During winter months of temperate regions, concurrent epidemics of multiple respiratory pathogens can occur, causing periods of increased clinical burden. Case time series, which are predominantly used to monitor infection levels, can exhibit substantial noise and day-of-the-week effects, limiting the visual interpretation of trends in raw data. However, statistical methods can infer smoothed trends within case time series by quantifying and accounting for different sources of noise. Here we apply statistical models to estimate the epidemic dynamics of SARS-CoV-2, respiratory syncytial virus (RSV), and influenza subtypes (influenza A H3N2, influenza A H1N1, and influenza B) in Victoria, Australia, over the 2024 winter season. We model trends in daily reported cases and the daily growth rate over time for all pathogens/subtypes. We present: (1) retrospective analyses using the final dataset up to 10 September 2024 and (2) weekly real-time analyses from 19 March 2024 to 10 September 2024 using data up to each timepoint, including a retrospective performance evaluation. We estimated similar peak timing of SARS-CoV-2 and RSV epidemics in late May, followed by a H3N2-dominant influenza epidemic, which peaked in early July. Transient increases in SARS-CoV-2 activity coincided with the emergence of new variants and transient decreases in influenza activity corresponded to the timing of school holidays. Real-time estimates demonstrated good agreement with those produced at the end of the season, with significant overlap of the 95% credible intervals. Our findings demonstrate how statistical methods can be implemented in real time to synthesise noisy case time-series data into interpretable trends (including uncertainty), enabling quantification of the strength of evidence for whether epidemic activity is increasing, stable or declining. Our real-time outputs were reported weekly to the Department of Health, Victoria during June-September 2024, complementing other routine surveillance indicators.

The National Neisseria Network (NNN), Australia, established in 1979, comprises reference laboratories in each state and territory. Since 1981, the NNN has reported data for the Australian Gonococcal Surveillance Programme (AGSP), on antimicrobial susceptibility profiles for Neisseria gonorrhoeae isolated from each jurisdiction for an agreed group of agents. The antibiotics reported represent current or potential agents used for the treatment of gonorrhoea, and include ceftriaxone, azithromycin, ciprofloxacin and penicillin. More recently, gentamicin and tetracycline are included in the AGSP Annual Report. Ceftriaxone, combined with azithromycin, is the recommended treatment regimen for gonorrhoea in Australia. Historically, there were substantial geographic differences in susceptibility patterns across the country, with certain remote regions of the Northern Territory and Western Australia having low gonococcal antimicrobial resistance rates. In these regions, an oral treatment regimen comprising amoxycillin, probenecid, and azithromycin was recommended. However, since January 2023, increasing reports of penicillin-resistant N. gonorrhoeae in the Northern Territory have changed treatment recommendations to align with the majority of Australia.1Additional data on other antibiotics are reported in the AGSP Annual Report. The AGSP has a programme-specific quality assurance process.

Australia is largely dependent on immigrant workers to bridge the employment gap in the agricultural sector and in agriculture-related food production; this poses a potential risk of the introduction and transmission of non-endemic vaccine preventable disease. We report the response to a Salmonella Typhi (S. Typhi) outbreak amongst workers from the Pacific Australia Labour Mobility (PALM) scheme in regional Queensland. A cluster of invasive Salmonella infections was investigated in accordance with the Communicable Diseases Network Australia guidelines. Active case finding of the at-risk group was undertaken to identify potential causal links and further transmission. Three confirmed cases of S. Typhi were reported, all male, with a median age of 31 years (range: 29-33 years). All cases were hospitalised and were managed with antibiotics and supportive care, with a median illness duration of nine days. Full recovery was reported for all cases, without complications. No recent travel history or contact with a recent typhoid case were reported. We identified 310 individuals in the exposed cohort, with a median age of 31 years (range: 22-55 years), all males. Of the exposed cohort, 305/310 individuals (98·4%) provided a faecal sample for S. Typhi testing; all returned a negative result. Genomic sequencing concluded the likely source of infection in this outbreak was chronic carriage of S. Typhi. Australia has had a significant increase in the number of PALM workers in regional areas, particularly within the agricultural sector, to mitigate employment gaps. A greater emphasis on culturally appropriate and linguistically sound hand hygiene education, and consideration of pre-employment health checks and vaccinations in these workers, would be beneficial in the reduction of communicable disease outbreaks.

