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Communicable diseases (including infectious and parasitic diseases) are those diseases capable of being transmitted from one person to another, or from one species to another. In 1999 infectious diseases accounted for 1.3% of all deaths in Australia (1,603 deaths). Influenza and pneumonia accounted for a further 1.5% of deaths (1,898 deaths). Death rates increased with age and were greater for males than females in most age groups.
Under the National Notifiable Diseases Surveillance System (NNDSS), State and Territory health authorities submit reports of communicable disease notifications for compilation by the Commonwealth Department of Health and Aged Care. The range of diseases required to be reported to State and Territory health authorities has varied over time, and case definitions of these diseases have varied from State to State. Since 1991 approximately 50 disease groups have been included, as recommended by the NHMRC. HIV infections are reported separately to the National Centre in HIV Epidemiology and Clinical Research.
Blood-borne diseases were the most frequently reported types of communicable diseases in 2000, accounting for 32.7% of all notifications; followed by sexually transmitted infections (27.5%) and gastrointestinal diseases (22.8%). Hepatitis C (unspecified) and Hepatitis B (unspecified) were the most commonly reported blood-borne diseases, chlamydial infection and gonococcal infection were the most frequently reported sexually transmitted diseases, and Campylobacterosis and Salmonellosis were the leading gastrointestinal diseases. Between 1998 and 2000, total notifications to the NNDSS increased by approximately 5% each year. There were some increases in rates for blood-borne diseases and sexually transmitted diseases and some decreases in rates for gastrointestinal diseases. Among other diseases notified over this time period, the number of notifications of meningococcal infection increased by nearly a third (from 453 to 599), representing an increase from a rate of 2.3 to 3.1 per 100,000 persons, with most of this increase occurring between 1998 and 1999 (table 9.25).
9.25 NATIONAL NOTIFIABLE DISEASE SURVEILLANCE SYSTEM REPORTS - 1998 to 2000
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 | Notifications(a)
| Rate per 100,000 population(b)
|
| |
| Disease(d) | 1998
no. | 1999
no. | 2000(c)
no. | 1998
| 1999
| 2000(c)
|
|
| Blood-borne diseases | | | | | | |
| Hepatitis B (incident) | 262 | 304 | 434 | 1.4 | 1.6 | 2.3 |
| Hepatitis B (unspecified) | 6,629 | 8,075 | 8,804 | 35.4 | 42.6 | 46.0 |
| Hepatitis C (incident) | 346 | 380 | 527 | 1.8 | 2.0 | 2.8 |
| Hepatitis C (unspecified) | 19,010 | 21,120 | 20,399 | 101.5 | 111.4 | 106.5 |
| Hepatitis D | 10 | 21 | 27 | 0.1 | 0.1 | 0.1 |
| Hepatitis n.e.c. | 4 | - | 1 | 0.0 | - | 0.0 |
| Gastrointestinal diseases | | | | | | |
| Botulism | 1 | - | 2 | 0.0 | - | 0.0 |
| Campylobacterosis | 13,283 | 12,515 | 13,522 | 107.2 | 99.7 | 106.5 |
| Haemolytic uraemic syndrome | 13 | 24 | 14 | 0.1 | 0.1 | 0.1 |
| Hepatitis A | 2,443 | 1,552 | 804 | 13.0 | 8.2 | 4.2 |
