other respiratory pathogens found. This is the first reported outbreak of hMPV in an aged care facility in Australia and this pathogen should be considered as the possible cause of outbreaks in aged care facilities when influenza and respiratory syncytial virus have been excluded.
www.health.gov.au/internet/main/publishing.nsf/.../cdi3301h.pdf
Huppatz C, Capuano C, Palmer K, Kelly PM, Durrheim DN. Lessons from the Pacific programme to eliminate lymphatic filariasis: a case study of 5 countries BMC Infectious Diseases 2009; 9(92): 1-6
The Global Programme to Eliminate Lymphatic Filariasis aims to eliminate LF as a public health problem by the year 2020. By June 2007, five of the eleven countries classified as endemic had completed five Mass Drug Administration campaigns and post-MDA prevalence surveys to assess their progress. Of the five countries in this case study, three countries (Tonga, Niue and Vanuatu) reached the target prevalence of <1% antigenaemia following five rounds of MDA. Limitations in the data preclude identification of key determinants of this achievement.
Coleman Marlize, Coleman Michael, Mabuza AM, Kok G, Coetzee M, Durrheim DN. Using the SaTScan method to detect local malaria clusters for guiding malaria control programmes. Malaria Journal 2009; 8:68.
SaTScan software using the Kulldorf method of retrospective space-time permutation and the Bernoulli purely spatial model was used to identify malaria clusters using definitively confirmed individual cases in seven towns over three malaria seasons. SaTScan detected five space-clusters and two space-time clusters during the study period.
http://www.malariajournal.com/content/8/1/68
Massey PD, Miller A, Durrheim DN, Speare R, Saggers S, Eastwood K. Pandemic influenza containment and the cultural and social context of Indigenous communities Rural and Remote Health 2009; 9:1179. 1-3.
The needs of marginalized communities have often been neglected in pandemic planning. For containment strategies to succeed genuine and respectful partnerships with Indigenous people are essentail.
http://www.rrh.org.au/articles/subviewnew.asp?ArticleID=1179
Edmiston N, Ooi C, Otton G, Boyle M. Vulval Crohn's Disease Sexual Health 2009; 6(1): 87-89.
A case of Vulval Crohn's disease is presented, the features of which were complicated by the presence of sexually transmissible infections.
http://www.publish.csiro.au/nid/166/issue/5048.htm
Durrheim DN E-surveillance: don't neglect sentinels in developing countries The Lancet 327(96): 2021-2022
The promise of e-surveillance for alerting us to emerging infectious diesease epidemics is being fulfilled. The power of HealthMap, ProMed-mail, and the Global Public Health Intelligence Network to interrogate available global electronic and print data for infectious disease surveillance.
Moses N, Wiggers J, Nicholas N Persistence of unmet need for care among people with systemic lupus erythematosus: a longitudinal study Quality of Life Research 17(6): 867-876
The extent and variability of unmet care needs over time of people with systemic lupus erythematosus (SLE) has not previously been reported. A prospective study has been undertaken to determine the variability over time of such needs. The results of the study suggest there is unacceptable persistence of care needs not being met. There is an ongoing need to identify mechanisms to help enhance care delivery so that the care needs of people with SLE are more effectively addressed.
http://www.springerlink.com/content/g3l0w41h111l0280/
Unicomb LE, Dalton CB, Gilbert GL, Becker NG, Patel MS. Age-Specific Risk Factors for Sporadic Campylobacter Infection in Regional Australia. Foodborne Pathogens and Disease 2008; 5(1): 79-85.
In a case–control study in the Hunter region of New South Wales, Australia, 354 cases and 593 controls were recruited to investigate meat, other food, and environmental exposures as potential risk factors for the domestically acquired Campylobacter illness. In a multivariable model, illness was significantly associated with household exposure to the diarrheal illness, consumption of restaurant chicken or beef, eating two or more ‘‘fast’’ food meals in a week, and overseas travel. Comparing exposures for the 0- to 4-year and 5-year and the older age groups allowed detection of some additional risk factors. Eating restaurant-prepared red meat and swimming were significantly associated with Campylobacter illness in the older group only. These findings demonstrate age-specific differences in risk factors for campylobacteriosis.
