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Neisseria meningitidis serogroup W (MenW) disease was believed to have little epidemic potential before the first international outbreak in 2000, which was related to the Hajj, and has subsequently been [...]

Objective To determine the frequency of presentations and infectious-disease burden at primary health care (PHC) services in young children in two remote Aboriginal communities in tropical northern Australia. Methods Children born after 1 January 2001, who were resident at 30 September 2005 and for whom consent was obtained, Were studied. Clinic records were reviewed for all presentations between 1 January 2002 and 30 September 2005. Data collected included reason for presentation (if infectious), antibiotic prescription and referral to hospital. Findings There were 7273 clinic presentations for 174 children aged 0-4.75 years, 55% of whom were male. The median presentation rate per child per year was 16 (23 in the first year of life). Upper-respiratory-tract infections (32%) and skin infections (18%) were the most common infectious reasons for presentation. First presentations for scabies and skin sores peaked at the age of 2 months. By 1 year of age, 63% and 69% of children had presented with scabies and skin sores, respectively. Conclusion These Aboriginal children average about two visits per month to PHC centres during their first year of life. This high rate is testament to the disease burden, the willingness of Aboriginal people to use health services and the high workload experienced by these health services. Scabies and skin sores remain significant health problems, with this study describing a previously undocumented burden of these conditions commencing within the first few months of life. Appropriate prevention and treatment strategies should encompass early infancy to reduce the high burden of infectious diseases in this population. Objectif Determiner la frequence de presentation dans les services de soins de sante primaire et la charge de morbidite des jeunes enfants de deux communautes aborigenes eloignees du Nord de l'Australie. Methodes Ont participe a l'etude les enfants nes apres le 1er, janvier 2001, residant a cet endroit le 30 septembre 2005 et pour lesquels un consentement avait ete obtenu. On a releve dans les registres des dispensaires toutes les presentations d'enfants entre le 1er janvier 2002 et le 30 septembre 2005. Parmi les informations recueillies figuraient les motifs de la presentation (en cas de pathologie infectieuse), ainsi que la prescription d'antibiotiques et l'orientation vers un hopital eventuelles. Resultats On a recense 7273 presentations dans un dispensaire, de 174 enfants de 0 a 4,75 ans, dont 55 % de garcons. La mediane du taux de presentation par enfant et par an etait de 16 (23 au cours de la premiere annee de vie). Les infections des voies respiratoires superieures (32 %) et les lesions cutanees (18 %) etaient les causes infectieuses les plus courantes de presentation. Les premieres presentations pour une gale ou une lesion cutanee atteignaient un pic pour l'age de 2 mois. Apres 1 an, 63 et 69 % respectivement des enfants avaient ete presentes pour une gale ou une Iesion cutanee. Conclusion En moyenne, ces enfants aborigenes etaient presentes deux fois par mois dans un centre de sante primaire pendant leur premiere annee de vie. Ce taux eleve de frequentation temoigne de la forte morbidite, de la volonte des populations aborigenes de recourir a ces services et de l'importante charge de travail qui pese sur ces demiers. La gale et les lesions cutanees restent des problemes de sante importants, representant une charge de morbidite notable des les premiers mois de la vie, comme l'atteste, pour la premiere fois, la presente etude. Les strategies de prevention et de traitement appropriees doivent englober la petite enfance pour reduire la forte charge de morbidite due aux maladies infectieuses dans cette population. Objetivo Determinar la frecuencia de visitas y la carga de morbilidad infecciosa en los servicios de atencion primaria (AP) entre los ninos pequenos en dos comunidades aborigenes remotas de zonas tropicales del norte de Australia. Metodos Se estudio a una poblacion de ninos que habian nacido despues del 1 de enero de 2001 y residian en la zona al 30 de septiembre de 2005, tras obtener el consentimiento informado oportuno. Se examinaron los datos clinicos correspondientes a todas las visitas realizadas entre el 1 de enero de 2002 y el 30 de septiembre de 2005. Entre los datos recopilados figuraban el motivo de la visita (si era un proceso infeccioso), la prescripcion de antibioticos y la posible derivacion a un hospital. Resultados Se consideraron en total 7273 visitas a consultorios de 174 ninos de 0 a 4,75 anos, el 55% de los cuales eran varones. La tasa mediana de visitas por nino y ano fue de 16 (23 en el primer ano de vida). Las infecciones de las vias respiratorias superiores (32%) y las infecciones cutaneas (18%) fueron las causas infecciosas mas frecuentes de visita al consultorio. Las primeras visitas por sarna o heridas cutaneas presentaban un pico a la edad de dos meses. Al ano de edad, el 63% y el 69% de los ninos habian acudido con sarna y heridas cutaneas, respectivamente. Conclusion Los ninos aborigenes estudiados hicieron como promedio unas dos visitas al mes a los centros de atencion primaria durante su primer ano de vida. Esa elevada tasa refleja la carga de morbilidad existente, la voluntad de la poblacion aborigen de usar los servicios de salud y el gran volumen de trabajo a que deben hacer frente esos servicios. La sarna y las heridas cutaneas siguen siendo problemas sanitarios importantes en esa poblacion, y el estudio pone de relieve por primera vez que esas afecciones suponen una carga ya en los primeros meses de vida, de modo que, para conseguir reducir la alta morbilidad infecciosa en esa poblacion, las estrategias de prevencion y tratamiento deben abarcar el periodo neonatal,, Introduction There is a disproportionate disease burden in remote Aboriginal communities compared with the general Australian population. (1-5) These discrepancies begin at birth: the perinatal mortality rate for Aboriginal infants [...]

The recently published Global Burden of Disease Study 2010 (GBD 2010) contains accurate, contemporary estimates of human morbidity and mortality, with substantial changes in the patterns of illness observed over the last two decades. One of the most significant alterations to these estimates has been the recognition that viral hepatitis is a leading cause of human mortality, with an estimated 1.29 million deaths worldwide in 2010. The global community must act to address emerging health priorities identified by GBD 2010, including the need to provide treatment and care to people living with viral hepatitis, especially in resource-poor settings.

Influenza within hospitals is receiving increasing attention as a result of planning for an influenza pandemic and the magnitude and severity of the 2007 influenza season in Australia. This article reviews current approaches to influenza surveillance of admitted patients, as opposed to surveillance of emergency departments, in hospitals internationally. Most examples came from the United States of America and Canada, although systems have been described in the United Kingdom and Japan. In-hospital surveillance of influenza occurs within broader surveillance systems established by national governments, and through other systems established by sub-national governments and individual hospitals. Systems vary in focus, i.e. laboratory confirmed influenza or influenza-like illness, and some are labour intensive while others incorporate differing degrees of automation. The approach to influenza surveillance within hospitals will depend on objectives and available resources, although an automated approach is likely to have greater longevity as labour requirements are reduced.