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Communicable Diseases Network Australia: National Arbovirus and Malaria Advisory Committee annual report 2004-05.

This report describes the epidemiology of mosquito-borne disease in Australia for the mosquito-borne disease season 1 July 2004 to 30 June 2005. Ross River virus (RRV) infections (45%), Barmah Forest virus (BFV) infections (30%) and malaria (19%) were the most common mosquito-borne diseases reported in 2004-05. The Northern Territory had the highest rate of RRV notifications and the peak notification rate (in February 2005) was 54 per cent less than the previous season. The Northern Territory also reported the highest BFV notification rate this season, peaking in April 2005, which was the second highest reported BFV notification rate since 1998. National RRV and BFV notification rates were highest in the 45-49 year age group. There were 799 notifications of malaria in 2004-05 of which none were reported as locally acquired. This was the third highest reporting season for malaria notifications since 1998. In contrast to previous years in which Plasmodium vivax was the predominant species, Plasmodium falciparum was reported as the infecting species in 57 per cent of the malaria notifications and Plasmodium vivax for 34 per cent of cases. Children in the 5-9 year age group had the highest number of cases compared to previous years in which the peak number of cases tended to be in young adult age groups. There were four cases of Kunjin virus (KUNV) and two cases of Murray Valley encephalitis virus (MVEV) reported in 2004-05. Sentinel chicken surveillance data for flaviviruses and sentinel pig surveillance data for Japanese encephalitis virus are reported. There were 188 notifications of dengue virus infection (DENV) in 2004-05, of which 46 per cent (n=86) were reported as having been acquired overseas. Dengue serotype 4 was the most frequently reported type, accounting for 32 per cent of cases (n=60).

Adolescent↗

Non-valvular atrial fibrillation and stroke prevention. National Blood Pressure Advisory Committee of the National Heart Foundation.

Atrial fibrillation (AF) affects 5% of people older than 65 years. Among patients with AF, the risk of stroke averages about 5% per year. The risk of stroke increases cumulatively with increasing age, previous transient ischaemic attack or stroke, hypertension, diabetes, impaired left ventricular function and a large left atrium. Management aims to identify and treat the underlying cause, control the ventricular rate, restore and maintain sinus rhythm, and minimise the risk of stroke. Warfarin reduces the risk of stroke by about two-thirds, and aspirin by about one-fifth. The risk of anticoagulant-associated haemorrhage increases with serious concomitant disease, and with poorly controlled hypertension and poorly controlled anticoagulation. All patients with chronic AF should be considered for oral anticoagulant therapy, and the decision based on the balance between the risks of thromboembolism and bleeding. The recommended INR (international normalised ratio) is 2.0-3.0. Treating 1,000 "average" AF patients (ie, those with a 5% per year risk of stroke) with warfarin prevents about 30 strokes and causes at least two episodes of major haemorrhage each year. Treating 1,000

Anticoagulants↗

Mumps vaccine. Recommendation of the Public Health Service Advisory Committee on Immunization Practices. Center for Disease Control, U.S. Department of Health, Education, and Welfare; Atlanta, Georgia.

This statement from the Center for Disease Control very briefly summarizes the characteristics of mumps, and then describes live-mumps-virus vaccine, including adverse effects and immunity response. The use of the vaccine is reviewed, for dosage, in relation to age, and precautions and contraindications. Five bibliographic references are appended.

Centers for Disease Control and Prevention, U.S.↗