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1301.0 - Year Book Australia, 2005  
Previous ISSUE Released at 11:30 AM (CANBERRA TIME) 21/01/2005   
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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 2002 these two groups accounted for 3.7% of all deaths in Australia (4,955 deaths). Influenza and pneumonia accounted for 62% (3,084) of these deaths. Death rates increase with age, and were greater for males than females in most age groups. In 2002-03, there were 92,810 hospital separations in Australia with a principal diagnosis of infectious and parasitic diseases (AIHW 2004a, 2004e). Acute respiratory infections including influenza and pneumonia were responsible for a further 128,415 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 (DoHA). 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 2003 is 102,203, a small increase (3.0%) on the 99,195 notifications in 2002 (table 9.27). In 2003 sexually transmitted infections (STI) were the most commonly reported communicable diseases, accounting for 37% of all notifications, followed by gastrointestinal diseases (23%) and blood-borne diseases (20%). Chlamydia was the most common STI (29,493 notifications, 78% of total STIs), campylobacteriosis the most common gastroenteritis (14,951 notifications, 63% of total) and hepatitis C (unspecified) was the most common blood-borne disease (14,106 notifications, 68% of total). Compared with 2002, there were increases in notifications of STIs due mainly to increases in chlamydia; while there were decreases in reports of blood borne diseases (except campylobacteriosis), gastrointestinal diseases and vaccine preventable diseases.


9.27 NATIONAL NOTIFIABLE DISEASE SURVEILLANCE SYSTEM REPORTS
Notifications
Rate(a)


2001(b)
2002(b)
2003(c)
2001(b)
2002(b)
2003(c)
Disease(d)
no.
no.
no.
%
%
%

Blood-borne diseases
Hepatitis B (incident)
397
393
329
2.0
2.0
1.7
Hepatitis B (unspecified)
8,111
6,808
5,805
41.8
34.7
29.2
Hepatitis C (incident)
631
425
444
3.3
2.2
2.2
Hepatitis C (unspecified)
18,816
15,910
14,106
96.9
81.0
71.0
Hepatitis D
20
20
26
0.1
0.1
0.1
Hepatitis n.e.c.
2
-
-
-
-
-
Gastrointestinal diseases
Botulism
2
-
1
-
-
-
Campylobacteriosis
15,668
1,4274
14,951
80.7
72.7
75.2
Cryptosporidiosis
1,535
3,235
1,185
7.9
16.5
6.0
Haemolytic uraemic syndrome
3
13
15
-
0.1
0.1
Hepatitis A
504
370
394
2.6
1.9
2.0
Hepatitis E
10
11
8
0.1
0.1
-
Listeriosis
59
57
68
0.3
0.3
0.3
Salmonellosis
6,726
7,617
6,759
34.6
38.8
34.0
Shigellosis
548
487
431
2.8
2.5
2.2
SLTEC, VTEC(e)
43
51
47
0.2
0.3
0.2
Typhoid
71
66
50
0.4
0.3
0.3
Quarantinable diseases
Cholera
4
5
1
-
-
-
Sexually transmissable diseases
Chlamydial infection
19,775
23,736
29,493
101.9
120.8
148.4
Donovanosis
28
14
14
0.1
0.1
0.1
Gonococcal infection
6,066
6147
6,426
31.2
31.3
32.3
Syphilis
1,125
1,936
1,986
5.8
9.9
10.0
Vaccine preventable diseases
Diphtheria
1
-
-
-
-
-
Haemophilus influenza type b
20
29
19
0.1
0.1
0.1
Influenza
1,279
3,653
3,577
6.6
18.6
18.0
Measles
134
30
91
0.7
0.2
0.5
Mumps
110
68
75
0.6
0.3
0.4
Pertussis
8,673
5,320
4,686
44.7
27.1
23.6
Pneumococcal disease
1,584
2,247
2,126
8.2
11.4
10.7
Rubella
258
248
54
1.3
1.3
0.3
Tetanus
3
3
3
-
-
-
Vector-borne diseases
Arbovirus infection n.e.c.
33
20
77
0.2
0.1
0.4
Barmah Forest virus infection
1,110
890
1,357
5.7
4.5
6.8
Dengue
171
216
852
0.9
1.1
4.3
Kunjin virus
5
-
19
-
-
0.1
Malaria
680
455
598
3.5
2.3
3.0
Murray Valley encephalitis
5
2
-
-
-
-
Ross River virus infection
3,182
1,434
3,548
16.4
7.3
17.8
Zoonoses
Brucellosis
19
39
17
0.1
0.2
0.1
Leptospirosis
227
153
122
1.2
0.8
0.6
Ornithosis
127
191
191
0.7
1.0
1.0
Q fever
637
745
526
3.3
3.8
2.6
Other diseases
Legionnellosis
294
311
317
1.5
1.6
1.6
Leprosy
3
5
4
-
-
-
Meningococcal infection
670
679
544
3.5
3.5
2.7
Tuberculosis
829
881
861
4.3
4.5
4.3
Total
100,196
99,195
102,203
516.1
505.0
514.1

(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 2001 and 2002 revised after consultations with states and territories.
(c) Notifications data for the year 2003 were provisional at the date of analysis (9 August 2004).
(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 2001-2003 were CJD, small pox, tularemia, plague, rabies, viral haemorrhagic fever, yellow fever, poliomyelitis, Japanese encephalitis, anthrax, Australian bat lyssavirus, other lussavirus n.e.c.
(e) SLTEC/VTEC is shiga-like toxins and verotoxin producing E. coli infections.

