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Shaban RZ, Li C, O'Sullivan MVN, Gerrard J, Stuart RL, Teh J, Gilroy N, Sorrell TC, White E, Bag S, Hackett K, Chen SCA, Kok J, Dwyer DE, Iredell JR, Maddocks S, Ferguson P, Varshney K, Carter I, Barratt R, Robertson M, Baskar SR, Friend C, Robosa RS, Sotomayor-Castillo C, Nahidi S, Macbeth DA, Alcorn KAD, Wattiaux A, Moore F, McMahon J, Naughton W, Korman TM, Catton M, Kanapathipillai R, Romanes F, Rowe E, Catford J, Kennedy B, Qiao M, Shaw D. COVID-19 in Australia: our national response to the first cases of SARS-CoV-2 infection during the early biocontainment phase. Intern Med J 2021; 51:42-51. [PMID: 33196128 PMCID: PMC7753759 DOI: 10.1111/imj.15105] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/27/2020] [Accepted: 08/27/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND On 31 December 2019, the World Health Organization recognised clusters of pneumonia-like cases due to a novel coronavirus disease (COVID-19). COVID-19 became a pandemic 71 days later. AIM To report the clinical and epidemiological features, laboratory data and outcomes of the first group of 11 returned travellers with COVID-19 in Australia. METHODS This is a retrospective, multi-centre case series. All patients with confirmed COVID-19 infection were admitted to tertiary referral hospitals in New South Wales, Queensland, Victoria and South Australia. RESULTS The median age of the patient cohort was 42 years (interquartile range (IQR), 24-53 years) with six men and five women. Eight (72.7%) patients had returned from Wuhan, one from Shenzhen, one from Japan and one from Europe. Possible human-to-human transmission from close family contacts in gatherings overseas occurred in two cases. Symptoms on admission were fever, cough and sore throat (n = 9, 81.8%). Co-morbidities included hypertension (n = 3, 27.3%) and hypercholesterolaemia (n = 2, 18.2%). No patients developed severe acute respiratory distress nor required intensive care unit admission or mechanical ventilation. After a median hospital stay of 14.5 days (IQR, 6.75-21), all patients were discharged. CONCLUSIONS This is a historical record of the first COVID-19 cases in Australia during the early biocontainment phase of the national response. These findings were invaluable for establishing early inpatient and outpatient COVID-19 models of care and informing the management of COVID-19 over time as the outbreak evolved. Future research should extend this Australian case series to examine global epidemiological variation of this novel infection.
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Affiliation(s)
- Ramon Z Shaban
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Infectious Diseases and Sexual Health Services, Westmead Hospital, Sydney, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia.,Westmead Hospital, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Cecilia Li
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Matthew V N O'Sullivan
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia
| | - John Gerrard
- Department of Infectious Diseases and Immunology, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Rhonda L Stuart
- Monash Infectious Diseases, Monash Health, Melbourne, Victoria, Australia.,Centre for Inflammatory Diseases, Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Joanne Teh
- Infectious Diseases Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Nicole Gilroy
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Tania C Sorrell
- Infectious Diseases and Sexual Health Services, Westmead Hospital, Sydney, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia
| | - Elizabeth White
- Westmead Hospital, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Shopna Bag
- Centre for Population Health, Western Sydney Public Health Unit, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Kate Hackett
- Westmead Hospital, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Sharon C A Chen
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia
| | - Jen Kok
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia
| | - Dominic E Dwyer
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia
| | - Jonathan R Iredell
- Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia.,Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, Sydney, New South Wales, Australia
| | - Susan Maddocks
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Patricia Ferguson
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Kavita Varshney
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Emergency Department Westmead Hospital, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Ian Carter
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Ruth Barratt
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Infectious Diseases and Sexual Health Services, Westmead Hospital, Sydney, New South Wales, Australia
