Dengue fever: is it endemic in Australia?

It is instructive to look at our early colonial history for insights as to what factors may be involved with the re-emergence of diseases once considered endemic in Australia. Malaria, for example, was responsible for large epidemics in the Northern Territory and the Gulf of Carpentaria, and was the reason for the desertion of the town of Port Essington, north of Darwin, in 1849.1 The north Queensland coast was considered endemic for malaria with a large epidemic in 1942 leading to the establishment of a malaria research unit in Cairns under the guidance of Colonel Neil Hamilton Fairley. The combination of effective malaria control in the allied forces combined with civilian mosquito control measures led to the disappearance of malaria soon after World War II, although sporadic epidemics, linked to introduced cases, have occurred since

Cloning and expression of the exposed portion of the envelop protein of the four dengue virus serotypes

[Extract] Dengue fever is a growing public health concern affecting millions of people during annual epidemics in endemic areas. The symptoms of the disease include acute biphasic fever, rash and general malaise. However, sequential infection by different serotypes of the virus can sometimes result in dengue haemorrhagic fever or dengue shock syndrome, which can be fatal.\ud \ud In the absence of a cure for the disease, the control of dengue virus infection can only be achieved by effective public health measures. There is an urgent need for rapid, specific and easy-to-use dengue viral diagnosis tests in endemic areas. The diagnosis of dengue virus infection relies upon either the detection of viraemia during the first 3-5 days of the illness or by the detection of antibody thereafter. The detection of dengue infection by ELISA is preferred in most clinical laboratories because they are easy to do and large numbers of specimens can be processed. Until recently there has been no commercial ELISA. Most laboratories use in-house tests based on published protocols (Kuno, Gomez and Gubler 1991, Bundo and Igarashi 1985). These tests have used viral antigen derived from cell culture. With a view towards development of serotype specific ELISA tests, we wish to report the cloning of E genes encoding the estramembraneous portions of D1 to D4 and their high level expression using the T7 expression system (Studier et al. 1990). We also report the production of soluble domain of E protein from Dengue 2 in insect cells using recombinant Baculovirus

"I was cut under the plantation palms": techniques and locations of penile cutting in Papua New guinea

Background: Papua New Guinea is a diverse country with a population of 6.8 million people speaking more than 800 languages. PNG has more than 90% of all reported cases of HIV in Oceania. There are a plethora of penile cutting styles, penile cutting techniques and penile cutting locations in Papua New Guinea. \ud \ud Methods: Structured questionnaires, interviews and focus group discussions were utilised to enquire about locations and techniques of male circumcision, penile cutting and/or penile modification. This occurred across four locations where people from across the country gather to study and/or work (two university campuses in large urban centres, a remote mountain gold mine and coastal oil palm plantation). The questionnaire included specific questions for men about where penile cutting occurred and what techniques were used to cut the foreskin. \ud \ud Results: 57% of the 864 male study participants reported having some form of penile cut. The majority have some form of longitudinal cut of the foreskin performed outside the medical system. Many men describe having their foreskin cut in or near a village by a male relative, friend or village expert and often linked to initiation ceremonies. Men who had attended boarding school or university reported having their foreskin cut while at school or university. Tools used include bamboo, razor blades, scalpel blades and large craft needles with strips of rubber tyre or fishing line. Many young men sourced scalpel blades, pain relief and antibiotic medication from medical clinics (either directly or via friends or relatives) and presented these to foreskin cutters. \ud \ud Conclusion: Any potential male circumcision for HIV Prevention programs in Papua New Guinea need to take into account the range of traditional and contemporary penile cutting practices

Stronger or tougher: reasons for penile cutting in Papua New Guinea

Background: Papua New Guinea is a diverse country with a population of 6.8 million people speaking more than 800 languages. PNG has more than 90% of all reported cases of HIV in Oceania. Following trials that showed male circumcision reduces the risk of heterosexual men acquiring HIV, MC is now recommended in comprehensive HIV prevention packages for populations with a heterosexual, generalised epidemic and where most men are not circumcised. The 'Acceptability and Feasibility of Male Circumcision for HIV Prevention in PNG' study documented reasons for penile cutting in four locations across PNG.\ud \ud Methods: Both men and women completed structured questionnaires about penile cutting. Sites were two university campuses in large urban centres, a remote mountain gold mine and coastal oil palm plantation. These are locations where people from across the country gather for work or study. The questionnaire included specific questions on the reasons for penile cutting.\ud \ud Results: 864 males and 560 females completed questionnaires. 57% of males reported some form of penile cutting. Reasons reported by men were both historical and contemporary: being a part of custom/tradition; cleanliness; peer influence; to increase the size of the penis; avoid STI; increase sexual pleasure; prolong sexual intercourse; perceived increase in female sexual pleasure.\ud \ud Conclusion: There was a diverse range of reasons for penile cutting reported in this study population. Any potential male circumcision for HIV prevention programs in Papua New Guinea need to take into account the wide range of traditional and contemporary penile cutting practices, and the reasons these cuts are being done

Male circumcision for HIV prevention in PNG: a summary of research evidence and recommendations for public health

In 2005, a clinical trial in South Africa found that circumcision of young men could reduce their risk of acquiring HIV (human immunodeficiency virus) infection by over 60%. In the following year, two more trials in Africa confirmed this finding, leading the World Health Organization to recommend male circumcision as a public health strategy for HIV prevention in high-incidence countries. In order to inform public health policy in Papua New Guinea (PNG), two major research projects were initiated with the goals of investigating the status of penile cutting practices and assessing understandings, acceptability, feasibility and cost-effectiveness of male circumcision for HIV prevention. In addition, behavioural surveillance surveys systematically asked questions on penile cutting practices and an ethnographic literature review informed historical perspectives of penile cutting in PNG. Key findings from these research activities were presented at a National Policy Forum on Male Circumcision for HIV Prevention held in Port Moresby in November 2011. The Forum made three key recommendations: (1) the formation of a joint National Department of Health/National AIDS Council Secretariat Policy Committee on male circumcision; (2) the establishment of an integrated harm reduction program; and (3) that future policy on wide-scale roll-out of male circumcision for HIV prevention in PNG be informed by a combination of data from (a) male circumcision intervention pilot programs and (b) research on the potential protective effect of other forms of penile cutting