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Phabmixay A, Polkinghorne B, Marmor A, Pingault N, Sloan-Gardner T, Kirk M. Lessons from a COVID-19 outbreak in the disability support sector, Australian Capital Territory, August 2021. Commun Dis Intell (2018) 2023; 47. [PMID: 37357182 DOI: 10.33321/cdi.2023.47.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Abstract People with disability are at higher risk of severe outcomes from SARS-CoV-2 infection. Due to complex client needs and available staffing, disability support providers (DSP) were limited in their ability to mitigate the introduction of SARS-CoV-2 into disability support settings. This report describes the characteristics of a Delta variant outbreak associated with a single DSP in Canberra, Australian Capital Territory (ACT), in August 2021. We calculated attack rates for workplace exposure sites and households, using the number of people present at workplaces and households as the denominator. Thirty confirmed cases were identified, comprised of 13 support workers, six clients, and 11 household and other contacts. The median age of cases was 30.5 years (range 1 to 80 years) and 5 cases (17%) were hospitalised. No cases were admitted to an intensive care unit (ICU) or died. Twenty-two percent of people in close contact with confirmed SARS-CoV-2 cases in this cluster (23/103) subsequently tested positive to SARS-CoV-2. Investigations identified multiple primary cases, with one primary case the likely infection source for at least 17 other cases. Despite the majority being eligible for vaccination, only two cases were fully vaccinated (two doses > 14 days before exposure). The mean secondary attack rate at workplace sites (15% or 12/80 close contacts infected) was lower than the tertiary attack rate (47.8% or 11/23 close contacts infected). The overall risk of contracting SARS-CoV-2 in DSP-related work sites was lower than for household settings (relative risk: 0.42; 95% confidence interval: 0.21-0.82). These findings demonstrate the importance of ongoing collaboration between governments and the disability support sector. Development and delivery of targeted health messaging to people with disability and to disability support workers, regarding infection control in the home setting, and identification of enablers for vaccination, should be the highest priorities from this collaboration.
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Affiliation(s)
- Aruna Phabmixay
- National Centre for Epidemiology and Public Health, Australian National University. Canberra, Australia
- Office of Health Protection, Australian Government Department of Health and Aged Care. Canberra, Australia
- Epidemiology, COVID-19 Response Coordination Centre, ACT Health. Canberra, Australia
| | - Ben Polkinghorne
- National Centre for Epidemiology and Public Health, Australian National University. Canberra, Australia
- Office of Health Protection, Australian Government Department of Health and Aged Care. Canberra, Australia
- Epidemiology, COVID-19 Response Coordination Centre, ACT Health. Canberra, Australia
| | - Alexandra Marmor
- Epidemiology, COVID-19 Response Coordination Centre, ACT Health. Canberra, Australia
| | - Nevada Pingault
- Epidemiology, COVID-19 Response Coordination Centre, ACT Health. Canberra, Australia
| | - Timothy Sloan-Gardner
- Epidemiology, COVID-19 Response Coordination Centre, ACT Health. Canberra, Australia
| | - Martyn Kirk
- National Centre for Epidemiology and Public Health, Australian National University. Canberra, Australia
- Office of Health Protection, Australian Government Department of Health and Aged Care. Canberra, Australia
- Epidemiology, COVID-19 Response Coordination Centre, ACT Health. Canberra, Australia
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Hall RN, Jones A, Crean E, Marriott V, Pingault N, Marmor A, Sloan-Gardner T, Kennedy K, Coleman K, Johnston V, Schwessinger B. Public health interventions successfully mitigated multiple incursions of SARS-CoV-2 Delta variant in the Australian Capital Territory. Epidemiol Infect 2023; 151:e30. [PMID: 36786292 PMCID: PMC10024954 DOI: 10.1017/s0950268823000201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
The COVID-19 pandemic has presented a unique opportunity to understand how real-time pathogen genomics can be used for large-scale outbreak investigations. On 12 August 2021, the Australian Capital Territory (ACT) detected an incursion of the SARS-CoV-2 Delta (B.1.617.2) variant. Prior to this date, SARS-CoV-2 had been eliminated locally since 7 July 2020. Several public health interventions were rapidly implemented in response to the incursion, including a territory-wide lockdown and comprehensive contact tracing. The ACT has not previously used pathogen genomics at a population level in an outbreak response; therefore, this incursion also presented an opportunity to investigate the utility of genomic sequencing to support contact tracing efforts in the ACT. Sequencing of >75% of the 1793 laboratory-confirmed cases during the 3 months following the initial notification identified at least 13 independent incursions with onwards spread in the community. Stratification of cases by genomic cluster revealed that distinct cohorts were affected by the different incursions. Two incursions resulted in most of the community transmission during the study period, with persistent transmission in vulnerable sections of the community. Ultimately, both major incursions were successfully mitigated through public health interventions, including COVID-19 vaccines. The high rates of SARS-CoV-2 sequencing in the ACT and the relatively small population size facilitated detailed investigations of the patterns of virus transmission, revealing insights beyond those gathered from traditional contact tracing alone. Genomic sequencing was critical to disentangling complex transmission chains to target interventions appropriately.
