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Pepin KM, Carlisle K, Anderson D, Baker MG, Chipman RB, Benschop J, French NP, Greenhalgh S, McDougall S, Muellner P, Murphy E, O'Neale DR, Plank MJ, Hayman DT. Steps towards operationalizing One Health approaches. One Health 2024; 18:100740. [PMID: 38707934 PMCID: PMC11067352 DOI: 10.1016/j.onehlt.2024.100740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 04/21/2024] [Indexed: 05/07/2024] Open
Abstract
One Health recognizes the health of humans, agriculture, wildlife, and the environment are interrelated. The concept has been embraced by international health and environmental authorities such as WHO, WOAH, FAO, and UNEP, but One Health approaches have been more practiced by researchers than national or international authorities. To identify priorities for operationalizing One Health beyond research contexts, we conducted 41 semi-structured interviews with professionals across One Health sectors (public health, environment, agriculture, wildlife) and institutional contexts, who focus on national-scale and international applications. We identify important challenges, solutions, and priorities for delivering the One Health agenda through government action. Participants said One Health has made progress with motivating stakeholders to attempt One Health approaches, but achieving implementation needs more guidance (action plans for how to leverage or change current government infrastructure to accommodate cross-sector policy and strategic mission planning) and facilitation (behavioral change, dedicated personnel, new training model).
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Affiliation(s)
- Kim M. Pepin
- United States Department of Agriculture's National Wildlife Research Center (USDA-NWRC), Fort Collins, CO, USA
| | - Keith Carlisle
- United States Department of Agriculture's National Wildlife Research Center (USDA-NWRC), Fort Collins, CO, USA
| | - Dean Anderson
- Manaaki Whenua - Landcare Research, Lincoln, New Zealand
| | - Michael G. Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Richard B. Chipman
- United States Department of Agriculture, Animal and Plant Health Inspection Services, Wildlife Services, National Rabies Management Program, NH, USA
| | | | | | | | | | - Petra Muellner
- Massey University, Palmerston North, Manawatu, New Zealand
- Epi-interactive, Wellington, New Zealand
| | - Emil Murphy
- Deer Industry New Zealand, Wellington, New Zealand
| | - Dion R.J. O'Neale
- University of Auckland, Auckland, New Zealand
- Te Pūnaha Matatini, Auckland, New Zealand
| | - Michael J. Plank
- School of Mathematics and Statistics, University of Canterbury, Christchurch, New Zealand
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Chambers T, Anglemyer A, Chen ATY, Baker MG. An evaluation of the COVID-19 self-service digital contact tracing system in New Zealand. Health Policy 2024; 144:105073. [PMID: 38657315 DOI: 10.1016/j.healthpol.2024.105073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 04/07/2024] [Accepted: 04/13/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Digital contact tracing (DCT) aims to improve time-to-isolation (timeliness) and find more potentially exposed individuals (sensitivity) to enhance the utility of contact tracing. The aim of this study was to evaluate the public uptake of a DCT self-service survey and its integration with the Bluetooth exposure notification system within the New Zealand Covid Tracer App (NZCTA). METHODS We adopted a retrospective cohort study design using community COVID-19 cases from February 2022 to August 2022 in New Zealand (1.2 million cases). We examined the proportion of cases completing a self-service survey and the time to complete the survey by age, sex and ethnicity. RESULTS Overall, 66 % of cases completed their self-service survey. Completion was influenced by age, sex and ethnicity. The median completion time was 1.8 h (IQR 0.2, 17.2), with 95 % of those completing this survey doing so within 48 h of case identification. Around 13 % of all survey completers also uploaded their Bluetooth data, which resulted in an average of 663 cases per day notifying 4.5 contacts per case. CONCLUSION The combination of high public uptake and rapid response times suggest self-service DCT could be a useful tool for future outbreaks, particularly if implemented in conjunction with manual processes and other DCT tools (e.g. Bluetooth) to address issues related to performance (sensitivity, timeliness), effectiveness, and health equity.
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Affiliation(s)
- Tim Chambers
- Department of Public Health, University of Otago, Wellington, New Zealand.
| | - Andrew Anglemyer
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Andrew Tzer-Yeu Chen
- Koi Tū: The Centre for Informed Futures, The University of Auckland, New Zealand
| | - Michael G Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
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Chambers T, Anglemyer A, Chen A, Atkinson J, Baker MG. Population and contact tracer uptake of New Zealand's QR-code-based digital contact tracing app for COVID-19. Epidemiol Infect 2024; 152:e66. [PMID: 38629265 PMCID: PMC11062780 DOI: 10.1017/s0950268824000608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 02/27/2024] [Accepted: 04/10/2024] [Indexed: 04/30/2024] Open
Abstract
This study aimed to understand the population and contact tracer uptake of the quick response (QR)-code-based function of the New Zealand COVID Tracer App (NZCTA) used for digital contact tracing (DCT). We used a retrospective cohort of all COVID-19 cases between August 2020 and February 2022. Cases of Asian and other ethnicities were 2.6 times (adjusted relative risk (aRR) 2.58, 99 per cent confidence interval (95% CI) 2.18, 3.05) and 1.8 times (aRR 1.81, 95% CI 1.58, 2.06) more likely than Māori cases to generate a token during the Delta period, and this persisted during the Omicron period. Contact tracing organization also influenced location token generation with cases handled by National Case Investigation Service (NCIS) staff being 2.03 (95% CI 1.79, 2.30) times more likely to generate a token than cases managed by clinical staff at local Public Health Units (PHUs). Public uptake and participation in the location-based system independent of contact tracer uptake were estimated at 45%. The positive predictive value (PPV) of the QR code system was estimated to be close to nil for detecting close contacts but close to 100% for detecting casual contacts. Our paper shows that the QR-code-based function of the NZCTA likely made a negligible impact on the COVID-19 response in New Zealand (NZ) in relation to isolating potential close contacts of cases but likely was effective at identifying and notifying casual contacts.
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Affiliation(s)
- Tim Chambers
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Andrew Anglemyer
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Andrew Chen
- Koi Tū: The Centre for Informed Futures, The University of Auckland, Auckland, New Zealand
| | - June Atkinson
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Michael G. Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
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Grout L, Hales S, Baker MG, French N, Wilson N. Severe weather events and cryptosporidiosis in Aotearoa New Zealand: A case series of space-time clusters. Epidemiol Infect 2024; 152:e64. [PMID: 38616329 PMCID: PMC11062783 DOI: 10.1017/s095026882400058x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 01/18/2024] [Accepted: 04/02/2024] [Indexed: 04/16/2024] Open
Abstract
Occurrence of cryptosporidiosis has been associated with weather conditions in many settings internationally. We explored statistical clusters of human cryptosporidiosis and their relationship with severe weather events in New Zealand (NZ). Notified cases of cryptosporidiosis from 1997 to 2015 were obtained from the national surveillance system. Retrospective space-time permutation was used to identify statistical clusters. Cluster data were compared to severe weather events in a national database. SaTScan analysis detected 38 statistically significant cryptosporidiosis clusters. Around a third (34.2%, 13/38) of these clusters showed temporal and spatial alignment with severe weather events. Of these, nearly half (46.2%, 6/13) occurred in the spring. Only five (38%, 5/13) of these clusters corresponded to a previously reported cryptosporidiosis outbreak. This study provides additional evidence that severe weather events may contribute to the development of some cryptosporidiosis clusters. Further research on this association is needed as rainfall intensity is projected to rise in NZ due to climate change. The findings also provide further arguments for upgrading the quality of drinking water sources to minimize contamination with pathogens from runoff from livestock agriculture.
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Affiliation(s)
- Leah Grout
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Simon Hales
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Michael G. Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nigel French
- Tāwharau Ora, School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Nick Wilson
- Department of Public Health, University of Otago, Wellington, New Zealand
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Huang QS, Turner N, Wood T, Anglemyer A, McIntyre P, Aminisani N, Dowell T, Trenholme A, Byrnes C, Balm M, McIntosh C, Jefferies S, Grant CC, Nesdale A, Dobinson HC, Campbell‐Stokes P, Daniells K, Geoghegan J, de Ligt J, Jelley L, Seeds R, Jennings T, Rensburg M, Cueto J, Caballero E, John J, Penghulan E, Tan CE, Ren X, Berquist K, O'Neill M, Marull M, Yu C, McNeill A, Kiedrzynski T, Roberts S, McArthur C, Stanley A, Taylor S, Wong C, Lawrence S, Baker MG, Kvalsvig A, Van Der Werff K, McAuliffe G, Antoszewska H, Dilcher M, Fahey J, Werno A, Elvy J, Grant J, Addidle M, Zacchi N, Mansell C, Widdowson M, Thomas PG, Webby RJ. Impact of the COVID-19 related border restrictions on influenza and other common respiratory viral infections in New Zealand. Influenza Other Respir Viruses 2024; 18:e13247. [PMID: 38350715 PMCID: PMC10864123 DOI: 10.1111/irv.13247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND New Zealand's (NZ) complete absence of community transmission of influenza and respiratory syncytial virus (RSV) after May 2020, likely due to COVID-19 elimination measures, provided a rare opportunity to assess the impact of border restrictions on common respiratory viral infections over the ensuing 2 years. METHODS We collected the data from multiple surveillance systems, including hospital-based severe acute respiratory infection surveillance, SHIVERS-II, -III and -IV community cohorts for acute respiratory infection (ARI) surveillance, HealthStat sentinel general practice (GP) based influenza-like illness surveillance and SHIVERS-V sentinel GP-based ARI surveillance, SHIVERS-V traveller ARI surveillance and laboratory-based surveillance. We described the data on influenza, RSV and other respiratory viral infections in NZ before, during and after various stages of the COVID related border restrictions. RESULTS We observed that border closure to most people, and mandatory government-managed isolation and quarantine on arrival for those allowed to enter, appeared to be effective in keeping influenza and RSV infections out of the NZ community. Border restrictions did not affect community transmission of other respiratory viruses such as rhinovirus and parainfluenza virus type-1. Partial border relaxations through quarantine-free travel with Australia and other countries were quickly followed by importation of RSV in 2021 and influenza in 2022. CONCLUSION Our findings inform future pandemic preparedness and strategies to model and manage the impact of influenza and other respiratory viral threats.
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Affiliation(s)
- Q. Sue Huang
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | | | - Tim Wood
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Andrew Anglemyer
- Institute of Environmental Science and ResearchWellingtonNew Zealand
- University of OtagoDunedinNew Zealand
| | | | | | | | - Adrian Trenholme
- Te Whatu Ora, Health New Zealand Counties ManukauAucklandNew Zealand
| | - Cass Byrnes
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
| | - Michelle Balm
- Te Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | | | - Sarah Jefferies
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Cameron C. Grant
- University of AucklandAucklandNew Zealand
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
| | - Annette Nesdale
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Hazel C. Dobinson
- Te Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Priscilla Campbell‐Stokes
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Karen Daniells
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Jemma Geoghegan
- Institute of Environmental Science and ResearchWellingtonNew Zealand
- University of OtagoDunedinNew Zealand
| | - Joep de Ligt
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Lauren Jelley
- Institute of Environmental Science and ResearchWellingtonNew Zealand
- University of OtagoDunedinNew Zealand
| | - Ruth Seeds
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Tineke Jennings
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Megan Rensburg
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Jort Cueto
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Ernest Caballero
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Joshma John
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Emmanuel Penghulan
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Chor Ee Tan
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Xiaoyun Ren
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Klarysse Berquist
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Meaghan O'Neill
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Maritza Marull
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Chang Yu
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Andrea McNeill
- Institute of Environmental Science and ResearchWellingtonNew Zealand
| | - Tomasz Kiedrzynski
- Te Pou Hauora Tūmatanui, the Public Health AgencyManatū Hauora, Ministry of HealthWellingtonNew Zealand
| | - Sally Roberts
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
| | - Colin McArthur
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
| | - Alicia Stanley
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
| | - Susan Taylor
- Te Whatu Ora, Health New Zealand Counties ManukauAucklandNew Zealand
| | - Conroy Wong
- Te Whatu Ora, Health New Zealand Counties ManukauAucklandNew Zealand
| | - Shirley Lawrence
- Te Whatu Ora, Health New Zealand Counties ManukauAucklandNew Zealand
| | | | | | - Koen Van Der Werff
- Te Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
| | - Gary McAuliffe
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
| | - Hanna Antoszewska
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
| | - Meik Dilcher
- Te Whatu Ora, Health New Zealand Waitaha CanterburyChristchurchNew Zealand
| | - Jennifer Fahey
- Te Whatu Ora, Health New Zealand Waitaha CanterburyChristchurchNew Zealand
| | - Anja Werno
- Te Whatu Ora, Health New Zealand Waitaha CanterburyChristchurchNew Zealand
| | - Juliet Elvy
- Southern Community LaboratoriesDunedinNew Zealand
| | - Jenny Grant
- Southern Community LaboratoriesDunedinNew Zealand
| | - Michael Addidle
- Te Whatu Ora, Health New Zealand Hauora a Toi Bay of PlentyTaurangaNew Zealand
| | - Nicolas Zacchi
- Te Whatu Ora, Health New Zealand Hauora a Toi Bay of PlentyTaurangaNew Zealand
| | - Chris Mansell
- Te Whatu Ora, Health New Zealand WaikatoHamiltonNew Zealand
| | | | - Paul G. Thomas
- WHO Collaborating CentreSt Jude Children's Research HospitalMemphisTennesseeUSA
| | - BorderRestrictionImpactOnFluRSV Consortium
- Institute of Environmental Science and ResearchWellingtonNew Zealand
- Te Whatu Ora, Health New Zealand Counties ManukauAucklandNew Zealand
- Te Whatu Ora, Health New Zealand Te Toka Tumai AucklandAucklandNew Zealand
- Regional Public HealthTe Whatu Ora, Health New Zealand Capital, Coast and Hutt ValleyWellingtonNew Zealand
- Te Whatu Ora, Health New Zealand Waitaha CanterburyChristchurchNew Zealand
| | - Richard J. Webby
- WHO Collaborating CentreSt Jude Children's Research HospitalMemphisTennesseeUSA
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Lacey JA, Bennett J, James TB, Hines BS, Chen T, Lee D, Sika-Paotonu D, Anderson A, Harwood M, Tong SY, Baker MG, Williamson DA, Moreland NJ. A worldwide population of Streptococcus pyogenes strains circulating among school-aged children in Auckland, New Zealand: a genomic epidemiology analysis. Lancet Reg Health West Pac 2024; 42:100964. [PMID: 38035130 PMCID: PMC10684382 DOI: 10.1016/j.lanwpc.2023.100964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/20/2023] [Accepted: 10/29/2023] [Indexed: 12/02/2023]
Abstract
Background Acute rheumatic fever (ARF) is a serious post-infectious sequala of Group A Streptococcus (GAS, Streptococcus pyogenes). In New Zealand (NZ) ARF is a major cause of health inequity. This study describes the genomic analysis of GAS isolates associated with childhood skin and throat infections in Auckland NZ. Methods Isolates (n = 469) collected between March 2018 and October 2019 from the throats and skin of children (5-14 years) underwent whole genomic sequencing. Equal representation across three ethnic groups was ensured through sample quotas with isolates obtained from Indigenous Māori (n = 157, 33%), NZ European/Other (n = 149, 32%) and Pacific Peoples children (n = 163, 35%). Using in silico techniques isolates were classified, assessed for diversity, and examined for distribution differences between groups. Comparisons were also made with GAS strains identified globally. Findings Genomic analysis revealed a diverse population consisting of 65 distinct sequence clusters. These sequence clusters spanned 49 emm-types, with 11 emm-types comprised of several, distinct sequence clusters. There is evidence of multiple global introductions of different lineages into the population, as well as local clonal expansion. The M1UK lineage comprised 35% of all emm1 isolates. Interpretation The GAS population was characterized by a high diversity of strains, resembling patterns observed in low- and middle-income countries. However, strains associated with outbreaks and antimicrobial resistance commonly found in high-income countries were also observed. This unique combination poses challenges for vaccine development, disease management and control. Funding The work was supported by the Health Research Council of New Zealand (HRC), award number 16/005.
