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1301.0 - Year Book Australia, 2003  
Previous ISSUE Released at 11:30 AM (CANBERRA TIME) 24/01/2003   
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Contents >> Health >> Communicable diseases

Communicable diseases (including infectious and parasitic diseases) are those diseases capable of being transmitted from one person to another, or from one species to another. In 2000, infectious diseases accounted for 3.6% of all deaths in Australia (4,582 deaths). Influenza and pneumonia accounted for 64% (2,937) of deaths due to communicable disease. Death rates increase with age, and were greater for males than females in most age groups. In 1999--2000, there were 12,859 hospitalisations in Australia with a primary diagnosis of communicable diseases. Influenza and pneumonia were responsible for 20% (2,591) of hospital admissions due to communicable diseases.

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 Commonwealth 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. Diseases which were becoming rare or of less public health significance in Australia were removed from the NNDSS. These diseases were chancroid, lymphogranuloma venereum, hydatid disease and yersiniosis.

The provisional total of notifications to NNDSS in 2001 is 100,669, an increase on the total notifications in 2000 (89,788) (table 9.23). This increase in notifications reflects the inclusion of new diseases as outlined above. For the diseases reportable in both years, there was a 12% increase. In 2001, sexually transmitted infections were the most commonly reported communicable diseases, accounting for 27.8% of all notifications, followed by food-borne diseases (26%) and blood-borne diseases (24.8%). Chlamydia was the most commonly reported sexually transmitted infection (20,185 notifications, 72% of total), campylobacteriosis the most common food-borne disease (16,185 notification, 61% of total) and hepatitis C (unspecified) was the most common blood-borne disease (15,649 notifications, 62% of total). Compared with previous years there were increases in the total numbers of notifications of food-borne and vaccine preventable diseases. Increases in food-borne disease are due to a continuing increase in cases of campylobacteriosis and the inclusion in 2001 of cases of cryptosporidiosis for the first time. The total vaccine preventable diseases increased due to the inclusion of influenza and pneumococcal disease for the first time in 2001 and increases in reports of pertussis.

Decreases in notifications of measles, mumps and rubella reflect successful vaccination campaigns. Declines in tuberculosis (TB) have given Australia one of the lowest rates of TB in the world.


9.23 NATIONAL NOTIFIABLE DISEASE SURVEILLANCE SYSTEM REPORTS

Notifications
Rate per 100,000 population(a)


1999(b)
2000(b)
2001(c)
1999(b)
2000(b)
2001(c)
Disease(d)
no.
no.
no.
%
%
%

Blood-borne diseases
Hepatitis B (incident)
303
395
420
1.6
2.1
2.2
Hepatitis B (unspecified)
7,218
7,918
8,312
38.4
41.8
43.2
Hepatitis C (incident)
396
441
589
2.6
2.9
3.7
Hepatitis C (unspecified)
18,798
19,607
15,649
99.1
102.3
80.6
Hepatitis D
19
27
21
0.1
0.2
0.1
Hepatitis n.e.c.
-
1
-
-
-
-
Gastrointestinal diseases
Botulism
-
2
2
-
-
-
Campylobacteriosis
12,657
13,595
16,185
100.8
107.1
125.7
Cryptosporidiosis
. .
. .
1,631
. .
. .
8.4
Haemolytic uraemic syndrome
23
15
5
0.1
0.1
-
Hepatitis A
1,554
812
534
8.2
4.2
2.7
Hepatitis E
9
10
10
0.1
0.1
0.1
Listeriosis
64
67
61
0.3
0.3
0.3
Salmonellosis
7,147
6,151
7,113
37.7
32.1
36.6
Shigellosis
547
487
568
4.4
3.8
2.9
SLTEC, VTEC(e)
47
33
48
0.3
0.2
0.2
Typhoid
68
58
84
0.4
0.3
0.4
Yersiniosis
125
73
. .
1.0
0.6
. .
Quarantinable diseases
Cholera
3
1
3
-
-
-
Sexually transmissable diseases
Chlamydial infection
14,045
16,866
20,185
74.1
88.0
103.9
Donovanosis
17
12
35
0.2
0.1
0.2
Gonococcal infection
5,644
5,686
6,394
29.8
29.7
32.9
Syphilis
1,844
1,755
1,392
9.7
9.2
7.2
Vaccine preventable diseases
Diphtheria
-
-
1
-
-
-
Haemophilus influenzae type b
40
28
26
0.2
0.1
0.1
Influenza
. .
. .
1,327
. .
. .
6.8
Measles
238
107
141
1.3
0.6
0.7
Mumps
172
212
114
1.1
1.4
0.6
Pertussis
4,417
5,942
9,565
23.3
31.0
49.2
Pneumococcal disease
. .
. .
165
. .
. .
8.5
Rubella
377
322
268
2.0
1.7
1.4
Tetanus
2
6
3
-
-
-
Vector-borne diseases
Arbovirus infection n.e.c.
62
69
37
0.3
0.4
0.2
Barmah Forest virus infection
638
634
1,144
3.4
3.3
5.9
Dengue
132
215
184
0.7
1.1
0.9
Kunjin virus
. .
. .
2
. .
. .
-
Malaria
732
951
718
3.9
5.0
3.7
Murray Valley encephalitis
. .
. .
3
. .
. .
-
Ross River virus infection
4,416
4,200
3,235
23.3
21.9
16.7
Zoonoses
Brucellosis
52
27
19
0.3
0.1
0.1
Hydatid infection
26
26
. .
0.2
0.2
. .
Leptospirosis
323
243
250
1.7
1.3
1.3
Ornithosis
84
100
140
0.9
1.1
0.7
Q fever
515
573
694
2.7
3.0
3.6
Other diseases
Legionnellosis
249
472
304
1.3
2.5
1.6
Leprosy
6
4
4
-
-
-
Meningococcal infection
591
621
670
3.1
3.2
3.4
Tuberculosis
1,143
1,024
927
6.0
5.3
4.8
Total
84,743
89,788
100,669
. .
. .
. .

