ORCID Profile
0000-0002-5725-0102
Current Organisations
Alfred Health
,
Monash University
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Publisher: Springer Singapore
Date: 2021
Publisher: Oxford University Press (OUP)
Date: 16-03-2020
DOI: 10.1093/OFID/OFAA090
Abstract: Tropical Australia has a high incidence of nocardiosis, with high rates of intrinsic antimicrobial resistance. Linezolid, the only antimicrobial to which all local Nocardia species are susceptible, has been recommended in empirical combination treatment regimens for moderate–severe Nocardia infections at Royal Darwin Hospital (RDH) since 2014. We report the safety and efficacy of linezolid use for nocardiosis in this setting. We identified cases through a retrospective review of all RDH Nocardia isolates from December 2014 to August 2018 and included 5 linezolid-treated cases from a previous cohort. Laboratory, demographic, and clinical data were included in the primary analysis of safety and treatment outcomes. Between 2014 and 2018, Nocardia was isolated from 35 in iduals 28 (80%) had clinically significant infection and 23 (82%) received treatment. All isolates were linezolid-susceptible. Safety and efficacy were assessed for 20 patients receiving linezolid-containing regimens and 8 receiving nonlinezolid regimens. Median linezolid induction therapy duration was 28 days. Common adverse effects in those receiving linezolid were thrombocytopenia (45%) and anemia (40%). Adverse events prompted discontinuation of trimethoprim-sulfamethoxazole more often than linezolid (40% vs 20%). Linezolid therapeutic drug monitoring was used in 1 patient, with successful dose reduction and outcome. There was no difference in 30-day survival between those treated with linezolid (90%) vs no linezolid (87%). One Nocardia-attributed death occurred during linezolid therapy. Linezolid is safe and efficacious in empirical treatment for moderate to severe nocardiosis in a monitored hospital setting, with 100% drug susceptibility and no difference in adverse events or outcomes compared with nonlinezolid regimens.
Publisher: Wiley
Date: 12-2014
DOI: 10.1111/IMJ.12598
Abstract: Mould species represent the pathogens most commonly associated with invasive fungal disease in patients with haematological malignancies and patients of haemopoietic stem cell transplants. Invasive mould infections in these patient populations, particularly in the setting of neutropenia, are associated with high morbidity and mortality, and significantly increase the complexity of management. While Aspergillus species remain the most prevalent cause of invasive mould infections, Scedosporium and Fusarium species and the Mucormycetes continue to place a significant burden on the immunocompromised host. Evidence also suggests that infections caused by rare and emerging pathogens are increasing within the setting of broad-spectrum antifungal prophylaxis and improved survival times placing immunosuppressed patients at risk for longer. These guidelines present evidence-based recommendations for the antifungal management of common, rare and emerging mould infections in both adult and paediatric populations. Where relevant, the role of surgery, adjunctive therapy and immunotherapy is also discussed.
Publisher: MDPI AG
Date: 11-05-2018
Publisher: Oxford University Press (OUP)
Date: 03-2023
DOI: 10.1093/JTM/TAAD029
Abstract: The recent emergence of Japanese encephalitis in south-eastern Australia highlights the changing epidemiology of this important disease and the need for integrated surveillance to inform risk-based discussions and vaccination advice for travellers and endemic populations.
