One hundred years ago in 1919: #NZ’s #birth #reduction #shock associated with an #influenza #pandemic (N Z Med J., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

N Z Med J. 2019 Dec 13;132(1507):57-62.

One hundred years ago in 1919: New Zealand’s birth reduction shock associated with an influenza pandemic.

Wilson N1, Turner N2, Baker MG1.

Author information: 1 Department of Public Health, University of Otago, Wellington. 2 Department of General Practice and Primary Care, University of Auckland, Auckland.

 

Abstract

AIM:

We aimed to conduct a preliminary analysis of any association between the 1918 influenza pandemic and its impact on birth rates in New Zealand.

METHODS:

Official data covering the period 1910 to 1930 were sourced from multiple New Zealand Yearbooks. Estimates were made of the size of the natality impacts and estimates made of the potential causes.

RESULTS:

In 1919 there were 3,756 fewer non-Māori and 239 fewer Māori births than the pre-pandemic year of 1917, with these representing reductions in birth rates per 1,000 population of 16.6% and 19.8% respectively. The birth rate reductions in the pandemic year of 1918 (relative to 1917) were less at 8.8% and 6.7% reductions respectively. We estimated the likely major driver of the natality deficit in 1919 was embryonic and fetal loss due to influenza infection in pregnancy. Smaller roles were plausibly played by adult deaths during the pandemic and reduced sexual activity associated with the social turbulence of the peak pandemic months.

CONCLUSIONS:

The reduction in birth rates in New Zealand in 1918 and especially 1919 are consistent with international data associated with the 1918 influenza pandemic. The relatively higher natality loss for Māori for 1919 is also consistent with other epidemiological data on the unequal burden from this pandemic. Pandemic planning needs to consider ways to prevent such future burdens and associated inequalities. There is also a need to improve on the current low level of routine influenza vaccination in pregnancy so as to minimise fetal loss from seasonal influenza infection.

PMID: 31830017

Keywords: Pandemic Influenza; Spanish Flu; New Zealand.

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Heterogeneity in #influenza seasonality and #vaccine #effectiveness in #Australia, #Chile, #NZ and #ZA: early #estimates of the 2019 influenza season (Euro Surveill., abstract)

[Source: Eurosurveillance, full page: (LINK). Abstract, edited.]

Heterogeneity in influenza seasonality and vaccine effectiveness in Australia, Chile, New Zealand and South Africa: early estimates of the 2019 influenza season

Sheena G Sullivan1, Carmen S Arriola2, Judy Bocacao3, Pamela Burgos4, Patricia Bustos5, Kylie S Carville6, Allen C Cheng7,8, Monique BM Chilver9, Cheryl Cohen10, Yi-Mo Deng11, Nathalie El Omeiri12, Rodrigo A Fasce13, Orienka Hellferscee10, Q Sue Huang3, Cecilia Gonzalez4, Lauren Jelley3, Vivian KY Leung1, Liza Lopez14, Johanna M McAnerney10, Andrea McNeill14, Maria F Olivares15, Heidi Peck11, Viviana Sotomayor15, Stefano Tempia2,10,16,17, Natalia Vergara15, Anne von Gottberg10, Sibongile Walaza10, Timothy Wood14

Affiliations: 1 World Health Organization (WHO) Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, and Doherty Department, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia; 2 Influenza Division, Centers for Disease Control and Prevention, Atlanta, United States; 3 National Influenza Centre, Institute of Environmental Science and Research, Wellington, New Zealand; 4 Programa Nacional de Inmunizaciones, Ministerio de Salud, Santiago, Chile; 5 Sección de Virus Respiratorios y Exantematicos, Instituto de Salud Publica de Chile, Santiago, Chile; 6 Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia; 7 School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; 8 Department of Infectious Diseases, Alfred Health, and Central Clinical School, Monash University, Melbourne, Australia; 9 Discipline of General Practice, University of Adelaide, Adelaide, Australia; 10 National Institute for Communicable Diseases, Johannesburg, South Africa; 11 WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at the Peter Doherty Institute for Reference and Research on Influenza, Melbourne, Australia; 12 Pan American Health Organization(PAHO)/WHO Regional Office for the Americas, Washington, United States; 13 Subdepartamento de Enfermedades Virales, Instituto de Salud Publica de Chile, Santiago, Chile; 14 Health Intelligence Team, Institute of Environmental Science and Research, Wellington, New Zealand; 15 Departamento de Epidemiologia, Ministerio de Salud, Santiago, Chile; 16 Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa; 17 MassGenics, Duluth, United States

