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1301.0 - Year Book Australia, 2004  
Previous ISSUE Released at 11:30 AM (CANBERRA TIME) 27/02/2004   
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Contents >> Health >> Communicable diseases

Communicable diseases are those diseases capable of being transmitted from one person to another, or from one species to another. Two major groups of communicable diseases, classified in the International Classification of Diseases (ICD-10), are infectious and parasitic diseases (ICD-10 codes A00-B99) and acute respiratory infections (ICD-10 codes J00-J22) which includes influenza and pneumonia as well as other acute upper and lower respiratory infections. In 2001, these two groups accounted for 3.6% of all deaths in Australia (4,444 deaths). Influenza and pneumonia accounted for 61% (2,702) of these deaths. Death rates increase with age, and were greater for males than females in most age groups. In 2000-01, there were 89,318 hospital separations in Australia with a principal diagnosis of infectious and parasitic diseases. Acute respiratory infections including influenza and pneumonia were responsible for a further 122,601 separations.

Under the National Notifiable Diseases Surveillance System (NNDSS), state and territory health authorities submit reports of more than 50 communicable disease notifications for compilation by the Department of Health and Ageing. In 2001, the diseases reported to NNDSS were revised to include cryptosporidiosis, influenza, pneumococcal disease, Japanese encephalitis, Kunjin virus, Murray Valley encephalitis, anthrax, Australian bat lyssavirus, and other lyssavirus infections. At the same time, diseases that were becoming rare or of less public health significance in Australia, namely chancroid, lymphogranuloma venereum, hydatid disease and yersiniosis were removed from the NNDSS.

The provisional total of notifications to NNDSS in 2002 is 101,319, a small decrease (2.7%) on the 104,125 notifications in 2001 (table 9.19). In 2002, sexually transmitted infections (STI) were the most commonly reported communicable diseases, accounting for 32% of all notifications, followed by gastrointestinal diseases (26%) and blood-borne diseases (24%). Chlamydia was the most common STI (24,011 notifications, 74% of total STIs), campylobacteriosis the most common gastroenteritis (14,571 notifications, 55% of total) and hepatitis C (unspecified) was the most common blood-borne disease (15,981 notifications, 67% of total). Compared with 2001, there were increases in notifications of STIs due mainly to increases in chlamydia; while there were decreases in reports of blood borne diseases, gastrointestinal diseases and vaccine preventable diseases.

9.19 NATIONAL NOTIFIABLE DISEASE SURVEILLANCE SYSTEM REPORTS

Notifications
Rate per 100,000 population(a)


2000(b)
2001(b)
2002(c)
2000(b)
2001(b)
2002(c)
Disease(d)
no.
no.
no.

Blood-borne diseases
Hepatitis B (incident)
399
428
426
2.1
2.2
2.2
Hepatitis B (unspecified)
7,908
8,413
6,916
41.3
43.3
35.2
Hepatitis C (incident)
357
669
481
1.9
3.4
2.4
Hepatitis C (unspecified)
19,647
19,543
15,981
102.6
100.7
81.3
Hepatitis D
27
20
20
0.1
0.1
0.1
Hepatitis n.e.c.
1
2
-
-
-
-
Gastrointestinal diseases
Botulism
2
2
-
-
-
-
Campylobacteriosis
13,528
16,038
14,571
70.6
82.6
74.1
Cryptosporidiosis
. .
1,567
3,256
. .
8.1
16.6
Haemolytic uraemic syndrome
10
10
13
0.1
0.1
0.1
Hepatitis A
834
521
395
4.4
2.7
2.0
Hepatitis E
7
13
12
-
0.1
0.1
Listeriosis
66
61
60
0.3
0.3
0.3
Salmonellosis
6,111
7,085
7,748
31.9
36.5
39.4
Shigellosis
487
566
498
2.5
2.9
2.5
SLTEC, VTEC(e)
41
47
52
0.2
0.2
0.3
Typhoid
59
84
72
0.3
0.4
0.4
Yersiniosis
74
. .
. .
0.4
. .
. .
Quarantinable diseases
Cholera
1
4
5
-
-
-
Sexually transmissable diseases
Chlamydial infection
16,770
20,222
24,011
87.6
104.2
122.1
Donovanosis
13
38
19
0.1
0.2
0.1
Gonococcal infection
5,708
6,232
6,247
29.8
32.1
31.8
Syphilis
1,780
1,407
2,103
9.3
7.2
10.7
Vaccine preventable diseases
Diphtheria
-
1
-
-
-
-
Haemophilus influenzae type b
28
26
29
0.1
0.1
0.1
Influenza
. .
1,286
3,668
. .
6.6
18.7
Measles
108
135
36
0.6
0.7
0.2
Mumps
214
114
74
1.1
0.6
0.4
Pertussis
5,814
9,085
5,842
30.4
46.8
29.7
Pneumococcal disease
. .
1,650
2,317
..
8.5
11.8
Rubella
319
268
252
1.7
1.4
1.3
Tetanus
7
3
2
-
-
-
Vector-borne diseases
Arbovirus infection n.e.c.
55
34
20
0.3
0.2
0.1
Barmah Forest virus infection
624
1,158
904
3.3
6.0
4.6
Dengue
232
178
224
1.2
0.9
1.1
Kunjin virus
. .
4
-
. .
-
-
Malaria
959
715
477
5.0
3.7
2.4
Murray Valley encephalitis
9
6
2
-
-
-
Ross River virus infection
4,272
3,353
1,457
22.3
17.3
7.4
Zoonoses
Brucellosis
26
21
39
0.1
0.1
0.2
Hydatid infection
25
. .
. .
0.1
. .
. .
Leptospirosis
243
245
156
1.3
1.3
0.8
Ornithosis
103
145
204
0.5
0.7
1.0
Q fever
523
738
764
2.7
3.8
3.9
Other diseases
Legionnellosis
469
315
327
2.4
1.6
1.7
Leprosy
5
3
6
-
-
-
Meningococcal infection
621
679
681
3.2
3.5
3.5
Tuberculosis
1,062
991
952
5.5
5.1
4.8
Total
89,548
104,125
101,319
467.5
536.4
515.3

(a) Rate per 100,000 population is calculated using the estimated resident population at the midpoint (30 June) of the relevant calendar year.
(b) NNDSS data for 2000 and 2001 revised after consultations with states and territories.
(c) Notifications data for the year 2002 were provisional at the date of analysis (22 July 2003).
(d) Diseases reported to NNDSS from all jurisdictions except hepatitis B (unspecified) not reported from NT; incident hepatitis C not reported from Qld; campylobacteriosis not reported from NSW; donovanosis not reported from SA. Diseases under surveillance for which no notifications were received in the period 1999-2001 were plague, rabies, viral haemorrhagic fever, yellow fever, chancroid, lymphogranuloma venereum, poliomyelitis, Japanese encephalitis, anthrax, Australian bat lyssavirus, other lyssavirus n.e.c.
(e) SLTEC/VTEC is shiga-like toxins and verotoxin producing E. coli infections.
Source: DoHA 2003.

HIV and AIDS

In collaboration with the state and territory health authorities and the Australian Government, surveillance for human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) is conducted by the National Centre in HIV Epidemiology and Clinical Research. This centre is part of the Faculty of Medicine, University of New South Wales and is funded primarily by the Department of Health and Ageing through the Australian National Council on AIDS, Hepatitis C and Related Diseases.

At 31 December 2002, the cumulative number of HIV cases (since 1985) was 22,550. The number of new HIV infections decreased steadily and reached a low in 1999. However, from then on, HIV infections appear to have increased by around 4% on average per year. The cumulative number of AIDS diagnoses was 9,083 (since 1981), and there had been a total of 6,272 deaths attributable to AIDS (table 9.20).

The reduced numbers of new AIDS diagnoses in recent years (table 9.20) has been due to the decline in HIV incidence that took place in the mid-1980s, and the use, since around 1996, of effective combination antiretroviral therapy for the treatment of HIV infection. In Australia, approximately 50% of all people living with HIV infection are receiving antiretroviral treatment. However, the long-term effectiveness of antiretroviral treatment remains unknown, and if treatments begin to fail for a substantial proportion of people, then AIDS incidence could increase again.

9.20 NEWLY DIAGNOSED HIV CASES(a), AIDS CASES AND DEATHS FOLLOWING AIDS(b)

Year of diagnosis(c)

Prior to 1994
1994
1995
1996
1997
1998
1999
2000
2001
2002
Total

HIV cases(a)
15,044
1,017
930
918
821
759
724
745
761
823
22,550
AIDS cases(b)
5,061
953
810
669
382
318
193
252
199
246
9,083
AIDS deaths(b)
3,496
753
655
515
245
156
127
134
100
91
6,272

(a) Not adjusted for multiple reporting. Total includes 8 cases for which the date of HIV diagnosis was not reported.
(b) AIDS cases diagnosed and deaths following AIDS in 2000, 2001 and 2002 were adjusted for reporting delays; AIDS cases diagnosed and deaths following AIDS in previous years were assumed to be completely reported.
(c) The number of HIV/AIDS diagnoses for each year may be revised over time due to late reports, updated information on exposure and testing history for reported cases, and removal of previously unrecognised duplicate diagnoses.
Source: National Centre in HIV Epidemiology and Clinical Research, 'HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2003', National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, NSW, 2003.

