Where has all the influenza gone? The impact of COVID-19 on the circulation of influenza and other respiratory viruses, Australia, March to September 2020.

The coronavirus disease pandemic was declared in March 2020, as the southern hemisphere's winter approached. Australia expected co-circulation of severe acute respiratory syndrome coronavirus 2, influenza and other seasonal respiratory viruses. However, influenza notifications were 7,029 (March-September) compared with an average 149,832 for the same period in 2015-2019 [corrected], despite substantial testing. Restrictions on movement within and into Australia may have temporarily eliminated influenza. Other respiratory pathogens also showed remarkably changed activity in 2020.

Intense interseasonal influenza outbreaks, Australia, 2018/19.

BackgroundInterseasonal influenza outbreaks are not unusual in countries with temperate climates and well-defined influenza seasons. Usually, these are small and diminish before the main influenza season begins. However, the 2018/19 summer-autumn interseasonal influenza period in Australia saw unprecedented large and widespread influenza outbreaks.AimOur objective was to determine the extent of the intense 2018/19 interseasonal influenza outbreaks in Australia epidemiologically and examine the genetic, antigenic and structural properties of the viruses responsible for these outbreaks.MethodsThis observational study combined the epidemiological and virological surveillance data obtained from the Australian Government Department of Health, the New South Wales Ministry of Health, sentinel outpatient surveillance, public health laboratories and data generated by the World Health Organization Collaborating Centre for Reference and Research on Influenza in Melbourne and the Singapore Agency for Science, Technology and Research.ResultsThere was a record number of laboratory-confirmed influenza cases during the interseasonal period November 2018 to May 2019 (n= 85,286; 5 times the previous 3-year average) and also more institutional outbreaks, hospitalisations and deaths, than what is normally seen.ConclusionsThe unusually large interseasonal influenza outbreaks in 2018/19 followed a mild 2018 influenza season and resulted in a very early start to the 2019 influenza season across Australia. The reasons for this unusual event have yet to be fully elucidated but are likely to be a complex mix of climatic, virological and host immunity-related factors. These outbreaks reinforce the need for year-round surveillance of influenza, even in temperate climates with strong seasonality patterns.

Probable epidemic Mycoplasma pneumoniae disease activity in metropolitan Sydney, 2015: combining surveillance data to cross-validate signal detection.

Mycoplasma pneumoniae is a leading cause of encephalitis and pneumonia in children. Active surveillance identified a cluster of children with suspected encephalitis associated with M.pneumoniae in NSW during July, 2015. An investigation that cross validated encephalitis surveillance with ED pneumonia surveillance and senitenal reference laboratory data revealed probable epidemic M.pneumoniae disease activity in Sydney during 2015.

An outbreak of Salmonella typhimurium 108/170 at a privately catered barbeque at a Sydney sports club.

An outbreak of gastrointestinal illness was identified among attendees at a large community barbeque at a Sydney sports club on 30 January 2009. A retrospective cohort study was initiated, and attendees were identified through hospital emergency department gastroenteritis presentations, snowball recruitment through known cases, responders to linguistically specific press, and those returning to the venue the next week. A symptom and food history was collected from attendees, and stool samples were provided for microbiological investigation. An environmental investigation and trace back of implicated foods was also undertaken. Attendance estimates at the barbeque ranged from 100 to 180, and the food was prepared by a family that was not registered as a food business. Seventy one of the 87 attendees identified met the case definition. Thirty attendees (42%) had laboratory confirmed Salmonella Typhimurium phage-type 108/170, all with the same multilocus variable number of tandem repeat analysis typing. Burden of illness was high with 76% of cases seeking medical attention and 18% admitted to hospital. Microbiological evidence confirmed that a number of food items were contaminated with Salmonella Typhimurium 108/170, with the raw egg mayonnaise used in a Russian salad being the most likely primary food vehicle (adjusted odds ratio=10.3 [95% confidence interval 1.79-59.5]). Further, having Russian salad on the plate even if it was not consumed increased the relative risk of illness, thus suggesting that other food items may have been contaminated when they came into contact with it on the plate. This Salmonella outbreak highlighted the risks associated with the improper handling of food in private residences, which are then sold at a large public event.

Determinants and patterns of soft drink consumption in young adults: a qualitative analysis.