| | - Mark Robertson
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia.,Department of Microbiology and Infectious Diseases, NSW Health Pathology, Gosford Hospital, Central Coast, New South Wales, Australia
| | - Sai R Baskar
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia.,Department of Microbiology and Infectious Diseases, NSW Health Pathology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - Caren Friend
- Counter Disaster Unit, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Roselle S Robosa
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia
| | | | - Shizar Nahidi
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Deborough A Macbeth
- Department of Infectious Diseases and Immunology, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Kylie A D Alcorn
- Department of Infectious Diseases and Immunology, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Andre Wattiaux
- Gold Coast Public Health Unit, Gold Coast, Queensland, Australia
| | - Frederick Moore
- Public Health Virology Laboratory, Forensic and Scientific Services, Brisbane, Queensland, Australia
| | - Jamie McMahon
- Public Health Virology Laboratory, Forensic and Scientific Services, Brisbane, Queensland, Australia.,Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - William Naughton
- Monash Infectious Diseases, Monash Health, Melbourne, Victoria, Australia
| | - Tony M Korman
- Monash Infectious Diseases, Monash Health, Melbourne, Victoria, Australia.,Centre for Inflammatory Diseases, Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mike Catton
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, Peter Doherty Institute for Infections and Immunity, Melbourne, Victoria, Australia
| | | | - Finn Romanes
- Department of Health and Human Services, State Government Victoria, Melbourne, Victoria, Australia
| | - Emily Rowe
- Infectious Diseases Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Jennifer Catford
- Infectious Diseases Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Brendan Kennedy
- Infectious Diseases Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Communicable Disease Control Branch, SA Health, Adelaide, South Australia, Australia
| | - Ming Qiao
- Directorate of Microbiology and Infectious Diseases, South Australia Pathology, Adelaide, South Australia, Australia
| | - David Shaw
- Infectious Diseases Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
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Caly L, Druce J, Roberts J, Bond K, Tran T, Kostecki R, Yoga Y, Naughton W, Taiaroa G, Seemann T, Schultz MB, Howden BP, Korman TM, Lewin SR, Williamson DA, Catton MG. Isolation and rapid sharing of the 2019 novel coronavirus (SARS-CoV-2) from the first patient diagnosed with COVID-19 in Australia. Med J Aust 2020; 212:459-462. [PMID: 32237278 PMCID: PMC7228321 DOI: 10.5694/mja2.50569] [Citation(s) in RCA: 237] [Impact Index Per Article: 59.3] [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: 02/25/2020] [Accepted: 03/05/2020] [Indexed: 12/13/2022]
Abstract
Objectives To describe the first isolation and sequencing of SARS‐CoV‐2 in Australia and rapid sharing of the isolate. Setting SARS‐CoV‐2 was isolated from a 58‐year‐old man from Wuhan, China who arrived in Melbourne on 19 January 2020 and was admitted to the Monash Medical Centre, Melbourne from the emergency department on 24 January 2020 with fever, cough, and progressive dyspnoea. Major outcomes Clinical course and laboratory features of the first reported case of COVID‐19 (the illness caused by SARS‐CoV‐2) in Australia; isolation, whole genome sequencing, imaging, and rapid sharing of virus from the patient. Results A nasopharyngeal swab and sputum collected when the patient presented to hospital were each positive for SARS‐CoV‐2 (reverse transcription polymerase chain reaction). Inoculation of Vero/hSLAM cells with material from the nasopharyngeal swab led to the isolation of SARS‐CoV‐2 virus in culture. Electron microscopy of the supernatant confirmed the presence of virus particles with morphology characteristic of viruses of the family Coronaviridae. Whole genome sequencing of the viral isolate and phylogenetic analysis indicated the isolate exhibited greater than 99.99% sequence identity with other publicly available SARS‐CoV‐2 genomes. Within 24 hours of isolation, the first Australian SARS‐CoV‐2 isolate was shared with local and overseas reference laboratories and major North American and European culture collections. Conclusions The ability to rapidly identify, propagate, and internationally share our SARS‐CoV‐2 isolate is an important step in collaborative scientific efforts to deal effectively with this international public health emergency by developing better diagnostic procedures, vaccine candidates, and antiviral agents.