Transmission of HIV in Australia continues to be mainly through sexual contact between men (77%). This was followed by transmission through heterosexual contact (11%) and injecting drug use (4.4%) (table 9.21). A small percentage of diagnosed infections were associated with a history of injecting drug use (2.2% in 2002). Mother-to-child transmission of HIV infection and transmission in a health care setting remain rare in Australia.

9.21 CHARACTERISTICS OF CASES OF NEWLY DIAGNOSED HIV INFECTION(a), Number of cases and proportion of total cases

Year of diagnosis(b)

Units
Prior to 1994
1994
1995
1996
1997
1998
1999
2000
2001
2002
Total(c)

Total cases
no.
15,044
1,017
930
918
821
759
724
745
761
823
22,550
Males
%
93.6
90.8
91.9
91.4
89.4
87.1
89.6
89.3
87.8
88.3
92.3
State/territory
New South Wales
%
60.3
49.8
57.9
50.0
53.0
53.5
52.8
48.3
44.9
47.1
57.2
Victoria
%
20.4
21.2
17.6
20.5
21.9
18.4
19.2
25.2
27.2
26.5
20.9
Queensland
%
8.9
15.9
11.9
16.7
13.8
13.8
17.3
15.3
13.7
15.8
10.9
South Australia
%
3.5
3.7
3.3
5.0
4.1
4.6
3.0
3.1
5.7
3.2
3.6
Western Australia
%
4.8
7.3
6.5
6.2
4.9
6.6
5.5
6.2
6.4
5.2
5.2
Tasmania
%
0.4
0.2
0.6
0.3
-
0.4
0.4
-
0.7
0.6
0.4
Northern Territory
%
0.5
0.5
0.2
0.5
1.3
1.6
0.7
0.4
0.5
1.0
0.6
Australian Capital Territory
%
1.2
1.4
1.9
0.8
1.0
1.0
1.1
1.5
0.9
0.6
1.2
Exposure category(d)
Male homosexual contact
%
81.2
74.4
73.7
75.5
72.8
65.5
65.5
68.2
66.5
71.3
77.4
Male homosexual contact and injecting drug use
%
3.6
6.4
5.2
4.0
4.8
4.7
6.3
3.4
5.1
3.5
4.1
Injecting drug use(e)
%
4.7
3.3
4.5
2.8
3.1
3.4
5.5
4.4
5.7
2.2
4.4
Heterosexual contact
%
6.1
13.7
15.1
16.7
18.2
25.2
21.8
23.6
22.1
22.6
11.0
Haemophilia/coagulation disorder
%
2.4
-
0.1
-
-
0.1
0.5
-
0.1
-
1.6
Receipt of blood/tissue
%
1.8
0.8
0.4
0.2
0.1
0.6
0.3
-
-
-
1.2
Mother with/at risk of HIV infection
%
0.2
1.0
0.8
0.8
0.9
0.4
0.1
0.4
0.4
0.3
0.4
Health care setting
%
-
0.3
0.1
-
-
-
-
-
-
0.1
0.1
Other/undetermined
%
20.9
5.1
7.5
9.7
9.1
8.0
9.5
8.3
7.9
10.8
16.7

(a) Not adjusted for multiple reporting.
(b) The number of HIV/AIDS diagnoses for each year may be revised over time due to late reports, updated information on exposure and testing history for reported cases, and removal of previously unrecognised duplicate diagnoses.
(c) Total includes 8 cases for which the date of HIV diagnosis was not reported.
(d) The ‘Other/undetermined’ category was excluded from the calculation of the percentage of cases attributed to each HIV exposure category.
(e) Excludes males who also reported a history of homosexual/bisexual contact.
Source: National Centre in HIV Epidemiology and Clinical Research, 'HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2003', National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, NSW, 2003.

Children's immunisation

The Australian Childhood Immunisation Register (ACIR), which commenced operation on 1 January 1996, aims to provide accurate and comprehensive information about immunisation coverage for all children under the age of seven. The register is administered by the Health Insurance Commission (HIC) on behalf of the Department of Health and Ageing and is a key component of initiatives to improve the immunisation status of Australian children.

Immunisation coverage goals for Australia for the year 2000, recommended by the National Health and Medical Research Council (NHMRC), called for 90% or more coverage of children at two years of age, and near universal coverage of children at school-entry age, against diphtheria, tetanus, pertussis (whooping cough), poliomyelitis, measles, mumps, rubella and hib (haemophilus influenza type b).

ACIR data indicated that, at 31 December 2002, 91% of one year olds, 89% of two year olds and 82% of 6 year olds were fully immunised according to the NHMRC Recommended Australian Standard Vaccination Schedule. State summaries by age group based on ACIR data are contained in the quarterly Communicable Diseases Intelligence bulletin, published on the HIC web site, <http://www.hic.gov.au>.

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