Source: DoHA 2004a.


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 DoHA through the Australian National Council on AIDS, Hepatitis C and Related Diseases.

At 31 December 2003 the cumulative number of HIV cases (since 1985) was 23,306. The number of new HIV infections decreased steadily and reached a low in 1999. However, from then on, HIV infections have increased. The cumulative number of AIDS diagnoses was 9,380 (since 1981) and there had been a total of 6,372 deaths attributable to AIDS (table 9.28).

The reduced numbers of new AIDS diagnoses in recent years 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.


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

Year of diagnosis(c)

Prior to 1995
1995
1996
1997
1998
1999
2000
2001
2002
2003
Total

HIV cases(a)
15,991
928
899
820
752
713
748
761
839
848
23,306
AIDS cases(b)
6,011
811
671
385
320
197
255
208
232
290
9,380
AIDS deaths(b)
4,248
654
515
245
156
128
134
100
88
104
6,372

(a) Not adjusted for multiple reporting. Total includes 7 cases for which the date of HIV diagnosis was not reported.
(b) AIDS cases diagnosed and deaths following AIDS in 2001, 2002 and 2003 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: AIHW 2004; National Centre in HIV Epidemiology and Clinical Research, 'HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2004', National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, NSW.


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 (4.3%) (table 9.29). Mother-to-child transmission of HIV infection and transmission in a health care setting remain rare in Australia.


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

Year of diagnosis(b)

Units
Prior to 1995
1995
1996
1997
1998
1999
2000
2001
2002
2003
Total(c)

Total cases
no.
15,991
928
899
820
752
713
748
761
839
848
23,306
Males
%
93.4
91.9
91.2
89.4
87.0
89.5
89.2
87.8
88.7
89.0
92.1
State/territory
New South Wales
%
59.9
58.0
50.5
52.7
53.0
52.3
48.5
44.7
47.5
49.3
57.0
Victoria
%
20.5
17.7
20.2
22.0
18.6
19.5
25.1
27.2
25.9
24.0
21.0
Queensland
%
9.1
11.9
16.1
13.8
13.8
17.3
15.2
13.8
15.6
14.9
10.9
South Australia
%
3.5
3.3
5.1
4.3
4.7
3.1
3.1
5.7
3.6
5.2
3.7
Western Australia
%
4.9
6.4
6.3
4.9
6.8
5.6
6.2
6.4
5.2
5.4
5.2
Tasmania
%
0.4
0.6
0.3
-
0.4
0.4
-
0.7
0.6
-
0.4
Northern Territory
%
0.5
0.2
0.6
1.3
1.6
0.7
0.4
0.5
1.0
0.6
0.6
Australian Capital Territory
%
1.2
1.9
0.8
1.0
1.1
1.1
1.5
1.0
0.6
0.6
1.2
Exposure category(d)
Male homosexual contact
%
81.2
74.0
75.2
72.9
65.4
65.4
68.4
66.5
71.1
74.0
77.3
Male homosexual contact and injecting drug use
%
3.9
5.3
4.2
4.8
4.8
6.3
3.3
5.1
4.0
4.2
4.2
Injecting drug use(e)
%
4.7
4.4
2.7
3.1
3.6
5.4
4.4
5.7
2.5
3.5
4.3
Heterosexual contact
%
6.6
15.1
16.8
18.1
25.1
21.9
23.4
22.1
22.1
18.0
11.2
Haemophilia/coagulation disorder
%
2.4
0.1
-
-
0.1
0.5
-
0.1
-
-
1.4
Receipt of blood/tissue
%
1.8
0.3
0.2
0.1
0.6
0.3
-
-
-
-
1.2
Mother with/at risk of HIV infection
%
0.2
0.8
0.9
0.9
0.4
0.2
0.4
0.4
0.3
0.3
0.4
Health care setting
%
0.1
0.1
-
-
-
-
-
-
0.1
-
0.1
Other/undetermined
%
19.6
7.5
9.5
9.0
7.8
9.1
8.2
7.4
10.0
9.6
16.4

(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 7 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: AIHW 2004; National Centre in HIV Epidemiology and Clinical Research, 'HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2004', National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, NSW.


Children's immunisation

Immunisation programs for children are recognised as an effective public health intervention, and have been responsible for eradicating or minimising infectious diseases such as diphtheriea, whooping cough and polio as major causes of death and disability in Australia.

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 DoHA 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, at 30 June 2004, 91% of one year olds, 92% of two year olds and 84% of six 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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