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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↗

Managing alcohol problems and risky drinking.

While overall alcohol consumption and alcohol-related automobile deaths have declined, rates of alcohol dependence, liver cirrhosis, and alcohol-related problems remain high among adults, and binge drinking continues as a major health risk for high school and college students. Some individual-level downstream interventions have been evaluated with sufficient rigor to recommend widespread dissemination, and widened availability of new pharmacotherapies could further increase effectiveness. Midstream population-based programs, such as screening and brief interventions in hospitals and managed care organizations, may have greater public health impact than tertiary treatment because of early identification and low cost. Upstream programs and policies that place limits on alcohol availability (e.g., higher legal purchasing age) have the greatest potential to reduce morbidity and mortality at the least cost to society.

Alcoholism↗

GP attendance by elderly Australians: evidence for unmet need in elderly men.

OBJECTIVES: To examine GP service use by elderly people and, in particular, to compare those who had not consulted a GP in one year with those who were low attenders and those who were high attenders. DESIGN: Medicare data on GP service use were matched to data collected by interview in 1990-1991 and reinterview in 1994 as part of a community study on health and well-being. SETTING: Canberra and Queanbeyan in the Australian Capital Territory. PARTICIPANTS: People aged 70 years and over, living in the community. MAIN OUTCOME MEASURES: The number of visits made to a GP in 12 months. RESULTS: Medicare data were available for 624 of the 897 participants interviewed (70%). While the women non-attenders reported similar levels of physical illness and symptoms to the low attenders, men non-attenders reported significantly higher levels of illness (P < 0.01) than the low-attender group. The health of men who were non-attenders was very similar to men who were high attenders of GP services. Men who had not seen a GP in one year reported significantly more pain (P = 0.002) and less social support than both low attenders and high attenders (P = 0.012 and P = 0.049, respectively). CONCLUSION: We identified a group of men who had not attended a GP in one year, despite significant levels of morbidity. Such a group may benefit from consultation with a GP and could be targeted in any attempt to improve elderly men's health.

Aged↗

The association between birthweight and current blood pressure: a cross-sectional study in an Australian Aboriginal community.

OBJECTIVES: To study the relationship of blood pressure to birthweight and current body mass index in a population with high rates of low birthweight (< 2.5 kg). DESIGN: A cross-sectional population screening program conducted between 1992 and 1998, with retrospective retrieval of birthweights. SETTING: A remote coastal Australian Aboriginal community with a high prevalence of diabetes, cardiovascular and renal disease. PARTICIPANTS: Eighty-two per cent of the community members (1473/1805) were screened. Birthweights were available for 767 (71%) of the screened participants aged 7-43 years. MAIN OUTCOME MEASURES: The association between birthweight and current blood pressure, accounting for current body mass index. RESULTS: Mean birthweights were low, and 18% of children and 35% of adults had been low-birthweight babies. In children (7-17 years), blood pressure was not correlated with birthweight, but in adults there was an inverse correlation - a 1 kg increase in birthweight was associated with a 2.9 mmHg (95% CI, 0.3-5.5 mmHg) decrease in systolic blood pressure, after adjusting for age, sex and current weight. Overweight adults with low birthweight had the highest blood pressures. CONCLUSIONS: Low birthweight is significantly associated with higher blood pressure in adult life, and the effect is amplified by higher current weight. Given the high rates of low birthweight in Aboriginal people in remote areas, and the detrimental effect of higher blood pressures on chronic diseases (currently present in epidemic proportions), interventions should focus on improving birthweights and on weight control in adolescents and adults. Special attention should be paid to children with low birthweight to avoid their becoming overweight in adult life.

Adolescent↗

[Public hygiene, microbiology and water management].

Over the last hundred and fifty years, hygienists and health-related water microbiologists have laid down rules of public hygiene and sanitary systems to protect the health of populations. This program has proven to be particularly effective against "fecal peril". But in developed countries waterborne infectious disease nevertheless still persists. This fact has led to much research on contamination due to waterborne micro-organisms. The emergence of the paradigm of risk assessment should allow microbiologists to focus their research effort on priority areas of prevention.

Communicable Disease Control↗

Long-term care in Canada.

Problems associated with long-term care in Canada include the growing number of elderly citizens, inconsistencies in social policy and legislative initiatives among provinces, effective quality assurance, and cost containment. Deinstitutionalization and independent living have shifted the focus to community participation.

Aged↗

New technology offers 'real time' picture of patients' status.

Health plans are seeing their patients "face to face" on a daily basis in this new age "virtual reality" population management program. Find out how several health plans are benefitting from a program that provides unique insight into their members' needs.

Community Health Planning↗

Guidelines for the practice of public health.

Guidelines based on the best science and expert opinion, widely disseminated to our state and local public health departments, private health care providers, and policy makers, will enhance our public health efforts. Communities will finally have information to guide them in developing population-based programs that have proven to be effective, both from the standpoints of health status and cost. The effort described in this article is to test the feasibility of public health practice guidelines.

Humans↗