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Affiliation(s)
- Leon Caly
- Victorian Infectious Diseases Reference Laboratory, Melbourne Health at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC
| | - Julian Druce
- Victorian Infectious Diseases Reference Laboratory, Melbourne Health at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC
| | - Jason Roberts
- Victorian Infectious Diseases Reference Laboratory, Melbourne Health at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC
| | - Katherine Bond
- Victorian Infectious Diseases Reference Laboratory, Melbourne Health at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC
| | - Thomas Tran
- Victorian Infectious Diseases Reference Laboratory, Melbourne Health at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC
| | - Renata Kostecki
- Victorian Infectious Diseases Reference Laboratory, Melbourne Health at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC
| | - Yano Yoga
- Victorian Infectious Diseases Reference Laboratory, Melbourne Health at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC
| | | | - George Taiaroa
- Peter Doherty Institute for Infection and Immunity, University of Melbourne and Royal Melbourne Hospital, Melbourne, VIC
| | - Torsten Seemann
- Microbiological Diagnostic Unit Public Health Laboratory, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC
| | - Mark B Schultz
- Microbiological Diagnostic Unit Public Health Laboratory, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC
| | - Benjamin P Howden
- Microbiological Diagnostic Unit Public Health Laboratory, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC
| | | | - Sharon R Lewin
- Peter Doherty Institute for Infection and Immunity, University of Melbourne and Royal Melbourne Hospital, Melbourne, VIC.,The Alfred, Melbourne, VIC
| | - Deborah A Williamson
- Microbiological Diagnostic Unit Public Health Laboratory, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC.,Melbourne Health, Melbourne, VIC
| | - Mike G Catton
- Victorian Infectious Diseases Reference Laboratory, Melbourne Health at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC
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Trad MA, Naughton W, Yeung A, Mazlin L, O'sullivan M, Gilroy N, Fisher DA, Stuart RL. Ebola virus disease: An update on current prevention and management strategies. J Clin Virol 2016; 86:5-13. [PMID: 27893999 DOI: 10.1016/j.jcv.2016.11.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 06/11/2016] [Revised: 10/06/2016] [Accepted: 11/08/2016] [Indexed: 11/28/2022]
Abstract
Ebola virus disease (EVD) is characterised by systemic viral replication, immuno-suppression, abnormal inflammatory responses, large volume fluid and electrolyte losses, and high mortality in under-resourced settings. There are various therapeutic strategies targeting EVD including vaccines utilizing different antigen delivery methods, antibody-based therapies and antiviral drugs. These therapies remain experimental, but received attention following their use particularly in cases treated outside West Africa during the 2014-15 outbreak, in which 20 (80%) out of 25 patients survived. Emerging data from current trials look promising and are undergoing further study, however optimised supportive care remains the key to reducing mortality from EVD.
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Affiliation(s)
- M A Trad
- Department of Infectious Diseases, Wollongong Hospital, Wollongong, NSW, Australia; Graduate School of Medicine, University of Wollongong, Wollongong, Australia; Medecins Sans Frontieres, Paris, France.
| | - W Naughton
- Department of Infectious Diseases, Monash Health, Clayton, Victoria, Australia
| | - A Yeung
- Department of Infectious Diseases, Monash Health, Clayton, Victoria, Australia
| | - L Mazlin
- Medecins Sans Frontieres, Brussels, Belgium
| | - M O'sullivan
- Centre for Infectious Diseases and Microbiology, Pathology West, Westmead Hospital, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, NSW, Australia
| | - N Gilroy
- Centre for Infectious Diseases and Microbiology, Pathology West, Westmead Hospital, NSW, Australia
| | - D A Fisher
- Division of Infectious Diseases, University Medicine Cluster, National University Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - R L Stuart
- Department of Infectious Diseases, Monash Health, Clayton, Victoria, Australia; Department of Medicine, Monash University, Victoria, Australia
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