OBJECTIVE: To explore knowledge, attitudes and behaviours regarding caloric soft drinks in a group of young adults attending university and to identify opportunities for a health promotion intervention aimed at reducing consumption. DESIGN: In-depth, semi-structured focus groups segmented by gender. SETTING: Sydney, Australia. SUBJECTS: Undergraduate University of Sydney students aged 18-30 years (n 35). RESULTS: Social and environmental cues, intrinsic qualities of beverages and personal health beliefs were identified as important influences on consumption. Social cues included settings in which alcohol is usually consumed, socialising with friends, and family influences. Environmental cues included purchasing of fast foods, and ready availability, preferential pricing and promotion of caloric beverages. Reinforcing intrinsic qualities of caloric soft drinks included taste, sugar and caffeine content, and their association with treats and rewards. Major gender differences as well as variations in individual readiness for behaviour change were observed. Raising awareness of the sugar content of various beverages and the potential health impacts associated with their consumption was considered important. CONCLUSIONS: The findings provide new insights with important implications for policy and practice, and suggest that there is considerable scope for promoting awareness in this group. Carefully designed social marketing campaigns highlighting the health issues and addressing social and environmental cues relating to caloric soft drink consumption are required. There is a need for gender-differentiated intervention programmes which are both informational and appealing to young adults. Further research is warranted, particularly to investigate beverage consumption relating to fast-food meal deals and young adults' consumption patterns in more depth.

Feral pig hunting: a risk factor for human brucellosis in north-west NSW?

A multi-agency investigation followed the notification of four locally acquired human brucellosis cases in north-west NSW. Feral pig hunting within a geographically discrete region was identified as the likely exposure with Brucella suis the suspected cause. To test whether feral pigs in the region were infected with Brucella, serological testing was performed on trapped feral pigs and testicular abscesses from condemned carcasses bound for export were cultured. Although no Brucella species were identified in the feral pigs tested in NSW, Leptospira species were. Strengthening of human surveillance and ongoing collaboration between animal and human health agencies is required to confirm that Brucella suis causes brucellosis in humans and feral pigs in north-west NSW.

Illicit use of prescribed stimulant medication among college students.

The authors investigated illicit use of stimulant medications at a midwestern university. They used a questionnaire to (a) examine the extent to which university students illicitly used stimulant medications prescribed for attention-deficit hyperactivity disorder; (b) determine why college students abused such drugs; and (c) identify the factors that predicted illicit use of prescribed stimulant medication. Findings revealed that 17% of 179 surveyed men and 11% of 202 women reported illicit use of prescribed stimulant medication. Forty-four percent of surveyed students stated that they knew students who used stimulant medication illicitly for both academic and recreational reasons. Students reported they experienced time pressures associated with college life and that stimulants were said to increase alertness and energy. Regression analysis revealed that the factor that predicted men's use was knowing where to get easily acquired stimulant medication, whereas the main predictor for women was whether another student had offered the prescribed stimulants.

Mourning 2.0--Continuing Bonds Between the Living and the Dead on Facebook.

This study examines the burgeoning phenomenon of Facebook memorial pages and how this research about online social networking environments can contribute to the existing literature related to Klass, Silverman, and Nickman (1996) continuing bonds thesis. I argue that memorial pages constitute a new ritualized and public space for maintaining these continued bonds and that individuals exhibit several types of bonding interactions with the deceased. I conducted a content analysis on a purposively selected sample of 12 public Facebook "pages" where I coded 1,270 individual Wall postings. Analyses demonstrated that many individuals routinely used these Walls to continue their relationships with the deceased. Findings revealed several Wall posting categories, "guidance from beyond and reunion with the deceased," "messages and visitations from the deceased," and "conversations with the deceased," which I then combined under a central thematic heading of "paranormal copresence." There were 267 Wall postings coded under "guidance and reunion," 26 for "messages and visitations," and 340 for "conversations," with the total of 633 Wall postings under the central thematic heading of paranormal copresence. This research highlights how individuals have transcended the limitations of time and physical space in relation to traditional bereavement behavior and rituals and how data found on public websites, such as Facebook, can be used to further theorize bereavement and to demonstrate continue bonds between the living and the dead.

Enhanced Q fever risk exposure surveillance may permit better informed vaccination policy.

The association between farming risks and Q fever is not well documented in Australia. In a review of New South Wales notifications, data were analysed using 3-year study periods from 1993 to 2007 to investigate possible trends and explore reported risk exposures. A retrospective case series was also conducted using acute Q fever cases notified during 2007 from a rural area of New South Wales. Occupation was recorded for less than 50% of Q fever notifications in New South Wales during the study period. A significant decline in the proportion of notifications occurred in the occupational group reported as 'Abattoir/ Meat' worker and a significant increase occurred in the 'Farmer/Livestock' category. The case series found that in the month prior to illness onset 78% (42/54) reported direct contact with animals. In the month prior to becoming ill with Q fever 71% (31/51) of employed cases had contact with newly introduced livestock in their workplace. As a result of their Q fever illness 93% of cases required time off work or school, with a median of 21 days. At the time of the structured interviews 63% had not fully recovered. The epidemiology of Q fever disease in New South Wales has changed and amongst notified cases the relative importance of non-abattoir contact with livestock, wildlife or feral animals appears to be increasing. The surveillance field 'Occupation' no longer alone adequately describes risk exposure for many of the people notified with Q fever and a new field that better describes risk exposures is required. This may allow more finely tuned vaccination policy.