Publisher: MDPI AG
Date: 11-06-2018
DOI: 10.3390/V10060319
Publisher: Springer Science and Business Media LLC
Date: 14-01-2014
Publisher: Oxford University Press (OUP)
Date: 2016
DOI: 10.1093/OFID/OFW208
Abstract: Nocardia is an opportunistic pathogen that can cause life-threatening disease. We aimed to characterize the epidemiological, microbiological, and clinical features of nocardiosis in the tropical north of Australia. We conducted a retrospective cohort study of nocardiosis diagnosed between 1997 and 2014. Population-based incidences were calculated using district population data. Clinically significant nocardiosis was identified in 61 patients. The unadjusted population-based annual incidence of nocardiosis was 2.02 (95% confidence interval [CI], 1.55–2.60) per 100000 people and was 1.7 (95% CI, .96–2.90) fold higher in Indigenous compared with non-Indigenous persons (P = .027). Of 61 patients, 47 (77%) had chronic lung disease, diabetes, and/or hazardous alcohol consumption 22 (36%) were immunocompromised and 8 (13%) had no identified comorbidities. Disease presentations included pulmonary (69% 42 of 61), cutaneous (13% 8 of 61), and disseminated nocardiosis (15% 9 of 61). The most commonly identified species were Nocardia asteroides and Nocardia cyriacigeorgica (each 11%). Linezolid was the only antimicrobial to which isolates were universally susceptible 89% (48 of 54), 60% (32 of 53), and 48% (26 of 54) of isolates were susceptible to trimethoprim-sulfamethoxazole, ceftriaxone, and imipenem, respectively. Eighteen patients (30%) required intensive care unit (ICU) admission, and 1-year mortality was 31%. The incidence of nocardiosis in tropical Australia is amongst the highest reported globally. Nocardiosis occurs in both immunocompromised and immunocompetent hosts, and it is associated with high rates of ICU admission, 1-year mortality, and resistance to commonly recommended antimicrobials. Diagnosis should be considered in patients with consistent clinical features, particularly if they are Indigenous or have chronic lung disease.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2005
DOI: 10.1097/01.MAO.0000185063.20081.50
Abstract: To determine if exogenous neurotrophins can prevent spiral ganglion neuron degeneration in the rat cochlea. The loss of hair cells resulting in sensorineural hearing loss also leads to the secondary degeneration of spiral ganglion neurons. The effectiveness of cochlear implantation in patients with profound sensorineural hearing loss relies in part on the survival of spiral ganglion neurons therefore, any therapy that can prevent or halt the loss of these neurons would be of potential clinical benefit. Previous research has shown that intracochlear infusion with neurotrophins can provide trophic support to SGNs in deafened guinea pigs. Whether this effect is seen in other species remains to be determined. After documenting the rate of spiral ganglion neuron degeneration after ototoxic deafening, we investigated the trophic effects of exogenous brain-derived neurotrophic factor (BDNF) on rat spiral ganglion neurons. The left cochleae of profoundly deafened rats were implanted with a drug delivery system connected to a mini-osmotic pump. BDNF or artificial perilymph was infused for 28 days then the cochleae were prepared for histological study. Treatment with BDNF led to a statistically significant increase in spiral ganglion neuron density and a highly significant increase in spiral ganglion neuron soma area compared with artificial perilymph-treated and untreated deafened cochleae. The study has demonstrated the trophic advantage of exogenous BDNF in the mature rat cochlea and provides confidence that spiral ganglion neuron rescue after sensorineural hearing loss with exogenous BDNF may have clinical application.
Publisher: Wiley
Date: 15-05-2015
Publisher: Wiley
Date: 24-03-2022
DOI: 10.1111/IMJ.14991
Abstract: Guidelines recommend screening for strongyloidiasis prior to immunosuppression in those at epidemiological risk, as hyperinfection following immunosuppression is often fatal. The uptake of this recommendation is unknown and we aimed to explore this in our setting. To determine the proportion of adult patients at epidemiological risk for strongyloidiasis who were screened prior to immunosuppression at the Royal Melbourne Hospital, and to explore the factors that influenced clinicians' decision to screen for strongyloidiasis prior to immunosuppression. This study used a mixed‐methods approach. First, a 12‐month (1 January 2018 to 1 January 2019) retrospective observational study was used to quantify the proportion of those at epidemiological risk who were screened prior to immunosuppression, while also identifying variables that were positively or negatively associated with screening. Second, clinicians from relevant specialties were recruited for focus group sessions to explore factors that influenced their decision to screen according to an interpretivist framework. A total of 230 newly immunosuppressed patients at epidemiological risk of strongyloidiasis were identified, of whom 87 (37.8%) were screened prior to immunosuppression. In multivariate analysis, older patients, outpatients and people from non‐English‐speaking backgrounds were significantly less likely to be screened. In focus groups, several barriers and enablers to screening were identified. Notably, clinicians reported that a major barrier was the cognitive load required to clinically reason about this uncommon disease, in addition to other priorities. We identified many missed opportunities to screen patients at risk of hyperinfection, particularly those most vulnerable. To improve screening, this study highlights the importance of reducing cognitive load by using decision‐support tools, which may facilitate screening in vulnerable patients and in time‐constrained settings.
Publisher: BMJ
Date: 03-2017
Publisher: American Society for Microbiology
Date: 24-02-2021
Abstract: Staphylococcus aureus is an important human pathogen that causes a wide range of clinical infections. In the past 2 decades, an epidemic of community-associated skin and soft tissue infections has been driven by S. aureus strains with specific virulence factors and resistance to beta-lactam antibiotics.
Publisher: Elsevier BV
Date: 05-2015
DOI: 10.1016/J.IJID.2015.03.006
Abstract: Extended-spectrum beta-lactamase-expressing Gram-negative bacilli (ESBL-GNB) now commonly cause community-acquired infections, including urinary tract infections (UTI), and represent a challenge for practitioners in choosing empirical antibiotics. The aim of this study was to describe the epidemiology and clinical characteristics of UTIs/bacteriuria due to ESBL-GNB in Australia. At a single-site tertiary referral hospital, 100 cases with UTIs/bacteriuria due to ESBL-GNB were matched to 100 cases where UTIs/bacteriuria were caused by organisms matching the ESBL bacterial species that had routine susceptibility to antibiotics. Potential risk factors for ESBL-GNB UTI/bacteriuria and differences in clinical outcomes were identified. Length of admission prior to positive s le (odds ratio (OR) 1.3, p = 0.03, per week), exposure to antibiotics (OR 5.7, p < 0.001), return from overseas travel (OR 6.5, p = 0.002), and nursing home residency (OR 4.2, p = 0.03) were identified as risk factors associated with ESBL-GNB UTI/bacteriuria in the multivariate analysis. In addition, ESBL-GNB-infected cases subsequently had a longer inpatient stay (median 6 vs. 2 days, p = 0.002) and were admitted to the intensive care unit more frequently (28/100 vs. 8/100, p < 0.001). Our results emphasize the need for culture of a mid-stream urine specimen prior to commencing antibacterials, especially in patients with the risk factors identified herein associated with ESBL-GNB UTI/bacteriuria.
Publisher: Oxford University Press (OUP)
Date: 06-03-2017
DOI: 10.1093/JTM/TAX011
Abstract: Vaccination is a safe and effective public health intervention that not only protects in idual travellers from vaccine-preventable diseases (VPDs), but prevents them from becoming a source of disease in their destination and on their return. Obtaining an accurate vaccination history from travellers during a pre-travel review can be difficult serology may be used to identify patients who are non-immune to specific diseases in order to guide vaccination requirements. Clinically relevant data about the usefulness of serology in this setting are lacking. We performed a retrospective audit of pre-travel VPD serology requested by practitioners of a busy community-based travel clinic. All serological results for measles, mumps, rubella, varicella zoster virus, hepatitis A and B requested over a 5-year period were extracted and analysed. Results were stratified by gender and year of birth and compared using Stata. Four thousand four hundred and fifty-one serological assays from 1445 in idual were assessed. Overall, 47% of patients tested had at least one negative serological result. High rates of seropositivity for measles, mumps and rubella were seen in those born prior to 1966 but >10% of travellers born after 1966 lacked serological evidence of protection against these diseases. Hepatitis A and B serological results revealed broadly lower rates of immunity in our community likely reflecting the absence of these vaccines from historical vaccine protocols. Serology can be a useful tool in the identification of non-immune travellers to enable targeted vaccination prior to travel. We recommend that travel health clinicians assess patients' vaccination and infection histories, and strongly consider serology or vaccination where there is doubt about immunity. This will help protect the traveller and prevent importation of disease into destination or home communities.
Publisher: Oxford University Press (OUP)
Date: 30-03-2017
DOI: 10.1093/JTM/TAX012
Publisher: Wiley
Date: 2015
DOI: 10.1111/IMJ.12638
Abstract: Leprosy remains an important global health concern, but little has been published about its diagnosis and management in developed settings. It has been postulated that delay in diagnosis is common in developed settings. We reviewed all the cases of leprosy seen at a major tertiary referral centre between 1999 and 2013 and demonstrated that delay in diagnosis is common, especially when patients present with symptoms of leprosy reactions rather than classical symptoms, such as hypo-pigmented hypo-aesthetic skin lesions and neuropathy.