FluTracking, an online participatory respiratory surveillance system, revealed that the coronavirus disease 2019 (COVID-19) pandemic led to historically low levels of fever and cough (FC) in the 2020-2021 influenza seasons in Australia. In 2022, the influenza peak occurred earlier and was shorter compared to pre-pandemic seasons. Based on weekly percentages of participants reporting FC, FluTracking identified four Omicron waves (BA.1, BA.2, BA.4/BA.5 and a mixed Omicron variant wave). These waves, while consistent with laboratory-confirmed COVID-19 trends, showed higher FC incidences in the BA.4/BA.5 and mixed variant waves. During the Omicron waves in 2022, up to 60% of FluTracking participants with FC reported positive SARS-CoV-2 tests, a significant increase from the less than 10% positivity rate for most of 2020-2021. These trends mirrored the timing of rises in National Notifiable Disease Surveillance System (NNDSS) COVID-19 notifications, although peak magnitudes varied between the two systems. Before November 2021, fewer than half (49.9% weekly mean) of participants with FC, and fewer than a third (27.7% weekly mean) with runny nose and sore throat reported being tested for SARS-CoV-2. Following the introduction of rapid antigen tests (RATs) in November 2021 and the spread of the Omicron variant of SARS-CoV-2 in early 2022, testing rates increased for both symptom profiles in 2022. Additionally, the reopening of international borders and the resurgence of influenza led to expanded respiratory panel testing in drive-through clinics, marked by a 36% increase in the mean weekly percentage of participants reporting an influenza polymerase chain reaction (PCR) test. FluTracking's participation grew by 107% in 2020 compared to 2019, then declined by 17.7% in 2021, likely due to participation and pandemic fatigue. However, participation stabilised with a 0.2% increase in 2022 compared to 2021. FluTracking offers valuable insights into respiratory illness trends, changes in testing behaviours, and positivity rates for influenza and SARS-CoV-2.

Shigella is a notifiable condition in Victoria under the Public Health and Wellbeing Act. Since 24 October 2022, the South East Public Health Unit (SEPHU) has been managing these notifications for the south east region of Melbourne. This study aimed to determine the demographics and risk factors for acquisition of shigellosis cases in the SEPHU catchment. A review was performed of all shigellosis notifications within the SEPHU catchment during the period 1 January 1 2022 - 31 March 2023. De-identified information was collated from the Public Health Event Surveillance System (PHESS) for analysis of demographics, risk factors and antimicrobial resistance. A total of 127 cases were notified: 51 were confirmed with culture, with the remaining 76 identified as probable cases through polymerase chain reaction testing. The greatest numbers of cases were within the 0-4 and 5-9 years of age categories (each 19/127; 15%), followed by the 30-34 years age group (18/127; 14%). The highest case numbers were recorded in the local government area (LGA) of Casey (30/127; 24%) while the highest rate across the 15-month study period, of 20.2 per 100,000, was from the Stonnington LGA. The most prominent primary risk factor was travel overseas (62/127, 49%) followed by contact between men who have sex with men (MSM) (16/127, 13%). Of confirmed cases, 61% (31/51) met the criteria for classification as critical antibiotic resistance (CAR) shigellosis. This review found that the LGAs with high number and rates of cases are Casey, Greater Dandenong and Stonnington. However, the risk factors for acquisition differs in these areas, indicating a need for LGA-specific education in the diverse SEPHU catchment.

