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Annual report National Notifiable Diseases Surveillance System, 2004
Table 24.
Deaths due to legionellosis, Australia, 2004, by state or territory and species
Species
State or territory
ACT NSW NT Qld SA Tas Vic WA
Total
Legionella longbeachae 0 2 0 0 1 0 2 2 7
Legionella pneumophila 0 2 0 0 1 0 2 1 6
Legionella micdadei 0 0 0 0 0 0 1 0 1
Unknown species 0 0 0 0 0 0 2 0 2
Total 0 4 0 0 2 0 7 3 16
Leprosy
Invasive meningococcal disease
Case defi nition – Leprosy
Only confirmed cases are notifi ed.
Confirmed case: Requires demonstration
of acid fast bacilli in split skin smears and
biopsies prepared from ear lobe or other
relevant sites or histopathological report from
skin or nerve biopsy compatible with leprosy
(Hansen’s disease) examined by an anatomical
pathologist or specialist microbiologist AND
compatible nerve conduction studies or peripheral
nerve enlargement or loss of neurological
function not attributable to trauma or other
disease process, or hypopigmented or reddish
skin lesions with defi nite loss of sensation.
Leprosy is a chronic infection of the skin and peripheral
nerves with the bacterium Mycobacterium
leprae. Leprosy is a rare disease in Australia, with
the majority of cases occurring among Indigenous
communities and migrants to Australia from leprosyendemic
countries.
In 2004, fi ve leprosy cases were notifi ed. This is the
same number of cases as were notifi ed in 2003.
Three cases in occurred in New South Wales and
one case occurred in both the Northern Territory and
Queensland. Four of the fi ve cases were female,
and two cases were Indigenous Australians (one
male and one female). Cases ranged in age from
30–79 years. Four cases had multibacillary leprosy
and one had paucibacillary leprosy. One case had
evidence of Grade 2 disability at presentation, with
visible deformity or damage to hands/feet and visual
impairment. 44
The WHO has established the goal of eliminating leprosy
by 2005, which is defined as a reduction in the
prevalence of leprosy to less than 1 case per 10,000
population. By the end of 2001, 36 of the 37 countries
and areas that make up the Western Pacific Region,
including Australia, reached this target. 45
Case defi nition – Invasive meningococcal
disease
Both confirmed cases and probable cases
are notifi ed.
Confirmed case: Defi ned as isolation of
Neisseria meningitidis from a normally sterile
site. Alternatively, detection of meningococcus
by nucleic acid testing, or Gram negative
diplococci in Gram stain in specimens from a
normally sterile site or from a suspicious skin
lesion, OR high titre IgM or a signifi cant rise
in IgM or IgG titres to outer membrane protein
antigens, OR positive polysaccharide antigen
test in cerebrospinal fl uid AND disease compatible
with invasive meningococcal disease.
Probable case: Defi ned as the absence of
evidence for other causes of clinical symptoms
AND EITHER clinically compatible disease
including haemorrhagic rash OR clinically
compatible disease and close contact with a
confi rmed case within the previous 60 days.
In Australia, serogroups B and C are the major
cause of invasive meningococcal disease. In
response to community concerns about increases in
meningococcal disease in Australia, the Australian
Government approved the National Meningococcal
C Vaccination Program, which commenced
in January 2003. 46
In 2004, there were 408 notifi cations of invasive
meningococcal disease in Australia, 170 cases
fewer than in 2003 and a decrease of 29 per cent.
The total in 2004 was the lowest since 1996 and is
below the historical range (the 5 year mean by minus
two standard deviations.) The national notifi cation
rate in 2004 was 2.2 cases per 100,000 population.
Three hundred and seventy-three cases (91%) were
confi rmed, and 35 (8%) had a probable diagnosis.
70 CDI Vol 30 No 1 2006