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Communicable diseases are those diseases capable of being transmitted from one person to another, or from one species to another. Two major groups of communicable diseases, classified in the International Classification of Diseases (ICD-10), are infectious and parasitic diseases (ICD-10 codes A00-B99) and acute respiratory infections (ICD-10 codes J00-J22) which includes influenza and pneumonia as well as other acute upper and lower respiratory infections. In 2002 these two groups accounted for 3.7% of all deaths in Australia (4,955 deaths). Influenza and pneumonia accounted for 62% (3,084) of these deaths. Death rates increase with age, and were greater for males than females in most age groups. In 2002-03, there were 92,810 hospital separations in Australia with a principal diagnosis of infectious and parasitic diseases (AIHW 2004a, 2004e). Acute respiratory infections including influenza and pneumonia were responsible for a further 128,415 separations.

Under the National Notifiable Diseases Surveillance System (NNDSS), state and territory health authorities submit reports of more than 50 communicable disease notifications for compilation by the Department of Health and Ageing (DoHA). In 2001, the diseases reported to NNDSS were revised to include cryptosporidiosis, influenza, pneumococcal disease, Japanese encephalitis, Kunjin virus, Murray Valley encephalitis, anthrax, Australian bat lyssavirus, and other lyssavirus infections. At the same time, diseases that were becoming rare or of less public health significance in Australia, namely chancroid, lymphogranuloma venereum, hydatid disease and yersiniosis were removed from the NNDSS.

The provisional total of notifications to NNDSS in 2003 is 102,203, a small increase (3.0%) on the 99,195 notifications in 2002 (table 9.27). In 2003 sexually transmitted infections (STI) were the most commonly reported communicable diseases, accounting for 37% of all notifications, followed by gastrointestinal diseases (23%) and blood-borne diseases (20%). Chlamydia was the most common STI (29,493 notifications, 78% of total STIs), campylobacteriosis the most common gastroenteritis (14,951 notifications, 63% of total) and hepatitis C (unspecified) was the most common blood-borne disease (14,106 notifications, 68% of total). Compared with 2002, there were increases in notifications of STIs due mainly to increases in chlamydia; while there were decreases in reports of blood borne diseases (except campylobacteriosis), gastrointestinal diseases and vaccine preventable diseases.

9.27 NATIONAL NOTIFIABLE DISEASE SURVEILLANCE SYSTEM REPORTS
		Notifications			Rate(a)
		2001(b)	2002(b)	2003(c)	2001(b)	2002(b)	2003(c)
Disease(d)		no.	no.	no.	%	%	%
Blood-borne diseases
	Hepatitis B (incident)	397	393	329	2.0	2.0	1.7
	Hepatitis B (unspecified)	8,111	6,808	5,805	41.8	34.7	29.2
	Hepatitis C (incident)	631	425	444	3.3	2.2	2.2
	Hepatitis C (unspecified)	18,816	15,910	14,106	96.9	81.0	71.0
	Hepatitis D	20	20	26	0.1	0.1	0.1
	Hepatitis n.e.c.	2	-	-	-	-	-
Gastrointestinal diseases
	Botulism	2	-	1	-	-	-
	Campylobacteriosis	15,668	1,4274	14,951	80.7	72.7	75.2
	Cryptosporidiosis	1,535	3,235	1,185	7.9	16.5	6.0
	Haemolytic uraemic syndrome	3	13	15	-	0.1	0.1
	Hepatitis A	504	370	394	2.6	1.9	2.0
	Hepatitis E	10	11	8	0.1	0.1	-
	Listeriosis	59	57	68	0.3	0.3	0.3
	Salmonellosis	6,726	7,617	6,759	34.6	38.8	34.0
	Shigellosis	548	487	431	2.8	2.5	2.2
	SLTEC, VTEC(e)	43	51	47	0.2	0.3	0.2
	Typhoid	71	66	50	0.4	0.3	0.3
Quarantinable diseases
	Cholera	4	5	1	-	-	-
Sexually transmissable diseases
	Chlamydial infection	19,775	23,736	29,493	101.9	120.8	148.4
	Donovanosis	28	14	14	0.1	0.1	0.1
	Gonococcal infection	6,066	6147	6,426	31.2	31.3	32.3
	Syphilis	1,125	1,936	1,986	5.8	9.9	10.0
Vaccine preventable diseases
	Diphtheria	1	-	-	-	-	-
	Haemophilus influenza type b	20	29	19	0.1	0.1	0.1
	Influenza	1,279	3,653	3,577	6.6	18.6	18.0
	Measles	134	30	91	0.7	0.2	0.5
	Mumps	110	68	75	0.6	0.3	0.4
	Pertussis	8,673	5,320	4,686	44.7	27.1	23.6
	Pneumococcal disease	1,584	2,247	2,126	8.2	11.4	10.7
	Rubella	258	248	54	1.3	1.3	0.3
	Tetanus	3	3	3	-	-	-
Vector-borne diseases
	Arbovirus infection n.e.c.	33	20	77	0.2	0.1	0.4
	Barmah Forest virus infection	1,110	890	1,357	5.7	4.5	6.8
	Dengue	171	216	852	0.9	1.1	4.3
	Kunjin virus	5	-	19	-	-	0.1
	Malaria	680	455	598	3.5	2.3	3.0
	Murray Valley encephalitis	5	2	-	-	-	-
	Ross River virus infection	3,182	1,434	3,548	16.4	7.3	17.8
Zoonoses
	Brucellosis	19	39	17	0.1	0.2	0.1
	Leptospirosis	227	153	122	1.2	0.8	0.6
	Ornithosis	127	191	191	0.7	1.0	1.0
	Q fever	637	745	526	3.3	3.8	2.6
Other diseases
	Legionnellosis	294	311	317	1.5	1.6	1.6
	Leprosy	3	5	4	-	-	-
	Meningococcal infection	670	679	544	3.5	3.5	2.7
	Tuberculosis	829	881	861	4.3	4.5	4.3
Total		100,196	99,195	102,203	516.1	505.0	514.1
(a) Rate per 100,000 population is calculated using the estimated resident population at the midpoint (30 June) of the relevant calendar year. (b) NNDSS data for 2001 and 2002 revised after consultations with states and territories. (c) Notifications data for the year 2003 were provisional at the date of analysis (9 August 2004). (d) Diseases reported to NNDSS from all jurisdictions except hepatitis B (unspecified) not reported from NT; incident hepatitis C not reported from Qld; campylobacteriosis not reported from NSW; donovanosis not reported from SA. Diseases under surveillance for which no notifications were received in the period 2001-2003 were CJD, small pox, tularemia, plague, rabies, viral haemorrhagic fever, yellow fever, poliomyelitis, Japanese encephalitis, anthrax, Australian bat lyssavirus, other lussavirus n.e.c. (e) SLTEC/VTEC is shiga-like toxins and verotoxin producing E. coli infections. Source: DoHA 2004a.