Publisher: AMPCo
Date: 04-2017
DOI: 10.5694/MJA16.01056
Abstract: To describe the epidemiology, clinical and laboratory features and outcomes of dengue in returned Australian travellers, applying the revised WHO dengue classification (2009) to this population. Retrospective case series analysis of confirmed dengue cases hospitalised at one of four Australian tertiary hospitals, January 2012 - May 2015. Clinical features, laboratory findings and outcomes of patients with dengue dengue classification according to 2009 WHO guidelines. 208 hospitalised patients (median age, 32 years range, 4-76 years) were included in the study. Dengue was most frequently acquired in Indonesia (94 patients, 45%) and Thailand (40, 19%). The most common clinical features were fever (98% of patients) and headache (76%). 84 patients (40%) met the WHO criteria for dengue with warning signs, and one the criteria for severe dengue the most common warning signs were mucosal bleeding (44 patients, 21%) and abdominal pain (43, 21%). Leukopenia (176 patients, 85%), thrombocytopenia (133, 64%), and elevated liver enzyme levels (154, 76%) were the most common laboratory findings. 46 patients (22%) had serological evidence of previous exposure to dengue virus. WHO guidelines were documented as a management benchmark in ten cases (5%) 46 patients (22%) received non-steroidal anti-inflammatory drugs (NSAIDs). A significant proportion of returning Australian travellers hospitalised for dengue have unrecognised warning signs of severe disease. Many received NSAIDs, which can increase the risk of haemorrhage in dengue. As travel to Asia from Australia continues to increase, it is vital for averting serious outcomes that clinicians can recognise and manage dengue.
Publisher: Wiley
Date: 10-07-2018
DOI: 10.1111/TMI.13080
Abstract: Acute respiratory infections (ARIs) disproportionately affect those living in low- and middle-income countries (LMICs). We aimed to determine whether hygiene interventions delivered in childcare, school or domestic settings in LMICs effectively prevent or reduce ARIs. We registered our systematic review with PROSPERO (CRD42017058239) and searched MEDLINE, EMBASE, CENTRAL, and Scopus from inception to 17 October 2017 for randomised controlled trials (RCTs) examining the impact of hygiene interventions on ARI morbidity in adults and children in community-based settings in LMICs. We stratified data into childcare, school and domestic settings and used the Grading of Recommendations Assessment, Development and Evaluation approach to assess evidence quality. We identified 14 cluster RCTs evaluating hand-hygiene interventions in LMICs with considerable heterogeneity in setting, size, intervention delivery and duration. We found reduced ARI-related absenteeism and illness in childcare settings (low- to moderate-quality evidence). In school settings, we found reduced ARI-related absenteeism and laboratory-confirmed influenza (moderate- to high-quality evidence), but no reduction in ARI illness (low-quality evidence). In domestic settings, we found reduced ARI illness and pneumonia amongst children in urban settlements (high-quality evidence) but not in rural settlements (low-quality evidence), and no effect on secondary transmission of influenza in households (moderate-quality evidence). Evidence suggests that hand-hygiene interventions delivered in childcare, school and domestic settings can reduce ARI morbidity, but effectiveness varies according to setting, intervention target and intervention compliance. Further studies are needed to develop, deliver and evaluate targeted and sustainable hygiene interventions in LMICs.
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.TMAID.2018.12.006
Abstract: Travellers who engage in sexual contact with a new sexual partner abroad may be at high risk of HIV and other sexually transmitted infections (STIs), but these risks can be reduced through appropriate planning during the pre-travel clinic visit. Here we discuss strategies available to the clinician to maximise travellers' sexual safety during travel. Strategies may include immunizations, condoms, HIV pre-exposure prophylaxis (PrEP), HIV post-exposure prophylaxis (PEP), self-initiated treatment of symptomatic bacterial STIs, post-exposure prophylaxis for bacterial STIs and hormonal contraception. We discuss the role of these different strategies for travellers, and provide resources to assist clinicians in making clinical decisions and in educating travellers about sexual safety.