http://www.liebertonline.com/toc/fpd/5/1
Unicomb LE, O'Reilly LC, Kirk MD, Stafford RJ, Smith HV, Becker NG, Patel MS, Gilbert GL. Risk factors for infection with Campylobacter jejuni flaA genotypes. Epidemiology and Infection 2008; 136(11): 1480-1491.
pending
Ewald BD, Webb CE, Durrheim DN, Russell RC Is there a risk of malaria transmission in NSW? NSW Public Health Bulletin 19(7-8): 127-131
Although Anopheles annulipes occurs in NSW it has been many years since the local transmission was documented. The factors known to influence malaria transmission are critically reviewed to determine current risk of introduction and transmission, and appropriate public health strategies to address this risk.
http://www.publish.csiro.au/nid/226/issue/4238.htm
Vellama SC, Durrheim D, Smith Je. Diagnosing childhood tuberculosis in rural clinics in Mpumalanga Province, South Africa Curationis 2008; 31(1): 52-58
Tuberculosis is a severe disease in young children and diagnosing tuberculosis in children is complex particularly challenging in developing countries where resources and access to sophisticated facilities are limited. As relatively low rates of childhood tuberculosis notification suggested tuberculosis may have been under-diagnosed in Mpumalanga Province, South Africa a study was conducted to determine the ability of the primary health care nurses to diagnose childhood tuberculosis in primary care public health facilities in Gert Sibande District, Mpumalanga Province. The study found limited use of complementary clinical and epidemiological features and diagnostic approaches to diagnose childhood tuberculosis. Child contacts screening was performed relatively infrequently and the diagnostic score chart advocated by the World Health Organization was rarely used. Nurses specifically trained on tuberculosis were more knowledgeable about diagnostic approaches and all respondents who were using the score chart had received specific tuberculosis training.
http://www.ncbi.nlm.nih.gov/pubmed/18592949
Hope K, Durrheim D, Muscatello D, Merritt T, Zheng W, Massey P, Cashman P, Eastwood K. Identifying pneumonia outbreaks of public health importance: can emergency department data assist in earlier identification? Australian and New Zealand Journal of Public Health 2008; 32(4): 361-363
We reviewed the performance of a near real-time Emergency Department (ED) Syndromic Surveillance System for identifying pneumonia outbreaks of public health importance. Retrospective data from a rural hospital that has experienced a cluster of pneumonia diagnoses among teenage males was used. With current thresholds, the ED syndromic surveillance system would have trigged a signal for pneumonia syndrome in children aged 5-16 years four days earlier than the notification by a paediatrician and this signal was maintained for 14 days.
http://www3.interscience.wiley.com/journal/117969397/home
Dalton CB, Durrheim DN, Conroy MA Likely impact of school and childcare closures on Public Health workforce during an Influenza Pandemic: A survey Communicable Disease Intelligence 32(2): 261-262
An influenza pandemic, is likely to result in public health staff not reporting to work due to illness, transport disruptions or care responsibilities. A survey of public health staff found that 38% of staff may be absent due to the impact of childcare and school closure, however 73% of these staff would be able to work from home with most having broadband Internet access (71%).
http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-cdi3202i.htm
Eastwood K, Osbourn M, Francis L, Merritt T, Nicholas N, Cashman P, Durrheim DN, Wiggers J Improving communicable disease outbreak preparedness in residential aged care facilities using an interventional interview strategy Australasian Journal of Ageing 27(3): 143-149
A study was conducted in 2005/6 to improve the capacity of residential aged care facilities (RACFs) to respond to communicable disease outbreaks. Three computer-assisted telephone interviews were conducted. The first survey gathered baseline information and then outbreak prevention resources were offered to address any perceived weaknesses. Subsequent surveys enabled the facilities’ progress to be monitored. Before the third survey, RACFs were sent a scorecard providing their standing against 19 readiness criteria. The number of RACFs with an outbreak management plan increased from 58 to 98%, and facilities reporting 16 or more of the 19 readiness criteria rose from 24 to 43% (P< 0.0006) at the second interview and 73% at the third interview (P< 0.0001). The strategy resulted in a substantial improvement in reported outbreak readiness.