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Affiliation(s)
- Robyn N Hall
- Research School of Biology, The Australian National University, Acton, Canberra, Australian Capital Territory, Australia
- COVID-19 Response Division, AC1850T Health Directorate, Canberra, Australian Capital Territory, Australia
- CSIRO Health & Biosecurity, Acton, Canberra, Australian Capital Territory, Australia
| | - Ashley Jones
- Research School of Biology, The Australian National University, Acton, Canberra, Australian Capital Territory, Australia
| | - Emma Crean
- Research School of Biology, The Australian National University, Acton, Canberra, Australian Capital Territory, Australia
| | - Victoria Marriott
- COVID-19 Response Division, AC1850T Health Directorate, Canberra, Australian Capital Territory, Australia
| | - Nevada Pingault
- COVID-19 Response Division, AC1850T Health Directorate, Canberra, Australian Capital Territory, Australia
| | - Alexandra Marmor
- COVID-19 Response Division, AC1850T Health Directorate, Canberra, Australian Capital Territory, Australia
| | - Timothy Sloan-Gardner
- COVID-19 Response Division, AC1850T Health Directorate, Canberra, Australian Capital Territory, Australia
| | - Karina Kennedy
- Department of Clinical Microbiology and Infectious Diseases, Canberra Health Services, Australian National University Medical School, Canberra, Australian Capital Territory, Australia
| | - Kerryn Coleman
- COVID-19 Response Division, AC1850T Health Directorate, Canberra, Australian Capital Territory, Australia
| | - Vanessa Johnston
- COVID-19 Response Division, AC1850T Health Directorate, Canberra, Australian Capital Territory, Australia
| | - Benjamin Schwessinger
- Research School of Biology, The Australian National University, Acton, Canberra, Australian Capital Territory, Australia
- Author for correspondence: Benjamin Schwessinger, E-mail:
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Padrotta J, Post J, Marmor A, Pingault N, Pourmarzi D. Kebabs with a side of Salmonella: Two outbreaks of Salmonella linked to kebab shops in Canberra, ACT. Commun Dis Intell (2018) 2022; 46. [DOI: 10.33321/cdi.2022.46.84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
We report two outbreaks of Salmonella associated with kebab shops in Canberra, Australian Capital Territory, detected through routine surveillance. The first consisted of 12 cases of Salmonella Agona, nine of whom reported eating chicken from the same kebab shop. The second consisted of two cases of Salmonella Virchow who both reported eating chicken from another (unrelated) kebab shop. Environmental investigations identified similar food safety issues at both businesses, including improper cleaning of kebab shaving equipment and serving cut rotisserie meat without further cooking. Environmental samples detected Salmonella genomically linked to the respective outbreak cases. These outbreaks highlight the importance of appropriate cleaning and sanitising of kebab shaving equipment and the use of a second cook step after kebab meat is shaved from the rotisserie.
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Allen K, Greenville F, Marmor A, Waters N, Wansink V, Hudson L, Pingault N. Donuts for weight loss? A norovirus outbreak associated with a bakery in the Australian Capital Territory. Commun Dis Intell (2018) 2022; 46. [PMID: 36303397 DOI: 10.33321/cdi.2022.46.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND An outbreak of gastroenteritis was investigated following complaints of illness after eating donuts from a food premises in the Australian Capital Territory (ACT). METHODS Food poisoning complainants and contacts were surveyed using a standard gastroenteritis questionnaire including menu items from the food premises. Descriptive analyses were performed on data collected for all responses. A case-control study was conducted for a group of 140 people at a catered function. Food safety inspections were conducted with food and environmental samples tested at the ACT Government Analytical Laboratory. Stool specimens were collected from cases who were ill at the time of interview. Neither active case finding, nor viral testing of food or environmental samples, could be conducted. RESULTS Three hundred and one people were surveyed, and 215 individuals (71.4%) reported vomiting and/or diarrhoea following consumption of a donut purchased from the business over a five-day period. All ill respondents reported eating a donut. The medians of incubation period and illness duration were 34 hours (interquartile range, IQR: 29-42 hours) and 48 hours (IQR: 29-72 hours) respectively. Diarrhoea, vomiting and abdominal pain were the most commonly reported symptoms. Eight out of 11 specimens collected from ill individuals were positive for norovirus. For the case-control study, data from 59 attendees were collected, with an attack rate of 46% (27/59). Eating any kind of filled donut was associated with a person becoming ill (odds ratio: 10.4; 95% confidence interval: 1.18-478.13). No single flavour was identified as the likely source of infection. Elevated levels of coliforms were present in two samples of donut filling obtained during the food safety inspection. CONCLUSION Donuts are a novel vehicle for norovirus infection. This implicated pathogen, plus evidence collected at the food premises suggestive of faecal contamination, indicates the source of this outbreak was likely an ill food handler. The findings of this outbreak highlight the importance of excluding food handlers from work while ill. While this was one of the largest foodborne outbreaks investigated in the ACT, the true extent of illness remains unknown. Active case finding should be pursued to determine the magnitude of outbreaks.
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Affiliation(s)
- Keeley Allen
- National Centre for Epidemiology and Population Health, Australian National University, Acton, Australia
- Communicable Disease Control Section, Health Protection Service, Public Health Protection and Regulation, ACT Health
| | - Felicity Greenville
- Communicable Disease Control Section, Health Protection Service, Public Health Protection and Regulation, ACT Health
| | - Alexandra Marmor
- Communicable Disease Control Section, Health Protection Service, Public Health Protection and Regulation, ACT Health
| | - Natasha Waters
- ACT Government Analytical Laboratory, Health Protection Service, Public Health Protection and Regulation, ACT Health
| | - Victoria Wansink
- ACT Government Analytical Laboratory, Health Protection Service, Public Health Protection and Regulation, ACT Health
| | - Lyndell Hudson
- Environmental Health Section, Health Protection Service, Public Health Protection and Regulation, ACT Health
| | - Nevada Pingault
- Communicable Disease Control Section, Health Protection Service, Public Health Protection and Regulation, ACT Health
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O’Neill C, Franklin N, Edwards A, Martin T, O’Keefe J, Jackson K, Pingault N, Glasgow K. Hepatitis A outbreak in Australia linked to imported Medjool dates, June–September 2021. Commun Dis Intell (2018) 2022; 46. [DOI: 10.33321/cdi.2022.46.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Imported, minimally processed food products have been historically associated with several hepatitis A outbreaks in Australia. Here, we report the first known hepatitis A outbreak in Australia linked to consumption of imported fresh Medjool dates. Between June and September 2021, six genetically identical hepatitis A cases were notified in New South Wales and the Australian Capital Territory. All cases reported date consumption during their exposure period. The implicated dates were positive for hepatitis A virus (HAV) by reverse transcription polymerase chain reaction. Rapid detection of this outbreak and the swift implementation of control measures was facilitated by two key factors. Firstly, Australian international border closures implemented in response to the COVID-19 pandemic meant that a common locally-acquired, as opposed to travel-acquired, source for cases was strongly suspected. Secondly, prompt awareness of a hepatitis A outbreak in the United Kingdom (which was found to be associated with date consumption) allowed for early hypothesis generation and investigation. This paper details the epidemiological and microbiological factors involved in this outbreak investigation and the actions taken to mitigate public health risk.
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6
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Sheel M, Vun Voo T, Pingault N, Sloan-Gardner TS, Marmor A, Kirk MD, Johnston V, Coleman K. Vaccine breakthrough infections in a highly-vaccinated Australian population during a SARS-CoV-2 Delta outbreak. Commun Dis Intell (2018) 2022; 46. [DOI: 10.33321/cdi.2022.46.32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Over 80% of residents in the Australian Capital Territory were fully vaccinated within 10 weeks of a SARS-CoV-2 Delta variant outbreak. Of the outbreak’s 1,545 cases, 10% were breakthrough infections. The incidence of infections among fully- and partially-vaccinated people was 98.5% and 90% lower, respectively, than for unvaccinated people.
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Rafferty AC, Hewitt MC, Wright R, Hogarth F, Coatsworth N, Ampt F, Dougall S, Alpren C, Causer L, Coffey C, Wakefield A, Campbell S, Pingault N, Harlock M, Smith KJ, Kirk MD. COVID-19 in health care workers, Australia 2020. Commun Dis Intell (2018) 2021. [PMID: 34711148 DOI: 10.33321//cdi.2021.45.57] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Health care workers are at increased risk of SARS-CoV-2 infection due to potential exposure to patients or staff in health care settings. Australian health care services and health care workers experienced intense pressure to prepare for and respond to SARS-CoV-2 infections. We summarise national data on health care worker infections and associated outbreaks during 2020. Methods We collected aggregated data on infected health care workers and outbreaks in health care facilities from all jurisdictions. Health care workers working solely in residential aged care and outbreaks in residential aged care facilities were excluded. Jurisdictions provided data on the number of health care setting outbreaks, confirmed cases, hospitalisation, source of infection, and health care worker role. We analysed data for two periods that aligned with two distinct peaks in the epidemic relative to 1 June 2020, referred to here as the first wave (23 January - 31 May 2020) and the second wave (1 June - 18 September 2020). Results Jurisdictions reported a total of 2,163 health care worker infections with SARS-CoV-2 during the surveillance period. Source of acquisition was known for 81.0% of cases (1,667/2,059). The majority of cases in the first wave were acquired overseas, shifting to locally-acquired cases in the second wave. The odds of infection in the second wave compared to the first wave were higher for nurses/midwives (odds ratio, OR: 1.61; 95% confidence interval (95% CI): 1.32-2.00), lower for medical practitioners (OR: 0.36; 95% CI: 0.28-0.47) and did not differ for 'other' health care workers (OR: 1.07; 95% CI: 0. 87-1.32). The odds of infection in the second wave were higher in a health care setting (OR: 1.76; 95% CI: 1.28-2.41) than in the community. There were 120 outbreaks in health care settings with 1,428 cases, of which 56.7% (809/1,428) were health care workers. The majority (88/120; 73.8%) of outbreaks in health care settings occurred in the second wave of the epidemic, with 90.9% of these (80/88) occurring in Victoria. Conclusions In the second wave of the epidemic, when there was heightened community transmission, health care workers were more likely to be infected in the workplace. Throughout the epidemic, nurses were more likely to be infected than staff in other roles.
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Affiliation(s)
- Anna C Rafferty
- National Incident Response Division, Australian Government Department of Health, Canberra, Australia
| | - Moira C Hewitt
- National Incident Response Division, Australian Government Department of Health, Canberra, Australia
| | - Rose Wright
- National Incident Response Division, Australian Government Department of Health, Canberra, Australia
| | - Freya Hogarth
- National Incident Response Division, Australian Government Department of Health, Canberra, Australia.,National Centre for Epidemiology and Population Health, Australian National University, Acton, ACT, Australia
| | - Nick Coatsworth
- Office of the Chief Medical Officer, Australian Government Department of Health, Canberra, Australia.,ANU Medical School, Australian National University, Acton, ACT, Australia
| | - Frances Ampt
- Victorian Department of Health and Human Services, Melbourne, Australia
| | - Sally Dougall
- Victorian Department of Health and Human Services, Melbourne, Australia
| | - Charles Alpren
- Victorian Department of Health and Human Services, Melbourne, Australia
| | - Louise Causer
- The Kirby Institute, University of NSW, Sydney, Australia
| | | | | | | | | | | | - Kylie J Smith
- Tasmanian Department of Health, Hobart, Australia.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Martyn D Kirk
- National Incident Response Division, Australian Government Department of Health, Canberra, Australia.,National Centre for Epidemiology and Population Health, Australian National University, Acton, ACT, Australia
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Rafferty AC, Hewitt MC, Wright R, Hogarth F, Coatsworth N, Ampt F, Dougall S, Alpren C, Causer L, Coffey C, Wakefield A, Campbell S, Pingault N, Harlock M, Smith KJ, Kirk MD. COVID-19 in health care workers, Australia 2020. Commun Dis Intell (2018) 2021; 45. [PMID: 34711148 DOI: 10.33321/cdi.2021.45.57] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background
Health care workers are at increased risk of SARS-CoV-2 infection due to potential exposure to patients or staff in health care settings. Australian health care services and health care workers experienced intense pressure to prepare for and respond to SARS-CoV-2 infections. We summarise national data on health care worker infections and associated outbreaks during 2020.