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Affiliation(s)
- Jake A. Lacey
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - Julie Bennett
- The Department of Public Health, University of Otago, Wellington, New Zealand
- The Maurice Wilkins Centre for Biodiscovery, The University of Auckland, Auckland, New Zealand
| | - Taylah B. James
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - Benjamin S. Hines
- School of Mathematics and Statistics, University of Melbourne, Melbourne, Victoria, Australia
| | - Tiffany Chen
- Department of Molecular Medicine and Pathology, School of Medical Sciences, The University of Auckland, Auckland, New Zealand
| | - Darren Lee
- Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Anneka Anderson
- Te Kupenga Hauora Māori, The University of Auckland, New Zealand
| | - Matire Harwood
- Department of General Practice and Primary Healthcare, The University of Auckland, Auckland, New Zealand
| | - Steven Y.C. Tong
- Victorian Infectious Diseases Service, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- Department of Infectious Diseases at the Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - Michael G. Baker
- The Department of Public Health, University of Otago, Wellington, New Zealand
- The Maurice Wilkins Centre for Biodiscovery, The University of Auckland, Auckland, New Zealand
| | - Deborah A. Williamson
- Department of Infectious Diseases at the Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
- Victorian Infectious Diseases Reference Laboratory, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Nicole J. Moreland
- The Maurice Wilkins Centre for Biodiscovery, The University of Auckland, Auckland, New Zealand
- Department of Molecular Medicine and Pathology, School of Medical Sciences, The University of Auckland, Auckland, New Zealand
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Telfar-Barnard L, Baker MG, Wilson N, Howden-Chapman P. The rise and fall of excess winter mortality in New Zealand from 1876 to 2020. Int J Biometeorol 2024; 68:89-100. [PMID: 38010416 PMCID: PMC10752914 DOI: 10.1007/s00484-023-02573-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/25/2023] [Accepted: 10/25/2023] [Indexed: 11/29/2023]
Abstract
Excess winter mortality (EWM) has been used as a measure of how well populations and policy moderate the health effects of cold weather. We aimed to investigate long-term changes in the EWM of Aotearoa New Zealand (NZ), and potential drivers of change, and to test for structural breaks in trends. We calculated NZ EWM indices from 1876 (4,698 deaths) to 2020 (33,310 deaths), total and by age-group and sex, comparing deaths from June to September (the coldest months) to deaths from February to May and October to January. The mean age and sex-standardised EWM Index (EWMI) for the full study period, excluding 1918, was 1.22. However, mean EWMI increased from 1.20 for 1886 to 1917, to 1.34 for the 1920s, then reduced over time to 1.14 in the 2010s, with excess winter deaths averaging 4.5% of annual deaths (1,450 deaths per year) in the 2010s, compared to 7.9% in the 1920s. Children under 5 years transitioned from a summer to winter excess between 1886 and 1911. Otherwise, the EWMI age-distribution was J-shaped in all time periods. Structural break testing showed the 1918 influenza pandemic strain had a significant impact on trends in winter and non-winter mortality and winter excess for subsequent decades. It was not possible to attribute the post-1918 reduction in EWM to any single factor among improved living standards, reduced severe respiratory infections, or climate change.
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Affiliation(s)
| | - Michael G Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nick Wilson
- Department of Public Health, University of Otago, Wellington, New Zealand
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8
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Murray C, Rose SB, Kvalsvig A, Baker MG. Key informant perspectives on a centralised contact tracing system for sexually transmitted infections. N Z Med J 2023; 136:65-74. [PMID: 38096436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
AIM To meet the demand of contact tracing requirements associated with Aotearoa New Zealand's COVID-19 pandemic response, a national contact tracing service was established. Contact tracing for sexually transmitted infections (STIs) like chlamydia, gonorrhoea and syphilis is usually done at the clinic level, and evidence suggests it is under-resourced and often incomplete. METHOD We considered the utility of a centralised contact tracing service for STIs by interviewing key informants. Interviews took place between December 2021 and March 2022, and were audio-recorded, transcribed and analysed using thematic analysis. RESULTS Twelve key informants from disciplines including sexual health, primary care, public health, research and contact tracing participated. Perceived benefits of a centralised system included efficiency, standardisation and reduced demands on clinician time. Potential challenges and considerations included concerns about trust and privacy, the importance of cultural safety, meeting the needs of priority populations and lack of local-level knowledge. CONCLUSION A centralised contact tracing service could enable a more consistent and comprehensive approach to contact tracing for STIs and alleviate some of the burden on already stretched clinicians. However, successful contact tracing requires high levels of trust and for some populations this may be best achieved through trusted local providers, who could be supported, if needed, by centralised expertise.
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Affiliation(s)
- Catriona Murray
- Masters Student and Public Health Registrar, Department of Public Health, University of Otago Wellington, New Zealand
| | - Sally B Rose
- Senior Research Fellow, Department of Primary Health Care and General Practice, University of Otago Wellington, New Zealand
| | - Amanda Kvalsvig
- Associate Professor, Department of Public Health, University of Otago Wellington, New Zealand
| | - Michael G Baker
- Professor, Department of Public Health, University of Otago Wellington, New Zealand
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Fulurija A, Cunningham MW, Korotkova N, Masterson MY, Bansal GP, Baker MG, Cannon JW, Carapetis JR, Steer AC. Research opportunities for the primordial prevention of rheumatic fever and rheumatic heart disease-streptococcal vaccine development: a national heart, lung and blood institute workshop report. BMJ Glob Health 2023; 8:e013534. [PMID: 38164699 PMCID: PMC10729269 DOI: 10.1136/bmjgh-2023-013534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/01/2023] [Indexed: 01/03/2024] Open
Abstract
Streptococcus pyogenes, also known as group A streptococcus (StrepA), is a bacterium that causes a range of human diseases, including pharyngitis, impetigo, invasive infections, and post-infection immune sequelae such as rheumatic fever and rheumatic heart disease. StrepA infections cause some of the highest burden of disease and death in mostly young populations in low-resource settings. Despite decades of effort, there is still no licensed StrepA vaccine, which if developed, could be a cost-effective way to reduce the incidence of disease. Several challenges, including technical and regulatory hurdles, safety concerns and a lack of investment have hindered StrepA vaccine development. Barriers to developing a StrepA vaccine must be overcome in the future by prioritising key areas of research including greater understanding of StrepA immunobiology and autoimmunity risk, better animal models that mimic human disease, expanding the StrepA vaccine pipeline and supporting vaccine clinical trials. The development of a StrepA vaccine is a complex and challenging process that requires significant resources and investment. Given the global burden of StrepA infections and the potential for a vaccine to save lives and livelihoods, StrepA vaccine development is an area of research that deserves considerable support. This report summarises the findings of the Primordial Prevention Working Group-VAX, which was convened in November 2021 by the National Heart, Lung, and Blood Institute. The focus of this report is to identify research gaps within the current StrepA vaccine landscape and find opportunities and develop priorities to promote the rapid and successful advancement of StrepA vaccines.
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Affiliation(s)
- Alma Fulurija
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
- Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
| | - Madeleine W Cunningham
- Department of Microbiology and Immunology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Natalia Korotkova
- Department of Microbiology, Immunology and Molecular Genetics, University of Kentucky, Lexington, Kentucky, USA
| | - Mary Y Masterson
- Center for Translation Research and Implementation Science (CTRIS), National Heart Lung and Blood Institute, Bethesda, Maryland, USA
| | - Geetha P Bansal
- John E Fogarty International Center, Bethesda, Maryland, USA
| | - Michael G Baker
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Jeffrey W Cannon
- Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
- Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Jonathan R Carapetis
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
- Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
- Department of Infectious Diseases, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Andrew C Steer
- Infection, Immunity and Global Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
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10
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Baker MG, Kvalsvig A, Plank MJ, Geoghegan JL, Wall T, Tukuitonga C, Summers J, Bennett J, Kerr J, Turner N, Roberts S, Ward K, Betty B, Huang QS, French N, Wilson N. Continued mitigation needed to minimise the high health burden from COVID-19 in Aotearoa New Zealand. N Z Med J 2023; 136:67-91. [PMID: 37797257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
In this article we review the COVID-19 pandemic experience in Aotearoa New Zealand and consider the optimal ongoing response strategy. We note that this pandemic virus looks likely to result in future waves of infection that diminish in size over time, depending on such factors as viral evolution and population immunity. However, the burden of disease remains high with thousands of infections, hundreds of hospitalisations and tens of deaths each week, and an unknown burden of long-term illness (long COVID). Alongside this there is a considerable burden from other important respiratory illnesses, including influenza and RSV, that needs more attention. Given this impact and the associated health inequities, particularly for Māori and Pacific Peoples, we consider that an ongoing respiratory disease mitigation strategy is appropriate for New Zealand. As such, the previously described "vaccines plus" approach (involving vaccination and public health and social measures), should now be integrated with the surveillance and control of other important respiratory infections. Now is also a time for New Zealand to build on the lessons from the COVID-19 pandemic to enhance preparedness nationally and internationally. New Zealand's experience suggests elimination (or ideally exclusion) should be the default first choice for future pandemics of sufficient severity.
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Affiliation(s)
- Michael G Baker
- Epidemiologist and Public Health Physician, University of Otago Wellington
| | | | - Michael J Plank
- Mathematical Modeler, School of Mathematics and Statistics, University of Canterbury, Co-lead Covid-19 Modelling Aotearoa
| | - Jemma L Geoghegan
- Molecular biologist, Department of Microbiology and Immunology, University of Otago Dunedin
| | - Teresa Wall
- Consultant on strengthening Māori health and equity, Wellington
| | - Collin Tukuitonga
- Public Health Physician, Pacific Health Researcher, The University of Auckland
| | | | | | - John Kerr
- Senior Research Fellow, University of Otago Wellington
| | - Nikki Turner
- General Practitioner and Medical Director of the Immunisation Advisory Centre, The University of Auckland
| | - Sally Roberts
- Clinical Microbiologist, Clinical Head of Microbiology and Infection Prevention and Control, Auckland Hospital, Te Whatu Ora - Health New Zealand, Te Toka Tumai Auckland
| | | | - Bryan Betty
- General Practitioner and Chair, General Practice New Zealand, Wellington
| | - Q Sue Huang
- Virologist, Director of WHO National Influenza Centre, Institute of Environmental Science and Research, Wellington
| | - Nigel French
- Epidemiologist, Massey University of New Zealand, Palmerston North
| | - Nick Wilson
- Epidemiologist and Public Health Physician, University of Otago Wellington
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11
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Baker MG, Masterson MY, Shung-King M, Beaton A, Bowen AC, Bansal GP, Carapetis JR. Research priorities for the primordial prevention of acute rheumatic fever and rheumatic heart disease by modifying the social determinants of health. BMJ Glob Health 2023; 8:e012467. [PMID: 37914185 PMCID: PMC10619085 DOI: 10.1136/bmjgh-2023-012467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 09/09/2023] [Indexed: 11/03/2023] Open
Abstract
The social determinants of health (SDH), such as access to income, education, housing and healthcare, strongly shape the occurrence of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) at the household, community and national levels. The SDH are systemic factors that privilege some more than others and result in poverty and inequitable access to resources to support health and well-being. Primordial prevention is the modification of SDH to improve health and reduce the risk of disease acquisition and the subsequent progression to RHD. Modifying these determinants using primordial prevention strategies can reduce the risk of exposure to Group A Streptococcus, a causative agent of throat and skin infections, thereby lowering the risk of initiating ARF and its subsequent progression to RHD.This report summarises the findings of the Primordial Prevention Working Group-SDH, which was convened in November 2021 by the National Heart, Lung, and Blood Institute to assess how SDH influence the risk of developing RHD. Working group members identified a series of knowledge gaps and proposed research priorities, while recognising that community engagement and partnerships with those with lived experience will be integral to the success of these activities. Specifically, members emphasised the need for: (1) global analysis of disease incidence, prevalence and SDH characteristics concurrently to inform policy and interventions, (2) global assessment of legacy primordial prevention programmes to help inform the co-design of interventions alongside affected communities, (3) research to develop, implement and evaluate scalable primordial prevention interventions in diverse settings and (4) research to improve access to and equity of services across the RHD continuum. Addressing SDH, through the implementation of primordial prevention strategies, could have broader implications, not only improving RHD-related health outcomes but also impacting other neglected diseases in low-resource settings.