http://www3.interscience.wiley.com/journal/117981049/home
Ewald B, Durrheim DN Australian Bat Lyssavirus: examination of post-exposure treatment in NSW NSW Public Health Bulletin 19(5-6): 104-107
This review of the literature ten years after the identification of Australian Bat Lyssavirus (ABL), provides best practice evidence for management and control of this recently emerged lyssavirus. The review provided the evidence for bringing post-exposure treatment against ABL in line with international approaches to lyssavirus 1 (classical rabies).
http://www.publish.csiro.au/?act=view_file&file_id=NB07050.pdf
Cashman P, Hueston L, Durrheim DN, Massey P, Doggett S, Russell R Barmah Forest Virus Serology: Implications For Diagnosis And Public Health Action Communicable Disease Intelligence 32(2): 263-265
Barmah Forest notifications diagnosed by a single positive IgM serology test have been increasing in the lower mid north coast of New South Wales. A prospective review of all routine notifications of BFV that 19% of patient sera contained no BFV antibodies, while 16% had BFV IgG only. A clinical presentation of fever with either rash or joint pain was associated with confirmation of recent BFV infection. Caution is advised in the interpretation of a single positive IgM for Barmah Forest disease.
http://www.health.gov.au/internet/main/publishing.nsf/content/cda-pubs-cdi-cdicur.htm
Barnes KI, Little F, Mabuza A, Mngomezulu N, Govere J, Durrheim DN, Roper C, Watkins B, White N Increased Gametocytemia after Treament: An Early Parasitological Indicator of Emerging Sulfadoxine-Pyrimethamine Resistance in Falciparum Malaria The Journal of Infectious Disease 197(11): 1605-1613
Reducing the carriage of Plasmodium falciparum gametocytes is critical for limiting malaria transmission and the spread of resistance. Biannual assessment of clinical and parasitological responses to the fixed-dose combination of sulfadoxine and pyrimethamine in patients with uncomplicated falciparum malaria provided evidence that increased duration and density of gametocyte carriage after sulfadoxine pyrimethamine treatment was an early indicator of drug resistance. This increased gametocytemia among patients who have primary infections with drug-resistant Plasmodium falciparum fuels the spread of resistance even before treatment failure rates increase significantly.
http://www.journals.uchicago.edu/toc/jid/2008/197/11
Huppatz C, Durrheim DN, Lammie P, Kelly P, Melrose M Eliminating lymphatic filariasis - the surveillance challenge Tropical Medicine and International Health Journal 13(3): 292-294
Lymphatic filariasis is one of the leading causes of disability worldwide. In 1997, the WHO launched the Global Programme to Eliminate Lymphatic Filariasis, which aims to eliminate LF from 80 countries in which it is endemic, by the year 2020 using a primary strategy of annual mass drug administration for five years. Now that a number of countries have completed their planned number of MDA rounds important decisions are required about future surveillance needs. This paper reviews the challenges of surveillance of an infection that is often asymptomatic for an extended period, has relatively poor surveillance diagnostic tests available and which is becoming increasingly rare.
Stafford R, Schluter P, Wilson A, Kirk M, Hall G, Unicomb L Population-Attributable Risk Estimates for Risk Factors Associated with Campylobacter Infection, Australia Emerging Infectious Diseases Journal 2008; 14(6): 895-901
Among foodborne risk factors, an estimated 50,500 (95% credible interval 10,000-105,500) cases of Campylobacter infection in persons >5 years of age could be directly attributed each year to the consumption of chicken in Australia. Our statistical technique could be applied more widely to the other communicable diseases that are subject to routine surveillance. Foodborne gastroenteritis is a major public health concern in many countries, including Australia.