Methods
We collected aggregated data on infected health care workers and outbreaks in health care facilities from all jurisdictions. Health care workers working solely in residential aged care and outbreaks in residential aged care facilities were excluded. Jurisdictions provided data on the number of health care setting outbreaks, confirmed cases, hospitalisation, source of infection, and health care worker role. We analysed data for two periods that aligned with two distinct peaks in the epidemic relative to 1 June 2020, referred to here as the first wave (23 January – 31 May 2020) and the second wave (1 June – 18 September 2020).
Results
Jurisdictions reported a total of 2,163 health care worker infections with SARS-CoV-2 during the surveillance period. Source of acquisition was known for 81.0% of cases (1,667/2,059). The majority of cases in the first wave were acquired overseas, shifting to locally-acquired cases in the second wave. The odds of infection in the second wave compared to the first wave were higher for nurses/midwives (odds ratio, OR: 1.61; 95% confidence interval (95% CI): 1.32–2.00), lower for medical practitioners (OR: 0.36; 95% CI: 0.28–0.47) and did not differ for ‘other’ health care workers (OR: 1.07; 95% CI: 0. 87–1.32). The odds of infection in the second wave were higher in a health care setting (OR: 1.76; 95% CI: 1.28–2.41) than in the community.
There were 120 outbreaks in health care settings with 1,428 cases, of which 56.7% (809/1,428) were health care workers. The majority (88/120; 73.8%) of outbreaks in health care settings occurred in the second wave of the epidemic, with 90.9% of these (80/88) occurring in Victoria.
Conclusions
In the second wave of the epidemic, when there was heightened community transmission, health care workers were more likely to be infected in the workplace. Throughout the epidemic, nurses were more likely to be infected than staff in other roles.
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Affiliation(s)
- Anna C Rafferty
- National Incident Response Division, Australian Government Department of Health, Canberra, Australia
| | - Moira C Hewitt
- National Incident Response Division, Australian Government Department of Health, Canberra, Australia
| | - Rose Wright
- National Incident Response Division, Australian Government Department of Health, Canberra, Australia
| | - Freya Hogarth
- National Incident Response Division, Australian Government Department of Health, Canberra, Australia; National Centre for Epidemiology and Population Health, Australian National University, Acton, ACT, Australia
| | - Nick Coatsworth
- Office of the Chief Medical Officer, Australian Government Department of Health, Canberra, Australia; ANU Medical School, Australian National University, Acton, ACT, Australia
| | - Frances Ampt
- Victorian Department of Health and Human Services, Melbourne, Australia
| | - Sally Dougall
- Victorian Department of Health and Human Services, Melbourne, Australia
| | - Charles Alpren
- Victorian Department of Health and Human Services, Melbourne, Australia
| | - Louise Causer
- The Kirby Institute, University of NSW, Sydney, Australia
| | | | | | | | | | | | - Kylie J Smith
- Tasmanian Department of Health, Hobart, Australia; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Martyn D Kirk
- National Incident Response Division, Australian Government Department of Health, Canberra, Australia; National Centre for Epidemiology and Population Health, Australian National University, Acton, ACT, Australia
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Bell R, Draper A, Fearnley E, Franklin N, Glasgow K, Gregory J, Harlock M, Hope K, Kane S, Miller M, Pingault N, Sloan-Gardner T, Stafford R, Ward K, Wright R. Monitoring the incidence and causes of disease potentially transmitted by food in Australia: Annual report of the OzFoodNet network, 2016. Commun Dis Intell (2018) 2021; 45. [PMID: 34587876 DOI: 10.33321/cdi.2021.45.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract In 2016, a total of 44,455 notifications of enteric diseases potentially related to food were received by state and territory health departments in Australia. Consistent with previous years, campylobacteriosis (n = 24,171) and salmonellosis (n = 18,060) were the most frequently-notified infections. Notable increases in incidence were observed for shiga toxin-producing Escherichia coli (n = 343; 166% increase), shigellosis (n = 1,408; 93% increase), campylobacteriosis (33% increase) and salmonellosis (30% increase) when compared with the historical five-year mean. The extent to which the introduction of culture-independent testing as a method of diagnosis has contributed to these increases remains unclear. In total, 188 gastrointestinal outbreaks, including 177 foodborne outbreaks, were reported in 2016. The 11 non-foodborne outbreaks were due to environmental or probable environmental transmission (nine outbreaks) and animal-to-person or probable animal-to-person transmission (two outbreaks). No outbreaks of waterborne or probable waterborne transmission were reported in 2016. Foodborne outbreaks affected 3,639 people, resulting in at least 348 hospital admissions and four deaths. Eggs continue to be a source of Salmonella Typhimurium infection across the country: 35 egg-related outbreaks, affecting approximately 510 people, were reported across six jurisdictions in 2016. Three large multi-jurisdictional Salmonella outbreaks associated with mung bean sprouts (n = 419 cases); bagged salad products (n = 311 cases); and rockmelons (n = 144 cases) were investigated in 2016. These outbreaks highlight the risks associated with fresh raw produce and the ongoing need for producers, retailers and consumers to implement strategies to reduce potential Salmonella contamination.