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Affiliation(s)
- Michael G Baker
- Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Mary Y Masterson
- Center for Translation Research and Implementation Science (CTRIS), National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
| | - Maylene Shung-King
- Health Policy and Systems Division, School of Public Health, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Andrea Beaton
- Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Asha C Bowen
- Department of Infectious Diseases, Perth Children's Hospital, Nedlands, Western Australia, Australia
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia
| | - Geetha P Bansal
- HIV Research and Training Program, John E Fogarty International Center, Bethesda, Maryland, USA
| | - Jonathan R Carapetis
- Department of Infectious Diseases, Perth Children's Hospital, Nedlands, Western Australia, Australia
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia
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12
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Hayman DTS, Baker MG. Low risk of variant Creutzfeldt-Jakob disease transmission from blood transfusions in Aotearoa New Zealand suggests donor exclusion policies can be relaxed. N Z Med J 2023; 136:66-70. [PMID: 37619229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
Aotearoa New Zealand currently excludes potential blood donors who lived in the United Kingdom (UK) for 6 months or more between 1980 and 1996. This action is due to the potential for variant Creutzfeldt-Jakob disease (vCJD) following blood transfusions from preclinical vCJD cases, who themselves mostly developed disease from the consumption of cattle with bovine spongiform encephalopathy (BSE) during this period, or from those incubating the misfolded prion proteins that cause disease. This donor exclusion policy led to 10% of New Zealand's active blood donors in 2000 being excluded, and it remains today despite periodic shortages of some blood products. Globally there have been 232 vCJD cases recorded-178 in the UK-with no new cases since 2019 and the peak numbers 23 years ago in 2000. Only three confirmed cases have been linked to blood transfusion. Here, we aimed to estimate the annual risk of vCJD from blood transfusion in New Zealand after restriction removal. We used UK case numbers, population estimates, and donor and recipient transfusion numbers to calculate the risk to the New Zealand public. We calculated the risk, based on approximately 131,000 transfusions a year and accounting for multiple transfusions, might lead to 0.005 cases annually, or approximately one in one billion nationally, and comparable to recent one in 1.45 billion estimates for Australia. Our analyses suggests that relaxing current blood donation restrictions, like Ireland and Australia's recent policy changes, would lead to an extremely low risk of vCJD transfusion-transmission in New Zealand. This policy change would help increase the supply of blood products for multiple medical needs.
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Affiliation(s)
- David T S Hayman
- Professor of Infectious Disease Ecology, Molecular Epidemiology and Public Health Laboratory, Massey University, Palmerston North, New Zealand
| | - Michael G Baker
- Professor of Public Health, Department of Public Health, University of Otago, Wellington, New Zealand
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13
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Nisa S, Vallee E, Marshall J, Collins-Emerson J, Yeung P, Prinsen G, Douwes J, Baker MG, Wright J, Quin T, Holdaway M, Wilkinson DA, Fayaz A, Littlejohn S, Benschop J. Leptospirosis in Aotearoa New Zealand: Protocol for a Nationwide Case-Control Study. JMIR Res Protoc 2023; 12:e47900. [PMID: 37289491 DOI: 10.2196/47900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 04/27/2023] [Accepted: 04/30/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND In Aotearoa New Zealand, 90% of patients with notified leptospirosis (a zoonotic bacterial disease) have been men working in agricultural industries. However, since 2008, the epidemiology of notified cases has been gradually changing, that is, more women are affected; there are more cases associated with occupations traditionally not considered high risk in New Zealand; infecting serovars have changed; and many patients experience symptoms long after infection. We hypothesized that there is a shift in leptospirosis transmission patterns with substantial burden on affected patients and their families. OBJECTIVE In this paper, we aimed to describe the protocols used to conduct a nationwide case-control study to update leptospirosis risk factors and follow-up studies to assess the burden and sources of leptospirosis in New Zealand. METHODS This study used a mixed methods approach, comprising a case-control study and 4 substudies that involved cases only. Cases were recruited nationwide, and controls were frequency matched by sex and rurality. All participants were administered a case-control questionnaire (study 1), with cases being interviewed again at least 6 months after the initial survey (study 2). A subset of cases from two high-risk populations, that is, farmers and abattoir workers, were further engaged in a semistructured interview (study 3). Some cases with regular animal exposure had their in-contact animals (livestock for blood and urine and wildlife for kidney) and environment (soil, mud, and water) sampled (study 4). Patients from selected health clinics suspected of leptospirosis also had blood and urine samples collected (study 5). In studies 4 and 5, blood samples were tested using the microscopic agglutination test to test for antibody titers against Leptospira serovars Hardjo type bovis, Ballum, Tarassovi, Pomona, and Copenhageni. Blood, urine, and environmental samples were also tested for pathogenic Leptospira DNA using polymerase chain reaction. RESULTS Participants were recruited between July 22, 2019, and January 31, 2022, and data collection for the study has concluded. In total, 95 cases (July 25, 2019, to April 13, 2022) and 300 controls (October 19, 2019, to January 26, 2022) were interviewed for the case-control study; 91 cases participated in the follow-up interviews (July 9, 2020, to October 25, 2022); 13 cases participated in the semistructured interviews (January 26, 2021, to January 19, 2022); and 4 cases had their in-contact animals and environments sampled (October 28, 2020, and July 29, 2021). Data analysis for study 3 has concluded and 2 manuscripts have been drafted for review. Results of the other studies are being analyzed and the specific results of each study will be published as individual manuscripts.. CONCLUSIONS The methods used in this study may provide a basis for future epidemiological studies of infectious diseases. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/47900.
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Affiliation(s)
- Shahista Nisa
- Molecular Epidemiology and Public Health Laboratory, School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Emilie Vallee
- EpiCentre, School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Jonathan Marshall
- School of Mathematical and Computational Sciences, Massey University, Palmerston North, New Zealand
| | - Julie Collins-Emerson
- Molecular Epidemiology and Public Health Laboratory, School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Polly Yeung
- School of Social Work, Massey University, Palmerston North, New Zealand
| | - Gerard Prinsen
- School of People, Environment and Planning, Massey University, Palmerston North, New Zealand
| | - Jeroen Douwes
- Research Centre for Hauora and Health, Massey University, Wellington, New Zealand
| | - Michael G Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Jackie Wright
- Enteric and Leptospira Reference Laboratory, Institute of Environmental Science and Research, Christchurch, New Zealand
| | - Tanya Quin
- Goodfellow Unit, University of Auckland, Auckland, New Zealand
| | - Maureen Holdaway
- College of Health, Massey University, Palmerston North, New Zealand
| | - David A Wilkinson
- Unité Mixte de Recherche, Animal, Santé, Territoires, Risques et Ecosystèmes, Centre de coopération internationale en recherche agronomique pour le développement, Institut national de la recherche agronomique, University of Montpellier, Plateforme Technologique Cyclotron Réunion Océan Indien, Sainte-Clotilde, La Réunion, France
| | - Ahmed Fayaz
- Molecular Epidemiology and Public Health Laboratory, School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Stuart Littlejohn
- Molecular Epidemiology and Public Health Laboratory, School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Jackie Benschop
- Molecular Epidemiology and Public Health Laboratory, School of Veterinary Science, Massey University, Palmerston North, New Zealand
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14
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Graham FF, Harte D, Zhang J, Fyfe C, Baker MG. Increased Incidence of Legionellosis after Improved Diagnostic Methods, New Zealand, 2000-2020. Emerg Infect Dis 2023; 29:1173-1182. [PMID: 37209673 DOI: 10.3201/eid2906.221598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023] Open
Abstract
Legionellosis, notably Legionnaires' disease, is recognized globally and in New Zealand (Aotearoa) as a major cause of community-acquired pneumonia. We analyzed the temporal, geographic, and demographic epidemiology and microbiology of Legionnaires' disease in New Zealand by using notification and laboratory-based surveillance data for 2000‒2020. We used Poisson regression models to estimate incidence rate ratios and 95% CIs to compare demographic and organism trends over 2 time periods (2000-2009 and 2010-2020). The mean annual incidence rate increased from 1.6 cases/100,000 population for 2000-2009 to 3.9 cases/100,000 population for 2010-2020. This increase corresponded with a change in diagnostic testing from predominantly serology with some culture to almost entirely molecular methods using PCR. There was also a marked shift in the identified dominant causative organism, from Legionella pneumophila to L. longbeachae. Surveillance for legionellosis could be further enhanced by greater use of molecular typing of isolates.
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15
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Hayman DTS, Garcia-Ramirez JC, Pita A, Velathanthiri N, Knox MA, Ogbuigwe P, Baker MG, Rostami K, Deroles-Main J, Gilpin BJ. Diagnosis of protozoa diarrhoea in Campylobacter patients increases markedly with molecular techniques. PLOS Glob Public Health 2023; 3:e0001527. [PMID: 37252910 DOI: 10.1371/journal.pgph.0001527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 04/21/2023] [Indexed: 06/01/2023]
Abstract
Cryptosporidium and Giardia are major causes of diarrhoea globally, and two of the most notified infectious diseases in New Zealand. Diagnosis requires laboratory confirmation carried out mostly via antigen or microscopy-based techniques. However, these methods are increasingly being superseded by molecular techniques. Here we investigate the level of protozoa detection by molecular methods in campylobacteriosis cases missed through antigen-based assays and investigate different molecular testing protocols. We report findings from two observational studies; the first among 111 people during a Campylobacter outbreak and the second during normal surveillance activities among 158 people presenting with diarrhoea and a positive Campylobacter test, but negative Cryptosporidium and Giardia antigen-based test results. The molecular methods used for comparison were in-house end-point PCR tests targeting the gp60 gene for Cryptosporidium and gdh gene for Giardia. DNA extraction was performed with and without bead-beating and comparisons with commercial real-time quantitative (qPCR) were made using clinical Cryptosporidium positive sample dilutions down to 10-5. The Cryptosporidium prevalence was 9% (95% CI: 3-15; 10/111) and Giardia prevalence 21% (95% CI: 12-29; 23/111) in the 111 Campylobacter outbreak patients. The Cryptosporidium prevalence was 40% (95% CI: 32-48; 62/158) and Giardia prevalence 1.3% (95% CI: 0.2-4.5; 2/158) in the 158 routine surveillance samples. Sequencing identified Cryptosporidium hominis, C. parvum, and Giardia intestinalis assemblages A and B. We found no statistical difference in positive test results between samples using end-point PCR with or without bead-beating prior to DNA extraction, or between the in-house end-point PCR and qPCR. The qPCR Ct value was 36 (95% CI: 35-37) for 1 oocyst, suggesting a high limit of detection. In conclusion in surveillance and outbreak situations we found diagnostic serology testing underdiagnoses Cryptosporidium and Giardia coinfections in Campylobacter patients, suggesting the impact of protozoa infections may be underestimated through underdiagnosis using antigen-based assays.
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Affiliation(s)
| | | | - Anthony Pita
- Massey University, Palmerston North, New Zealand
| | | | | | - Paul Ogbuigwe
- Waikato District Health Board, Hamilton, New Zealand
| | | | - Kamran Rostami
- MidCentral District Health Board, Palmerston North, New Zealand
| | | | - Brent J Gilpin
- Institute of Environmental Science and Research Ltd. (ESR), Christchurch, New Zealand
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16
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Graham FF, Harte DJG, Baker MG. Environmental Investigation and Surveillance for Legionella in Aotearoa New Zealand, 2000-2020. Curr Microbiol 2023; 80:156. [PMID: 36997742 PMCID: PMC10063469 DOI: 10.1007/s00284-023-03261-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 03/07/2023] [Indexed: 04/01/2023]
Abstract
The reported rate of legionellosis is increasing in Aotearoa New Zealand (NZ) with most cases community-acquired, sporadic (non-outbreak) and without an identifiable source. This analysis used two datasets to describe the environmental sources that contribute to Legionella in NZ, based on linkages with outbreaks and sporadic clinical cases, and analysis of environmental testing data. These findings highlight the need for enhanced environmental investigation of clinical cases and outbreaks. There is also a need for systematic surveillance testing of high-risk source environments to support more rigorous controls to prevent legionellosis.
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Affiliation(s)
- Frances F Graham
- Department of Public Health, University of Otago, P. O. 7343, Wellington South, 6242, New Zealand.
| | - David J G Harte
- ESR, Legionella Reference Laboratory, Health Programme, Kenepuru Science Centre, Wellington, New Zealand
| | - Michael G Baker
- Department of Public Health, University of Otago, P. O. 7343, Wellington South, 6242, New Zealand
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17
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Kvalsvig A, Tuari-Toma B, Timu-Parata C, Bennett J, Sinnema C, Summers J, Davies C, Jackson C, Dickson A, Barnard LT, Baker MG. Protecting school communities from COVID-19 and other infectious disease outbreaks: the urgent need for healthy schools in Aotearoa New Zealand. N Z Med J 2023; 136:7-19. [PMID: 36893391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Affiliation(s)
- Amanda Kvalsvig
- Department of Public Health, University of Otago Wellington, New Zealand
| | - Belinda Tuari-Toma
- Tū Kotahi Māori Asthma and Research Trust, Lower Hutt, New Zealand. Ngāti Porou, Te Whānau-a-Apanui ki Upokorehe, Ngāti Tūwharetoa, Te Whenua Moemoeā
| | - Carmen Timu-Parata
- Department of Public Health, University of Otago Wellington, New Zealand. Ngāti Kahungunu
| | - Julie Bennett
- Department of Public Health, University of Otago Wellington, New Zealand
| | - Claire Sinnema
- Faculty of Education and Social Work, School of Learning, Development and Professional Practice, University of Auckland
| | - Jennifer Summers
- Department of Public Health, University of Otago Wellington, New Zealand
| | - Cheryl Davies
- Tū Kotahi Māori Asthma Trust, Lower Hutt, New Zealand; Department of Public Health, University of Otago Wellington, New Zealand. Ngāti Raukawa, Ngāti Mutunga ki te Wharekauri, Ngāti Pikiao
| | - Constanza Jackson
- Department of Public Health, University of Otago Wellington, New Zealand
| | | | | | - Michael G Baker
- Department of Public Health, University of Otago Wellington, New Zealand
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18
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Toombs-Ruane LJ, Marshall JC, Benschop J, Drinković D, Midwinter AC, Biggs PJ, Grange Z, Baker MG, Douwes J, Roberts MG, French NP, Burgess SA. Extended-spectrum β-lactamase- and AmpC β-lactamase-producing Enterobacterales associated with urinary tract infections in the New Zealand community: a case-control study. Int J Infect Dis 2023; 128:325-334. [PMID: 36529370 DOI: 10.1016/j.ijid.2022.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/28/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To assess whether having a pet in the home is a risk factor for community-acquired urinary tract infections associated with extended-spectrum β-lactamase (ESBL)- or AmpC β-lactamase (ACBL)- producing Enterobacterales. METHODS An unmatched case-control study was conducted between August 2015 and September 2017. Cases (n = 141) were people with community-acquired urinary tract infection (UTI) caused by ESBL- or ACBL-producing Enterobacterales. Controls (n = 525) were recruited from the community. A telephone questionnaire on pet ownership and other factors was administered, and associations were assessed using logistic regression. RESULTS Pet ownership was not associated with ESBL- or ACBL-producing Enterobacterales-related human UTIs. A positive association was observed for recent antimicrobial treatment, travel to Asia in the previous year, and a doctor's visit in the last 6 months. Among isolates with an ESBL-/ACBL-producing phenotype, 126/134 (94%) were Escherichia coli, with sequence type 131 being the most common (47/126). CONCLUSIONS Companion animals in the home were not found to be associated with ESBL- or ACBL-producing Enterobacterales-related community-acquired UTIs in New Zealand. Risk factors included overseas travel, recent antibiotic use, and doctor visits.
