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Annual report National Notifiable Diseases Surveillance System, 2004
MVEV and KUNV for the Alice Springs region and
other regions in January 2004, and for the Top End in
March 2004 after sentinel chicken seroconversions in
the Leanyer swamp area near Darwin, and in April for
the whole of the Northern Territory after notification of
the MVEV case.
Kunjin virus
Case defi nition – Kunjin virus
Only confirmed cases are reported.
Confirmed case: Requires isolation of
Kunjin virus, OR detection of Kunjin virus by
nucleic acid testing, OR IgG seroconversion
or a signifi cant increase in antibody level or a
fourfold or greater rise in titre to Kunjin virus,
OR detection of Kunjin virus-specifi c IgM in
cerebrospinal fl uid, OR detection of Kunjin
virus-specifi c IgM in serum in the absence of
IgM to Murray Valley encephalitis, Japanese
encephalitis or dengue viruses. This is only
accepted as laboratory evidence for encephalitic
illnesses.
AND Non-encephalitic disease: acute febrile
illness with headache, myalgia and/or rash,
OR encephalitic disease: acute febrile meningoencephalitis
characterised by one or more of
the following: 1. focal neurological disease or
clearly impaired level of consciousness, 2. an
abnormal computerised tomograph or magnetic
resonance image or electrocardiograph, 3.
presence of pleocytosis in cerebrospinal fl uid,
OR asymptomatic disease: case detected as
part of a serosurvey should not be notifi ed.
Confi rmation of laboratory result by a second
arbovirus reference laboratory is required if the
case occurs in areas of Australia not known to
have established enzootic/endemic activity or
regular epidemic activity.
There were 12 notifi cations of KUNV during 2004,
with 11 of the cases reported from Queensland.
These 11 cases were symptomatic with a mild febrile
illness but without encephalitis. Of the 11 cases, nine
were reported in January and February 2004 and it
is likely that these cases were identifi ed because of
increased testing undertaken in north Queensland
due to the major dengue outbreak (Jeffrey Hanna,
personal communication). There is nothing to indicate
any genuine increase in human health risk from
Kunjin virus activity during that time.
The other jurisdiction to report a KUNV notifi cation
in 2004 was Victoria. In October 2004, a 35-year-old
female was notifi ed as having acquired KUNV infection.
The person lived in metropolitan Melbourne,
but a detailed investigation did not reveal any likely
exposure within Victoria, nor was there any other
evidence of KUNV activity. She had travelled extensively
overseas and it is assumed that she acquired
KUNV or a closely-related virus while overseas.
Dengue virus infection
Case defi nition – dengue virus
Only confirmed cases are reported.
Confirmed case: Requires isolation of
dengue virus, OR detection of dengue virus by
nucleic acid testing, OR IgG seroconversion
or a signifi cant increase in antibody level or a
fourfold or greater rise in titre to dengue virus,
proven by neutralisation or another specifi c
test, OR detection of dengue virus-specifi c
IgM in cerebrospinal fl uid, in the absence of
IgM to Murray Valley encephalitis, Kunjin, or
Japanese encephalitis viruses, OR detection
of dengue virus-specifi c IgM in serum, except
in North Queensland. In North Queensland,
dengue virus-specifi c IgM in serum is acceptable
evidence ONLY when this occurs during a
proven outbreak.
AND A clinically compatible illness (e.g. fever,
headache, arthralgia, myalgia, rash, nausea,
and vomiting, with a possible progression to
dengue haemorrhagic fever, dengue shock
syndrome or meningoencephalitis).
Confi rmation of laboratory result by a second
arbovirus reference laboratory is required if
the case occurs in previously unaffected areas
of Australia. Currently North Queensland is
the only area with the potential for indigenous
(epidemic) dengue virus in Australia.
58 CDI Vol 30 No 1 2006