(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 1999 and 2000 revised after consultations with states and territories in December 2001.
(c) Notifications data for the year 2001 were provisional at the date of analysis (6 July 2002).
(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: National Notifiable Disease Surveillance System.


HIV and AIDS

In collaboration with the state and territory health authorities and the Commonwealth 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 Commonwealth Department of Health and Ageing through the Australian National Council on AIDS, Hepatitis C and Related Diseases.

At 31 December 2001, the cumulative number of HIV cases (since 1985) was 21,725. Also, the cumulative number of AIDS diagnoses was 8,810 (since 1981), and there had been a total of 6,174 deaths attributable to AIDS (table 9.24).

The reduced numbers of new AIDS diagnoses in recent years (table 9.24) 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.


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

Year of diagnosis

Prior to 1993
1993
1994
1995
1996
1997
1998
1999
2000
2001
Total

HIV cases(a)
13,953
1,078
1,015
930
915
815
760
725
746
777
21,725
AIDS cases(b)
4,217
845
954
809
669
381
315
189
253
178
8,810
AIDS deaths(b)
2,790
701
753
654
515
245
156
127
136
97
6,174

(a) Not adjusted for multiple reporting. Total includes 11 cases for which the date of HIV diagnosis was not reported.
(b) AIDS cases diagnosed and deaths following AIDS in 1999, 2000 and 2001 were adjusted for reporting delays; AIDS cases diagnosed and deaths following AIDS in previous years were assumed to be completely reported.

Source: National Centre in HIV Epidemiology and Clinical Research, 'HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2002', National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, NSW, 2002.


Transmission of HIV in Australia continues to be mainly through sexual contact between men (77.6%). A small percentage of diagnosed infections were associated with a history of injecting drug use (4.5%) or heterosexual contact only (10.6%) (table 9.25). Mother-to-child transmission of HIV infection remains rare in Australia.


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

Year of diagnosis

Units
Prior to 1993
1993
1994
1995
1996
1997
1998
1999
2000
2001
Total(b)

Total cases
no.
13,953
1,078
1,015
930
915
815
760
725
746
777
21,725
Males
%
93.6
92.5
90.7
91.8
91.6
89.4
87.0
89.5
89.0
87.5
92.3
State/territory
New South Wales
%
60.7
55.4
49.7
57.9
50.0
52.8
53.6
53.1
48.4
47.6
57.6
Victoria
%
20.4
20.6
21.3
17.6
20.4
22.1
18.4
19.2
25.2
26.5
20.7
Queensland
%
8.7
12.4
16.0
12.1
16.8
14.0
13.8
17.1
15.4
13.1
10.7
South Australia
%
3.4
5.1
3.7
3.3
5.0
4.2
4.6
3.0
3.1
5.4
3.7
Western Australia
%
4.7
4.7
7.3
6.3
6.1
4.6
6.6
5.4
6.2
5.8
5.1
Tasmania
%
0.4
0.2
0.2
0.6
0.3
-
0.4
0.4
-
0.3
0.4
Northern Territory
%
0.5
0.9
0.5
0.2
0.5
1.3
1.6
0.7
0.4
0.5
0.6
Australian Capital Territory
%
1.2
0.6
1.3
1.9
0.8
1.0
1.0
1.1
1.3
0.8
1.2
Exposure category(c)
Male homosexual contact
%
81.4
79.1
74.3
73.9
75.5
72.8
65.2
65.0
68.2
67.2
77.6
Male homosexual contact and injecting drug use
%
4.3
3.6
6.3
4.9
4.0
4.6
4.6
6.1
3.4
4.6
4.0
Injecting drug use(d)
%
4.8
3.5
3.4
4.6
2.8
3.1
3.4
5.8
4.4
5.5
4.5
Heterosexual contact
%
5.6
12.8
13.7
15.3
16.6
18.4
25.6
22.2
23.6
22.1
10.6
Haemophilia/coagulation disorder
%
2.6
-
-
0.1
-
-
0.1
0.5
-
0.1
1.6
Receipt of blood/tissue
%
1.9
0.3
0.8
0.3
0.2
0.1
0.6
0.3
-
-
1.3
Mother with/at risk of HIV infection
%
0.2
0.5
1.0
0.8
0.9
1.0
0.4
0.1
0.4
0.4
0.4
Health care setting
%
-
0.2
0.3
0.1
-
-
-
-
-
-
-
Other/undetermined
%
22.1
9.3
5.2
7.9
9.8
9.4
8.6
9.8
8.2
10.8
17.3

(a) Not adjusted for multiple reporting.
(b) Total includes 11 cases for which the date of HIV diagnosis was not reported.
(c) The ‘Other/undetermined’ category was excluded from the calculation of the percentage of cases attributed to each HIV exposure category.
(d) 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 2002', National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, NSW, 2002.


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 Commonwealth 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 March 2002, 90.5% of one year olds and 87.8% of two year olds were fully immunised according to the NHMRC Recommended Immunisation Schedule. State summaries by age group based on ACIR data are published quarterly in Communicable Diseases Intelligence bulletin.

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