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Affiliation(s)
- Leah J Toombs-Ruane
- (m)EpiLab, School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Jonathan C Marshall
- (m)EpiLab, School of Veterinary Science, Massey University, Palmerston North, New Zealand; School of Mathematical and Computational Sciences, Massey University, Palmerston North, New Zealand
| | - Jackie Benschop
- (m)EpiLab, School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Dragana Drinković
- Microbiology Department, North Shore Hospital, Auckland, New Zealand
| | - Anne C Midwinter
- (m)EpiLab, School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Patrick J Biggs
- (m)EpiLab, School of Veterinary Science, Massey University, Palmerston North, New Zealand; School of Natural Sciences, Massey University, Palmerston North, New Zealand; New Zealand Food Safety Science and Research Centre, Massey University, Palmerston North, New Zealand
| | - Zoë Grange
- (m)EpiLab, School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Michael G Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Jeroen Douwes
- Research Centre for Hauora and Health, Massey University, Wellington, New Zealand
| | - Mick G Roberts
- New Zealand Institute for Advanced Study, Massey University, Auckland, New Zealand
| | - Nigel P French
- (m)EpiLab, School of Veterinary Science, Massey University, Palmerston North, New Zealand; New Zealand Food Safety Science and Research Centre, Massey University, Palmerston North, New Zealand; Research Centre for Hauora and Health, Massey University, Wellington, New Zealand
| | - Sara A Burgess
- (m)EpiLab, School of Veterinary Science, Massey University, Palmerston North, New Zealand.
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19
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Howden-Chapman P, Crane J, Keall M, Pierse N, Baker MG, Cunningham C, Amore K, Aspinall C, Bennett J, Bierre S, Boulic M, Chapman R, Chisholm E, Davies C, Fougere G, Fraser B, Fyfe C, Grant L, Grimes A, Halley C, Logan-Riley A, Nathan K, Olin C, Ombler J, O’Sullivan K, Pehi T, Penny G, Phipps R, Plagman M, Randal E, Riggs L, Robson B, Ruru J, Shaw C, Schrader B, Teariki MA, Telfar Barnard L, Tiatia R, Toy-Cronin B, Tupara H, Viggers H, Wall T, Wilkie M, Woodward A, Zhang W. He Kāinga Oranga: reflections on 25 years of measuring the improved health, wellbeing and sustainability of healthier housing. J R Soc N Z 2023. [DOI: 10.1080/03036758.2023.2170427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- Philippa Howden-Chapman
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Julian Crane
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Michael Keall
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Nevil Pierse
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Michael G. Baker
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Chris Cunningham
- Research Centre for Hauora & Health, Massey University, Wellington, New Zealand
| | - Kate Amore
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Clare Aspinall
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Julie Bennett
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Sarah Bierre
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Mikael Boulic
- School of the Built Environment, Massey University, Auckland, New Zealand
| | - Ralph Chapman
- School of Geography, Environment and Earth Sciences, Te Herenga Waka, Victoria University of Wellington, New Zealand
| | - Elinor Chisholm
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Cheryl Davies
- Tu Kotahi Māori Asthma Trust, Wainuiomata, Lower Hutt, New Zealand
| | - Geoff Fougere
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Brodie Fraser
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Caro Fyfe
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Libby Grant
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Arthur Grimes
- Motu Economic and Public Policy Research, Wellington, New Zealand
| | - Caroline Halley
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Amber Logan-Riley
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Kim Nathan
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Crystal Olin
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Jenny Ombler
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Kimberley O’Sullivan
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Tiria Pehi
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Guy Penny
- EMPlan Services Ltd, Wellington, New Zealand
| | - Robyn Phipps
- Faculty of Architecture and Design Innovation, Te Herenga Waka, Victoria University of Wellington, Wellington, New Zealand
| | - Manfred Plagman
- Building Research Association of New Zealand, Porirua, New Zealand
| | - Edward Randal
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Lynn Riggs
- Motu Economic and Public Policy Research, Wellington, New Zealand
| | - Bridget Robson
- Eru Pomare Māori Health Research Centre, University of Otago, Wellington, New Zealand
| | - Jacinta Ruru
- Faculty of Law, University of Otago, Dunedin, New Zealand
| | - Caroline Shaw
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Ben Schrader
- Stout Research Centre, Te Herenga Waka, Victoria University of Wellington, Wellington, New Zealand
| | - Mary Anne Teariki
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Lucy Telfar Barnard
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Ramona Tiatia
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | | | - Hope Tupara
- Research Centre for Hauora & Health, Massey University, Wellington, New Zealand
| | - Helen Viggers
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | | | - Marg Wilkie
- Research Centre for Hauora & Health, Massey University, Wellington, New Zealand
| | - Alistair Woodward
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Wei Zhang
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
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20
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Graham FF, Baker MG. Epidemiology and direct health care costs of hospitalised legionellosis in New Zealand, 2000-2020. Infect Dis Health 2023; 28:27-38. [PMID: 36038465 DOI: 10.1016/j.idh.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/01/2022] [Accepted: 07/11/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Legionellosis is a collective term used for disease caused by Legionella species which result in community and hospital acquired pneumonia worldwide. The aim of this analysis was to describe the epidemiology of legionellosis hospitalisations in Aotearoa New Zealand (NZ) over a 21-year period and quantify the health care costs. METHOD This study combined national legionellosis notification and hospital discharge data that were linked via the National Health Index (NHI) to provide a more complete dataset of hospitalised cases. The direct cost of hospital care was estimated by multiplying the diagnosis-related group cost-weight by the national price and inflating to 2020/2021 values. RESULTS There were 1479 records matched across notifications and discharge databases, including 990 with principal and 489 with additional diagnosis of legionellosis. Incidence rose to an average of 143 cases per annum for 2016-2020, a rate of 3·2/100,000. The median LOS was 6 days (IQR 4-13·5) with direct costs of $2·1 million per annum over that period. Rates were highest in those aged 65 years and above, male, and of European/Other ethnicity. Hospitalisations showed a peak in spring and summer. CONCLUSION The rate of hospitalised legionellosis in New Zealand rose from 2000 to 2015, largely reflecting improved diagnosis. This preventable disease results in substantial health care costs. Greater efforts are needed to identify and control sources of exposure. Surveillance could be improved by routine integration of notification and hospital discharge data.
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Affiliation(s)
- Frances F Graham
- Department of Public Health, University of Otago, Wellington, New Zealand.
| | - Michael G Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
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21
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Grout L, Gottfreðsson M, Kvalsvig A, Baker MG, Wilson N, Summers J. Comparing COVID-19 pandemic health responses in two high-income island nations: Iceland and New Zealand. Scand J Public Health 2023:14034948221149143. [PMID: 36717984 PMCID: PMC9892804 DOI: 10.1177/14034948221149143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
AIMS We aimed to compare COVID-19 control measures, epidemiological characteristics and economic performance measures in two high-income island nations with small populations, favorable border control options, and relatively good outcomes: Iceland and New Zealand (NZ). METHODS We examined peer-reviewed journal articles, official websites, reports, media releases and press articles for data on pandemic preparedness and COVID-19 public health responses from 1 January 2020 to 1 June 2022 in Iceland and NZ. We calculated epidemiological characteristics of the COVID-19 pandemic, as well as measures of economic performance. RESULTS Both nations had the lowest excess mortality in the OECD from the start of the pandemic up to June 2022. Iceland pursued a mitigation strategy, never used lockdowns or officially closed its border to foreign nationals, and instead relied on extensive testing and contact tracing early in the pandemic. Meanwhile, NZ pursued an elimination strategy, used a strict national lockdown to stop transmission, and closed its international border to everyone except citizens and permanent residents going through quarantine and testing. Iceland experienced a larger decrease in gross domestic product in 2020 (relative to 2019) than NZ (-8·27% vs. -1·22%, respectively). In late 2021, NZ announced a shift to a suppression strategy and in 2022 began to reopen its border in stages, while Iceland ended all public restrictions on 25 February 2022. CONCLUSIONS
Many of Iceland's and NZ's pandemic control measures appeared successful and features of the responses in both countries could potentially be adopted by other jurisdictions to address future disease outbreaks and pandemic threats.
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Affiliation(s)
- Leah Grout
- Department of Public Health, University of Otago, Wellington, New Zealand,Leah Grout, Larner College of Medicine, University of Vermont, 89 Beaumont Avenue, Burlington, Vermont 05405, USA. E-mail:
| | - Magnús Gottfreðsson
- Faculty of Medicine, School of Health Sciences, University of Iceland,Landspitali University Hospital, Iceland
| | - Amanda Kvalsvig
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Michael G. Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nick Wilson
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Jennifer Summers
- Department of Public Health, University of Otago, Wellington, New Zealand
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22
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Baker MG, Durrheim D, Hsu LY, Wilson N. COVID-19 and other pandemics require a coherent response strategy. Lancet 2023; 401:265-266. [PMID: 36646106 PMCID: PMC9839352 DOI: 10.1016/s0140-6736(22)02489-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/30/2022] [Indexed: 01/15/2023]
Affiliation(s)
- Michael G Baker
- Department of Public Health, University of Otago, Wellington 6242, New Zealand.
| | - David Durrheim
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Li Yang Hsu
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Nick Wilson
- Department of Public Health, University of Otago, Wellington 6242, New Zealand
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23
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Grout L, Chambers T, Hales S, Prickett M, Baker MG, Wilson N. The potential human health hazard of nitrates in drinking water: a media discourse analysis in a high-income country. Environ Health 2023; 22:9. [PMID: 36658626 PMCID: PMC9851889 DOI: 10.1186/s12940-023-00960-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Recent studies linking low levels of nitrate in drinking water to colorectal cancer have raised public concerns over nitrate contamination. The aim of this study was to analyze the media discourse on the potential human health hazard of nitrates in drinking water in a high-income country with a large livestock industry: New Zealand (NZ). METHODS Searches of media sources ("major newspapers") held by the Factiva database for the NZ setting in the five-year period 17 December 2016 to 20 December 2021. RESULTS The largest number of media items was observed for 2017 (n = 108), the year of a NZ general election, with a notable decrease in 2020 (n = 20) that was likely due to the Covid-19 pandemic, which dominated health media. However, the percentage of these media items with a health focus steadily increased over time, from 11.1% of all articles in 2017 to 51.2% in 2021. The most commonly mentioned health hazard was colorectal cancer, followed by methemoglobinemia. The temporal pattern of media items suggests that the release of scientific studies and scholarly blogs was associated with the publication of subsequent media items. Major stakeholders involved in the discourse included representatives of local and central government, environmental and recreational interest groups, researchers, local residents, agricultural interest groups, and health organizations. Māori (Indigenous New Zealanders) values or perspectives were rarely mentioned. CONCLUSIONS Analysis of major newspapers for a five-year period indicated that a wide range of expert comment and opinions were made available to the public and policy makers on the issue of nitrates in water. While many different stakeholder views were captured in the media discourse, there is scope for the media to better report the views of Māori on this topic. There is also a need for articles detailing the health issues to also refer to the environmental, recreational, and cultural aspects of protecting water quality to ensure that the public, policy makers, and regulators are aware of co-benefits.
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Affiliation(s)
- Leah Grout
- Department of Public Health, University of Otago, Wellington, 6021, New Zealand.
