Recently, a man in New South Wales acquired eosinophilic meningitis (angiostrongyliasis) after ingesting a slug.

The 1st Australian case of human angiostrongyliasis was reported in 1971, in Brisbane.

At first, sporadic cases were reported only from coastal Queensland, northern New South Wales.

Four cases were reported in Victoria to 1999 (3 of these imported from Fiji; one fatal case).

Seropositivity is common among aboriginals.

Reservoirs:
The parasite has been identified in dogs in Sydney as well as in grey-headed fruit bats (Pteropus poliocephalus) Bennett’s wallaby (Macropus rufogriseus) rufous bettongs (Aepyprymnus rufescens) and captive tamarins (Sanguinus spp).

Further information regarding this, and all other diseases endemic to Australia, is available in Infectious Diseases of Australia. Los Angeles, Gideon Informatics, 2010. 488 pp. [edited] www.gideononline.com/ebooks/country/infectious-diseases-of-australia/

Update: Published in ProMED

A recent ProMED warning to backpackers is well taken – leptospirosis is a common disease in the Pacific region. In the following graphs I’ve compared disease rates for Australia and New Zealand with those of the United States.

Leptospirosis rates in nearby New Caledonia are even more striking, and exceed those of salmonellosis, hepatitis A, hepatitis B, gonorrhea, and tuberculosis.

The incidence of Hepatitis A in Australia has decreased dramatically in recent decades – from a high of 12,876 cases in 1962, to only 274 cases in 2008.

Since the 1970′s, rates of Hepatitis A in Australia have been strikingly similar to those of the United States (see graph):

Graph notes:
1.3. During 1991 to 1997, highest rates (52 per 100,000) were reported in the Northern Territory.
2. During 1991 to 2006, rates in New South Wales declined from 18.9 per 100,000 to 1.4 per 100,000.
Individual years:
1991 – 46.7% from New South Wales.
1994 – 39.7% from Northern Territory and 25.1% from Queensland.
1996 – 45.6% from New South Wales.
1997 – 47.3% from New South Wales.
1998 – 44.9% from Queensland and 37.8% from New South Wales.
2005 – 15.4% from Queensland and 25.5% from New South Wales.
2009 – Increasing rates in Victoria and South Australia appear to have been associated with ingestion of contaminated semi-dried tomatoes.

No fatal cases were reported during 1991 to 1997; 8 during 1998 to 2000.

570 cases were reported from eastern Sydney during 1991 to 1992, of which 58% were men who have sex with men.
– 236 cases were reported from south-eastern Sydney during June 1997 to May 1998 – over 60% of male cases acquired through homosexual contact; 118 during June 1998 to May 1999 – 29% through homosexual contact.

Seroprevalence surveys:
41.1% of Australians, 68.8% in the Northern Territory (1998)
75% of HIV-posititive MSM (2007 publication)
48% of homeless persons in Sydney (2003 to 2005)
3.0% of STD clinic patients (Canberra, 2000 to 2002)
37% of prisoners in New South Wales (1994)

Since 1993, hepatitis A has been the most common cause of infectious disease death among indigenous children in northern Queensland.
– Clinically apparent and severe hepatitis A are more common among indigenous children than their non-indigenous counterparts
– A vaccination program for this population was introduced in 1999.
– During 2003 to 2006, disease rates were 8.1 per 100,000 among indigenous people vs. 1.7 per 100,000 in other populations.

Notable outbreaks:
1970 (publication year) – An outbreak of Infectious hepatitis was reported in an institution.
1980 (publication year) – An outbreak (15 cases) was reported in a home for mentally-retarded children in Sydney. {p 6929674}
1991 – An outbreak (495 cases) in Melbourne involved men who have sex with men.
1993 – An outbreak (11 cases) was reported at a center for young people with developmental disabilities.
1996 (publication year) – An outbreak (7 cases) at a hospital in North Queensland may have been related to handling of contaminated bile.
1997 – An outbreak (7 cases) occurred among boys using a domestic spa in Melbourne.
1997 – An outbreak (270 cases or more) in New South Wales was traced to raw oysters.
1998 – An outbreak (45 cases) in Sydney was ascribed to illicit drug use.
2003 – An outbreak (10 cases) in Tasmania, Victoria and Queensland occurred among people who had been on tour in the Northern Territory.
2003 – An outbreak (21 cases) at a youth camp in central Australia was associated with ingestion of contaminated coleslaw.
2008 – An outbreak (15 cases) was associated with a cafe in Melbourne, Victoria.
2009 – An outbreak (200 cases) in Victoria was associated with consumption of semi-dried tomatoes.

A recent outbreak in Australia serves as a classic exercise in Epidemiology. Although Queensland and New South Wales account for most cases of Ross River disease, rates per 100,000 are consistently highest in Northern Territory.

Update: Referenced in ProMED

Just as the kangaroo is largely limited to Australia, a number of mosquito-borne viral infections are found almost exclusively in this country. In the following graph, I’ve contrasted reporting rates for six of these diseases. Sporadic infection by six additional viruses are also encountered in Australia: Sindbis, Stratford, Edge Hill, Gan Gan, Kokobara and Trubanaman.

Update: Reported in ProMED

A recent upsurge in Ross River virus infection in Queensland highlights the fact that this state has consistently accounted for the majority of cases in Australia for several years. See graph: