Can Skin Infection With Group A Streptococcus Cause Acute Rheumatic Fever?
Funder
National Health and Medical Research Council
Funding Amount
$459,450.00
Summary
It is traditionally taught that the cause of acute rheumatic fever (ARF) is always infection of the throat with the bacterium group A streptococcus (GAS). However, in Aboriginal communities of the Top End of the Northern Territory the incidence of ARF is the highest reported in the world, yet GAS is uncommonly isolated from the throat. There is further information to suggest that GAS skin sores may underlie many cases of ARF. If this were proven, it would completely alter the traditional view of ....It is traditionally taught that the cause of acute rheumatic fever (ARF) is always infection of the throat with the bacterium group A streptococcus (GAS). However, in Aboriginal communities of the Top End of the Northern Territory the incidence of ARF is the highest reported in the world, yet GAS is uncommonly isolated from the throat. There is further information to suggest that GAS skin sores may underlie many cases of ARF. If this were proven, it would completely alter the traditional view of the cause of ARF, and have important implications for prevention of ARF around the world. Presently, these approaches focus on diagnosing and treating sore throat, but no country has proven that such a program can be successful in substantially reducing new cases of ARF. If it was known that skin infection could lead to ARF, then countries (including Australia) could emphasise the importance of skin health programs. A further benefit of this knowledge would be to influence GAS vaccine development, which presently is largely focused on the prevention of sore throat. A different possibility has recently been raised - that the cause of ARF may not always be GAS, but instead that the related bacteria GCS and GGS may have the potential to cause this disease. Proof of this hypothesis would even more dramatically alter our understanding of disease causation, prevention, and vaccine development. We propose to determine the cause of ARF in Aboriginal communities by regularly swabbing families of people with a history of ARF, and using genetic fingerprinting of the bacteria from the skin and throat swabs. When cases of ARF occur, we will be able to determine the site and type of infection that precipitated the attack. We will conduct a related study in more communities, in which we will swab family members of people with ARF and of control families (without ARF) to determine the bacteria most commonly isolated from ARF families.Read moreRead less
Revealing the evolutionary and ecological dynamics of avian influenza virus. This project aims to understand how avian influenza virus (AIV) emerges, evolves and spreads in wild birds. AIV has the potential to devastate the poultry industry and cause human pandemics, but the factors that shape the genetic diversity of AIV in its wild bird reservoir are poorly understood. The project plans to combine genomic, ecological and phylogenetic approaches to reveal key aspects of AIV evolution, as well a ....Revealing the evolutionary and ecological dynamics of avian influenza virus. This project aims to understand how avian influenza virus (AIV) emerges, evolves and spreads in wild birds. AIV has the potential to devastate the poultry industry and cause human pandemics, but the factors that shape the genetic diversity of AIV in its wild bird reservoir are poorly understood. The project plans to combine genomic, ecological and phylogenetic approaches to reveal key aspects of AIV evolution, as well as the risk for future viral emergence. Using sampling sites in Australia and Antarctica, it plans to investigate AIV diversity, the evolutionary dynamics of AIV in wild birds and poultry, and the role played by environmental transmission in AIV ecology.Read moreRead less
Can and should we link data at a national level? Vaccine safety surveillance: A case study. This project provides many benefits for the community, exploring the legal and ethical issues around consent for data linkage, convening Citizens' Juries to weigh the evidence and make recommendations. It addresses National Research Priorities: Promoting and Maintaining Good Health and Safeguarding Australia as well as National Collaborative Research Infrastructure Strategy priorities. It uses vaccine sa ....Can and should we link data at a national level? Vaccine safety surveillance: A case study. This project provides many benefits for the community, exploring the legal and ethical issues around consent for data linkage, convening Citizens' Juries to weigh the evidence and make recommendations. It addresses National Research Priorities: Promoting and Maintaining Good Health and Safeguarding Australia as well as National Collaborative Research Infrastructure Strategy priorities. It uses vaccine safety surveillance as a case study to evaluate the effectiveness of data linkage (through linking Commonwealth immunisation data to state hospital data) and the methodologies and lessons learnt from cross jurisdictional data linkage can be transferred to other areas. Read moreRead less
Estimating The Burden Of Group A Streptococcal Diseases In Victoria
Funder
National Health and Medical Research Council
Funding Amount
$386,760.00
Summary
Despite the considerable advances in the diagnosis and treatment of group A streptococcal (GAS) diseases made during the last century, the impressive spectrum of infections caused by this organism continues to have a significant impact in developed countries. This spectrum includes diseases that are mild but common (e.g. sore throat, skin sores), rare but very severe (e.g. bloodstream infections, flesh-eating bacteria) and those that are more common in developing countries and the Aboriginal pop ....Despite the considerable advances in the diagnosis and treatment of group A streptococcal (GAS) diseases made during the last century, the impressive spectrum of infections caused by this organism continues to have a significant impact in developed countries. This spectrum includes diseases that are mild but common (e.g. sore throat, skin sores), rare but very severe (e.g. bloodstream infections, flesh-eating bacteria) and those that are more common in developing countries and the Aboriginal population (e.g. rheumatic fever, kidney disease). Streptococcal sore throat remains one of the most common childhood infections, and severe group A streptococcal diseases are thought to be increasing in incidence in Australia. Yet, there are no accurate data on the incidence and costs of these or other GAS diseases in non-Aboriginal Australians, or in most other populations around the world. It is becoming more urgent to collect this data as numerous vaccine candidates are entering human trials, new approaches to the treatment of sore throat are emerging, and new strategies to treat and control the spread of severe disease are being developed. We propose a comprehensive strategy to measure the incidence, prevalence and costs of each group of GAS diseases. We will follow a group of families for 12 months to detect cases of GAS sore throat and skin sores and measure the impact on the family. We will survey children in schools to estimate the prevalence of skin sores. We will check hospital records to calculate the number of cases of rheumatic fever and kidney disease. And we will maintain surveillance for severe diseases by checking hospital and laboratory records. We will also check to see if family members of people with severe disease have the GAS bacterium in their throats. We will then compile these data into a comprehensive estimate of the burden of disease in Victoria, and estimate the cost-effectiveness of different treatment and prevention strategies.Read moreRead less
