Integrated Epidemiological Insights in the ACT: From Carbapenemase Producing Enterobacterales investigation, Influenza Like Illness Surveillance, COVID 19 Waves to Enhanced Gonococcal Data Evaluation

Abstract

This thesis was developed as a requirement for the Master of Philosophy in Applied Epidemiology (MAE) and presents four projects along with additional public health experiences undertaken during my placement from February 2023 to October 2024. I completed my placement in the Public Health Epidemiology Reporting and Data Science(PHERDS) section of the Preparedness Planning and Surveillance (PPS) branch. This branch of the Australian Capital Territory (ACT) Health Directorate monitors infectious diseases and implements public health actions. The first chapter describes my MAE experience and field placement activities I completed to meet the MAE competencies. The second chapter presents an evaluation of the gonococcal-enhanced case questionnaire. The third chapter details an outbreak investigation into the local transmission of Klebsiella pneumoniae exhibiting NDM-5 and OXA-48 carbapenemase genes at a tertiary hospital. The fourth chapter presents a validation of an influenza-like illness syndromic surveillance (FluTracking Australia for ACT) using ACT syndromic and laboratory-confirmed influenza notifications. The fifth chapter reports the descriptive epidemiology characteristics of the three COVID-19 waves due to pre-Delta, Delta, and Omicron variants in the ACT from 12 March 2020 to 31 December 2022, and Chapter six is a scoping review that reviewed the associated risk factors and clinical presentations of long COVID in Australia. The seventh chapter outlines the teaching experiences and lessons from the field. The thesis also describes other activities undertaken during this period, including a presentation at the 2024 Communicable Diseases and Immunisation Conference in Brisbane, contributions to the investigation into the Ralstonia Pickettii associated with contaminated saline, contact tracing of the farmworkers implicated in the highly pathogenic avian influenza (H5N1), peer-reviewed publications, and short courses completed