Publisher: Wiley
Date: 09-04-2023
DOI: 10.5694/MJA2.51918
Abstract: To assess the mental health and wellbeing of health and aged care workers in Australia during the second and third years of the coronavirus disease 2019 (COVID‐19) pandemic, overall and by occupation group. Longitudinal cohort study of health and aged care workers (ambulance, hospitals, primary care, residential aged care) in Victoria: May–July 2021 (survey 1), October–December 2021 (survey 2), and May–June 2022 (survey 3). Proportions of respondents (adjusted for age, gender, socio‐economic status) reporting moderate to severe symptoms of depression (Patient Health Questionnaire‐9, PHQ‐9), anxiety (Generalized Anxiety Disorder scale, GAD‐7), or post‐traumatic stress (Impact of Event Scale‐6, IES‐6), burnout (abbreviated Maslach Burnout Inventory, aMBI), or high optimism (10‐point visual analogue scale) mean scores (adjusted for age, gender, socio‐economic status) for wellbeing (Personal Wellbeing Index–Adult, PWI‐A) and resilience (Connor Davidson Resilience Scale 2, CD‐RISC‐2). A total of 1667 people responded to at least one survey (survey 1, 989 survey 2, 1153 survey 3, 993 response rate, 3.3%). Overall, 1211 survey responses were from women (72.6%) most respondents were hospital workers (1289, 77.3%) or ambulance staff (315, 18.9%). The adjusted proportions of respondents who reported moderate to severe symptoms of depression (survey 1, 16.4% survey 2, 22.6% survey 3, 19.2%), anxiety (survey 1, 8.8% survey 2, 16.0% survey 3, 11.0%), or post‐traumatic stress (survey 1, 14.6% survey 2, 35.1% survey 3, 14.9%) were each largest for survey 2. The adjusted proportions of participants who reported moderate to severe symptoms of burnout were higher in surveys 2 and 3 than in survey 1, and the proportions who reported high optimism were smaller in surveys 2 and 3 than in survey 1. Adjusted mean scores for wellbeing and resilience were similar at surveys 2 and 3 and lower than at survey 1. The magnitude but not the patterns of change differed by occupation group. Burnout was more frequently reported and mean wellbeing and resilience scores were lower in mid‐2022 than in mid‐2021 for Victorian health and aged care workers who participated in our study. Evidence‐based mental health and wellbeing programs for workers in health care organisations are needed. Australian New Zealand Clinical Trials Registry: ACTRN12621000533897 (observational study retrospective).
Publisher: American Society of Tropical Medicine and Hygiene
Date: 05-03-2020
Publisher: Wiley
Date: 2019
DOI: 10.1111/IMJ.13993
Abstract: Bali, Indonesia, presents significant infectious and non-infectious health risks for Australian travellers. Understanding this spectrum of illnesses has the potential to assist clinicians in evaluating unwell returning travellers and guide provision of pre-travel advice. To describe the spectrum of illnesses seen in returned travellers from Bali. Using a novel text mining approach, we performed a retrospective, observational study of all adult emergency department presentations to a metropolitan health service in Melbourne, from 2011 to 2015. Outcome measures included demographic, clinical and laboratory features of travel-related illnesses. A total of 464 patients met inclusion criteria. Gastroenteritis (119/464, 26%), systemic febrile illness (88/464, 19%) and respiratory tract infection (51/464, 11%) were the most common diagnoses. Dengue was the most common laboratory-confirmed diagnosis (25/464, 5%). No cases of malaria were identified. Common non-infectious presentations included traumatic injury (47/464, 10%) and animal bites requiring rabies post-exposure prophylaxis (29/464, 6%). A total of 110 patients (24%) was admitted to the hospital those presenting with systemic febrile illness were more likely to be admitted compared to those presenting with other illnesses (odds ratio 3.42, 95% confidence interval 2.02-5.75, P < 0.001). This is the first study to use a text mining approach to identify and describe emergency department presentations related to diseases acquired in Bali by Australian travellers. Although infections are important causes of illness, trauma and animal bites account for a significant number of hospital presentations. Our findings contribute to the knowledge on the health risks for travellers to Bali, and will assist clinicians in relevant pre- and post-travel evaluations.
Publisher: American Chemical Society (ACS)
Date: 13-03-2020
Publisher: Elsevier BV
Date: 10-2015
Publisher: American Society of Tropical Medicine and Hygiene
Date: 05-03-2020
Publisher: MDPI AG
Date: 19-04-2022
Abstract: Objective: the COVID-19 pandemic has incurred psychological risks for healthcare workers (HCWs). We established a Victorian HCW cohort (the Coronavirus in Victorian Healthcare and Aged-Care Workers (COVIC-HA) cohort study) to examine COVID-19 impacts on HCWs and assess organisational responses over time. Methods: mixed-methods cohort study, with baseline data collected via an online survey (7 May–18 July 2021) across four healthcare settings: ambulance, hospitals, primary care, and residential aged-care. Outcomes included self-reported symptoms of depression, anxiety, post-traumatic stress (PTS), wellbeing, burnout, and resilience, measured using validated tools. Work and home-related COVID-19 impacts and perceptions of workplace responses were also captured. Results: among 984 HCWs, symptoms of clinically significant depression, anxiety, and PTS were reported by 22.5%, 14.0%, and 20.4%, respectively, highest among paramedics and nurses. Emotional exhaustion reflecting moderate–severe burnout was reported by 65.1%. Concerns about contracting COVID-19 at work and transmitting COVID-19 were common, but 91.2% felt well-informed on workplace changes and 78.3% reported that support services were available. Conclusions: Australian HCWs employed during 2021 experienced adverse mental health outcomes, with prevalence differences observed according to occupation. Longitudinal evidence is needed to inform workplace strategies that support the physical and mental wellbeing of HCWs at organisational and state policy levels.
