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,

Published: 24 July 2019

Issue Section: Research letter



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:

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (

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



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:




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.


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.


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.


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.


Health Research Council of New Zealand.

Keywords: Legionnaire’s diseases; New Zealand.


[#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.




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).


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


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.


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.


#Influenza in #NZ Before 1918: A Preliminary #Report (Am J Epidemiol., abstract)

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

Am J Epidemiol. 2018 Aug 22. doi: 10.1093/aje/kwy180. [Epub ahead of print]

Influenza in New Zealand Before 1918: A Preliminary Report.

Rice GW1.

Author information: 1 Department of History, University of Canterbury, New Zealand.



This paper aims to test the hypothesis of possible fatal immunological reactions to the A/H1N1 virus of the 1918 “Spanish” influenza pandemic caused by previous exposure to the A/H3N8 virus of the 1890-2 “Russian” influenza pandemic. Reconstruction of mortality peaks from influenza and excess pneumonia deaths in New Zealand before 1918 from newspapers and official death records enables comparison with peaks of influenza mortality by age in 1918 from individual death records. Influenza outbreaks in 1885, 1890-2, 1894 and 1898 appear to match mortality peaks for males in the 1918 pandemic. Peaks of female deaths in 1918 correspond to the previous influenza outbreaks of 1887 and 1890-2. The peak mortality for both sexes was in the age-groups 28-32 years. While lending strong support to the hypothesis of fatal immunological reaction derived from early exposure to a different influenza virus, this study also raises more puzzles: given that the A/H1N1 virus of 1918 was exceptionally virulent, why did so few children aged 5-15 die from it? Influenza normally kills only the very young and the very old. And why did twice as many European males than females die in the young-adult age-groups, while Māori males and females died at almost identical rates?

PMID: 30137202 DOI: 10.1093/aje/kwy180

Keywords: Influenza A; Pandemic Influenza; Spanish Flu; H1N1; H3N8; New Zealand.


#Risk factors and attack rates of seasonal #influenza #infection: results of the #SHIVERS seroepidemiologic cohort study (J Infect Dis., abstract)

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

Risk factors and attack rates of seasonal influenza infection: results of the SHIVERS seroepidemiologic cohort study

Q Sue Huang, Don Bandaranayake, Tim Wood, E Claire Newbern, Ruth Seeds, Jacqui Ralston, Ben Waite, Ange Bissielo, Namrata Prasad, Angela Todd, Lauren Jelley, Wendy Gunn, Anne McNicholas, Thomas Metz, Shirley Lawrence, Emma Collis, Amanda Retter, Sook-san Wong, Richard Webby, Judy Bocacao, Jennifer Haubrock, Graham Mackereth, Nikki Turner, Barbara McArdle, John Cameron, Gary Reynolds, Michael G Baker, Cameron C Grant, Colin McArthur, Sally Roberts, Adrian Trenholme, Conroy Wong, Susan Taylor, Paul Thomas, Jazmin Duque, Diane Gross, Mark G Thompson, Marc-Alain Widdowson, SHIVERS investigation team

The Journal of Infectious Diseases, jiy443,

Published: 17 July 2018




Understanding the attack rate of influenza infection and the proportion who become ill by risk group is key to implementing prevention measures. While population-based studies of anti-haemagglutinin antibody responses have been described previously, studies examining both anti-haemagglutinin and anti-neuraminidase antibodies are lacking.


In 2015, we conducted a sero-epidemiologic cohort study of individuals randomly selected from a population in New Zealand. We tested paired sera for haemagglutinin-inhibition (HAI) or neuraminidase-inhibition (NAI) titres for seroconversion . We followed participants weekly and performed influenza PCR for those reporting influenza-like illness (ILI).


Influenza infection (either HAI or NAI seroconversion) was found in 321 (35%; 95%CI:32-38%) of 911 unvaccinated participants, of which 100 (31%) seroconverted to NAI alone. Young children and Pacific peoples experienced the highest influenza infection attack rates, but overall only a quarter of all infected reported influenza-PCR-confirmed ILI and one-quarter of these sought medical attention. Seroconversion to NAI alone was higher among children aged <5 years vs. those aged ≥5 years (14% vs 4%; p<0.001) and among those with influenza B vs A(H3N2) virus infections (7% vs 0.3%; p<0.001).


Measurement of anti-neuraminidase antibodies in addition to anti- hemagglutinin antibodies may be important in capturing the true influenza infection rates.

influenza, infection attack rate, influenza-like illness, sero-epidemiologic cohort, haemagglutinin-inhibition antibody, neuraminidase-inhibition antibody

Issue Section: Major Article

© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail:

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (

Keywords: Seasonal Influenza; Seroprevalence; New Zealand.


