ARDC Research Link Australia

ORCID Profile
Orcid icon. 0000-0001-7234-509X

Current Organisations
University of Technology Sydney , Universidade Federal de Goiás , University of Sydney , Escola Nacional de Administração Pública , NSW Ministry of Health , National Centre for Immunisation Research and Surveillance

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Publications

Publication

Acute Flaccid Paralysis in Australian Children from 2007 to 2017

Publisher: S. Karger AG

Date: 07-12-2022

DOI: 10.1159/000528293

Abstract: b i Introduction: /i /b Acute flaccid paralysis (AFP) surveillance continues globally as part of the World Health Organization’s goal to eradicate poliomyelitis. The Australian Paediatric Surveillance Unit (APSU), Paediatric Active Enhanced Disease Surveillance (PAEDS) network, and National Enterovirus Reference Laboratory (NERL) collaborate in AFP surveillance in Australia, capturing and reviewing cases of AFP for all aetiologies in order to exclude poliovirus. We aimed to describe the AFP epidemiology in childhood over an 11 year period. b i Methods: /i /b Data were reported nationally by paediatricians via prospective APSU surveillance, PAEDS surveillance nurses at five tertiary paediatric hospitals and NERL from 2007 to 2017. Children aged 0–15 years with AFP were included. We combined APSU, PAEDS, and NERL datasets, analysed epidemiological trends, and described clinical features and investigations for major diagnoses. b i Results: /i /b Of 590 AFP-compatible cases, 49% were male 47% were aged 0–4 years, 9% aged & #x3c year. Annual incidence of AFP was 1.3 cases per 100,000 children aged & #x3c years. Lower limb paralysis was the most frequent presenting symptom. The most frequent diagnoses were Guillain-Barre syndrome (GBS 36%), transverse myelitis (TM 17%), and acute disseminated encephalomyelitis (ADEM 15%). No secular trend was seen in frequency of AFP cases nor amongst major diagnoses. Seasonality was observed with ADEM occurring more frequently in winter. We observed periods of increased AFP frequency in 2013 and 2016, coinciding with increased reporting of non-polio anterior horn cell disease (AHCD) and detection of non-polio enterovirus (NPEV). b i Conclusions: /i /b Estimated incidence of GBS, ADEM, and TM in Australian children was comparable with international rates. There was stable incidence of AFP in Australian children between 2007 and 2017. GBS, ADEM, and TM are the major causes of AFP. We observed clustering of cases associated with NPEV that emphasises a need for ongoing vigilance in surveillance given continue emerging infectious disease threats.

Publication

Risk factors and disease severity in Australian infants aged under 6 months hospitalised with influenza 2011–2019

Publisher: Wiley

Date: 20-12-2022

DOI: 10.1111/JPC.15857

Abstract: Infants aged months are vulnerable to severe influenza disease and no vaccine is approved for use in this age group. We aimed to describe the epidemiology, risk factors associated with severe outcomes and management of influenza in Australian infants aged months. Incident cases aged months of laboratory‐confirmed influenza were captured through two national active prospective sentinel hospital‐based surveillance systems in Australia from 2011 to 2019, inclusive. Demographic and clinical features, disease risk factors and outcomes (intensive care unit (ICU) admission and length of stay) and oseltamivir use were analysed. The proportion of infant influenza hospitalisations and nosocomial cases among all hospitalisations were also reported. Of 680 hospitalised infants aged months, 57.9% were male and 14.5% were Indigenous Australian. Median age was 2.6 months, 19.2% were born premature and 19.0% had a comorbidity, excluding prematurity. Overall, 77.9% had influenza A. Nosocomial cases accounted for 7.8%. ICU admission occurred in 14.7% and oseltamivir was prescribed for 18.8%. Factors associated with ICU admission included age month (adjusted odds ratio (aOR) 3.95, 95% confidence interval (CI): 1.47–10.60), comorbidity (aOR 7.69, 95% CI: 4.04–14.64) and prematurity (aOR 2.60, 95% CI: 1.40–4.81). The proportion of infants with influenza among all infant hospitalisations ranged 1.0–2.6% in the 2019 influenza season. Infants aged months, and particularly neonates, experience serious disease from influenza. This data underpins the need for preventative strategies such as maternal immunisation and continued investigation into the possibility of safe and efficacious vaccination prior to 6 months of age.

Publication

Preventing severe influenza in Australian infants: Maternal influenza vaccine effectiveness in the PAEDS-FluCAN networks using the test-negative design

Publisher: Elsevier BV

Date: 04-2022

DOI: 10.1016/J.VACCINE.2022.03.042

Publication

Influenza and pertussis vaccine coverage in pregnancy in Australia, 2016–2021

Publisher: Wiley

Date: 29-05-2023

DOI: 10.5694/MJA2.51989

Abstract: Vaccination in pregnancy is the best strategy to reduce complications from influenza or pertussis infection in infants who are too young to be protected directly from vaccination. Pregnant women are also at risk of influenza complications preventable through antenatal vaccination. Both vaccines are funded under the National Immunisation Program for pregnant women in Australia, but coverage is not routinely reported nationally. We reviewed all reported Australian maternal influenza and pertussis vaccine coverage data for the period 2016–2021, to identify gaps and information needs. Maternal influenza vaccine coverage was suboptimal at 58% for 2016–2018, with higher coverage of 62–75% reported in two states (Victoria and Western Australia) for 2019–2021. Maternal pertussis vaccine coverage from 2016 was generally higher than for influenza at 70%, with the highest jurisdictional coverage of 89% reported in Western Australia in 2020. Vaccination rates were often suboptimal among First Nations pregnant women and up to 20% lower than among non‐First Nations Australian women while data were limited, coverage was low among culturally and linguistically erse women and among women of lower socio‐economic status. Jurisdictional perinatal data collections were the best source of information on antenatal vaccine coverage but were only available for a minority of the population a nationally consistent systematic approach is lacking. Timely and comprehensive data are needed to provide feedback to improve maternal vaccination coverage, particularly among groups with higher risk and/or low uptake, and as new vaccines are recommended, including COVID‐19 vaccination.

Publication