Congenital syphilis is a preventable yet severe condition resulting from untreated maternal syphilis. Since 2016, Australia has recorded over 95 congenital syphilis cases, with 31/95 (33%) associated with perinatal death. Syphilis serology is complex and therefore performed in designated central laboratories. In the Northern Territory, specimen transport times associated with vast geographic distances lead to delayed results in remote regions. This study evaluates the introduction of the Abbott Determine™ Syphilis TP lateral flow immunoassay (LFI) at Alice Springs Hospital (ASH) to reduce turnaround times for maternal syphilis screening. During the period 2 September - 1 December 2024, eighty-eight LFIs were performed on serum from 74 pregnant women at the ASH laboratory. LFI results were available within 24 hours for 99% of cases, with a median turnaround time of six hours compared to 61 hours for the screen done in Darwin (p < 0.001). No new syphilis cases were detected; all positive LFI results reflected past treated infections. LFI demonstrated 100% sensitivity and specificity compared to standard serology. Although syphilis LFI cannot distinguish active from past infections, it significantly improves the timeliness of screening results, reducing risks of delayed treatment and of loss to follow-up. Implementing a syphilis LFI in remote laboratory settings offers a strategy to enhance syphilis diagnosis and prevention, with broader applicability in high-burden remote regions.

An outbreak of salmonellosis occurred in August 2024 after consuming wild hunted kangaroo in a remote area of the Northern Territory (NT), Australia. We conducted an outbreak investigation via telephone and face-to-face interviews, using a standardised questionnaire that recorded symptoms and exposures to foods and activities prior to onset of symptoms. A confirmed outbreak case was defined as anyone with laboratory confirmed Salmonella Muenchen infection who was part of a group of people who shared meals on 25-26 August 2024. A probable outbreak case was defined as anyone who was part of a group of people who shared meals on 25-26 August 2024 and subsequently experienced diarrhoea, in the absence of a laboratory test. Of the seven members of the group who shared meals, all became ill (attack rate 100%); three were confirmed cases and four were probable cases. The median age was 32 years (range 23-65 years); six (86%) were male. The median incubation period was 24 hours (range 6-30 hours). The most commonly reported symptoms were diarrhoea (100%, 7/7) and abdominal pain (86%, 6/7). Two cases were admitted to hospital, both for an overnight stay; all recovered. All seven cases consumed the same meal - a single, locally hunted and butchered kangaroo. Contamination likely occurred due to unsafe butchering, storage, transportation and insufficient cooking of the meat. This outbreak highlights the risks of contamination of game meat (in this case kangaroo) with Salmonella. Those preparing hunted meat should wash hands and knives regularly while butchering an animal to avoid contamination; should store butchered meat below 5 °C to avoid bacterial growth and cook foods thoroughly to kill microbes. We estimate that the cost to society of this outbreak was 9,810 Australian dollars.

A 71-year-old Australian-born man with previous extended travel to the Philippines presented with bilateral lymphoedema, fevers and rigors. Examination of a nocturnal blood film revealed microfilariae of Wuchereria bancrofti, confirming a diagnosis of Bancroftian filariasis. This case highlights the challenges of diagnosing and managing lymphatic filariasis in non-endemic regions.

This document provides guidelines for tuberculosis (TB) workforce policy and development in Australia, detailing the multidisciplinary nature of the TB workforce, the roles, required skills, and priorities within that workforce, and strategies for its development. Training and development responsibilities and roles of various bodies are also detailed: the National TB Advisory Committee; jurisdictional TB programs and their administrators; the Australian Centre for Disease Control; and sundry other national and international bodies.

The reference laboratories of the Australian Meningococcal Surveillance Programme (AMSP) report data on the number of cases of invasive meningococcal disease (IMD) confirmed by laboratory testing using culture and molecular based techniques. Data contained in quarterly reports are restricted to a description of case numbers of IMD by jurisdiction and serogroup, where known and expanded in 2024 to include antimicrobial resistance data for ceftriaxone, penicillin, ciprofloxacin and rifampicin. A full analysis of laboratory confirmations of IMD in each calendar year is contained in the AMSP annual reports.