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Affiliation(s)
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- Office of Health Protection and Response, Australian Government Department of Health
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Braima K, Zahedi A, Egan S, Austen J, Xiao L, Feng Y, Witham B, Pingault N, Perera S, Oskam C, Reid S, Ryan U. Molecular analysis of cryptosporidiosis cases in Western Australia in 2019 and 2020 supports the occurrence of two swimming pool associated outbreaks and reveals the emergence of a rare C. hominis IbA12G3 subtype. Infect Genet Evol 2021; 92:104859. [PMID: 33848684 DOI: 10.1016/j.meegid.2021.104859] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/03/2021] [Accepted: 04/08/2021] [Indexed: 12/24/2022]
Abstract
Cryptosporidium is an important protozoan parasite and due to its resistance to chlorine is a major cause of swimming pool-associated gastroenteritis outbreaks. The present study combined contact tracing and molecular techniques to analyse cryptosporidiosis cases and outbreaks in Western Australia in 2019 and 2020. In the 2019 outbreak, subtyping at the 60 kDa glycoprotein (gp60) gene identified 89.0% (16/18) of samples were caused by the C. hominis IdA15G1 subtype. Amplicon next generation sequencing (NGS) at the gp60 locus identified five C. hominis IdA15G1 subtype samples that also had C. hominis IdA14 subtype DNA, while multi locus sequence typing (MLST) analysis on a subset (n = 14) of C. hominis samples identified three IdA15G1 samples with a 6 bp insertion at the end of the trinucleotide repeat region of the cp47 gene. In 2020, 88.0% (73/83) of samples typed were caused by the relatively rare C. hominis subtype IbA12G3. Four mixed infections were observed by NGS with three IdA15G1/ IdA14 mixtures and one C. parvum IIaA18G3R1 sample mixed with IIaA16G3R1. No genetic diversity using MLST was detected. Epidemiological and molecular data indicates that the outbreaks in 2019 and 2020 were each potentially from swimming pool point sources and a new C. hominis subtype IbA12G3 is emerging in Australia. The findings of the present study are important for understanding the introduction and transmission of rare Cryptosporidium subtypes to vulnerable populations.
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Affiliation(s)
- Kamil Braima
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, Perth, Western Australia 6150, Australia.
| | - Alireza Zahedi
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, Perth, Western Australia 6150, Australia
| | - Siobhon Egan
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, Perth, Western Australia 6150, Australia
| | - Jill Austen
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, Perth, Western Australia 6150, Australia
| | - Lihua Xiao
- Key Laboratory of Zoonosis of Ministry of Agriculture, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510642, China
| | - Yaoyu Feng
- Key Laboratory of Zoonosis of Ministry of Agriculture, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510642, China
| | - Benjamin Witham
- OzFoodNet Communicable Disease Control Directorate, Perth, Western Australia, Australia
| | - Nevada Pingault
- OzFoodNet Communicable Disease Control Directorate, Perth, Western Australia, Australia
| | - Shalinie Perera
- Western Diagnostic Pathology, Perth, Western Australia 6154, Australia
| | - Charlotte Oskam
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, Perth, Western Australia 6150, Australia
| | - Simon Reid
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland 4006, Australia
| | - Una Ryan
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, Perth, Western Australia 6150, Australia
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Donato CM, Pingault N, Demosthenous E, Roczo-Farkas S, Bines JE. Characterisation of a G2P[4] Rotavirus Outbreak in Western Australia, Predominantly Impacting Aboriginal Children. Pathogens 2021; 10:350. [PMID: 33809709 PMCID: PMC8002226 DOI: 10.3390/pathogens10030350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/12/2021] [Accepted: 03/12/2021] [Indexed: 01/13/2023] Open
Abstract
In May, 2017, an outbreak of rotavirus gastroenteritis was reported that predominantly impacted Aboriginal children ≤4 years of age in the Kimberley region of Western Australia. G2P[4] was identified as the dominant genotype circulating during this period and polyacrylamide gel electrophoresis revealed the majority of samples exhibited a conserved electropherotype. Full genome sequencing was performed on representative samples that exhibited the archetypal DS-1-like genome constellation: G2-P[4]-I2-R2-C2-M2-A2-N2-T2-E2-H2 and phylogenetic analysis revealed all genes of the outbreak samples were closely related to contemporary Japanese G2P[4] samples. The outbreak samples consistently fell within conserved sub-clades comprised of Hungarian and Australian G2P[4] samples from 2010. The 2017 outbreak variant was not closely related to G2P[4] variants associated with prior outbreaks in Aboriginal communities in the Northern Territory. When compared to the G2 component of the RotaTeq vaccine, the outbreak variant exhibited mutations in known antigenic regions; however, these mutations are frequently observed in contemporary G2P[4] strains. Despite the level of vaccine coverage achieved in Australia, outbreaks continue to occur in vaccinated populations, which pose challenges to regional areas and remote communities. Continued surveillance and characterisation of emerging variants are imperative to ensure the ongoing success of the rotavirus vaccination program in Australia.
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Affiliation(s)
- Celeste M. Donato
- Enteric Diseases Group, Murdoch Children’s Research Institute, Parkville 3052, Australia; (E.D.); (S.R.-F.); (J.E.B.)
- Department of Paediatrics, The University of Melbourne, Parkville 3010, Australia
- Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton 3800, Australia
| | - Nevada Pingault
- Department of Health Western Australia, Communicable Disease Control Directorate, Perth 6004, Australia;
| | - Elena Demosthenous
- Enteric Diseases Group, Murdoch Children’s Research Institute, Parkville 3052, Australia; (E.D.); (S.R.-F.); (J.E.B.)
- Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton 3800, Australia
| | - Susie Roczo-Farkas
- Enteric Diseases Group, Murdoch Children’s Research Institute, Parkville 3052, Australia; (E.D.); (S.R.-F.); (J.E.B.)
| | - Julie E. Bines
- Enteric Diseases Group, Murdoch Children’s Research Institute, Parkville 3052, Australia; (E.D.); (S.R.-F.); (J.E.B.)