Chemo-prevention of tropical canine parasitoses and vector-borne diseases. This project will determine the prevalence and diversity of established, emerging and novel canine vector-borne agents and endoparasites in a tropical setting by using conventional and next generation molecular diagnostic tools. It will fill an important gap by providing independently-verified evidence on how well canine anti-parasitic products marketed in Australia and Asia by Bayer Animal Health, perform in high-infecti ....Chemo-prevention of tropical canine parasitoses and vector-borne diseases. This project will determine the prevalence and diversity of established, emerging and novel canine vector-borne agents and endoparasites in a tropical setting by using conventional and next generation molecular diagnostic tools. It will fill an important gap by providing independently-verified evidence on how well canine anti-parasitic products marketed in Australia and Asia by Bayer Animal Health, perform in high-infection pressure settings, as a chemo-preventative for these disease agents. Tropical regions spanning northern Australia and Southern Asia are highly conducive to a plethora of canine vector-borne and parasitic pathogens that cause significant morbidity and mortality in dogs. Many of these agents also pose a risk to public health. The outcomes will be directly translated to best-practice guidelines for the advancement of companion animal (and indirectly human) health and welfare.Read moreRead less
Estimating per capita use and release of chemicals by wastewater analysis. This project aims to systematically collect and analyse wastewater to assess human exposure to chemicals including drugs, pharmaceuticals, lifestyle chemicals and environmental pollutants. By combining temporal sampling from key sewage treatment plants with comprehensive nationwide sampling over the week of the 2016 census day, the project expects to estimate the per-capita human exposure to chemicals in the Australian po ....Estimating per capita use and release of chemicals by wastewater analysis. This project aims to systematically collect and analyse wastewater to assess human exposure to chemicals including drugs, pharmaceuticals, lifestyle chemicals and environmental pollutants. By combining temporal sampling from key sewage treatment plants with comprehensive nationwide sampling over the week of the 2016 census day, the project expects to estimate the per-capita human exposure to chemicals in the Australian population. Accurate and objective per-capita based consumption and release estimates for a wide range of chemicals is intended to provide a baseline against which to measure changes in our chemosphere.Read moreRead less
Program evaluation of the osteoarthritis awareness hub. Persons with osteoarthritis generally have poor knowledge about their disease and its appropriate management. The aim of this project is to evaluate whether improved knowledge, and management decisions of persons with osteoarthritis, can ultimately lead to improved health outcomes.
A SENTINEL STUDY OF TRENDS IN CORONARY HEART DISEASE RISK FACTORS IN AUSTRALIA. This project will use data collected by the Sydney Adventist Hospital from the managerial workforce during the past 25 years to examine the relationships of food consumption, smoking and lifestyle habits to risk of heart disease, obesity and mature onset diabetes. The lifestyles of different groups of people will be compared and related to disease risk. The effectiveness of hospital based health promotion in reducing ....A SENTINEL STUDY OF TRENDS IN CORONARY HEART DISEASE RISK FACTORS IN AUSTRALIA. This project will use data collected by the Sydney Adventist Hospital from the managerial workforce during the past 25 years to examine the relationships of food consumption, smoking and lifestyle habits to risk of heart disease, obesity and mature onset diabetes. The lifestyles of different groups of people will be compared and related to disease risk. The effectiveness of hospital based health promotion in reducing these disease risk factors will be assessed. Likely outcomes include better understanding of the causes of heart disease, obesity and diabetes; more effective hospital based health promotion strategies, and new disease surveillance systemsRead moreRead less
Evaluation in health promotion: gathering evidence to improve effectiveness. Effective disease prevention and health promotion to address the public health challenges facing Australia requires a strong evidence base for policy and practice. Evaluation of programs in natural contexts is a vital source of this evidence, valuable for improving strategy design and delivery, building sustainability and guiding funding. The aim of this project is to determine the strengths and limitations of evaluatio ....Evaluation in health promotion: gathering evidence to improve effectiveness. Effective disease prevention and health promotion to address the public health challenges facing Australia requires a strong evidence base for policy and practice. Evaluation of programs in natural contexts is a vital source of this evidence, valuable for improving strategy design and delivery, building sustainability and guiding funding. The aim of this project is to determine the strengths and limitations of evaluation by health promotion agencies, and to identify the roles of individual, organisational and system-level factors in relation to evaluation practice and use. This knowledge is expected to guide efforts to build capacity for evaluation, improve systems for organisational learning, and enable evidence gathering to improve effectiveness.Read moreRead less
Molecular dissection of the functional regions of genes that encode actinins (ACTN2 and ACTN3) and their contribution to normal variation in skeletal muscle function. The project has discovered a common genetic variant that affects skeletal muscle structure, function and metabolism and influences athletic ability, and response to diet and exercise. The project will study how this gene influences muscle bulk and strength, the metabolic efficiency of muscle and the risk of obesity in the general ....Molecular dissection of the functional regions of genes that encode actinins (ACTN2 and ACTN3) and their contribution to normal variation in skeletal muscle function. The project has discovered a common genetic variant that affects skeletal muscle structure, function and metabolism and influences athletic ability, and response to diet and exercise. The project will study how this gene influences muscle bulk and strength, the metabolic efficiency of muscle and the risk of obesity in the general population.Read moreRead less