COMMUNICABLE DISEASE

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 ICD-10, are certain 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 2005 these two groups accounted for 3.7% of all deaths in Australia (4,859 deaths). Influenza and pneumonia accounted for 62% (3,034) of these deaths. Death rates increased with age, and were greater for males than females in most age groups. In 2005-06, there were 96,138 hospital separations in Australia with a principal diagnosis of infectious and parasitic diseases.

Through the National Notifiable Diseases Surveillance System (NNDSS), state and territory health authorities submit reports of more than 60 communicable disease notifications for compilation by DoHA.

The total of notifications to NNDSS in 2006 was 138,550, an increase of 10% on the 125,414 notifications made in 2005 (table 11.25). In 2006 sexually transmitted infections (STI) were the most commonly reported communicable diseases, accounting for 42% of all notifications, followed by gastrointestinal diseases (20%) and blood-borne diseases (14%).

Chlamydia was the most common STI (47,030 notifications, 81% of total STIs); campylobacteriosis the most common gastroenteritis (15,398 notifications, 55% of total) and hepatitis C (unspecified) was the most common blood-borne disease (12,057 notifications, 63% of total).


HIV and AIDS

In collaboration with the state and territory health authorities and the Australian Government, surveillance for human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) is conducted by the National Centre in HIV Epidemiology and Clinical Research. This centre is part of the Faculty of Medicine, University of New South Wales and is funded primarily by DoHA.

At 31 December 2006 the cumulative number of cases of newly diagnosed HIV infections (since 1985) was 26,268. The annual number of new HIV diagnoses reached a low of 716 in 1999, after which there was a continual increase (to 998 in 2006). The cumulative number of AIDS diagnoses, adjusted for reporting delay, was 10,119 (since 1981) and there was a total of 6,723 deaths following AIDS (table 11.26).

There has been a reduction in numbers of new AIDS diagnoses since the late-1990s, which has been due to the decline in HIV incidence that took place in the mid-1980s, and the use, since around 1996, of effective combination antiretroviral therapy for the treatment of HIV infection.

11.26 NEWLY DIAGNOSED HIV CASES(a), AIDS cases and deaths following AIDS(b)
	Year of diagnosis
	Prior to 2003	2003	2004	2005	2006	Total
HIV cases(a)	22 529	871	908	962	998	26 268
AIDS cases(b)	9 172	242	201	243	261	10 119
AIDS deaths(b)	6 353	91	107	78	94	6 723
(a) Not adjusted for multiple reporting.
(b) AIDS cases diagnosed and deaths following AIDS in the years from 2002 were adjusted for reporting delays; AIDS cases diagnosed and deaths following AIDS in previous years were assumed to be completely reported.
Source: 'HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2007', National Centre in HIV Epidemiology and Clinical Research, University of New South Wales; Australian Institute of Health and Welfare.

Transmission of HIV in Australia continues to be mainly through sexual contact between men (71.7% in 2006). Exposure to HIV was attributed to heterosexual contact in 24.8% of new diagnoses and to injecting drug use in 2.8% of diagnoses (table 11.27). Mother-to-child transmission of HIV remains rare in Australia.

11.27 CHARACTERISTICS OF CASES OF NEWLY DIAGNOSED HIV INFECTION(a), Number of cases and proportion of total cases
			Year of diagnosis(b)
			2003	2004	2005	2006	Total(c)
Total cases		no.	871	908	962	998	26 268
	Males	%	89.8	85.9	90.3	85.4	91.6
State and territory
	New South Wales	%	49.1	45.0	42.3	39.6	55.5
	Victoria	%	23.4	23.7	26.8	28.7	21.6
	Queensland	%	14.6	17.2	17.4	16.3	11.4
	South Australia	%	5.2	5.9	5.3	6.1	3.9
	Western Australia	%	6.3	5.5	6.6	7.3	5.4
	Tasmania	%	0.2	1.0	0.6	0.6	0.5
	Northern Territory	%	0.6	0.9	0.3	0.9	0.6
	Australian Capital Territory	%	0.6	0.8	0.7	0.5	1.1
Exposure category(d)
	Male homosexual contact	%	73.4	67.8	72.2	67.8	76.4
	Male homosexual contact and injecting drug use	%	4.6	3.9	4.4	3.9	4.4
	Injecting drug use(e)	%	3.5	4.3	3.4	2.8	4.1
	Heterosexual contact	%	18.3	23.6	19.3	24.8	12.4
	Haemophilia/coagulation disorder	%	-	-	-	-	1.3
	Receipt of blood/tissue	%	-	0.1	0.1	-	1.0
	Mother with/at risk of HIV infection	%	0.2	0.1	0.6	0.7	0.4
	Health care setting	%	-	0.1	-	-	0.1
	Other/undetermined	%	7.3	7.3	8.8	7.9	14.8
- nil or rounded to zero (including null cells)
(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) Includes figures for years prior to 2003.
(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: 'HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2007', National Centre in HIV Epidemiology and Clinical Research, University of New South Wales; Australian Institute of Health and Welfare.

Children's immunisation

Immunisation programs for children are recognised as an effective public health intervention, and have been responsible for eradicating or minimising infectious diseases such as diphtheria, whooping cough and polio as major causes of death and disability in Australia.

The Australian Childhood Immunisation Register (ACIR), which commenced operation on 1 January 1996, aims to provide accurate and comprehensive information about immunisation coverage for all children under the age of seven. The register is administered by Medicare Australia and is a key component of initiatives to improve the immunisation status of Australian children.

Immunisation coverage goals for Australia for the year 2000, recommended by the NHMRC, called for 90% or more coverage of children at two years of age, and near universal coverage of children at school-entry age, against diphtheria, tetanus, pertussis (whooping cough), poliomyelitis, measles, mumps, rubella and Hib (Haemophilus influenza type b).

ACIR data indicated, at 31 March 2007, 91% of one year olds, 92% of two year olds and 88% of six year olds were fully immunised according to the NHMRC Recommended Australian Standard Vaccination Schedule. State summaries by age group based on ACIR data are published on the Medicare Australia website at: <http://www.medicareaustralia.gov.au>.

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