Correspondence:  Sheena G Sullivan

Citation style for this article: Sullivan Sheena G, Arriola Carmen S, Bocacao Judy, Burgos Pamela, Bustos Patricia, Carville Kylie S, Cheng Allen C, Chilver Monique BM, Cohen Cheryl, Deng Yi-Mo, El Omeiri Nathalie, Fasce Rodrigo A, Hellferscee Orienka, Huang Q Sue, Gonzalez Cecilia, Jelley Lauren, Leung Vivian KY, Lopez Liza, McAnerney Johanna M, McNeill Andrea, Olivares Maria F, Peck Heidi, Sotomayor Viviana, Tempia Stefano, Vergara Natalia, von Gottberg Anne, Walaza Sibongile, Wood Timothy. Heterogeneity in influenza seasonality and vaccine effectiveness in Australia, Chile, New Zealand and South Africa: early estimates of the 2019 influenza season. Euro Surveill. 2019;24(45):pii=1900645. https://doi.org/10.2807/1560-7917.ES.2019.24.45.1900645

Received: 23 Oct 2019;   Accepted: 06 Nov 2019

 

Abstract

We compared 2019 influenza seasonality and vaccine effectiveness (VE) in four southern hemisphere countries: Australia, Chile, New Zealand and South Africa. Influenza seasons differed in timing, duration, intensity and predominant circulating viruses. VE estimates were also heterogeneous, with all-ages point estimates ranging from 7–70% (I2: 33%) for A(H1N1)pdm09, 4–57% (I2: 49%) for A(H3N2) and 29–66% (I2: 0%) for B. Caution should be applied when attempting to use southern hemisphere data to predict the northern hemisphere influenza season.

©  This work is licensed under a Creative Commons Attribution 4.0 International License.

Keywords: Seasonal Influenza; Vaccines; Australia; Chile; New Zealand; South Africa.

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#Genomic Analysis of #Fluoroquinolone- and #Tetracycline-Resistant #Campylobacter jejuni Sequence Type 6964 in #Humans and #Poultry, #NZ, 2014–16 (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 25, Number 12—December 2019 / Research

Genomic Analysis of Fluoroquinolone- and Tetracycline-Resistant Campylobacter jejuni Sequence Type 6964 in Humans and Poultry, New Zealand, 2014–2016

Nigel P. French  , Ji Zhang, Glen P. Carter, Anne C. Midwinter, Patrick J. Biggs, Kristin Dyet, Brent J. Gilpin, Danielle J. Ingle, Kerry Mulqueen, Lynn E. Rogers, David A. Wilkinson, Sabrina S. Greening, Petra Muellner, Ahmed Fayaz, and Deborah A. Williamson

Author affiliations: Massey University, Palmerston North, New Zealand (N.P. French, J. Zhang, A.C. Midwinter, P.J. Biggs, L.E. Rogers, D.A. Wilkinson, S.S. Greening, A. Fayaz); New Zealand Food Safety Science and Research Centre, Palmerston North (N.P. French, D.A. Wilkinson); The University of Melbourne, Melbourne, Victoria, Australia (G.P. Carter, D.J. Ingle, D.A. Williamson); Institute of Environmental Science and Research Limited, Christchurch, New Zealand (K. Dyet, B.J. Gilpin); Australian National University, Canberra, Australian Capital Territory, Australia (D.J. Ingle); Poultry Industry Association of New Zealand, Auckland, New Zealand (K. Mulqueen); EPI-interactive, Wellington, New Zealand (P. Muellner)

 

Abstract

In 2014, antimicrobial drug–resistant Campylobacter jejuni sequence type 6964 emerged contemporaneously in poultry from 3 supply companies on the North Island of New Zealand and as a major cause of campylobacteriosis in humans in New Zealand. This lineage, not previously identified in New Zealand, was resistant to tetracycline and fluoroquinolones. Genomic analysis revealed divergence into 2 major clades; both clades were associated with human infection, 1 with poultry companies A and B and the other with company C. Accessory genome evolution was associated with a plasmid, phage insertions, and natural transformation. We hypothesize that the tetO gene and a phage were inserted into the chromosome after conjugation, leaving a remnant plasmid that was lost from isolates from company C. The emergence and rapid spread of a resistant clone of C. jejuni in New Zealand coupled with evolutionary change in the accessory genome demonstrate the need for ongoing Campylobacter surveillance among poultry and humans.

Keywords: Antibiotics; Drugs Resistance; Tetracyclines; Fluoroquinolones; Campylobacter jejuni; Human; Poultry; New Zealand.

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The ‘H-Bug’ #epidemic: lessons from #antibiotic #resistant #staphylococcal #outbreaks in #NZ #hospitals from 1955-1963 (N Z Med J., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

N Z Med J. 2019 Sep 20;132(1502):84-95.

The ‘H-Bug’ epidemic: lessons from antibiotic-resistant staphylococcal outbreaks in New Zealand hospitals from 1955-1963.

Jowitt D1.

Author information: 1 PhD (History), University of Auckland, Auckland.

 

Abstract

Deadly outbreaks of antibiotic-resistant staphylococcal infection occurred in New Zealand from the mid-1950s to early 1960s. The ‘H’ or ‘Hospital-Bug’ epidemic was part of a pandemic wave characterised by high numbers of nosocomial staphylococcal infections and the capacity of Staphylococcus aureus to develop resistance to commonly used antibiotics. Surgical patients and childbearing women and babies proved particularly vulnerable to the predominant pathogenic strain, identified as phage type 80/81. The post-war baby boom was at its height in New Zealand, and overcrowded maternity hospitals and outdated nursing techniques increased the risks of infection. The outbreaks challenged the medical profession, which had become reliant on antibiotics for prophylaxis and treatment. The Health Department ascribed responsibility for the indiscriminate use of antibiotics to medical practitioners but had little control over their prescribing habits. Confronted by increasing infection rates and falling public confidence in the maternity services, health officials supported a fundamental change in maternity care to ‘rooming-in’ of mother and baby, epidemiological research on staphylococcal transmission in hospitals, notification of nosocomial infections, improved barrier nursing and heightened awareness of appropriate aseptic techniques. Phage type 80/81 waned in the early 1960s concurrent with the arrival of methicillin but the emergence of methicillin-resistant S. aureus (MRSA) in the 1980s, vancomycin-resistant S. aureus (VRSA) in the 2000s, and the rapid emergence and spread of multi-drug resistant Gram-negative bacteria over the past decade, highlights the potential for further outbreaks while the use of antimicrobials remains high. Non-pharmacological interventions such as those promoted during the ‘H-Bug’ epidemic are likely to be central to controlling future waves of resistant nosocomial infection.

PMID: 31563930

Keywords: Public Health; Antibotics; Drugs Resistance; Staphylococcus aureus; Nosocomial outbreaks; New Zealand.

—–

Co-occurrence of #mcr1 and #mcr3 #genes in a single #Escherichia coli in #NZ (J Antimicrob Chemother., abstract)

[Source: Journal of Antimicrobial Chemotherapy, full page: (LINK). Abstract, edited.]

Co-occurrence of mcr-1 and mcr-3 genes in a single Escherichia coli in New Zealand

Julie Creighton, Trevor Anderson, Julia Howard, Kristin Dyet, Xiaoyun Ren,Joshua Freeman

Journal of Antimicrobial Chemotherapy, dkz311, https://doi.org/10.1093/jac/dkz311

Published: 24 July 2019

Issue Section: Research letter

___

Sir,

The discovery of the plasmid-mediated colistin resistance gene mcr-1, first identified in 2015 among both clinical and animal isolates in China, raised concerns about pan-resistant bacteria.1 A plethora of publications quickly followed, suggesting mcr-1 was already established in many countries and across many continents, in various bacterial species, on a variety of plasmids types, and in bacteria isolated from diverse animal species, environmental sources and human health settings.2 Furthermore, several other mcr-like genes and gene variants have since been discovered.2,3

Colistin is among a diminishing group of antimicrobial agents available for…

(…)

____

© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: Antibiotics; Drugs Resistance; Colistin; E. Coli; New Zealand.

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The burden of #Legionnaires’ disease in #NZ (#LegiNZ): a national #surveillance study (Lancet Infect Dis., abstract)

[Source: Lancet Infectious Diseases, full page: (LINK). Abstract, edited.]