http://www.cdc.gov/eid/content/14/6/pdfs/895.pdf
Coleman M, Coleman M, Kok e G, Coetzee M, Durrheim D Evaluation of an operational malaria outbreak identification and response system in Mpumalanga Province, South Africa Malaria Journal 2008; 7(69): 1-26
Pending
http://www.malariajournal.com/content/7/1/69
Huppatz C, Munnoch S, Worgan T, Merritt T, Dalton C, Kelly P, Durrheim D A norovirus outbreak associated with consumption of NSW oysters: implications for quality assurance systems Communicable Disease Intelligence Journal 2008; 32(1): 88-91
Pending
Ng J, Eastwood K, Durrheim DN, Massey P, Walker B, Armson A, Ryan U Evidence supporting zoonotic transmission of Cryptosporidium in rural New South Wales Experiemental Parasitology Journal 2008; 119(1): 192-195
Cryptosporidium hominis and Cryptosporidium parvum are the two species primarily responsible for causing infection in humans. The study took Cryptosporidium in 7 human and 15 cattle cases of sporadic cryptosporidiosis in rural western NSW during the period from November 2005 to January 2006 and identified them to the level of species/genotype and subgenotypes. This was determined by PCR sequence analysis of the 18S rRNA and C. parvum and C. hominis isolates were subgenotyped by sequence analysis of the GP60 gene. Fourteen of 15 cattle-derived isolates were identified as C. parvum and 1 as a C. bovis/C. parvum mixture. Four of the human isolates were C. parvum and 3 were C. hominis. Two different subgenotypes were identified with the human C. hominis isolates and six different subgenotypes were identified within the C. parvum species from humans and cattle. All of the C. parvum subtypes found in humans were also found in the cattle, suggesting that zoonotic transmission may be an significant contributor to sporadic human cases of cryptosporidiosis in rural NSW.
http://0-www.sciencedirect.com.library.newcastle.edu.au/science
Huppatz C, Durrheim DN. Control of Neglected Tropical Diseases. New England Journal of Medicine 2007; 357(23): 2407-2408.
The need for surveillance for the neglected tropical diseases is advocated. Despite resource and methodological challenges, without adequate surveillance the ultimate success of programmes will not be able to be established, nor ongoing elimination confirmed.
http://content.nejm.org/cgi/content/extract/357/23/2407
Massey P, Durrheim DN, Speare R. Inadequate chemoprophylaxis and the risk of malaria Australian Family Physician 2007; 36(12): 1058-1060.
BACKGROUND Malaria is an important disease for Australian travellers, particularly to Papua New Guinea. Chemoprophylaxis along with mosquito-bite prevention strategies are effective in preventing malaria in travellers. During 2007, six people were diagnosed with malaria from a group of 38 who had travelled to Papua New Guinea. This cluster of cases prompted a public health investigation. METHOD A retrospective cohort investigation into malaria risk in a group of adult Australians that trekked the Kokoda trail in Papua New Guinea was undertaken. RESULTS All of the group members were contacted and agreed to be a part of the investigation. Of the 12 individuals who took chemoprophylaxis for the recommended period post-travel none developed malaria compared to 4/24 travellers who terminated prophylaxis prematurely, and 2/2 developed malaria who had taken no chemoprophylaxis for the trip. DISCUSSION Chemoprophylaxis is effective if taken for the full recommended period following travel to a malaria endemic area. The recommendations for the post-travel period are: 4 weeks for doxycycline and mefloquine, and 7 days for atovaquone+proguanil.
http://www.afp.racgp.org.au/afp/200712/21099
Todd K, Durrheim DN, Pickles R, Eastwood K, Merritt T, Tapsall J, Sanghamitra R, Limnios A. Using epidemiological and molecular methods to investigate an outbreak of gonorrhoea associated with heterosexual contact in Newcastle, NSW, Australia Sexual Health 2007; 4(4): 233-236
Gonorrhoea is a laboratory-notifiable condition in NSW under the NSW Public Health Act 1991. The Hunter New England Health Area in NSW, with its population of 840 000, has an average of 49 notifications of gonococcal infection per annum (range 27-69 based on notifications for 1996-2004). By the third week of October 2005, it was noted that 16 cases of gonorrhoea had already been notified for that month. A retrospective epidemiological investigation of all notified cases and to prospectively followup all new notifications to determine risk factors for transmission and explore possible links between cases with a view to defining and interrupting the outbreak.
http://www.publish.csiro.au/nid/166/issue/3767.htm
Merritt T, Durrheim DN, Hope K, Byron P. General practice intervention to increase opportunistic screening for chlamydia Sexual Health 2007; 4(4): 249-251
We describe an intervention in 6 General Practices over an 18-month period that was designed to improve opportunistic screening for chlamydia. Key strategies included engaging and informing general practitioners, adopting a simplified screening protocol, providing feedback on practice testing performance and developing resources for use with patients. The overall impact on testing was modest and largely transient, and was insufficient to impact on the current chlamydia epidemic. Major additional measures would be required to further substantially increase testing levels. These could include financial incentives linked to screening performance and increased community awareness to increase patient demand for testing.
http://www.publish.csiro.au/nid/166/issue/3767.htm
Govere JM, Durrheim DN. (Debboun M, Frances SP, Strickman DA. Insect Repellents: Principles, Methods, and Uses Chapter Techniques for Evaluating Insect repellents Taylor & Francis CRC Press 2007; 084371961: Chapter 8:147-159
Evaluation of insect repellents should be as simple and practical as possible to encourage standard comparison and universal acceptance. Although candidate repellents should be taken to the field to determine protection time and effectiveness under field
Cashman P, Durrheim D, Massey P, Islam F, Merritt T, Eastwood K. Pneumonia cluster in a boarding school- implications for influenza control. Communicable Diseases Intelligence 2007; 31(3): 296-298. Communicable Disease Intelligence Journal 2008; 31(3): 296-298
An outbreak of community acquired pneumonia affected 25 previously well students in a New South Wales boarding school, with Streptococcus pneumoniae 1 confirmed in two cases. The school experienced a concurrent influenza outbreak with a high influenza-lik
http://www.health.gov.au/internet/wcms/publishing.nsf/Content/cda-pubs-cdi-cdiintro.htm
Mehta U, Durrheim D, Mabuza A, Blumberg L, Allen E, Barnes K. Malaria Pharmacovigilance in Africa Lessons from a Pilot Project in Mpumalanga Province, South Africa. Drug Safety 2007; 30(10): 899-910.
A pharmacovigilance strategy consisting of five methods of detecting serious adverse drug reactions (ADRs) and signals related to artesunate plus sulfadoxine/pyrimethamine was implemented in rural Mpumalanga province, South Africa. The evaluation demonstr
http://drugsafety.adisonline.com/
Chui C, Durrheim D. A review of the efficacy of human Q fever vaccine registered in Australia. NSW Public Health Bulletin 2007; 18(7-8):133-136
Australia has a registered Q fever vaccine that is recommended in high risk occupational groups. A literature review found that its efficacy ranged from 83-100% but study designs limitations hampered a precise estimate. The Q fever vaccine available in Au
http://www.publish.csiro.au/nid/226.htm
Irwin M, Lloyd A, Massey P. Bug Breakfast in the Bulletin: Q fever. NSW Public Health Bulletin 2007; 18(7-8): 137-138.
Q fever remains a significant public health concern, particularly for rural communities. Australia has access to the only licensed vaccine against Q fever available worldwide (QVax, CSL Ltd). Immunisation of high-risk occupational groups has been the majo
http://www.publish.csiro.au/nid/226.htm
Durrheim D, Kelly H, Ferson M, Featherstone D Remaining measles challenges in Australia Medical Journal of Australia 2007; 187(3): 181-184.
Measles is now rare in Australia, and cases are usually linked to importation from endemic countries. To prevent measles outbreaks in Australia, high vaccination coverage with two doses of the vaccine must be sustained.
http://www.mja.com.au/public/issues/187_03_060807/dur10061_fm.html
Vally H, Dowse G, Eastwood K, Cameron S An outbreak of chickenpox at a child care centre in Western Australia. Costs to the community and implications for vaccination policy Australian and New Zealand Journal of Public Health 2007; 31(2): 113-119.
Between May and June 2002 an outbreak of chickenpox occurred at the child care centre in Perth, Western Australia. An epidemiological study was undertaken in order to determine the characteristics of the outbreak, assess vaccine effectiveness, and to als
http://www.blackwell-synergy.com/doi/pdf/10.1111/j.1753-6405.2007.00027.x
Merritt T, Sintchenko V, Jelfs P, Worthing M, RObinson B, Durrheim D, Gilbert G An outbreak of pulmonary tuberculosis in young Australians Medical Journal of Australia 2007; 186(5): 240-242.