- Larner College of Medicine, University of Vermont, VT, Burlington, USA.
| | - Tim Chambers
- Department of Public Health, University of Otago, Wellington, 6021, New Zealand
| | - Simon Hales
- Department of Public Health, University of Otago, Wellington, 6021, New Zealand
| | - Marnie Prickett
- Department of Public Health, University of Otago, Wellington, 6021, New Zealand
| | - Michael G Baker
- Department of Public Health, University of Otago, Wellington, 6021, New Zealand
| | - Nick Wilson
- Department of Public Health, University of Otago, Wellington, 6021, New Zealand
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24
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Durrheim DN, Xu A, Baker MG, Hsu LY, Takashima Y. China has the momentum to eliminate measles. Lancet Reg Health West Pac 2023; 30:100669. [PMID: 36691602 PMCID: PMC9860474 DOI: 10.1016/j.lanwpc.2022.100669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/05/2022] [Indexed: 01/11/2023]
Affiliation(s)
- David N. Durrheim
- University of Newcastle, Wallsend, New South Wales, Australia,Corresponding author.
| | - Aiqiang Xu
- Shangdong Center for Disease Prevention and Control, Jinan, Shandong Province, People’s Republic of China
| | | | - Li Yang Hsu
- National University of Singapore, Saw Swee Hock School of Public Health, Singapore
| | - Yoshihiro Takashima
- Vaccine-preventable Diseases and Immunization, Western Pacific Regional Office, World Health Organization, Philippines
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25
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Murray C, Rose SB, Kvalsvig A, Baker MG. Contact tracing for sexually transmitted infections in Aotearoa New Zealand: a review of clinician-notified gonorrhoea and syphilis data. J Prim Health Care 2023. [DOI: 10.1071/hc22147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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26
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Chambers T, Wilson N, Hales S, Prickett M, Ellison E, Baker MG. Beyond muddy waters: Three Waters reforms required to future-proof water service delivery and protect public health in Aotearoa New Zealand. N Z Med J 2022; 135:87-95. [PMID: 36455181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
A 2016 drinking water-related campylobacteriosis outbreak in Aotearoa New Zealand made much of an entire town sick leading to reforms colloquially called "Three Waters", which aims to improve the management and delivery of waste, storm and drinking water systems. Public discourse on the Three Waters reforms has been dominated by anti-co-governance rhetoric, concerns around privatisation and loss of local control and alternative less comprehensive reform models. This debate has drowned out the fundamental problem statement justifying the reforms, that is, the management of drinking water resources is currently: 1) demonstrably inadequate to protect public health and promote health equity; and 2) economically inefficient. We discuss four areas where the proposed Three Waters reforms are likely to address current and future challenges and improve public health. We conclude by outlining four areas of remaining contention.
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Affiliation(s)
- Tim Chambers
- Health, Environment & Infection Research Unit, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nick Wilson
- Health, Environment & Infection Research Unit, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Simon Hales
- Health, Environment & Infection Research Unit, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Marnie Prickett
- Health, Environment & Infection Research Unit, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Edward Ellison
- Upoko (Head), Te Rūnanga o Ōtākou, Tamatea Road, Otago Peninsula, Dunedin, New Zealand
| | - Michael G Baker
- Health, Environment & Infection Research Unit, Department of Public Health, University of Otago, Wellington, New Zealand
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27
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Baker MG, Gurney J, Moreland NJ, Bennett J, Oliver J, Williamson DA, Pierse N, Wilson N, Merriman TR, Percival T, Jackson C, Edwards R, Mow FC, Thomson WM, Zhang J, Lennon D. Risk factors for acute rheumatic fever: A case-control study. Lancet Reg Health West Pac 2022; 26:100508. [PMID: 36213134 PMCID: PMC9535428 DOI: 10.1016/j.lanwpc.2022.100508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain an inequitable cause of avoidable suffering and early death in many countries, including among Indigenous Māori and Pacific populations in New Zealand. There is a lack of robust evidence on interventions to prevent ARF. This study aimed to identify modifiable risk factors, with the goal of producing evidence to support policies and programs to decrease rates of ARF. METHODS A case-control study was undertaken in New Zealand using hospitalised, first episode ARF cases meeting a standard case-definition. Population controls (ratio of 3:1) were matched by age, ethnicity, socioeconomic deprivation, location, sex, and recruitment month. A comprehensive, pre-tested questionnaire was administered face-to-face by trained interviewers. FINDINGS The study included 124 cases and 372 controls. Multivariable analysis identified strong associations between ARF and household crowding (OR 3·88; 95%CI 1·68-8·98) and barriers to accessing primary health care (OR 2·07; 95% CI 1·08-4·00), as well as a high intake of sugar-sweetened beverages (OR 2·00; 1·13-3·54). There was a marked five-fold higher ARF risk for those with a family history of ARF (OR 4·97; 95% CI 2·53-9·77). ARF risk was elevated following self-reported skin infection (aOR 2·53; 1·44-4·42) and sore throat (aOR 2·33; 1·49-3·62). INTERPRETATION These globally relevant findings direct attention to the critical importance of household crowding and access to primary health care as strong modifiable causal factors in the development of ARF. They also support a greater focus on the role of managing skin infections in ARF prevention. FUNDING This research was funded by the Health Research Council of New Zealand (HRC) Rheumatic Fever Research Partnership (supported by the New Zealand Ministry of Health, Te Puni Kōkiri, Cure Kids, Heart Foundation, and HRC) award number 13/959.
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Affiliation(s)
- Michael G. Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
- Maurice Wilkins Centre, The University of Auckland, Auckland, New Zealand
| | - Jason Gurney
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nicole J. Moreland
- Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre, The University of Auckland, Auckland, New Zealand
| | - Julie Bennett
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Jane Oliver
- Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Victoria, Australia
| | - Deborah A. Williamson
- Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Victorian Infectious Diseases Reference Laboratory at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Nevil Pierse
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nigel Wilson
- Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Starship Children's Hospital, Auckland, New Zealand
- Green Lane Paediatric and Congenital Cardiac Services, Auckland, New Zealand
| | - Tony R. Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, United States of America
| | - Teuila Percival
- Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Moana Research, Auckland, New Zealand
| | | | - Richard Edwards
- Department of Public Health, University of Otago, Wellington, New Zealand
| | | | | | - Jane Zhang
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Diana Lennon
- Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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28
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Bennett J, Moreland NJ, Zhang J, Crane J, Sika-Paotonu D, Carapetis J, Williamson DA, Baker MG. Risk factors for group A streptococcal pharyngitis and skin infections: A case control study. Lancet Reg Health West Pac 2022; 26:100507. [PMID: 35789826 PMCID: PMC9250036 DOI: 10.1016/j.lanwpc.2022.100507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Group A streptococcal (GAS) infections can trigger an immune-mediated response resulting in acute rheumatic fever (ARF). The role of social and environmental risk factors for GAS pharyngitis and skin infections are not well understood. This study aimed to identify factors associated with GAS pharyngitis and skin infections, and to determine if these are the same as those for ARF. METHODS A case-control study, including 733 children aged 5-14 years, was undertaken between March 2018 and October 2019 in Auckland, New Zealand. Healthy controls (n = 190) and symptomatic cases including GAS pharyngitis (n = 210), GAS seronegative carriers (n = 182), and GAS skin infections (n = 151) were recruited. Trained interviewers administered a comprehensive, pre-tested, face-to-face questionnaire. FINDINGS Multivariable analysis identified strong associations between barriers to accessing primary healthcare and having GAS pharyngitis (adjusted OR 3·3; 95% CI 1·8-6·0), GAS carriage (aOR 2·9; 95% CI 1·5-6·0) or a GAS skin infection (aOR 3·5; 95% CI 1·6-7·6). Children who had GAS skin infections were more likely than all other groups to report living in a crowded home (aOR 1·9; 95% CI 1·0-3·4), have Māori or Pacific grandparents (aOR 3·0; 95% CI 1·2-7·6), a family history of ARF (aOR 2·2; 95% CI 1·1-4·3), or having a previous diagnosis of eczema (aOR 3·9; 95% CI 2·2-6·9). INTERPRETATION Reducing barriers to accessing primary healthcare (including financial restrictions, the inability to book an appointment, lack of transport, and lack of childcare for other children) to treat GAS pharyngitis and skin infections could potentially reduce these infections and lead to a reduction in their sequelae, including ARF. These strategies should be co-designed and culturally appropriate for the communities being served and carefully evaluated. FUNDING This work was supported by the Health Research Council of New Zealand (HRC), award number 16/005.
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Affiliation(s)
- Julie Bennett
- Department of Public Health, University of Otago, 23A Mein Street, Newtown, Wellington 6021, New Zealand
| | - Nicole J. Moreland
- School of Medical Sciences, the University of Auckland, 85 Park Road, Grafton, Auckland 1023, New Zealand
- Maurice Wilkins Centre, the University of Auckland, 85 Park Road, Grafton, Auckland 1023, New Zealand
| | - Jane Zhang
- Department of Public Health, University of Otago, 23A Mein Street, Newtown, Wellington 6021, New Zealand
| | - Julian Crane
- Department of Medicine, University of Otago, 23A Mein Street, Newtown, Wellington 6021, New Zealand
| | - Dianne Sika-Paotonu
- Department of Pathology and Molecular Medicine, University of Otago, 23A Mein Street, Newtown, Wellington 6021, New Zealand
| | - Jonathan Carapetis
- Telethon Kids Institute, 15 Hospital Ave, Nedlands, Perth, 6009, Western Australia
- Centre for Child Health and Research, University of Western Australia, 35 Stirling Hwy, Crawley, Perth 6009, Western Australia
- Perth Children's Hospital, 15 Hospital Ave, Nedlands, Perth, 6009, Western Australia
| | - Deborah A. Williamson
- Department of Infectious Disease, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3004, Australia
| | - Michael G. Baker
- Department of Public Health, University of Otago, 23A Mein Street, Newtown, Wellington 6021, New Zealand
- Maurice Wilkins Centre, the University of Auckland, 85 Park Road, Grafton, Auckland 1023, New Zealand
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29
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Boyd M, Baker MG, Nelson C, Wilson N. The 2021 Global Health Security (GHS) Index: Aotearoa New Zealand's improving capacity to manage biological threats must now be consolidated. N Z Med J 2022; 135:89-98. [PMID: 35999802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The 2021 Global Health Security (GHS) Index Report was published on 8 December 2021. With an average country score of 38.9 out of a possible 100 points, global scores are essentially unchanged from 2019. Despite experience with the COVID-19 pandemic, no country is adequately prepared for future biological threats. No country scored above 75.9 and the scores of the bottom 11 States have all fallen since 2019. Aotearoa New Zealand, however, has substantially improved its country score, rising to 13th in the world at 62.5/100. This gain is partly driven by consolidation of capabilities developed and deployed in response to COVID-19. This is promising progress, but a lot more can be done to ensure legacy benefits from the pandemic response, notably through the proposed restructuring of the health system (Pae Ora (Healthy Futures) Bill). In this viewpoint article, we discuss this recent further development of the GHS Index, highlight the global results for 2021, delve into New Zealand's progress, and discuss what more is needed.
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Affiliation(s)
- Matt Boyd
- Research Director, Adapt Research Ltd, Reefton, New Zealand
| | - Michael G Baker
- School of Public Health, University of Otago, Wellington, New Zealand
| | - Cassidy Nelson
- Future of Humanity Institute, University of Oxford, Oxford, United Kingdom
| | - Nick Wilson
- School of Public Health, University of Otago, Wellington, New Zealand
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30
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Rentta NN, Bennett J, Leung W, Webb R, Jack S, Harwood M, Baker MG, Lund M, Wilson N. Medical Treatment for Rheumatic Heart Disease: A Narrative Review. Heart Lung Circ 2022; 31:1463-1470. [PMID: 35987720 DOI: 10.1016/j.hlc.2022.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 07/03/2022] [Accepted: 07/06/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are rare in high-income countries; however, in Aotearoa New Zealand ARF and RHD disproportionately affect Indigenous Māori and Pacific Peoples. This narrative review explores the evidence regarding non-surgical management of patients with clinically significant valve disease or heart failure due to RHD. METHODS Medline, EMBASE and Scopus databases were searched, and additional publications were identified through cross-referencing. Included were 28 publications from 1980 onwards. RESULTS Of the available interventions, improved anticoagulation management and a national RHD register could improve RHD outcomes in New Zealand. Where community pharmacy anticoagulant management services (CPAMS) are available good anticoagulation control can be achieved with a time in the therapeutic range (TTR) of more than 70%, which is above the internationally recommended level of 60%. The use of pharmacists in anticoagulation control is cost-effective, acceptable to patients, pharmacists, and primary care practitioners. There is a lack of local data available to fully assess other interventions; including optimal therapy for heart failure, equitable access to specialist RHD care, prevention, and management of endocarditis. CONCLUSION As RHD continues to disproportionately affect Indigenous and minority groups, pro-equity tertiary prevention interventions should be fully evaluated to ensure they are reducing disease burden and improving outcomes in patients with RHD.
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Affiliation(s)
| | - Julie Bennett
- Department of Public Health, University of Otago, Wellington, New Zealand.