| Hepatitis E | 1 | 2 | 1 | 0.0 | 0.0 | 0.0 |
| Listeriosis | 55 | 71 | 58 | 0.4 | 0.4 | 0.3 |
| Salmonellosis | 7,489 | 7,084 | 6,030 | 40.0 | 37.3 | 31.5 |
| Shigellosis | 594 | 542 | 482 | 4.8 | 4.3 | 3.8 |
| SLTEC, VTEC(e) | 14 | 43 | 38 | 0.1 | 0.3 | 0.3 |
| Typhoid | 63 | 72 | 69 | 0.3 | 0.4 | 0.4 |
| Yersiniosis | 190 | 142 | 70 | 1.5 | 1.1 | 0.6 |
| Quarantinable diseases | | | | | | |
| Cholera | 4 | 3 | 1 | 0.0 | 0.0 | 0.0 |
| Sexually transmitted infections | | | | | | |
| Chancroid | 1 | - | - | 0.0 | - | - |
| Chlamydial infection | 11,338 | 13,917 | 17,559 | 60.5 | 73.4 | 91.7 |
| Donovanosis | 27 | 16 | 16 | 0.2 | 0.1 | 0.1 |
| Gonococcal infection | 5,398 | 5,593 | 5,972 | 28.8 | 29.5 | 31.2 |
| Syphilis | 1,677 | 1,934 | 1,888 | 9.0 | 10.2 | 9.9 |
| Vaccine preventable diseases | | | | | | |
| Haemophilus influenzae type b | 34 | 39 | 30 | 0.2 | 0.2 | 0.2 |
| Measles | 290 | 229 | 107 | 1.5 | 1.2 | 0.6 |
| Mumps | 182 | 184 | 210 | 1.0 | 1.0 | 1.1 |
| Pertussis | 5,739 | 4,345 | 5,938 | 30.6 | 22.9 | 31.0 |
| Rubella | 745 | 372 | 319 | 4.0 | 2.0 | 1.7 |
| Tetanus | 8 | 2 | 6 | 0.0 | 0.0 | 0.0 |
| Vector-borne diseases | | | | | | |
| Arbovirus infection n.e.c. | 83 | 62 | 59 | 0.4 | 0.3 | 0.3 |
| Barmah Forest virus infection | 531 | 628 | 629 | 2.8 | 3.3 | 3.3 |
| Dengue | 509 | 128 | 214 | 2.7 | 0.7 | 1.1 |
| Malaria | 647 | 718 | 935 | 3.5 | 3.8 | 4.9 |
| Ross River virus infection | 3,128 | 4,392 | 4,181 | 16.7 | 23.2 | 21.8 |
| Zoonoses | | | | | | |
| Brucellosis | 43 | 51 | 24 | 0.2 | 0.3 | 0.1 |
| Hydatid infection | 40 | 29 | 25 | 0.3 | 0.2 | 0.2 |
| Leptospirosis | 189 | 317 | 233 | 1.0 | 1.7 | 1.2 |
| Ornithosis | 64 | 84 | 103 | 0.7 | 0.9 | 1.1 |
| Q fever | 560 | 509 | 506 | 3.0 | 2.7 | 2.6 |
| Other diseases | | | | | | |
| Legionnellosis | 262 | 248 | 478 | 1.4 | 1.3 | 2.5 |
| Leprosy | 4 | 6 | 4 | 0.0 | 0.0 | 0.0 |
| Meningococcal infection | 453 | 563 | 599 | 2.3 | 3.0 | 3.1 |
| Tuberculosis | 974 | 1,118 | 1,018 | 5.2 | 5.9 | 5.3 |
| Total | 83,337 | 87,428 | 92,347 | . . | . . | . . |
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(a) Year of notification. Date of notification is a composite of three components: (i) the true onset date from a clinician, if available, or (ii) the date the laboratory test was ordered, or (iii) the date reported to the State/Territory public health unit. The 1998 figures previously published were for year of report and differ from the figures presented here which are for year of notification, which is closer to the date of onset.
(b) Rate per 100,000 population is calculated using the estimated resident population at the mid-point (30 June) of the relevant calendar year. Where a disease is not notifiable in a particular State or Territory, the population of that State or Territory is excluded from the Australian population when calculating the rate. Diseases not notifiable for all States/Territories are campylobacterosis, shigellosis and yersiniosis (not notifiable in NSW), hepatitis E (WA), SLTEC/VTEC (Qld, WA), donovanosis (NSW, Qld).
(c) Notifications data for the year 2000 were provisional at the date of analysis (6 July 2001).