A cross-sectional #survey of #Australian and New Zealand #public #opinion on methods to #triage IC #patients in an #influenza #pandemic (Crit Care Resusc., abstract)

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

Crit Care Resusc. 2017 Sep;19(3):254-265.

A cross-sectional survey of Australian and New Zealand public opinion on methods totriage intensive care patients in an influenza pandemic.

Cheung W1, Myburgh J2, McGuinness S3, Chalmers D4, Parke R3, Blyth F5, Seppelt I6, Parr M7, Hooker C8, Blackwell N9, DeMonte S10, Gandhi K11, Kol M12, Kerridge I8, Nair P13, Saunders NM14, Saxena MK15, Thanakrishnan G12, Naganathan V5; Influenza Pandemic ICU Triage 3 study investigators; Australian and New Zealand Intensive Care Society Clinical Trials Group.

Author information: 1 Intensive Care Unit, Concord Repatriation General Hospital, Sydney, NSW, Australia. 2 Critical Care and Trauma Division, The George Institute for Global Health, Sydney, NSW, Australia. 3 Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital, Auckland, New Zealand. 4 Intensive Care Unit, Hawke’s Bay Fallen Soldiers’ Memorial Hospital, Hastings, New Zealand. 5 Sydney Medical School, Concord, University of Sydney, Sydney, NSW, Australia. 6 Department of Intensive Care, Nepean Hospital, Sydney, NSW, Australia. 7 University of New South Wales, Sydney, NSW, Australia. 8 Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW, Australia. 9 University of Queensland, Brisbane, QLD, Australia. 10 Prince Charles Hospital, Brisbane, QLD, Australia. 11 Department of Intensive Care, Blacktown Hospital, Sydney, NSW, Australia. 12 Intensive Care Unit, Concord Repatriation General Hospital, Sydney, NSW, Australia. 13 St. Vincent’s Hospital, Sydney, NSW, Australia. 14 Norfolk and Norwich University Hospital National Health Service Foundation Trust, Norfolk, United Kingdom. 15 Department of Intensive Care Medicine, St. George Hospital, Sydney, NSW, Australia.




An influenza pandemic has the potential to overwhelm intensive care resources, but the views of the general public on how resources should be allocated in such a scenario were unknown. We aimed to determine Australian and New Zealand public opinion on how intensive care unit beds should be allocated during an influenza pandemic.


A postal questionnaire was sent to 4000 randomly selected registered voters; 2000 people each from the Australian Electoral Commission and New Zealand Electoral Commission rolls.


The respondents’ preferred method to triage ICU patients in an influenza pandemic. Respondents chose from six methods: use a “first in, first served” approach; allow a senior doctor to decide; use pre-determined health department criteria; use random selection; use the patient’s ability to pay; use the importance of the patient to decide. Respondents also rated each of the triage methods for fairness.


Australian respondents preferred that patients be triaged to the ICU either by a senior doctor (43.2%) or by pre-determined health department criteria (38.7%). New Zealand respondents preferred that triage be performed by a senior doctor (45.9%). Respondents from both countries perceived triage by a senior doctor and by pre-determined health department criteria to be fair, and the other four methods of triage to be unfair.


In an influenza pandemic, when ICU resources would be overwhelmed, survey respondents preferred that ICU triage be performed by a senior doctor, but also perceived the use of pre-determined triage criteria to be fair.

PMID: 28866976

Keywords: Pandemic Influenza; Pandemic Preparedness; Australia; New Zealand.


Little #risk of severe #complications associated with #Zika infection in #NewZealand (N Z Med J., abstract)

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

N Z Med J. 2016 Aug 19;129(1440):108-113.

Little risk of severe complications associated with Zika infection in New Zealand.

Parry GJ1, Peacey M1, Buenz EJ1.

Author information: 1Nelson Marlborough Institute of Technology, New Zealand.



Zika virus infection has raised considerable concern in New Zealand, but the risks faced by most New Zealanders, while real, are quite small as New Zealand does not harbor the primary mosquito vector. Furthermore, in individuals with a competent immune system, the acute illness caused by Zika virus infection is generally mild. Serious complication associated with Zika virus infections include microcephaly and Guillain-Barré Syndrome. Pacific Island countries have reported cases of Zika virus infection and these climates support the mosquito vector. Thus, travelers to these areas are at risk of infection. New Zealand travelers returning from endemic areas have developed the illness associated with the virus, but the probability of autochthonous transmission in New Zealand is very small.

PMID: 27538044

[PubMed – as supplied by publisher]

Keywords: Research; Abstracts; Zika Virus; New Zealand.