| | - William Leung
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Rachel Webb
- Auckland District Health Board, Auckland, New Zealand; University of Auckland, Department of Paediatrics: Child and Youth Health, Auckland, New Zealand
| | - Susan Jack
- Public Health South, Southern District Health Board, Dunedin, New Zealand
| | - Matire Harwood
- General Practice and Primary Healthcare, University of Auckland, Auckland, New Zealand
| | - Michael G Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Mayanna Lund
- Counties Manukau District Health Board, Auckland, New Zealand
| | - Nigel Wilson
- Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Auckland, New Zealand; Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand
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31
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Bennett J, Shorter C, Kvalsvig A, Telfar Barnard L, Wilson N, Crane J, Douwes J, Cunningham C, Taptiklis P, Phipps R, Trompetter B, Plagmann M, Boulic M, Summers J, Berry TA, Baker MG, Howden-Chapman P. Indoor air quality, largely neglected and in urgent need of a refresh. N Z Med J 2022; 135:136-139. [PMID: 35999791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Julie Bennett
- Senior Research Fellow, Department of Public Health, University of Otago, Wellington
| | - Caroline Shorter
- Senior Research Fellow, Department of Medicine, University of Otago, Wellington
| | - Amanda Kvalsvig
- Senior Research Fellow, Health Environment and Infection Research Unit (HEIRU), Department of Public Health, University of Otago Wellington
| | | | - Nick Wilson
- Professor of Public Health, Health Environment and Infection Research Unit, University of Otago, Wellington
| | - Julian Crane
- Research Professor, Department of Medicine, University of Otago, Wellington
| | - Jeroen Douwes
- Professor of Public Health, Research Centre for Hauora and Health, Massey University, Wellington
| | - Chris Cunningham
- Professor of Māori & Public Health, Research Centre for Hauora and Health, Massey University, Wellington and He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington
| | | | - Robyn Phipps
- Professor of Building Science, School of Architecture, Victoria University of Wellington and He Kāinga Oranga/Housing and Health Research Programme
| | - Bill Trompetter
- Senior Scientist, GNS Science, NZ Indoor Air Quality Research Centre, Chair of Indoor air quality special interest group for CASANZ
| | - Manfred Plagmann
- Principal Scientist, BRANZ Ltd., NZ Indoor Air Quality Research Centre
| | - Mikael Boulic
- Senior Lecturer, School of Built Environment, Massey University, Auckland
| | - Jennifer Summers
- Senior Research Fellow, Health Environment and Infection Research Unit, University of Otago, Wellington
| | - Terri-Ann Berry
- Director (ESRC) and Associate Professor, Environmental Solutions Research Centre (ESRC) and School of Construction and Engineering, Unitec Institute of Technology, Auckland
| | - Michael G Baker
- Professor of Public Health, He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington
| | - Philippa Howden-Chapman
- Distinguished Professor, He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington
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Walker TA, Grainger R, Quirke T, Roos R, Sherwood J, Mackereth G, Kiedrzynski T, Eyre R, Paine S, Wood T, Jagroop A, Baker MG, Jones N. Reactive arthritis incidence in a community cohort following a large waterborne campylobacteriosis outbreak in Havelock North, New Zealand. BMJ Open 2022; 12:e060173. [PMID: 35667727 PMCID: PMC9171216 DOI: 10.1136/bmjopen-2021-060173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 05/16/2022] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES In August 2016, Campylobacter spp contaminated an untreated reticulated water supply resulting in a large-scale gastroenteritis outbreak affecting an estimated 8320 people. We aimed to determine the incidence of probable reactive arthritis (ReA) cases in individuals with culture-confirmed campylobacteriosis (CC), self-reported probable campylobacteriosis (PC) and those reporting no diarrhoea (ND). DESIGN We conducted a retrospective cohort study to identify incidence of probable ReA cases. We identified cases with new ReA symptoms using an adapted acute ReA (AReA) telephone questionnaire. Those reporting ≥1 symptom underwent a telephone interview with the study rheumatologist. Probable ReA was defined as spontaneous onset of pain suggestive of inflammatory arthritis in ≥1 previously asymptomatic joint for ≥3 days occurring ≤12 weeks after outbreak onset. SETTING Population-based epidemiological study in Havelock North, New Zealand. PARTICIPANTS We enrolled notified CC cases with gastroenteritis symptom onsets 5 August 2016-6 September 2016 and conducted a telephone survey of households supplied by the contaminated water source to enrol PC and ND cases. RESULTS One hundred and six (47.3%) CC, 47 (32.6%) PC and 113 (34.3%) ND cases completed the AReA telephone questionnaire. Of those reporting ≥1 new ReA symptom, 45 (75.0%) CC, 13 (68.4%) PC and 14 (82.4%) ND cases completed the rheumatologist telephone interview. Nineteen CC, 4 PC and 2 ND cases developed probable ReA, resulting in minimum incidences of 8.5%, 2.8% and 0.6% and maximum incidences of 23.9%, 12.4% and 2.15%. DISCUSSION We describe high probable ReA incidences among gastroenteritis case types during a very large Campylobacter gastroenteritis outbreak using a resource-efficient method that is feasible to employ in future outbreaks.
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Affiliation(s)
- Tiffany A Walker
- Institute of Environmental Science and Research Ltd, Porirua, The New Zealand
| | - Rebecca Grainger
- Department of Medicine, University of Otago, Wellington, The New Zealand
| | - Terence Quirke
- Institute of Environmental Science and Research Ltd, Porirua, The New Zealand
| | - Rebekah Roos
- Institute of Environmental Science and Research Ltd, Porirua, The New Zealand
| | - Jill Sherwood
- Institute of Environmental Science and Research Ltd, Porirua, The New Zealand
| | - Graham Mackereth
- Institute of Environmental Science and Research Ltd, Porirua, The New Zealand
| | | | - Rachel Eyre
- Hawke's Bay District Health Board, Napier, The New Zealand
| | - Shevaun Paine
- Institute of Environmental Science and Research Ltd, Porirua, The New Zealand
| | - Tim Wood
- Institute of Environmental Science and Research Ltd, Porirua, The New Zealand
| | - Anita Jagroop
- School of Health and Sport Science, Eastern Institute of Technology, Napier, The New Zealand
| | - Michael G Baker
- Department of Public Health, University of Otago, Dunedin, The New Zealand
| | - Nicholas Jones
- Hawke's Bay District Health Board, Napier, The New Zealand
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Durrheim DN, Baker MG, Capeding MR, Goh KT, Lee D, Papania M, Rota PA, Soo TL, Tsang TH, Xu A. Accelerating measles elimination in the Western Pacific Region during the calm between the storms. Lancet Reg Health West Pac 2022; 23:100495. [PMID: 35663430 PMCID: PMC9153286 DOI: 10.1016/j.lanwpc.2022.100495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
- David N. Durrheim
- Chairperson: Western Pacific Measles and Rubella Elimination Regional Verification Commission, Professor of Public Health Medicine, University of Newcastle, Wallsend, New South Wales, Australia
- Corresponding author.
| | - Michael G. Baker
- Professor of Public Health, University of Otago, Wellington, New Zealand
| | - Maria Rosario Capeding
- Head Department of Pediatric Infectious Diseases, Asian Hospital and Medical Centre, Muntinlupa City, Philippines
| | - Kee Tai Goh
- Adjunct Professor of Public Health, Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Dukhyoung Lee
- Invited Professor, International Tuberculosis Research Centre, Gyeongsangnam-do, Republic of Korea
| | - Mark Papania
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Paul A. Rota
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Thian Lian Soo
- Clinical Associate Professor, International Medical University, Malaysia
| | - Thomas H. Tsang
- President, Hong Kong College of Community Medicine, Hong Kong Special Administrative Region, China
| | - Aiqiang Xu
- Chief Expert in Epidemiology, Shangdong Center for Disease Prevention and Control, Jinan, Shandong Province, People's Republic of China
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Grout L, Marshall J, Hales S, Baker MG, French N. Dairy Cattle Density and Temporal Patterns of Human Campylobacteriosis and Cryptosporidiosis in New Zealand. Ecohealth 2022; 19:273-289. [PMID: 35689151 PMCID: PMC9276729 DOI: 10.1007/s10393-022-01593-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 03/18/2022] [Indexed: 06/15/2023]
Abstract
Public health risks associated with the intensification of dairy farming are an emerging concern. Dairy cattle are a reservoir for a number of pathogens that can cause human illness. This study examined the spatial distribution of dairy cattle density and explored temporal patterns of human campylobacteriosis and cryptosporidiosis notifications in New Zealand from 1997 to 2015. Maps of dairy cattle density were produced, and temporal patterns of disease rates were assessed for urban versus rural areas and for areas with different dairy cattle densities using descriptive temporal analyses. Campylobacteriosis and cryptosporidiosis rates displayed strong seasonal patterns, with highest rates in spring in rural areas and, for campylobacteriosis, summer in urban areas. Increases in rural cases often preceded increases in urban cases. Furthermore, disease rates in areas with higher dairy cattle densities tended to peak before areas with low densities or no dairy cattle. Infected dairy calves may be a direct or indirect source of campylobacteriosis or cryptosporidiosis infection in humans through environmental or occupational exposure routes, including contact with animals or feces, recreational contact with contaminated waterways, and consumption of untreated drinking water. These results have public health implications for populations living, working, or recreating in proximity to dairy farms.
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Affiliation(s)
- Leah Grout
- Department of Public Health, University of Otago, Wellington, 6021, New Zealand.
| | - Jonathan Marshall
- School of Mathematical and Computational Sciences, Massey University, Palmerston North, 4474, New Zealand
| | - Simon Hales
- Department of Public Health, University of Otago, Wellington, 6021, New Zealand
| | - Michael G Baker
- Department of Public Health, University of Otago, Wellington, 6021, New Zealand
| | - Nigel French
- School of Veterinary Science, Hopkirk Research Institute, Massey University, Palmerston North, 4474, New Zealand
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35
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Thompson J, McClure R, Blakely T, Wilson N, Baker MG, Wijnands JS, De Sa TH, Nice K, Cruz C, Stevenson M. Modelling SARS-CoV-2 disease progression in Australia and New Zealand: an account of an agent-based approach to support public health decision-making. Aust N Z J Public Health 2022; 46:292-303. [PMID: 35238437 PMCID: PMC9111129 DOI: 10.1111/1753-6405.13221] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 08/01/2021] [Accepted: 01/01/2022] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE In 2020, we developed a public health decision-support model for mitigating the spread of SARS-CoV-2 infections in Australia and New Zealand. Having demonstrated its capacity to describe disease progression patterns during both countries' first waves of infections, we describe its utilisation in Victoria in underpinning the State Government's then 'RoadMap to Reopening'. METHODS Key aspects of population demographics, disease, spatial and behavioural dynamics, as well as the mechanism, timing, and effect of non-pharmaceutical public health policies responses on the transmission of SARS-CoV-2 in both countries were represented in an agent-based model. We considered scenarios related to the imposition and removal of non-pharmaceutical interventions on the estimated progression of SARS-CoV-2 infections. RESULTS Wave 1 results suggested elimination of community transmission of SARS-CoV-2 was possible in both countries given sustained public adherence to social restrictions beyond 60 days' duration. However, under scenarios of decaying adherence to restrictions, a second wave of infections (Wave 2) was predicted in Australia. In Victoria's second wave, we estimated in early September 2020 that a rolling 14-day average of <5 new cases per day was achievable on or around 26 October. Victoria recorded a 14-day rolling average of 4.6 cases per day on 25 October. CONCLUSIONS Elimination of SARS-CoV-2 transmission represented in faithfully constructed agent-based models can be replicated in the real world. IMPLICATIONS FOR PUBLIC HEALTH Agent-based public health policy models can be helpful to support decision-making in novel and complex unfolding public health crises.
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Affiliation(s)
- Jason Thompson
- Transport, Health and Urban Design (THUD) Research Lab, The University of Melbourne, Victoria,Correspondence to: Dr Jason Thompson, Transport, Health and Urban Design Research Lab, Melbourne School of Design, The University of Melbourne, VIC 3010
| | - Rod McClure
- Faculty of Medicine and Health, The University of New England, New South Wales
| | - Tony Blakely
- Melbourne School of Population and Global Health, The University of Melbourne, Victoria
| | - Nick Wilson
- Department of Public Health, The University of Otago, New Zealand
| | - Michael G. Baker
- Department of Public Health, The University of Otago, New Zealand
| | - Jasper S. Wijnands
- Transport, Health and Urban Design (THUD) Research Lab, The University of Melbourne, Victoria
| | - Thiago Herick De Sa
- Center for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Brazil
| | - Kerry Nice
- Transport, Health and Urban Design (THUD) Research Lab, The University of Melbourne, Victoria
| | - Camilo Cruz
- Transport, Health and Urban Design (THUD) Research Lab, The University of Melbourne, Victoria
| | - Mark Stevenson
- Transport, Health and Urban Design (THUD) Research Lab, The University of Melbourne, Victoria,Melbourne School of Population and Global Health, The University of Melbourne, Victoria,Melbourne School of Engineering, The University of Melbourne, Victoria
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36
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Ammar SE, Mclntyre M, Baker MG, Hales S. New Zealand travellers to high-risk destinations for arbovirus infection make little effort to avoid mosquito bites. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2071951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Sherif E. Ammar
- Department of Public Health, University of Otago, Wellington, New Zealand
- Institute of Environmental Science and Research (ESR), Wellington, New Zealand
| | - Mary Mclntyre
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Michael G. Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Simon Hales
- Department of Public Health, University of Otago, Wellington, New Zealand
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37
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Alves DE, Mamelund SE, Dimka J, Simonsen L, Mølbak M, Ørskov S, Sattenspiel L, Tripp L, Noymer A, Chowell-Puente G, Dahal S, Van Doren TP, Wissler A, Heffernan C, Renfree Short K, Battles H, Baker MG. Indigenous peoples and pandemics. Scand J Public Health 2022; 50:662-667. [PMID: 35546099 PMCID: PMC9361406 DOI: 10.1177/14034948221087095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Daniele E Alves
- Centre for Research on Pandemics & Society, Oslo Metropolitan University, Norway
| | - Svenn-Erik Mamelund
- Centre for Research on Pandemics & Society, Oslo Metropolitan University, Norway
| | - Jessica Dimka
- Centre for Research on Pandemics & Society, Oslo Metropolitan University, Norway
| | | | | | | | | | - Lianne Tripp
- Department of Anthropology, University of Northern British Columbia, Canada
| | - Andrew Noymer
- Program in Public Health, University of California, Irvine, USA
| | | | - Sushma Dahal
- Department of Population Health Sciences, Georgia State University, USA
| | | | - Amanda Wissler
- School of Human Evolution and Social Change, Arizona State University, USA
| | - Courtney Heffernan
- Tuberculosis Program Evaluation and Research Unit, University of Alberta, Canada
| | - Kirsty Renfree Short
- School of Chemistry and Molecular Biosciences, University of Queensland, Australia
| | - Heather Battles
- Department of Anthropology, University of Auckland, New Zealand
| | - Michael G Baker
- Health Environment Infection Research Unit, University of Otago, New Zealand
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38
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Richards J, Chambers T, Hales S, Joy M, Radu T, Woodward A, Humphrey A, Randal E, Baker MG. Nitrate contamination in drinking water and colorectal cancer: Exposure assessment and estimated health burden in New Zealand. Environ Res 2022; 204:112322. [PMID: 34740625 DOI: 10.1016/j.envres.2021.112322] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 09/30/2021] [Accepted: 10/29/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Epidemiological evidence in multiple jurisdictions has shown an association between nitrate exposure in drinking water and an increased risk of colorectal cancer (CRC). OBJECTIVE We aimed to review the extent of nitrate contamination in New Zealand drinking water and estimate the health and financial burden of nitrate-attributable CRC. METHODS We collated data on nitrate concentrations in drinking water for an estimated 85% of the New Zealand population (∼4 million people) who were on registered supplies. We estimated nitrate levels for the remaining population (∼600,000 people) based on samples from 371 unregistered (private) supplies. We used the effective rate ratio from previous epidemiological studies to estimate CRC cases and deaths attributable to nitrate in drinking water. RESULTS Three-quarters of New Zealanders are on water supplies with less than 1 mg/L NO3-N. The population weighted average for nitrate exposure for people on registered supplies was 0.49 mg/L NO3-N with 1.91% (95%CI 0.49, 3.30) of CRC cases attributable to nitrates. This correlates to 49.7 cases per year (95%CI 14.9, 101.5) at a cost of 21.3 million USD (95% 6.4, 43.5 million USD). When combining registered and unregistered supplies, we estimated 3.26% (95%CI 0.84, 5.57) of CRC cases were attributable to nitrates, resulting in 100 cases (95%CI 25.7, 171.3) and 41 deaths (95%CI 10.5, 69.7) at a cost of 43.2 million USD (95%CI 10.9, 73.4). CONCLUSION A substantial minority of New Zealanders are exposed to high or unknown levels of nitrates in their drinking water. Given the international epidemiological studies showing an association between cancer and nitrate ingestion from drinking water, this exposure may cause an important burden of preventable CRC cases, deaths, and economic costs. We consider there is sufficient evidence to justify a review of drinking water standards. Protecting public health adds to the strong environmental arguments to improve water management in New Zealand.