Clinicians should maintain a high index of suspicion for pulmonary TB in a person presenting with a cough lasting more than 3 weeks, weight loss, haemoptysis, night sweats and also chest pain, even if the person is not an overseas-born or elderly. A comp
http://www.mja.com.au/public/issues/186_05_050307/mer10787_fm.html
Mehta U, Durrheim D, Blumberg L, Donohue S, Hansford F, Mabuza A, Kruger P, Gumede K, Immelman E, Canal Sanchez A, Hugo J, Swart G, Barnes K Malaria deaths as sentinel events to monitor healthcare delivery and antimalarial drug safety Tropical Medicine and International Health 2007; 12(5): 617-628.
To identify case management, health system and antimalarial drug factors contributing to malaria deaths. A confidential enquity into malaria-related deaths is a useful tool for identifying the preventable factors, health system failures and also adverse
http://www.blackwell-synergy.com/toc/tmi/12/5
Dalton C Business Continuity Management and Pandemic Influenza NSW Public Health Bulletin 2006; 17(9-10): 138-141.
Pandemic influenza planning presents challenges for both government and businesses. Effective cooperation and communication before and also during a pandemic will help mitigate the major threats to societal function. The major challenges for governement
http://www.publish.csiro.au/?act=view_file&file_id=NB06035.pdf
Muscatello D, Cretikos M, Bartlett M, Churches T, Carter I, Eastwood K, Heron L, McPhie K Planning for pandemic influenza surveillance in NSW NSW Public Health Bulletin 2006; 17(9-10): 146-149.
Early detection of the novel strain of influenza virus in NSW population is the key to controlling a pandemic. If this occurs, then ongoing surveillance will help determine the epidemiology and risk factors of the virus as well as its impact on essential
http://www.health.nsw.gov.au/pubs/date/2007.html
Wynd S, Carron J, Selve B, Leggat P, Melrose P, Durrheim D Qualitative analysis of the impact of a lymphatic filariasis elimination programme using mass drug administration on Misima Island, Papua New Guinea Filaria Journal 2007; 6(1): 1-1.
Although interim evaluation indicates the programme has been parasitologically successful, an appreciation that sustainable health gains depend on the understanding and accommodating of local beliefs prompted this qualitative study.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1770912
Sharp B, Kleinschmidt I, Streat E, Maharaj R, Barnes K, Durrheim D, Ridl F, Morris N, Seocharan I, Kunene S, Grange J, Mthembu J, Maartens F, Martin C, Barreto A Seven Years of Regional Malaria control collaboration - Mozambique, South Africa, and Swaziland Americal Journal of Tropical Medicine and Hygiene 2007; 76(1): 42-47.
The Lubombo Spatial Development Initiative is a joint development program between governments of Mozambique, Swaziland, and South Africa which includes malaria control as a core component .
http://www.ajtmh.org/cgi/content/abstract/76/1/42
Ferson MJ, Durrheim DN Investing in capacity to meet the challenge of an Influenza Pandemic NSW Health Bulletin 2006; 17: 129-130.
Further developments and improvements in systems, including the staged introduction of electronic transfer of laboratory notifications and the linking of influenza diagnostic data from animal to human sources, will place NSW in a good position to provide
http://www.health.nsw.gov.au/public-health/phb/phb.html
Durrheim D, Ferson M Preparing for the inevitable - An Influenza Pandemic NSW Public Health Bulletin 2006; 17(7): 97-98.
The world is currently at 'Global Phase 3' of the World Health Organisation's influenza pandemic alert phases. Given instability of the influenza virus, the world is waiting for the first influenza pandemic of the twenty-first century. It is thus timely
http://www.health.nsw.gov.au/public-health/phb/phb.html
Durrheim D, Massey P, Kelly H Re-emerging poliomyelitis - is Australia's surveillance adequate? Communicable Diseases Intelligence 2006; 30(3): 275-277.
In the past two years there has been a resurgence of polio, 21 previously polio-free countries importing wild poliovirus. Wild poliovirus importations into polio-free areas continue to occur until endemic transmission is interrupted globally. Australias
http://www.health.gov.au/internet/wcms/publishing.nsf/Content/cda-cdi3003a.htm
Burkot TR, Durrheim D, Melrose WD, Speare R, Ichimori K The argument for integrating vector control with multiple drug administration campaigns to ensure elimination of lymphatic filariasis Filaria Journal 2006; 5(10): 1-7.