Publisher: Oxford University Press (OUP)
Date: 05-2015
DOI: 10.1111/JTM.12183
Abstract: An important role of pre-travel consultations is to improve travelers' understanding of travel-related diseases, but the efficacy of education provided is unknown. This study sought to assess recall and knowledge immediately following a pre-travel consultation. The study was conducted at a hospital-based pre-travel clinic in Melbourne, Australia. Travelers aged ≥16 years seen between September 2010 and March 2012 were invited to complete an anonymous self-administered questionnaire immediately following their consultation to assess knowledge of appropriate preventive measures and presumptive self-treatment strategies for common travel risks. The doctor of each participating traveler also completed a survey regarding issues discussed. A total of 300 participants were recruited (34% male, median age 31 years). Most were traveling for vacation (77%) and reported previous travel (95%). Main travel destinations were Asia (43%), Americas (21%), and Africa (17%). Doctors' and travelers' surveys showed variable levels of concordance: 94% of patients recalled discussion of malaria, 84% rabies, and 76% dengue. For malaria, 95% remembered discussions regarding insect repellents, and 92% recalled that medical advice should be sought if fever developed. For travelers with whom rabies was discussed, 94% recalled that medical advice must be urgently sought following a bite/scratch. For travelers' diarrhea (TD), 99% knew to drink only boiled/bottled water, but 13% did not recall avoiding unpeeled fruit/vegetables as a prevention strategy. There was 20% discordance between doctors and travelers regarding antibiotics for TD self-treatment, but only 4% discordance regarding prescription of malaria prophylaxis. Factors associated with improved recall were doctor discussion, previous travel, and a university education. Key travel health messages are well assimilated after pre-travel consultation. However, large amounts of information are discussed and immediate recollection of all information is not possible. This study reinforces the importance of providing supplementary information (eg, written and/or electronic resources) to accompany pre-travel consultations.
Publisher: MDPI AG
Date: 21-12-2018
DOI: 10.3390/W11010012
Abstract: Riverbank filtration (RBF) systems were installed in four rural villages along a 64 km stretch of the upper Krishna River in southern India with each one designed to supply approximately 2500 people. Site selection criteria included hydrogeological suitability, land availability and access, proximity to villages and their population sizes, and electric power supply. Water s les were collected from the river and the RBF wells over more than one year (November 2015 to December 2017) and were analyzed for Escherichia coli bacteria, major ions, and a range of other physicochemical and chemical parameters. The shallow groundwater at the study sites was also s led, but less frequently. The hydrogeology of the four RBF systems was described in terms of bore-log data, mixing of river and groundwater, pumping test data, and vertical water column profiling. E. coli removal percentages of .9% were observed immediately before and during the monsoon, when E. coli concentrations in the river were the highest. The results provide evidence that RBF installations are challenging but possible under the climate and hydrogeologic conditions prevailing in this part of southern India. Specifically, when installing RBF wells in the study, area one needs to balance the well depth and set-back distance from the river against the limited extent of alluvial deposits. The viability of RBF systems as a domestic water source is also influenced by other factors that are not limited to southern India, including surface water and groundwater salinity, agricultural practices surrounding RBF wells, and the reliability of the power grid.
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Publisher: AMPCo
Date: 07-2012
DOI: 10.5694/MJA12.10678
Publisher: Springer Science and Business Media LLC
Date: 06-2023
DOI: 10.1007/S11908-023-00804-W
Abstract: Recent changes in Japanese encephalitis (JE) distribution, including its emergence in mainland Australia, call for a review of the epidemiology, diagnosis, treatment and prevention of this important disease. Climate change, urbanisation and changes in vector ecology have driven changes in JE epidemiology including expansion to new areas. Residents of and travellers to endemic areas face potential exposure risks. Surveillance gaps and diagnostic challenges lead to under-appreciation of the true disease burden. Treatment is supportive, but modern vaccines are safe and efficacious. The recent emergence of JE in south-eastern Australia highlights its changing epidemiology and the threat this disease poses to other areas with largely naive human populations and with competent mosquito vectors and vertebrate hosts. Awareness of disease features and diagnostic approaches is critical to case detection in travellers and endemic populations, and preventive measures including vaccination should be advised for those with exposure risk.
No related grants have been discovered for Sarah McGuinness.