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Affiliation(s)
- Jayne Richards
- School of Architecture, Building and Civil Engineering, Loughborough University, Epinal Way, Loughborough, LE11 3TU, UK
| | - Tim Chambers
- Health, Environment & Infection Research Unit, Department of Public Health, University of Otago, Wellington, New Zealand.
| | - Simon Hales
- Health, Environment & Infection Research Unit, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Mike Joy
- School of Government, Victoria University of Wellington, New Zealand
| | - Tanja Radu
- School of Architecture, Building and Civil Engineering, Loughborough University, Epinal Way, Loughborough, LE11 3TU, UK
| | - Alistair Woodward
- Epidemiology & Biostatistics, School of Population Health, University of Auckland, New Zealand
| | | | - Edward Randal
- Health, Environment & Infection Research Unit, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Michael G Baker
- Health, Environment & Infection Research Unit, Department of Public Health, University of Otago, Wellington, New Zealand
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39
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Gray L, MacDonald C, Puloka A, Bocock C, Gwyther R, Rushton A, Puloka V, Becker JS, Kvalsvig A, Baker MG. The lived experience of hotel isolation and quarantine at the Aotearoa New Zealand border for COVID-19: A qualitative descriptive study. Int J Disaster Risk Reduct 2022; 70:102779. [PMID: 36569446 PMCID: PMC9764876 DOI: 10.1016/j.ijdrr.2021.102779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/28/2021] [Accepted: 12/30/2021] [Indexed: 06/17/2023]
Abstract
Hotel-based Managed Isolation and Quarantine (MIQ) is a key public health intervention in Aotearoa New Zealand's (NZ) COVID-19 border control strategy for returning citizens and permanent residents. We aimed to investigate the experience of transiting through MIQ in NZ, to inform future refinements of this type of system. A qualitative thematic analysis method was utilised to explore experiences in depth with seventy-five individuals who had undergone MIQ in NZ between April 2020 and July 2021. Participants were interviewed by telephone or Zoom or completed an online qualitative questionnaire. Interviews were audio recorded, transcribed and coded; questionnaire responses were sorted and coded. All data were subjected to thematic analysis. Three main themes described the key elements of the participants' experience of MIQ that influenced their overall experiences: 1) The MIQ process, 2) MIQ Hotels, and 3) Individual experience. The variation in participants' overall experience of MIQ was strongly influenced by their perceptions of how well the MIQ process was managed (including communication, flexibility, and compliance with disease prevention and control measures); and the quality of the hotels they were allocated to (in particular hotel staff, meals and information). This valuable insight into the experience of individuals in NZ MIQ hotels can inform better planning, management and implementation of the MIQ process for NZ and adds to the literature of countries utilising such strategies to minimise the transmission of COVID-19, whilst protecting the wellbeing of those using the system.
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Affiliation(s)
- Lesley Gray
- University of Otago, Wellington, 6242, Aotearoa, New Zealand
- Joint Centre for Disaster Research, Massey University, Wellington, New Zealand
| | | | - Aivi Puloka
- University of Otago, Wellington, 6242, Aotearoa, New Zealand
| | - Claudia Bocock
- University of Otago, Wellington, 6242, Aotearoa, New Zealand
| | - Ruth Gwyther
- University of Otago, Wellington, 6242, Aotearoa, New Zealand
| | - Ashleigh Rushton
- Joint Centre for Disaster Research, Massey University, Wellington, New Zealand
| | - Viliami Puloka
- University of Otago, Wellington, 6242, Aotearoa, New Zealand
| | - Julia S Becker
- Joint Centre for Disaster Research, Massey University, Wellington, New Zealand
| | - Amanda Kvalsvig
- University of Otago, Wellington, 6242, Aotearoa, New Zealand
| | - Michael G Baker
- University of Otago, Wellington, 6242, Aotearoa, New Zealand
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40
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Whitcombe AL, McGregor R, Bennett J, Gurney JK, Williamson DA, Baker MG, Moreland NJ. OUP accepted manuscript. J Infect Dis 2022; 226:167-176. [PMID: 35134931 PMCID: PMC9373162 DOI: 10.1093/infdis/jiac043] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/01/2022] [Indexed: 11/26/2022] Open
Abstract
Background Group A Streptococcus (GAS) causes superficial pharyngitis and skin infections as well as serious autoimmune sequelae such as acute rheumatic fever (ARF) and subsequent rheumatic heart disease. ARF pathogenesis remains poorly understood. Immune priming by repeated GAS infections is thought to trigger ARF, and there is growing evidence for the role of skin infections in this process. Methods We utilized our recently developed 8-plex immunoassay, comprising antigens used in clinical serology for diagnosis of ARF (SLO, DNase B, SpnA), and 5 conserved putative GAS vaccine antigens (Spy0843, SCPA, SpyCEP, SpyAD, Group A carbohydrate), to characterize antibody responses in sera from New Zealand children with a range of clinically diagnosed GAS disease: ARF (n = 79), GAS-positive pharyngitis (n = 94), GAS-positive skin infection (n = 51), and matched healthy controls (n = 90). Results The magnitude and breadth of antibodies in ARF was very high, giving rise to a distinct serological profile. An average of 6.5 antigen-specific reactivities per individual was observed in ARF, compared to 4.2 in skin infections and 3.3 in pharyngitis. Conclusions ARF patients have a unique serological profile, which may be the result of repeated precursor pharyngitis and skin infections that progressively boost antibody breadth and magnitude.
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Affiliation(s)
- Alana L Whitcombe
- School of Medical Sciences and Maurice Wilkins Centre, University of Auckland, Auckland, New Zealand
| | - Reuben McGregor
- School of Medical Sciences and Maurice Wilkins Centre, University of Auckland, Auckland, New Zealand
| | - Julie Bennett
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Jason K Gurney
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Deborah A Williamson
- University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Michael G Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nicole J Moreland
- Correspondence: Nicole J. Moreland, BSc, PhD, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand ()
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Wilson B, Jones N, Wood T, Jagroop-Dearing A, Kubovy J, Baker MG. Clinical outcomes of campylobacteriosis: a case series analysis of hospitalisations associated with the Havelock North Campylobacter outbreak. N Z Med J 2021; 134:71-84. [PMID: 35728111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
AIM In August 2016, a large waterborne campylobacteriosis outbreak occurred in Havelock North, New Zealand. This analysis describes the clinical complications of cases admitted to hospital as a result of acute infection, identifies risk factors for hospitalisation and compares deaths between hospitalised and non-hospitalised cases. Hospital admissions with post-infectious sequelae were excluded as they are the subject of a separate analysis. METHODS A case series analysis was undertaken by reviewing the electronic medical records of 933 residents of Hawke's Bay District Health Board with probable and confirmed campylobacteriosis linked to the Havelock North Campylobacter outbreak. RESULTS A total of 67 hospital admissions, among 58 individuals, are described. Pre-existing comorbidity and advanced age were significant risk factors for hospital admission in univariate analysis. Dehydration (74.1%), electrolyte imbalance (35.8%) and acute kidney injury (27.6%) were common among hospitalised cases. The proportion of hospitalised cases that died within one year was significantly higher when compared to deaths among non-hospitalised cases (OR 5.0, 95% CI: 2.3-10.7), although this trend was not statistically significant after adjusting for age and comorbidity (OR 2.3, 95% CI: 0.96-5.3). CONCLUSIONS This study highlights the serious health impacts that occurred from a campylobacteriosis outbreak of this magnitude.
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Affiliation(s)
- Bridget Wilson
- Public Health Physician, Hawke's Bay District Health Board, Hastings 4156, New Zealand
| | - Nicholas Jones
- Clinical Director, Health Improvement and Equity Directorate, Hawke's Bay District Health Board, Hastings 4156, New Zealand
| | - Tim Wood
- Senior Scientist (Epidemiology), Health Intelligence Group, Institute of Environmental Science and Research Limited (ESR), Porirua 5022, New Zealand
| | - Anita Jagroop-Dearing
- Senior Academic Staff Member, Eastern Institute of Technology, Napier 4112, New Zealand
| | - Jan Kubovy
- Department of Gastroenterology, Christchurch Hospital, Christchurch 8011, New Zealand
| | - Michael G Baker
- Professor of Public Health, University of Otago, Wellington 6242, New Zealand
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Baker MG, Kvalsvig A, Crengle S, Harwood M, Tukuitonga C, Betty B, Bonning J, Wilson N. The next phase in Aotearoa New Zealand's COVID-19 response: a tight suppression strategy may be the best option. N Z Med J 2021; 134:135. [PMID: 35728119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Michael G Baker
- Professor of Public Health, Director of CoSearch, Department of Public Health, University of Otago, Wellington
| | - Amanda Kvalsvig
- Senior Research Fellow, Co-Director of CoSearch, Department of Public Health, University of Otago Wellington
| | - Sue Crengle
- Professor in Māori Health, Department of Preventive and Social Medicine, University of Otago, Dunedin; Specialist General Practitioner, Invercargill
| | - Matire Harwood
- Associate Professor, Department of General Practice and Primary Care, University of Auckland; Specialist General Practitioner, Papakura Marae Health Clinic, Auckland
| | - Collin Tukuitonga
- Associate Dean (Pacific) and Associate Professor of Public Health, Faculty of Medical and Health Sciences, University of Auckland
| | - Bryan Betty
- Medical Director of the Royal New Zealand College of General Practitioners; Specialist General Practitioner, Cannons Creek, East Porirua
| | - John Bonning
- FACEM, Emergency Physician Waikato Hospital; Chair of the Council of Medical Colleges of Aotearoa NZ; Immediate Past president ACEM
| | - Nick Wilson
- Professor of Public Health, BODE3 Programme, Department of Public Health, University of Otago, Wellington
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Lorenz N, Ho TKC, McGregor R, Davies MR, Williamson DA, Gurney JK, Smeesters PR, Baker MG, Moreland NJ. Serological Profiling of Group A Streptococcus Infections in Acute Rheumatic Fever. Clin Infect Dis 2021; 73:2322-2325. [PMID: 33639619 DOI: 10.1093/cid/ciab180] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Indexed: 01/28/2023] Open
Abstract
Rheumatic fever is a serious post-infectious sequela of group A Streptococcus (GAS). Prior GAS exposures were mapped in sera using a large panel of M-type specific peptides. Rheumatic fever patients had serological evidence of significantly more GAS exposures than matched controls suggesting immune priming by repeat infections contributes to pathogenesis.
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Affiliation(s)
- Natalie Lorenz
- School of Medical Sciences, University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Biodiscovery, Auckland, New Zealand
| | - Timothy K C Ho
- School of Medical Sciences, University of Auckland, Auckland, New Zealand
| | - Reuben McGregor
- School of Medical Sciences, University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Biodiscovery, Auckland, New Zealand
| | - Mark R Davies
- Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Australia
| | - Deborah A Williamson
- Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Australia
| | - Jason K Gurney
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Pierre R Smeesters
- Molecular Bacteriology Laboratory, Université Libre de Bruxelles, Brussels, Belgium
| | - Michael G Baker
- Maurice Wilkins Centre for Biodiscovery, Auckland, New Zealand.,Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nicole J Moreland
- School of Medical Sciences, University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Biodiscovery, Auckland, New Zealand
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44
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Baker MG, Kvalsvig A, Crengle S, Harwood M, Tukuitonga C, Betty B, Bonning J, Wilson N. The next phase in Aotearoa New Zealand's COVID-19 response: a tight suppression strategy may be the best option. N Z Med J 2021; 134:8-16. [PMID: 34855729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Michael G Baker
- Professor of Public Health, Director of CoSearch, Department of Public Health, University of Otago, Wellington
| | - Amanda Kvalsvig
- Senior Research Fellow, Co-Director of CoSearch, Department of Public Health, University of Otago Wellington
| | - Sue Crengle
- Professor in Māori Health, Department of Preventive and Social Medicine, University of Otago, Dunedin; Specialist General Practitioner, Invercargill
| | - Matire Harwood
- Associate Professor, Department of General Practice and Primary Care, University of Auckland; Specialist General Practitioner, Papakura Marae Health Clinic, Auckland
| | - Collin Tukuitonga
- Associate Dean (Pacific) and Associate Professor of Public Health, Faculty of Medical and Health Sciences, University of Auckland
| | - Bryan Betty
- Medical Director of the Royal New Zealand College of General Practitioners; Specialist General Practitioner, Cannons Creek, East Porirua
| | - John Bonning
- FACEM, Emergency Physician Waikato Hospital; Chair of the Council of Medical Colleges of Aotearoa NZ; Immediate Past president ACEM
| | - Nick Wilson
- Professor of Public Health, BODE3 Programme, Department of Public Health, University of Otago, Wellington
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45
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Oliu-Barton M, Pradelski BSR, Algan Y, Baker MG, Binagwaho A, Dore GJ, El-Mohandes A, Fontanet A, Peichl A, Priesemann V, Wolff GB, Yamey G, Lazarus JV. Elimination versus mitigation of SARS-CoV-2 in the presence of effective vaccines. Lancet Glob Health 2021; 10:e142-e147. [PMID: 34739862 PMCID: PMC8563003 DOI: 10.1016/s2214-109x(21)00494-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/13/2021] [Accepted: 10/13/2021] [Indexed: 12/21/2022]
Abstract
There is increasing evidence that elimination strategies have resulted in better outcomes for public health, the economy, and civil liberties than have mitigation strategies throughout the first year of the COVID-19 pandemic. With vaccines that offer high protection against severe forms of COVID-19, and increasing vaccination coverage, policy makers have had to reassess the trade-offs between different options. The desirability and feasibility of eliminating SARS-CoV-2 compared with other strategies should also be re-evaluated from the perspective of different fields, including epidemiology, public health, and economics. To end the pandemic as soon as possible—be it through elimination or reaching an acceptable endemic level—several key topics have emerged centring around coordination, both locally and internationally, and vaccine distribution. Without coordination it is difficult if not impossible to sustain elimination, which is particularly relevant in highly connected regions, such as Europe. Regarding vaccination, concerns remain with respect to equitable distribution, and the risk of the emergence of new variants of concern. Looking forward, it is crucial to overcome the dichotomy between elimination and mitigation, and to jointly define a long-term objective that can accommodate different political and societal realities.