9.28 NEWLY DIAGNOSED HIV CASES(a), AIDS CASES AND DEATHS FOLLOWING AIDS(b)
	Year of diagnosis(c)
	Prior to 1995	1995	1996	1997	1998	1999	2000	2001	2002	2003	Total
HIV cases(a)	15,991	928	899	820	752	713	748	761	839	848	23,306
AIDS cases(b)	6,011	811	671	385	320	197	255	208	232	290	9,380
AIDS deaths(b)	4,248	654	515	245	156	128	134	100	88	104	6,372
(a) Not adjusted for multiple reporting. Total includes 7 cases for which the date of HIV diagnosis was not reported. (b) AIDS cases diagnosed and deaths following AIDS in 2001, 2002 and 2003 were adjusted for reporting delays; AIDS cases diagnosed and deaths following AIDS in previous years were assumed to be completely reported. (c) The number of HIV/AIDS diagnoses for each year may be revised over time due to late reports, updated information on exposure and testing history for reported cases, and removal of previously unrecognised duplicate diagnoses. Source: AIHW 2004; National Centre in HIV Epidemiology and Clinical Research, 'HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2004', National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, NSW.

9.29 CHARACTERISTICS OF CASES OF NEWLY DIAGNOSED HIV INFECTION(a), Number of cases and proportion of total cases
			Year of diagnosis(b)
		Units	Prior to 1995	1995	1996	1997	1998	1999	2000	2001	2002	2003	Total(c)
Total cases		no.	15,991	928	899	820	752	713	748	761	839	848	23,306
Males		%	93.4	91.9	91.2	89.4	87.0	89.5	89.2	87.8	88.7	89.0	92.1
State/territory
	New South Wales	%	59.9	58.0	50.5	52.7	53.0	52.3	48.5	44.7	47.5	49.3	57.0
	Victoria	%	20.5	17.7	20.2	22.0	18.6	19.5	25.1	27.2	25.9	24.0	21.0
	Queensland	%	9.1	11.9	16.1	13.8	13.8	17.3	15.2	13.8	15.6	14.9	10.9
	South Australia	%	3.5	3.3	5.1	4.3	4.7	3.1	3.1	5.7	3.6	5.2	3.7
	Western Australia	%	4.9	6.4	6.3	4.9	6.8	5.6	6.2	6.4	5.2	5.4	5.2
	Tasmania	%	0.4	0.6	0.3	-	0.4	0.4	-	0.7	0.6	-	0.4
	Northern Territory	%	0.5	0.2	0.6	1.3	1.6	0.7	0.4	0.5	1.0	0.6	0.6
	Australian Capital Territory	%	1.2	1.9	0.8	1.0	1.1	1.1	1.5	1.0	0.6	0.6	1.2
Exposure category(d)
	Male homosexual contact	%	81.2	74.0	75.2	72.9	65.4	65.4	68.4	66.5	71.1	74.0	77.3
	Male homosexual contact and injecting drug use	%	3.9	5.3	4.2	4.8	4.8	6.3	3.3	5.1	4.0	4.2	4.2
	Injecting drug use(e)	%	4.7	4.4	2.7	3.1	3.6	5.4	4.4	5.7	2.5	3.5	4.3
	Heterosexual contact	%	6.6	15.1	16.8	18.1	25.1	21.9	23.4	22.1	22.1	18.0	11.2
	Haemophilia/coagulation disorder	%	2.4	0.1	-	-	0.1	0.5	-	0.1	-	-	1.4
	Receipt of blood/tissue	%	1.8	0.3	0.2	0.1	0.6	0.3	-	-	-	-	1.2
	Mother with/at risk of HIV infection	%	0.2	0.8	0.9	0.9	0.4	0.2	0.4	0.4	0.3	0.3	0.4
	Health care setting	%	0.1	0.1	-	-	-	-	-	-	0.1	-	0.1
	Other/undetermined	%	19.6	7.5	9.5	9.0	7.8	9.1	8.2	7.4	10.0	9.6	16.4
(a) Not adjusted for multiple reporting. (b) The number of HIV/AIDS diagnoses for each year may be revised over time due to late reports, updated information on exposure and testing history for reported cases, and removal of previously unrecognised duplicate diagnoses. (c) Total includes 7 cases for which the date of HIV diagnosis was not reported. (d) The ‘Other/undetermined’ category was excluded from the calculation of the percentage of cases attributed to each HIV exposure category. (e) Excludes males who also reported a history of homosexual/bisexual contact. Source: AIHW 2004; National Centre in HIV Epidemiology and Clinical Research, 'HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2004', National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, NSW.