- Department of Paediatrics, The University of Melbourne, Parkville 3010, Australia
- Department of Gastroenterology and Clinical Nutrition, Royal Children’s Hospital, Parkville 3052, Australia
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Wallace RL, Bulach D, Valcanis M, Polkinghorne BG, Pingault N, Stylianopoulos A, Givney RC, Glass K, Kirka MD. Identification of the first erm(B)-positive Campylobacter jejuni and Campylobacter coli associated with novel multidrug resistance genomic islands in Australia. J Glob Antimicrob Resist 2020; 23:311-314. [PMID: 33010486 DOI: 10.1016/j.jgar.2020.09.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/29/2020] [Accepted: 09/03/2020] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES This report describes the first identification of two Campylobacter isolates harbouring erm(B) in Australia. METHODS Two erm(B)-positive isolates, Campylobacter coli 18V1065H1 and Campylobacter jejuni 19W1001H1, were isolated from diarrhoeal faecal samples from two travellers who had recently returned from Southeast Asia. Isolates underwent whole-genome sequencing using an Illumina NextSeq system and were analysed with the Nullarbor pipeline. Antimicrobial resistance genes were identified using AMRFinderPlus and sequence types (STs) were determined by multilocus sequence typing and the PubMLST Campylobacter jejuni/coli typing scheme. RESULTS Besideserm(B), C. jejuni 19W1001H1 possessed six other resistance genes [aad9, aadE, aph(3')-Illa, blaOXA-185, catA13 and tet(O)], the gyrA T86I mutation and the RE-CmeABC multidrug efflux pump variant. Campylobacter coli 18V1065H1 also possessed six resistance genes [aad9, aadE, aph(3')-IIIa, blaOXA-61, sat4 and tet(O)] in addition to erm(B); however, this isolate lacked genetic evidence for resistance to fluoroquinolones (no gyrA mutation). The erm(B) locus differed between isolates and neither was identical to previously identified erm(B) multidrug resistance genomic island (MDRGI) types. Both erm(B)-bearing isolates belonged to novel sequence types: ST9967 (C. jejuni 19W1001H1) and ST10161 (C. coli 18V1065H1). CONCLUSIONS This study detected the presence oferm(B) in Campylobacter for the first time in Australia. This novel mechanism of macrolide resistance is a major concern both for human and animal health and warrants close surveillance as macrolides are often the drug of choice for treating campylobacteriosis. The erm(B) gene is associated with several MDRGIs and dissemination of this resistance mechanism will likely limit treatment options for Campylobacter infections.
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Affiliation(s)
- Rhiannon L Wallace
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Dieter Bulach
- Melbourne Bioinformatics, The University of Melbourne, Melbourne, Victoria, Australia; Microbiological Diagnostic Unit Public Health Laboratory, The Peter Doherty Institute, Melbourne, Victoria, Australia
| | - Mary Valcanis
- Microbiological Diagnostic Unit Public Health Laboratory, The Peter Doherty Institute, Melbourne, Victoria, Australia
| | - Benjamin G Polkinghorne
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | | | | | | | - Kathryn Glass
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Martyn D Kirka
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia.
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Middleton BF, Danchin M, Quinn H, Ralph AP, Pingault N, Jones M, Estcourt M, Snelling T. Retrospective Case-Control Study of 2017 G2P[4] Rotavirus Epidemic in Rural and Remote Australia. Pathogens 2020; 9:pathogens9100790. [PMID: 32993048 PMCID: PMC7601783 DOI: 10.3390/pathogens9100790] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/22/2020] [Accepted: 09/22/2020] [Indexed: 01/08/2023] Open
Abstract
Background: A widespread G2P[4] rotavirus epidemic in rural and remote Australia provided an opportunity to evaluate the performance of Rotarix and RotaTeq rotavirus vaccines, ten years after their incorporation into Australia’s National Immunisation Program. Methods: We conducted a retrospective case-control analysis. Vaccine-eligible children with laboratory-confirmed rotavirus infection were identified from jurisdictional notifiable infectious disease databases and individually matched to controls from the national immunisation register, based on date of birth, Aboriginal status and location of residence. Results: 171 cases met the inclusion criteria; most were Aboriginal and/or Torres Strait Islander (80%) and the median age was 19 months. Of these cases, 65% and 25% were fully or partially vaccinated, compared to 71% and 21% of controls. Evidence that cases were less likely than controls to have received a rotavirus vaccine dose was weak, OR 0.79 (95% CI, 0.46–1.34). On pre-specified subgroup analysis, there was some evidence of protection among children <12 months (OR 0.48 [95% CI, 0.22–1.02]), and among fully vs. partially vaccinated children (OR 0.65 [95% CI, 0.42–1.01]). Conclusion: Despite the known effectiveness of rotavirus vaccination, a protective effect of either rotavirus vaccine during a G2P[4] outbreak in these settings among predominantly Aboriginal children was weak, highlighting the ongoing need for a more effective rotavirus vaccine and public health strategies to better protect Aboriginal children.
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Affiliation(s)
- Bianca F. Middleton
- Global and Tropical Health, Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia; (A.P.R.); (T.S.)
- Division of Women, Children and Youth, Royal Darwin Hospital, Darwin 0810, Australia
- Correspondence: ; Tel.: +61-4-0209-3321
| | - Margie Danchin
- Department of Paediatrics, University of Melbourne, Melbourne 3052, Australia;
- Murdoch Children’s Research Institute, Melbourne 3052, Australia
- Department of General Medicine, Royal Children’s Hospital, Melbourne 3052, Australia
| | - Helen Quinn
- The National Centre for Immunisation Research and Surveillance (NCIRS), The Children’s Hospital at Westmead, Sydney 2145, Australia;
- Faculty of Medicine and Health, Westmead Clinical School, The University of Sydney, Westmead 2145, Australia
| | - Anna P. Ralph
- Global and Tropical Health, Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia; (A.P.R.); (T.S.)
