Transmission of Influenza on International Flights, May 2009

Understanding the dynamics of influenza transmission on international flights is necessary for prioritizing public health response to pandemic incursions. A retrospective cohort study to ascertain in-flight transmission of pandemic (H1N1) 2009 and influenza-like illness (ILI) was undertaken for 2 long-haul flights entering Australia during May 2009. Combined results, including survey responses from 319 (43%) of 738 passengers, showed that 13 (2%) had an ILI in flight and an ILI developed in 32 (5%) passengers during the first week post arrival. Passengers were at 3.6% increased risk of contracting pandemic (H1N1) 2009 if they sat in the same row as or within 2 rows of persons who were symptomatic preflight. A closer exposed zone (2 seats in front, 2 seats behind, and 2 seats either side) increased the risk for postflight disease to 7.7%. Efficiency of contact tracing without compromising the effectiveness of the public health intervention might be improved by limiting the exposed zone

Integrating General Practice into the Australian COVID-19 response: A description of the GP Respiratory Clinic program in Australia

Integrating primary care within the health response is key to managing pandemics and other health emergencies. In recognition of this role the Australian Government established a network of General Practitioner (GP) led respiratory clinics (GPRCs) in response to the COVID-19 pandemic, as part of a suite of broader measures aimed at sustaining community access to primary care. GPRCs provide holistic face to face assessment and treatment to those with respiratory symptoms in an environment with strict protocols for infection prevention and control; ensuring that this patient cohort is able to access high quality primary care whilst protecting the General Practice workforce and other patients. The GPRC model was rapidly developed and operationalised with the first 2 GPRCs opening on March 21, 10 days after the policy was announced. Subsequently a total of 150 GPRCs have opened with broad geographic coverage that have serviced over 800,000 individuals living in more than 99% of Australia's postcodes. Through use of a standardised data collection tool GPRCs also provide the largest and most complete source of primary care surveillance data of respiratory illness in Australia. The success of the GPRC model has been possible through strong partnerships with Primary Health Networks and individual general practices who rapidly shifted operations to embrace this new approach. The GPRC network offers ongoing infrastructure and workforce capability to manage other health emergencies, and may be able to be adapted to other settings.http://deepblue.lib.umich.edu/bitstream/2027.42/166482/1/AFM_105-20_PP.pdfDescription of AFM_105-20_PP.pdf : Main ArticleSEL

Evaluating the potential for opportunistic vaccination in a Northern Territory hospital

Objective: To evaluate the potential for opportunistic vaccination and a simple intervention aimed at improving vaccination coverage for children in hospital. Methods: Hospital records were reviewed for children under 7 years, discharged from paediatric wards (PW) and the emergency department (ED) for 4 weeks before and after an intervention (423 and 446 children, respectively). This comprised the education of staff and the introduction of prompts to record vaccination status. Results: Documentation of vaccination status increased in the PW (63-90%) and the ED (24-46%), as did the adequacy of detail recorded (51-77% and 8-36%, respectively). Opportunistic vaccination increased from zero of 84 opportunities during the first audit to six of 139 following the intervention. All but one vaccine was given in the PW. Opportunistic vaccination improved when documentation identified a need for vaccination (P = 0.02). Conclusion: There were numerous missed opportunities to vaccinate children in hospital, especially in the ED. Simple prompts improved documentation of vaccination status and the detail of information recorded. Despite improved documentation, opportunistic vaccination failed to improve in the ED. Improving documentation of vaccination status is not sufficient in itself to improve opportunistic vaccination

Border screening for SARS in Australia: what has been learnt?

Objective: To assess the effectiveness of the Australian border entry screening program to detect arriving travellers with symptoms of severe acute respiratory syndrome (SARS). Design and setting: Descriptive study of outcomes of screening at Australian airports and seaports between 5 April 2003 and 16 June 2003. To determine the number of international travellers who were symptomatic on arrival in Australia but missed by screening, data were obtained on the number of arrivals screened and the number with symptoms (from the Australian Quarantine and Inspection Service [AQIS]), as well as the number of people investigated for SARS (from the Australian SARS Case Register). Results: There were 1.84 million arrivals into Australia during the study period, and 794 were referred for screening to AQIS staff. Of these, the findings in four travellers were consistent with the World Health Organization case definition for SARS, and they were referred by the Chief Quarantine Officers to designated hospitals for further investigation. None of these people was confirmed to have SARS. One person reported as a probable SARS case acknowledged being symptomatic on arrival, but had been missed by border screening. Conclusions: The low identification rate was attributed to the low prevalence of SARS, the use of exit screening by affected countries, and the subjective measures used in the screening process. With current knowledge about SARS, border screening should focus on educating incoming travellers, especially groups at high risk of transmitting the disease (the elderly and those with underlying chronic illnesses). Objective screening measures should be used during SARS outbreaks to prevent importation of the disease