The re-emergence of influenza following the COVID-19 pandemic in Victoria, Australia, 2021 to 2022.

BackgroundCOVID-19 pandemic mitigation measures, including travel restrictions, limited global circulation of influenza viruses. In Australia, travel bans for non-residents and quarantine requirements for returned travellers were eased in November 2021, providing pathways for influenza viruses to be re-introduced.AimWe aimed to describe the epidemiological and virological characteristics of the re-emergence of influenza in Victoria, Australia to inform public health interventions.MethodsFrom 1 November 2021 to 30 April 2022, we conducted an epidemiological study analysing case notification data from the Victorian Department of Health to describe case demographics, interviewed the first 200 cases to establish probable routes of virus reintroduction and examined phylogenetic and antigenic data to understand virus diversity and susceptibility to current vaccines.ResultsOverall, 1,598 notifications and 1,064 positive specimens were analysed. The majority of cases (61.4%) occurred in the 15-34 years age group. Interviews revealed a higher incidence of international travel exposure during the first month of case detections, and high levels of transmission in university residential colleges were associated with return to campus. Influenza A(H3N2) was the predominant subtype, with a single lineage predominating despite multiple importations.ConclusionEnhanced testing for respiratory viruses during the COVID-19 pandemic provided a more complete picture of influenza virus transmission compared with previous seasons. Returned international travellers were important drivers of influenza reemergence, as were young adults, a group whose role has previously been under-recognised in the establishment of seasonal influenza epidemics. Targeting interventions, including vaccination, to these groups could reduce future influenza transmission.

Q fever prevention: Perspectives from university animal science and veterinary students and livestock farmers.

OBJECTIVE: To explore animal science and veterinary students' and livestock farmers' perceptions concerning Q fever prevention. DESIGN: An online survey with an open-ended question seeking knowledge and perceptions about Q fever prevention was distributed among participants during March-September 2019. We applied thematic analysis to identify emerging themes. SETTING: Animal science and veterinary students enrolled at the University of Adelaide and members of Livestock South Australia representing cattle, sheep and goat farmers in South Australia. PARTICIPANTS: A total of56 animal science and veterinary students and 154 livestock farmers responded to the open-ended question. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Perceived challenges and opportunities for a coordinated Q fever prevention approach including human vaccination reported by the participants. RESULTS: Two major themes arose in each group. Students and farmers viewed Q fever vaccination as important. However, excessive cost for students was a barrier and for farmers, it was general practitioners' lack of knowledge of Q fever and access to an accredited immunisation provider. Similarly, both groups highlighted the need for education and increasing public and community awareness of Q fever. CONCLUSION: Our findings underscore that a sector-wide approach involving community awareness programmes, education and training for general practitioners, and subsidised vaccination as well as commitment from government and industry partners may contribute to reducing the burden of Q fever among at-risk populations.

Short-Term Effects of Climate Variability on Childhood Diarrhoea in Bangladesh: Multi-Site Time-Series Regression Analysis.

The aim of this study was to estimate the effects of climate on childhood diarrhoea hospitalisations across six administrative divisions in Bangladesh and to provide scientific evidence for local health authorities for disease control and prevention. Fortnightly hospital admissions (August/2013-June/2017) for diarrhoea in children under five years of age, and fortnightly average maximum temperature, relative humidity and rainfall recordings for six administrative divisions were modelled using negative binomial regression with distributed lag linear terms. Flexible spline functions were used to adjust models for seasonality and long-term trends. During the study period, 25,385 diarrhoea cases were hospitalised. Overall, each 1 °C rise in maximum temperature increased diarrhoea hospitalisations by 4.6% (IRR = 1.046; 95% CI, 1.007-1.088) after adjusting for seasonality and long-term trends in the unlagged model. Using lagged effects of maximum temperature, and adjusting for relative humidity and rainfall for each of the six administrative divisions, the relationship between maximum temperature and diarrhoea hospitalisations varied between divisions, with positive and negative effect estimates. The temperature-diarrhoea association may be confounded by seasonality and long-term trends. Our findings are a reminder that the effects of climate change may be heterogeneous across regions, and that tailored diarrhoea prevention strategies need to consider region-specific recommendations rather than relying on generic guidelines.

Q fever prevention and vaccination: Australian livestock farmers' knowledge and attitudes to inform a One Health approach.

BACKGROUND: Livestock farmers are at risk of Q fever, a zoonotic disease transmitted to humans from animals such as cattle, sheep and goats. Australia bears substantial Q fever burden, particularly among farmers. A One Health approach engages cross-sectoral collaboration among animal, human and environmental health and is the preferred framework for Q fever prevention. METHODS: Cattle, sheep and goat farmers were invited to participate in an online survey in 2019 to gauge perceptions about Q fever and its prevention. Participants were recruited via membership newsletters and social media. Descriptive analyses and logistic regressions were performed. RESULTS: A total of 351 farmers completed the survey. Most respondents (80%) had been farming for ≥20 years, with sheep and beef cattle their primary stock. 71% reported knowledge of Q fever, and 85% identified transmission through contaminated dust inhalation was highly likely. The majority of respondents (97%) were aware of Q fever vaccine, and 95% agreed it was effective in preventing disease, yet 42% remained unvaccinated. Reported barriers to vaccination included poor access to a trained doctor and time and cost related to vaccination. Most farmers (≥91%) believed that subsidized vaccination and improved awareness would promote higher uptake. CONCLUSION: While Q fever knowledge among respondents was good, their practices related to airborne transmission prevention were poor. Livestock farmers would benefit from adherence to dust and aerosol transmission prevention practices. One Health partnership between government and industry is needed to promote Q fever awareness and address low vaccination rates among livestock farmers by funding vaccination programs.

Is a One Health Approach Utilized for Q Fever Control? A Comprehensive Literature Review.

Q fever, a zoonotic disease transmitted from animals to humans, is a significant public health problem with a potential for outbreaks to occur. Q fever prevention strategies should incorporate human, animal, and environmental domains. A One Health approach, which engages cross-sectoral collaboration among multiple stakeholders, may be an appropriate framework and has the underlying principles to control Q fever holistically. To assess whether components of One Health for Q fever prevention and control have been applied, a comprehensive literature review was undertaken. We found 16 studies that had practiced or recommended a One Health approach. Seven emerging themes were identified: Human risk assessment, human and animal serology, integrated human⁻animal surveillance, vaccination for at-risk groups, environmental management, multi-sectoral collaboration, and education and training. Within the multi-sectoral theme, we identified five subthemes: Policy and practice guidelines, information sharing and intelligence exchange, risk communication, joint intervention, and evaluation. One Health practices varied between studies possibly due to differences in intercountry policy, practice, and feasibility. However, the key issue of the need for multi-sectoral collaboration was highlighted across most of the studies. Further research is warranted to explore the barriers and opportunities of adopting a One Health approach in Q fever prevention and control.