The burden of Legionnaires’ disease in New Zealand (LegiNZ): a national surveillance study

Patricia C Priest, DPhil †, Sandy Slow, PhD †, Prof Stephen T Chambers, MD, Claire M Cameron, PhD, Michelle N Balm, FRCPA, Mark W Beale, FRACP, Timothy K Blackmore, PhD, Andrew D Burns, FRACP, Dragana Drinković, MD, Juliet A Elvy, FRCPath, Richard J Everts, FRACP, David A Hammer, FRCPA, Paul J Huggan, FRACP, Christopher J Mansell, FRCPA, Vicki M Raeder, DipMLT, Sally A Roberts, FRCPA, Murray C Robinson, DipMLT, Vani Sathyendran, FRCPA, Susan L Taylor, FRCPA, Alyssa W Thompson, DO, James E Ussher, PhD, Antje J van der Linden, FRCPA, Melanie J Williams, BMLSc, Roslyn G Podmore, BSc, Trevor P Anderson, MSc, Kevin Barratt, MSc, Joanne L Mitchell, PhD, David J Harte, MSc, Virginia T Hope, FAFPHM, Prof David R Murdoch, MD

Published: June 10, 2019 / DOI: https://doi.org/10.1016/S1473-3099(19)30113-6

 

Summary

Background

Legionnaires’ disease is under-diagnosed because of inconsistent use of diagnostic tests and uncertainty about whom to test. We assessed the increase in case detection following large-scale introduction of routine PCR testing of respiratory specimens in New Zealand.

Methods

LegiNZ was a national surveillance study done over 1-year in which active case-finding was used to maximise the identification of cases of Legionnaires’ disease in hospitals. Respiratory specimens from patients of any age with pneumonia, who could provide an eligible lower respiratory specimen, admitted to one of 20 participating hospitals, covering a catchment area of 96% of New Zealand’s population, were routinely tested for legionella by PCR. Additional cases of Legionnaires’ disease in hospital were identified through mandatory notification.

Findings

Between May 21, 2015, and May 20, 2016, 5622 eligible specimens from 4862 patients were tested by PCR. From these, 197 cases of Legionnaires’ disease were detected. An additional 41 cases were identified from notification data, giving 238 cases requiring hospitalisation. The overall incidence of Legionnaires’ disease cases in hospital in the study area was 5·4 per 100 000 people per year, and Legionella longbeachae was the predominant cause, found in 150 (63%) of 238 cases.

Interpretation

The rate of notified disease during the study period was three-times the average over the preceding 3 years. Active case-finding through systematic PCR testing better clarified the regional epidemiology of Legionnaires’ disease and uncovered an otherwise hidden burden of disease. These data inform local Legionnaires’ disease testing strategies, allow targeted antibiotic therapy, and help identify outbreaks and effective prevention strategies. The same approach might have similar benefits if applied elsewhere in the world.

Funding

Health Research Council of New Zealand.

Keywords: Legionnaire’s diseases; New Zealand.

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[#NZ] New Zealand’s #experience of the 1918-19 #influenza #pandemic: a systematic review after 100 years (N Z Med J., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

N Z Med J. 2018 Dec 14;131(1487):54-69.

New Zealand’s experience of the 1918-19 influenza pandemic: a systematic review after 100 years.

Summers JA1, Baker M2, Wilson N2.

Author information: 1 Postdoctoral Research Fellow in Medical Statistics, School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom. 2 Professor of Public Health, Department of Public Health, University of Otago, Wellington.

 

Abstract

BACKGROUND:

The 1918-1919 influenza pandemic has been New Zealand’s most severe disaster event (around 9,000 deaths). We aimed to review the literature related to this pandemic in New Zealand and among New Zealanders overseas, to identify any remaining research gaps (given ongoing risks of future influenza pandemics and from new pathogens, eg, synthetic bioweapons).

METHODS:

Systematic literature searches and comparisons with international findings for this pandemic to facilitate identification of research gaps.

RESULTS:

A total of 61 relevant publications were identified. The epidemiological patterns reported were largely consistent with the international literature for this pandemic. These features included the w-shaped age-distribution for mortality, and the much higher mortality rates for indigenous people (ie, seven-fold for Māori vs New Zealand European). But some novel risk factors were identified (eg, large chest size as a risk factor for death in military personnel), and there was an extremely high mortality troop ship outbreak (probably related to crowding). In contrast to some international work, there was an apparent lack of a socio-economic gradient in mortality rates in two studies using modern analytical methods. New Zealand work has clearly shown how the pandemic spread via the rail network and internal shipping routes and the rarity of successful measures to prevent spread in contrast to some other jurisdictions. It has also found a marked lack of memorials to the pandemic (in contrast to war memorials). Nevertheless, some research gaps remain, including on the apparent marked reduction in birth rates in 1918-1919 and the reasons for no socio-economic gradient despite other New Zealand evidence for occupational class variation in lifespan at this time.

CONCLUSIONS:

This is a relatively well-studied disaster event but there remain important research questions relating to this pandemic in New Zealand. Filling these gaps may contribute to improved planning for managing future pandemics.

PMID: 30543612

Keywords: Pandemic Influenza; Spanish Flu; New Zealand.

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