- Division of Medicine, Royal Darwin Hospital, Darwin 0810, Australia
| | - Nevada Pingault
- Department of Health Western Australia, Communicable Disease Control Directorate, Perth 6004, Australia;
| | - Mark Jones
- Health and Clinical Analytics, School of Public Health, The University of Sydney, Sydney 2006, Australia; (M.J.); (M.E.)
| | - Marie Estcourt
- Health and Clinical Analytics, School of Public Health, The University of Sydney, Sydney 2006, Australia; (M.J.); (M.E.)
| | - Tom Snelling
- Global and Tropical Health, Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia; (A.P.R.); (T.S.)
- Wesfarmers Centre for Vaccine and Infectious Diseases, Telethon Kids Institute, Perth 6009, Australia
- School of Public Health, Curtin University, Perth 6102, Australia
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Braima K, Zahedi A, Oskam C, Reid S, Pingault N, Xiao L, Ryan U. Retrospective analysis of Cryptosporidium species in Western Australian human populations (2015-2018), and emergence of the C. hominis IfA12G1R5 subtype. Infect Genet Evol 2019; 73:306-313. [PMID: 31146044 DOI: 10.1016/j.meegid.2019.05.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/18/2019] [Accepted: 05/25/2019] [Indexed: 11/29/2022]
Abstract
Cryptosporidium species are a major cause of diarrhoea worldwide. In the present study, a retrospective analysis of 109 microscopically Cryptosporidium-positive faecal specimens from Western Australian patients, collected between 2015 and 2018 was conducted. Sequence analysis of the 18S rRNA and the 60 kDa glycoprotein (gp60) gene loci identified four Cryptosporidium species: C. hominis (86.2%, 94/109), C. parvum (11.0%, 12/109), C. meleagridis (1.8%, 2/109) and C. viatorum (0.9%, 1/109). Subtyping at the gp60 locus identified a total of 11 subtypes including the emergence of the previously rare C. hominis IfA12G1R5 subtype in 2017 as the dominant subtype (46.7%, 21/45). This subtype has also recently emerged as the dominant subtype in the United States but the reasons for its emergence are unknown. This is also the first report of C. viatorum in humans in Australia and a novel subtype (XVaA3g) was identified in the one positive patient.
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Affiliation(s)
- Kamil Braima
- Vector and Waterborne Pathogens Research Group, College of Science, Health, Engineering and Education, Murdoch University, Perth 6150, Australia
| | - Alireza Zahedi
- Vector and Waterborne Pathogens Research Group, College of Science, Health, Engineering and Education, Murdoch University, Perth 6150, Australia
| | - Charlotte Oskam
- Vector and Waterborne Pathogens Research Group, College of Science, Health, Engineering and Education, Murdoch University, Perth 6150, Australia
| | - Simon Reid
- School of Public Health, The University of Queensland, Herston, Queensland 4006, Australia
| | - Nevada Pingault
- OzFoodNet Communicable Disease Control Directorate, Perth, Western Australia, Australia
| | - Lihua Xiao
- Key Laboratory of Zoonosis of Ministry of Agriculture, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510642, China
| | - Una Ryan
- Vector and Waterborne Pathogens Research Group, College of Science, Health, Engineering and Education, Murdoch University, Perth 6150, Australia.
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Moffatt CRM, Musto J, Pingault N, Combs B, Miller M, Stafford R, Gregory J, Polkinghorne BG, Kirk MD. Recovery of Salmonella enterica from Australian Layer and Processing Environments Following Outbreaks Linked to Eggs. Foodborne Pathog Dis 2017; 14:478-482. [PMID: 28570831 DOI: 10.1089/fpd.2016.2268] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Cameron R M Moffatt
- 1 OzFoodNet, Communicable Disease Control, Health Protection Service, Australian Capital Territory Health Directorate , Canberra, Australia .,2 National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University , Canberra, Australia
| | - Jennie Musto
- 3 Health Protection New South Wales, New South Wales Ministry of Health , Sydney, Australia
| | - Nevada Pingault
- 4 Department of Health, OzFoodNet, Communicable Disease Control Directorate, Government of Western Australia , Perth, Australia
| | - Barry Combs
- 4 Department of Health, OzFoodNet, Communicable Disease Control Directorate, Government of Western Australia , Perth, Australia
| | - Megge Miller
- 5 OzFoodNet, Communicable Disease Control Branch, South Australia Health , Adelaide, Australia
| | - Russell Stafford
- 6 OzFoodNet, Communicable Diseases Branch, Queensland Health , Brisbane, Australia
| | - Joy Gregory
- 7 Victorian Department of Health and Human Services, OzFoodNet, Communicable Disease Epidemiology and Surveillance , Melbourne, Australia
| | - Benjamin G Polkinghorne
- 8 Australian Government Department of Health, OzFoodNet, Office of Health Protection , Canberra, Australia
| | - Martyn D Kirk
- 2 National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University , Canberra, Australia
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Moffatt CRM, Musto J, Pingault N, Miller M, Stafford R, Gregory J, Polkinghorne BG, Kirk MD. Salmonella Typhimurium and Outbreaks of Egg-Associated Disease in Australia, 2001 to 2011. Foodborne Pathog Dis 2016; 13:379-85. [PMID: 27028267 DOI: 10.1089/fpd.2015.2110] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Salmonellosis is a significant public health problem, with eggs frequently identified as a food vehicle during outbreak investigations. Salmonella enterica serovar Typhimurium and Salmonella enterica serovar Enteritidis are the two most frequently identified causes of egg-associated disease in industrialized countries. In Australia, a comprehensive review of egg-associated outbreaks has not been previously undertaken. METHODS Using a national register of foodborne outbreaks, we undertook a descriptive review of egg-associated outbreaks between 2001 and 2011. Included in our review was additional detail from the findings of trace back investigations conducted to the farm level. Evidence classifications were developed and applied to each outbreak based on descriptive and analytical epidemiology, food safety investigations, and microbiological testing of clinical, food, and trace back-derived samples. RESULTS Over the study period, the proportion of foodborne Salmonella outbreaks linked to eggs increased significantly (p < 0.001). In total, 166 outbreaks were identified, with 90% caused by Salmonella Typhimurium. The majority of outbreaks were linked to commercial food providers, with raw egg use the major contributing factor. These events resulted in more than 3200 cases, more than 650 hospitalizations, and at least 4 deaths. Fifty-four percent of investigations used analytical epidemiology, food microbiology, and trace back microbiology to demonstrate links between human illness and eggs. Trace back investigations identified S. enterica indistinguishable from outbreak-associated clinical or food samples on 50% of sampled egg farms. CONCLUSION Effective control of egg-associated salmonellosis remains a challenge in Australia, with Salmonella Typhimurium dominating as the causative serotype in outbreak events. Although outbreaks predominantly occur in the settings of restaurants, the high recovery rate of indistinguishable Salmonella on epidemiologically implicated egg farms suggests that further efforts to minimize infection pressure at the primary production level are needed in Australia.