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Affiliation(s)
- Miquel Oliu-Barton
- Université Paris-Dauphine-PSL, Paris, France; Bruegel, Brussels, Belgium; Esade Centre for Economic Policy, Madrid, Spain.
| | - Bary S R Pradelski
- French National Centre for Scientific Research, Grenoble, France; Oxford-Man Institute of Quantitative Finance, University of Oxford, Oxford, UK
| | - Yann Algan
- HEC Paris, Jouy-en-Josas, France; Council of Economic Analysis, Paris, France
| | | | | | - Gregory J Dore
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | | | - Arnaud Fontanet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université de Paris, Paris, France; Conservatoire National des Arts et Métiers, PACRI Unit, Paris, France
| | - Andreas Peichl
- University of Munich, Munich, Germany; ifo Institute, Munich, Germany; CESifo, Munich, Germany
| | - Viola Priesemann
- Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany
| | | | - Gavin Yamey
- Centre for Policy Impact in Global Health, Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
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46
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Binny RN, Baker MG, Hendy SC, James A, Lustig A, Plank MJ, Ridings KM, Steyn N. Early intervention is the key to success in COVID-19 control. R Soc Open Sci 2021; 8:210488. [PMID: 34804563 PMCID: PMC8596003 DOI: 10.1098/rsos.210488] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/28/2021] [Indexed: 06/02/2023]
Abstract
New Zealand responded to the COVID-19 pandemic with a combination of border restrictions and an Alert Level (AL) system that included strict stay-at-home orders. These interventions were successful in containing an outbreak and ultimately eliminating community transmission of COVID-19 in June 2020. The timing of interventions is crucial to their success. Delaying interventions may reduce their effectiveness and mean that they need to be maintained for a longer period. We use a stochastic branching process model of COVID-19 transmission and control to simulate the epidemic trajectory in New Zealand's March-April 2020 outbreak and the effect of its interventions. We calculate key measures, including the number of reported cases and deaths, and the probability of elimination within a specified time frame. By comparing these measures under alternative timings of interventions, we show that changing the timing of AL4 (the strictest level of restrictions) has a far greater impact than the timing of border measures. Delaying AL4 restrictions results in considerably worse outcomes. Implementing border measures alone, without AL4 restrictions, is insufficient to control the outbreak. We conclude that the early introduction of stay-at-home orders was crucial in reducing the number of cases and deaths, enabling elimination.
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Affiliation(s)
- Rachelle N. Binny
- Manaaki Whenua, Lincoln, New Zealand
- Te Pūnaha Matatini: the Centre for Complex Systems and Networks, Auckland, New Zealand
| | - Michael G. Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand
| | - Shaun C. Hendy
- Department of Physics, University of Auckland, Auckland, New Zealand
- Te Pūnaha Matatini: the Centre for Complex Systems and Networks, Auckland, New Zealand
| | - Alex James
- School of Mathematics and Statistics, University of Canterbury, Christchurch, New Zealand
- Te Pūnaha Matatini: the Centre for Complex Systems and Networks, Auckland, New Zealand
| | - Audrey Lustig
- Manaaki Whenua, Lincoln, New Zealand
- Te Pūnaha Matatini: the Centre for Complex Systems and Networks, Auckland, New Zealand
| | - Michael J. Plank
- School of Mathematics and Statistics, University of Canterbury, Christchurch, New Zealand
- Te Pūnaha Matatini: the Centre for Complex Systems and Networks, Auckland, New Zealand
| | - Kannan M. Ridings
- Department of Physics, University of Auckland, Auckland, New Zealand
- Te Pūnaha Matatini: the Centre for Complex Systems and Networks, Auckland, New Zealand
| | - Nicholas Steyn
- School of Mathematics and Statistics, University of Canterbury, Christchurch, New Zealand
- Department of Physics, University of Auckland, Auckland, New Zealand
- Te Pūnaha Matatini: the Centre for Complex Systems and Networks, Auckland, New Zealand
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47
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Bar-Yam Y, Gurdasani D, Baker MG, Scally G, George S, Kvalsvig A, Fhaoláin SN, Chiou ST, Drury J, Duckett S, Ding EL, Gershenson C, Gibson C, Greenhalgh T, Hamdy A, Hyde Z, James T, Jimenez JL, McKee M, Michie S, Pagel C, Philippe C, Prather K, Raina SK, Ricciardi W, Rubin M, Ryan T, Schneider MF, Staines A, West R, Ziauddeen H. The World Health Network: a global citizens' initiative. Lancet 2021; 398:1567-1568. [PMID: 34755625 PMCID: PMC8553262 DOI: 10.1016/s0140-6736(21)02246-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 10/04/2021] [Indexed: 12/24/2022]
Affiliation(s)
- Yaneer Bar-Yam
- New England Complex Systems Institute, Boston, MA 02139, USA.
| | - Deepti Gurdasani
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Michael G Baker
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Gabriel Scally
- Department of Public Health, University of Bristol, Bristol, UK
| | | | - Amanda Kvalsvig
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | | | - Shu-Ti Chiou
- Health and Sustainable Development Foundation, Yilan, Taiwan; College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - John Drury
- School of Psychology, University of Sussex, Brighton, UK
| | - Stephen Duckett
- Health and Aged Care program, Grattan Institute, Melbourne, VIC, Australia; School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Eric L Ding
- New England Complex Systems Institute, Boston, MA 02139, USA; Federation of American Scientists, Washington, DC, USA
| | - Carlos Gershenson
- Instituto de Investigaciones en Matemáticas Aplicadas y Sistemas and Centro de Ciencias de la Complejidad, Universidad Nacional Autonóma de México, Mexico City, Mexico
| | - Christine Gibson
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Zoë Hyde
- Western Australian Centre for Health and Ageing, University of Western Australia, Perth, WA, Australia
| | | | - Jose L Jimenez
- Department of Chemistry and Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, UK
| | - Christina Pagel
- Clinical Operational Research Unit, University College London, London, UK
| | | | - Kim Prather
- Department of Chemistry and Biochemistry, University of California, San Diego, CA, USA
| | - Sunil K Raina
- Community Medicine, Dr Rajendra Prasad Government Medical College, Himachal Pradesh, India
| | - Walter Ricciardi
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Tomás Ryan
- School of Biochemistry and Immunology and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | | | - Anthony Staines
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Robert West
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Hisham Ziauddeen
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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48
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Bennett J, Moreland NJ, Williamson DA, Carapetis J, Crane J, Whitcombe AL, Jack S, Harwood M, Baker MG. Comparison of group A streptococcal titres in healthy children and those with pharyngitis and skin infections. J Infect 2021; 84:24-30. [PMID: 34710392 DOI: 10.1016/j.jinf.2021.10.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/04/2021] [Accepted: 10/15/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Rates of acute rheumatic fever, a sequelae of group A Streptococcal (GAS) infection, remain unacceptably high in Indigenous Māori and Pacific children in New Zealand. This prospective study aimed to describe GAS antibody titres in healthy children (5-14 years) by ethnicity, and to determine how paired titres vary with GAS culture positive and negative pharyngitis, and GAS skin infections. METHODS Analysis included 887 children (32% Māori, 36% Pacific, 33% European/Other) from Auckland, New Zealand. Cases comprise 772 children who had a sore throat or skin infection, which resulted in a swab taken for culture. Healthy controls were asymptomatic (N = 154) and matched by age, ethnicity and region. All participants had a serum sample, with a second sample collected from cases only. Sera were analysed for anti-streptolysin O (ASO) and anti-DNase-B (ADB) antibodies. RESULTS Healthy Māori and Pacific children had higher GAS antibody titres than healthy European/Other children. Children with GAS-positive sore throat had the highest mean ASO titres and children with GAS-positive skin infection had the highest mean ADB titres. When a two-fold increase or an upper limit of normal cut-off (ASO 450 IU/ml, ADB 400 U/ml) was applied to titres from children with GAS-positive sore throat, 62.1% were classified as having serologically confirmed GAS pharyngitis and 37.9% had GAS detected without serological response. CONCLUSIONS Elevated ASO titres were associated with GAS pharyngitis and elevated ADB titres were associated with GAS skin infections in New Zealand children. Higher ASO/ADB titres in healthy Māori and Pacific children could indicate a greater prior exposure to GAS infections.
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Affiliation(s)
- Julie Bennett
- Department of Public Health, University of Otago, 23A Mein Street, Newtown, Wellington 6021, New Zealand.
| | - Nicole J Moreland
- Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand; Maurice Wilkins Centre, The University of Auckland, Auckland, New Zealand
| | - Deborah A Williamson
- Peter Doherty Institute for Infection and Immunity, University of Melbourne, Victoria, Australia
| | - Jonathan Carapetis
- Telethon Kids Institute and Perth Children's Hospital, University of Western Australia, Perth 6009, Australia
| | - Julian Crane
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Alana L Whitcombe
- Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand; Maurice Wilkins Centre, The University of Auckland, Auckland, New Zealand
| | - Susan Jack
- Public Health South, Southern District Health Board, Dunedin, New Zealand
| | - Matire Harwood
- Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Michael G Baker
- Department of Public Health, University of Otago, 23A Mein Street, Newtown, Wellington 6021, New Zealand; Maurice Wilkins Centre, The University of Auckland, Auckland, New Zealand
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49
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Grout L, Katar A, Ait Ouakrim D, Summers JA, Kvalsvig A, Baker MG, Blakely T, Wilson N. Failures of quarantine systems for preventing COVID-19 outbreaks in Australia and New Zealand. Med J Aust 2021; 215:320-324. [PMID: 34472122 PMCID: PMC8661623 DOI: 10.5694/mja2.51240] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To identify COVID-19 quarantine system failures in Australia and New Zealand. DESIGN, SETTING, PARTICIPANTS Observational epidemiological study of travellers in managed quarantine in Australia and New Zealand, to 15 June 2021. MAIN OUTCOME MEASURES Number of quarantine system failures, and failure with respect to numbers of travellers and SARS-CoV-2-positive travellers. RESULTS We identified 22 quarantine system failures in Australia and ten in New Zealand to 15 June 2021. One failure initiated a COVID-19 outbreak that caused more than 800 deaths (the Victorian "second wave"); nine lockdowns were linked with quarantine system failures. The failure risk was estimated to be 5.0 failures per 100 000 travellers passing through quarantine and 6.1 (95% CI, 4.0-8.3) failures per 1000 SARS-CoV-2-positive travellers. The risk per 1000 SARS-CoV-2-positive travellers was higher in New Zealand than Australia (relative risk, 2.0; 95% CI, 1.0-4.2). CONCLUSIONS Quarantine system failures can be costly in terms of lives and economic impact, including lockdowns. Our findings indicate that infection control in quarantine systems in Australia and New Zealand should be improved, including vaccination of quarantine workers and incoming travellers, or that alternatives to hotel-based quarantine should be developed.
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Affiliation(s)
- Leah Grout
- University of OtagoWellingtonNew Zealand
| | - Ameera Katar
- Centre for Epidemiology and BiostatisticsMelbourne School of Population and Global HealthUniversity of MelbourneMelbourneVIC
| | - Driss Ait Ouakrim
- Centre for Epidemiology and BiostatisticsMelbourne School of Population and Global HealthUniversity of MelbourneMelbourneVIC
| | | | | | | | - Tony Blakely
- Centre for Epidemiology and BiostatisticsMelbourne School of Population and Global HealthUniversity of MelbourneMelbourneVIC
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50
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Bennett J, Rentta NN, Leung W, Atkinson J, Wilson N, Webb R, Baker MG. Early diagnosis of acute rheumatic fever and rheumatic heart disease as part of a secondary prevention strategy: Narrative review. J Paediatr Child Health 2021; 57:1385-1390. [PMID: 34296804 DOI: 10.1111/jpc.15664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 07/05/2021] [Accepted: 07/14/2021] [Indexed: 01/07/2023]
Abstract
Acute rheumatic fever (ARF) and its sequela rheumatic heart disease (RHD) remain significant causes of morbidity and mortality. In New Zealand, ARF almost exclusively affects Indigenous Māori and Pacific children. This narrative review aims to present secondary interventions to improve early and accurate diagnosis of ARF and RHD, in order to minimise disease progression in New Zealand. Medline, EMBASE and Scopus databases were searched as well as other electronic publications. Included were 56 publications from 1980 onwards. Diagnosing ARF and RHD as early as possible is central to reducing disease progression. Recent identification of specific ARF biomarkers offer the opportunity to aid initial diagnosis and portable echocardiography has the potential to detect undiagnosed RHD in high-risk areas. However, further research into the benefits and risks to children with subclinical RHD is necessary, as well as an economic evaluation.
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Affiliation(s)
- Julie Bennett
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Neilenuo N Rentta
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - William Leung
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - June Atkinson
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nigel Wilson
- Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Auckland, New Zealand.,Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Rachel Webb
- Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand.,KidzFirst Children's Hospital, Counties Manukau District Health Board, Auckland, New Zealand.,Department of Paediatric Infectious Diseases, Starship Children's Hospital, Auckland, New Zealand
| | - Michael G Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
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