Serosurvey for Japanese encephalitis virus antibodies following an outbreak in an immunologically naïve population, Victoria, 2022: a cross-sectional study.

OBJECTIVES: To investigate the distribution and prevalence of Japanese encephalitis virus (JEV) antibody (as evidence of past infection) in northern Victoria following the 2022 Japanese encephalitis outbreak, seeking to identify groups of people at particular risk of infection; to investigate the distribution and prevalence of antibodies to two related flaviviruses, Murray Valley encephalitis virus (MVEV) and West Nile virus Kunjin subtype (KUNV). STUDY DESIGN: Cross-sectional serosurvey (part of a national JEV serosurveillance program). SETTING: Three northern Victorian local public health units (Ovens Murray, Goulburn Valley, Loddon Mallee), 8 August - 1 December 2022. PARTICIPANTS: People opportunistically recruited at pathology collection centres and by targeted recruitment through community outreach and advertisements. People vaccinated against or who had been diagnosed with Japanese encephalitis were ineligible for participation, as were those born in countries where JEV is endemic. MAIN OUTCOME MEASURES: Seroprevalence of JEV IgG antibody, overall and by selected factors of interest (occupations, water body exposure, recreational activities and locations, exposure to animals, protective measures). RESULTS: 813 participants were recruited (median age, 59 years [interquartile range, 42-69 years]; 496 female [61%]); 27 were JEV IgG-seropositive (3.3%; 95% confidence interval [CI], 2.2-4.8%) (median age, 73 years [interquartile range, 63-78 years]; 13 female [48%]); none were IgM-seropositive. JEV IgG-seropositive participants were identified at all recruitment locations, including those without identified cases of Japanese encephalitis. The only risk factors associated with JEV IgG-seropositivity were age (per year: prevalence odds ratio [POR], 1.07; 95% CI, 1.03-1.10) and exposure to feral pigs (POR, 21; 95% CI, 1.7-190). The seroprevalence of antibody to MVEV was 3.0% (95% CI, 1.9-4.5%; 23 of 760 participants), and of KUNV antibody 3.3% (95% CI, 2.1-4.8%; 25 of 761). CONCLUSIONS: People living in northern Victoria are vulnerable to future JEV infection, but few risk factors are consistently associated with infection. Additional prevention strategies, including expanding vaccine eligibility, may be required to protect people in this region from Japanese encephalitis.

Undergraduate physiotherapy students' expectations and perceptions of rural/regional clinical placements.

OBJECTIVE: To explore undergraduate physiotherapy students' expectations and preconceptions of undertaking a rural/regional clinical placement and determine if these preconceptions differ between regional and metropolitan-based students. DESIGN: Data was collected via focus groups and analysed via thematic analysis of emerging themes. SETTING: All focus groups were undertaken in tutorial rooms at the participating universities between classes at a time convenient to participants. PARTICIPANTS: Undergraduate physiotherapy students yet to complete a major clinical placement were invited to participate. Second year physiotherapy students from regional and metropolitan universities were recruited to form focus groups, allowing comparison between the two groups. Four metropolitan students and nine regional students made up the sample size. RESULTS: Three major themes were identified via thematic analysis of transcripts; socio-cultural factors, education and professional factors. The significance of socio-cultural factors was far beyond what was expected to be found. Regional students did not generally have a more accurate perspective of rural/regional placement and voiced more concerns about missing out on educational opportunities. CONCLUSIONS: Rural/regional clinical educators need to be mindful of creating quality experiences with caseloads appropriate for the specific placement's requirements. The impact of external socio-cultural factors must be acknowledged. Supervision strategies must be put in place to ensure students on rural/regional clinical placements are well supported to achieve a successful outcome for student and educator.