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Affiliation(s)
- Cameron R M Moffatt
- 1 OzFoodNet, Communicable Disease Control, Health Protection Service, Australian Capital Territory Health Directorate , Canberra, Australia .,2 National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University , Canberra, Australia
| | - Jennie Musto
- 3 Health Protection New South Wales, New South Wales Ministry of Health , Sydney, Australia
| | - Nevada Pingault
- 4 OzFoodNet, Communicable Disease Control Directorate, Government of Western Australia , Department of Health, Perth, Australia
| | - Megge Miller
- 5 OzFoodNet, Communicable Disease Control Branch, South Australia Health , Adelaide, Australia
| | - Russell Stafford
- 6 OzFoodNet, Communicable Diseases Branch , Queensland Health, Brisbane, Australia
| | - Joy Gregory
- 7 OzFoodNet, Infectious Disease Epidemiology and Surveillance , Victorian Department of Health, Melbourne, Australia
| | - Benjamin G Polkinghorne
- 8 OzFoodNet, Office of Health Protection , Australian Government Department of Health, Canberra, Australia
| | - Martyn D Kirk
- 2 National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University , Canberra, Australia
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Merritt T, Combs B, Pingault N. Campylobacter outbreaks associated with poultry liver dishes. Commun Dis Intell Q Rep 2011; 35:299-300. [PMID: 22624491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Tony Merritt
- Hunter New England Population Health, Hunter New England Local Health District, New South Wales.
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Ng JSY, Pingault N, Gibbs R, Koehler A, Ryan U. Molecular characterisation of Cryptosporidium outbreaks in Western and South Australia. Exp Parasitol 2010; 125:325-8. [PMID: 20219461 DOI: 10.1016/j.exppara.2010.02.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2009] [Revised: 02/18/2010] [Accepted: 02/23/2010] [Indexed: 10/19/2022]
Abstract
Molecular typing at the 18S rRNA and Gp60 loci was conducted on Cryptosporidium-positive stool samples from cases collected during 2007 Western Australian and South Australian outbreaks of cryptosporidiosis. Analysis of 48 Western Australian samples identified that all isolates were C. hominis and were from five different Gp60C. hominis subtype families. The IbA10G2 subtype was most common across all age groups (37/48). In South Australia, analysis of 24 outbreak samples, identified 21 C. hominis isolates, two C. parvum isolates and one sample with both C. hominis and C. parvum. All C. hominis isolates were identified as the IbA10G2 subtype.
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Affiliation(s)
- Josephine S Y Ng
- Division of Veterinary and Biomedical Sciences, Murdoch University, Murdoch, WA 6150, Australia
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Gibbs R, Pingault N, Mazzucchelli T, O'Reilly L, MacKenzie B, Green J, Mogyorosy R, Stafford R, Bell R, Hiley L, Fullerton K, Van Buynder P. An outbreak of Salmonella enterica serotype Litchfield infection in Australia linked to consumption of contaminated papaya. J Food Prot 2009; 72:1094-8. [PMID: 19517740 DOI: 10.4315/0362-028x-72.5.1094] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
An outbreak of 26 cases of Salmonella Litchfield infection occurred in the states of Western Australia and Queensland between October 2006 and January 2007. A case-control study was conducted with 12 cases and 24 controls, and a significant association was found between illness and consumption of papaya (odds ratio, 32.8; 95% confidence interval, 2.71 to 883.5). Papaya samples were collected from 26 stores in Western Australia, and 9 of 38 samples were contaminated with Salmonella Litchfield. These samples had pulsed-field gel electrophoresis patterns and multilocus variable-number tandem-repeat analysis profiles indistinguishable from the outbreak strain. Three farms in Western Australia supplied the contaminated papaya, and two of these farms were inspected. Salmonella Litchfield was not detected in papaya samples, fungal sprays, or water samples from the farms; however, at one farm other serotypes of Salmonella were detected in untreated river water that was used for washing papaya. Only treated potable water should be used for washing fresh produce that is to be eaten raw.
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Affiliation(s)
- Robyn Gibbs
- Department of Health Western Australia, P.O. Box 8172, Perth Business Centre, Western Australia 6849, Australia.
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