Although the global lymphatic filariasis elimination programme is based on repeated annual mass drug therapy there are indications that this will not be adequate to ensure elimination in all environments. Vector control has been demonstrated to eliminate
http://www.filariajournal.com/content/5/1/10
Unicomb L, Ferguson J, Stafford R, Ashbolt R, Kirk M, Becker N, Patel M, Gilbert G, Valcanis M, Mickan L Low-Level Fluoroquinolone Resistance among Campylobacter jejuni Isolates in Australia Clinical Infectious Diseases 2006; 42:1368-1374.
Ciprofloxacin-resistant Campylobacter jejuni isolates obtain from the infected patients in Australia have not been detected in studies of isolates from specific geographic areas. The Australian government prohibited the use of fluoroquinolone in food-pro
http://www.journals.uchicago.edu/CID/journal/issues/v42n10/38489/38489.web.pdf
Finch M, Sutherland R, Harrison M, Collins C Canteen purchasing practices of year 1-6 primary school children and association with SES and weight status Australian and New Zealand Journal of Public Health 2006; 30(3): 247-251.
This cross-sectional study was conducted in the Hunter region of New South Wales. Primary schools were randomly selected from a list of government schools and 5,206 students from years 1-6, 16 schools were invited to participate. Findings show the ma
http://www.phaa.net.au/members_only/journalpdf_2006/june_2006/ANZJPH%202006-3%20-%20Finch.pdf
Johnstone E, Knight J, Gillham K, Campbell E, Nicholas C, Wiggers J System-wide adoption of health promotion practices by schools: evaluation of a telephone and mail-based dissemination strategy in Australia Health promotion International Oxford Journals 2006; 21(3).
Schools can potentially benefit from system-wide approaches to the dissemination of health promotion practices. This intervention study undertaken in the Hunter Region of NSW, Australia used a pre-post design to assess whether the phone and mail interven
http://heapro.oxfordjournals.org/cgi/reprint/dal020v1
Speare R, Latasi F, Nelesone T, Harmen S, Melrose W, Durrheim D, Heukelbach J Prevalence of soil transmitted nematodes on Nukufetau, a remote Pacific Island in Tuvalu BMC Infectious Diseases 2006; 6:110-110.
Nukufetau is a remote coral atoll island in the nation of Tuvalu in the Western Pacific. Annual mass drug administration with diethylcarbamazine and albendazole occurred in 2001, 2002 and 2003 for lymphatic filariasis elimination. A cross-sectional surve
http://www.biomedcentral.com/1471-2334/6/110
Kypri K, Donaldson A, Johnstone E The Physical Inactivity Matrix: Lessons from the classifications of physical inactivity interventions Journal of Science and Medicine in Sport 2006; 9: 98-102.
The aims of this study were to (1) develop a system for classifying physical inactivity intervention studies, (2) examine the distribution of the PI interventions published in the peer-reviewed health literature using a developed system, and (3) consider
Williams K, Leonard H, d'Espaignet Tursan E, Colvin L, Slack-Smith L, Stanley F Hospitalisation from birth to 5 years in a population cohort of Western Australian children with intellectual disability Archives if Disease in Childhood 2005; 90: 1243-1248.
Although intellectual disability (ID) comprises about 7% of all disabling conditions in Australia, relatively little is known about its causes and sequelae. A similar situation applies in other economically developed countries. The US Surgeon General re
http://adc.bmjjournals.com/cgi/reprint/90/12/1243
Adams RJ, Wilson DH, Taylor AW, Daly A, d'Espaignet Tursan E, Grande Dal E, Ruffin R Coexistent Chronic Conditions and Asthma Quality of Life Chest Journal 2006; 129(2): 285-291.
Reports of the prevalence and impact of comorbid conditions among people with asthma have been limited to certain population groups and or convenience samples. Our aim was to examine the prevalence of major comorbidity in asthma and associations with qua
http://www.chestjournal.org/cgi/content/full/129/2/285
Oxenford CJ, Black AP, Bell RJ, Munnoch SA, Irwin MJ, Hanson RN, Owen RL Investigation of a multi-state outbreak of Salmonella Hvittingfoss using a web-based case reporting form Communicable Diseases Intelligence 2005; 29(4): 379-381.
Hvittingfoss is a serovar often isolated from human, animal and environmental sources in northern Queensland, but is rarely identified in other parts of Australia. OzFoodNet used NetEpi to investigate this outbreak on behalf of the Communicable Disease Ne
http://www.health.gov.au/internet/wcms/Publishing.nsf/Content/cda-cdi2904f.htm
Wright A, Harris M, Wiggers J, Jorm A, Cotton S, Harrigan S, Hurworth R, McGorry P Recognition of depression and psychosis by young Australians and their beliefs about treatment Medical Journal of Australia 2005; 183(1): 18-23.
A survey was conducted as a baseline measure for the community awareness campaign. The survey identified gaps in mental health literacy which may help to improve community educations and the responsiveness of the health care system, thus ensuring that yo
http://www.mja.com.au/public/issues/183_01_040705/wri10870_fm.html
Mabuza A, Govere J, la Grange K, M ngomezulu N, Allen E, Zitha A, M bokazi M, Durrheim D, Barnes K Therapeutic efficacy of sulfadoxine-pyrimethamine for Plasmodium falciparum malaria South African Medical Journal 2005; 95(5): 346-349.
The therapeutic efficacy of sulfadoxine pyrimethamine (SP) was determined 5 years after introduction as first-line treatment of uncomplicated Plasmodium falciparum malaria in Mpumalanga, South Africa. As gametocyte carriage has increased significantly, a
Ho Y, Muller R, Veitch C, Rane A, Durrheim D Faecal incontinence: an unrecognised epidemic in rural North Queensland? Results of a hospital-based outpatient study Australian Journal of Public Health 2005; 13(1): 28-34.
The prevalence of faecal incontinence (FI) in a referral hospital outpatient population in North Queensland was determined as 20.7%. The median duration of FI was 2 years with more than half of those affected soiling themselves at least once a month with
http://www.blackwell-synergy.com/doi/full/10.1111/j.1440-1854.2004.00642.x
Nelesone T, Durrheim D, Speare R, Kiedrzynski T, Melrose W. Strengthening sub-national communicable disease surveillance in a remote Pacific Island country by adapting a successful African outbreak surveillance model Tropical Medicine and International Health 2006; 11(1): 17-21.
The SARS pandemic proved that global communicable disease surveillance was only as robust as sub-national surveillance in each developing country. Effective sub-national surveillance depends on effective bidirectional information flow to and from the peri
http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-3156.2005.01534.x
Monaghan, K A Country's Hidden and Untapped Resource: Exploring Attitudes, Beliefs, Perceptions and Knowledge of Hygiene in Kandahar, Afghanistan. Environmental Health 2005; 5(1): 62-72.
A qualitative study using participatory action research was used to explore attitudes, beliefs, perceptions and knowledge of hygiene and hygiene related behaviour involving 122 women and 89 men in Kandahar, Afghanistan over a four-week period in Dec/Jan 2
http://www.aieh.org.au/journal/index.php
Dürrheim DN, Williams HA. Assuring effective malaria treatment in Africa: Drug efficacy is necessary but not sufficient. Journal of Epidemiology and Community Health 2005; 59(3): 178-179.
Malaria drug resistance has resulted in dramatic increases in malaria prevalence and mortality during the past decade in sub-Saharan Africa. The early results from field trials of artemisinin containing combination therapy (ACT) have been promising. A n
http://0-jech.bmjjournals.com.library.newcastle.edu.au/contents-by-date.0.shtml
Oberdorfer A, Wiggers J, Bowman J, Burrows S, Cockburn J, Considine R. Monitoring and educational feedback to improve the compliance of tattooists and body piercers with infection control standards: A randomized controlled trial. American Journal of Infection Control 2004; 32(3): 147-154.
A randomised control trial was conducted amongst 37 tattooists and body-piercing premises in Sydney, NSW Australia. The findings demonstrate the efficacy of an audit and feedback strategy in increasing tattooists and piercers' infection control complianc
http://www2.us.elsevierhealth.com/scripts/om.dll/serve?action=searchDB&searchDBfor=home&ID=ic
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