(d) Diseases under surveillance for which no notifications were received in the period 1998-2000 were plague, rabies, viral haemorrhagic fever, yellow fever, lymphogranuloma venereum, diphtheria and poliomyelitis.
(e) SLTEC/VTEC is shiga-like toxins and verotoxin producing E. coli infections.
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Source: National Notifiable Disease Surveillance System.
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HIV and AIDS
In collaboration with the State and Territory health authorities and the Commonwealth Government, surveillance for human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) is conducted by the National Centre in HIV Epidemiology and Clinical Research (NCHECR). This centre is part of the Faculty of Medicine, University of New South Wales and is funded primarily by the Commonwealth Department of Health and Aged Care through the Australian National Council on AIDS and Related Diseases (ANCARD).
By the end of 2000, it was estimated that 20,955 HIV cases, 8,616 AIDS diagnoses and 6,017 deaths attributable to AIDS had occurred in Australia (table 9.26). Surveillance indicates that AIDS incidence peaked during 1994, and a steady decline was observed from 1994 to 1999. This decline can be attributed to the fall in HIV transmission in the mid 1980s and the introduction of more effective antiretroviral therapy for the treatment of HIV infection in the mid 1990s.
9.26 NEWLY DIAGNOSED HIV CASES(a), AIDS CASES AND DEATHS FOLLOWING AIDS(b) - to 2000
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| Year of diagnosis
| |
| | Prior to 1992
no. | 1992
no. | 1993
no. | 1994
no. | 1995
no. | 1996
no. | 1997
no. | 1998
no. | 1999
no. | 2000
no. | Total
no. |
|
| HIV cases(a) | 12,672 | 1,241 | 1,091 | 1,023 | 937 | 926 | 826 | 772 | 734 | 723 | 20,955 |
| AIDS cases(b) | 3,428 | 791 | 845 | 955 | 807 | 664 | 376 | 311 | 184 | 255 | 8,616 |
| AIDS deaths(b) | 2,158 | 600 | 695 | 737 | 651 | 505 | 236 | 156 | 122 | 157 | 6,017 |
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(a) Not adjusted for multiple reporting. Total includes 10 cases for which the date of HIV diagnosis was not reported.
(b) AIDS cases diagnosed and deaths following AIDS in 1998, 1999 and 2000 were adjusted for reporting delays; AIDS cases diagnosed and deaths following AIDS in previous years were assumed to be completely reported. |
Source: HIV/AIDS, Hepatitis C and Sexually Transmissible Infections in Australia Annual Surveillance Report 2001, National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, 2001. |
HIV infection continues to overwhelmingly affect males, and disease transmission continues to predominantly occur by sexual contact between men (table 9.27 and graph 9.28). Between 1992 and 2000, both the total annual number of new cases of HIV and the annual number of male homosexually acquired cases declined. Although the proportion of new cases acquired through heterosexual contact has increased over this period, peaking in 1998, the number of these new cases has remained relatively stable at 140 to 200 per year.
9.27 CHARACTERISTICS OF CASES OF NEWLY DIAGNOSED HIV INFECTION(a),
Number of Cases and Percentage of Total Cases - to 2000
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| Year of diagnosis
| |
| | Unit | Prior to 1992 | 1992 | 1993 | 1994 | 1995 | 1996 | 1997 | 1998 | 1999 | 2000 | Total(b) |
|
| Total cases | no. | 12,672 | 1,241 | 1,091 | 1,023 | 937 | 926 | 826 | 772 | 734 | 723 | 20,955 |
| Males | % | 93.7 | 92.3 | 92.5 | 90.8 | 91.9 | 91.7 | 89.6 | 87.2 | 89.5 | 89.2 | 92.5 |
| State/Territory | | | | | | | | | | | | |
| New South Wales | % | 60.8 | 57.6 | 55.6 | 49.8 | 58.0 | 50.3 | 53.3 | 54.1 | 53.4 | 46.3 | 57.9 |
| Victoria | % | 20.5 | 20.5 | 20.4 | 21.1 | 17.5 | 20.2 | 21.8 | 18.1 | 19.1 | 26.0 | 20.5 |
| Queensland | % | 8.3 | 12.4 | 12.6 | 16.2 | 12.3 | 16.7 | 13.8 | 13.6 | 16.9 | 16.2 | 10.7 |
| South Australia | % | 3.5 | 2.7 | 5.0 | 3.6 | 3.3 | 5.0 | 4.2 | 4.5 | 3.0 | 3.2 | 3.6 |
| Western Australia | % | 4.8 | 4.2 | 4.7 | 7.2 | 6.2 | 6.1 | 4.6 | 6.5 | 5.4 | 6.5 | 5.1 |
| Tasmania | % | 0.4 | 0.8 | 0.2 | 0.2 | 0.6 | 0.3 | 0.0 | 0.4 | 0.4 | 0.0 | 0.4 |
| Northern Territory | % | 0.5 | 0.5 | 0.9 | 0.5 | 0.2 | 0.5 | 1.3 | 1.6 | 0.7 | 0.4 | 0.6 |
| Australian Capital Territory | % | 1.2 | 1.3 | 0.6 | 1.4 | 1.9 | 0.9 | 1.0 | 1.2 | 1.1 | 1.4 | 1.2 |
| Exposure category(c) | | | | | | | | | | | | |
| Male homosexual contact | % | 81.7 | 76.7 | 79.0 | 74.3 | 73.9 | 75.5 | 72.6 | 65.4 | 65.0 | 68.4 | 77.9 |
| Male homosexual contact and injecting drug use | % | 3.5 | 4.0 | 3.6 | 6.2 | 4.9 | 3.9 | 4.4 | 4.6 | 6.1 | 3.6 | 3.9 |
| Injecting drug use(d) | % | 4.8 | 4.8 | 3.5 | 3.4 | 4.5 | 2.8 | 3.2 | 3.4 | 5.6 | 4.4 | 4.5 |
| Heterosexual contact | % | 4.8 | 12.3 | 12.8 | 13.9 | 15.3 | 16.8 | 18.7 | 25.4 | 22.4 | 23.1 | 10.2 |
| Haemophilia/coagulation disorder | % | 3.0 | 0.4 | 0.0 | 0.0 | 0.1 | 0.0 | 0.0 | 0.1 | 0.5 | 0.0 | 1.7 |
| Receipt of blood/tissue | % | 2.0 | 1.1 | 0.3 | 0.8 | 0.3 | 0.2 | 0.1 | 0.6 | 0.3 | 0.0 | 1.3 |
| Mother with/at risk of HIV infection | % | 0.2 | 0.4 | 0.5 | 1.0 | 0.8 | 0.8 | 0.9 | 0.4 | 0.1 | 0.5 | 0.4 |
| Health care setting | % | 0.0 | 0.3 | 0.2 | 0.3 | 0.1 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.1 |
| Other/undetermined | % | 23.7 | 11.8 | 9.4 | 5.8 | 8.3 | 10.6 | 9.6 | 9.3 | 10.5 | 8.6 | 18.0 |
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(a) Not adjusted for multiple reporting.
(b) Total includes 10 cases in males for which the date of HIV diagnosis was not reported.
(c) The ‘Other/undetermined’ category was excluded from the calculation of the percentage of cases attributed to each HIV exposure category.
(d) Excludes males who also reported a history of homosexual/bisexual contact. |
Source: HIV/AIDS, Hepatitis C and Sexually Transmissible Infections in Australia Annual Surveillance Report 2001, National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, 2001. |
Children's immunisation
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 the Health Insurance Commission (HIC) on behalf of the Commonwealth Department of Health and Aged Care 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 that, at June 2001, 91.5% of one year olds and 86.6% of two year olds were fully immunised according to the NHMRC Recommended Immunisation Schedule. State summaries by age group based on ACIR data are published quarterly in Communicable Diseases Intelligence (CDI) bulletin.
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