Introduction

Australia's notifiable diseases status 2006, is an annual surveillance report of nationally notifiable communicable diseases. Communicable disease surveillance in Australia operates at the national, state and local levels. Primary responsibility for public health action lies with the state and territory health departments. The role of communicable disease surveillance at a national level includes:

• identifying national trends;
• guidance for policy development and resource allocation at a national level;
• monitoring the need for and impact of national disease control programs;
• coordination of response to national or multi-jurisdictional outbreaks;
• description of the epidemiology of rare diseases, that occur infrequently at state and territory levels;
• meeting various international reporting requirements, such as providing disease statistics to the World Health Organization (WHO), and;
• support for quarantine activities, which are the responsibility of the national government.

Methods

Australia is a federation of 6 states (New South Wales, Queensland, South Australia, Tasmania, Victoria and Western Australia) and 2 territories (the Australian Capital Territory and the Northern Territory). State and territory health departments collect notifications of communicable diseases under their public health legislation. In 2006, the Australian Government Department of Health and Ageing (DoHA) did not have any legislated responsibility for public health apart from human quarantine. States and territories voluntarily forwarded data on a nationally agreed set of communicable diseases to DoHA for the purposes of national communicable disease surveillance.

Sixty-six communicable diseases (Table 1) agreed upon nationally through the Communicable Diseases Network Australia (CDNA) were reported to the National Notifiable Diseases Surveillance System (NNDSS). The system was complemented by other surveillance systems, which provided information on various diseases, including some that are not reported to NNDSS.

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Table 1. Diseases notified to the National Notifiable Diseases Surveillance System, Australia, 2006

Disease	Data received from
Bloodborne diseases
Hepatitis (NEC)	All jurisdictions
Hepatitis B (incident)	All jurisdictions
Hepatitis B (unspecified)*	All jurisdictions
Hepatitis C (incident)	All jurisdictions, except Queensland
Hepatitis C (unspecified)*,†	All jurisdictions
Hepatitis D	All jurisdictions
Gastrointestinal diseases
Botulism	All jurisdictions
Campylobacteriosis‡	All jurisdictions, except NSW
Cryptosporidiosis	All jurisdictions
Haemolytic uraemic syndrome	All jurisdictions
Hepatitis A	All jurisdictions
Hepatitis E	All jurisdictions
Listeriosis	All jurisdictions
Salmonellosis	All jurisdictions
Shigellosis	All jurisdictions
STEC, VTEC§	All jurisdictions
Typhoid	All jurisdictions
Quarantinable diseases
Cholera	All jurisdictions
Highly pathogenic avian influenza	All jurisdictions
Plague	All jurisdictions
Rabies	All jurisdictions
Severe acute respiratory syndrome	All jurisdictions
Smallpox	All jurisdictions
Viral haemorrhagic fever	All jurisdictions
Yellow fever	All jurisdictions
Sexually transmissible infections
Chlamydial infections (NEC)||	All jurisdictions
Donovanosis	All jurisdictions
Gonococcal infection	All jurisdictions
Syphilis (all)¶	All jurisdictions
Syphilis – <2 years duration	All jurisdictions
Syphilis – >2 years or unspecified duration	All jurisdictions
Syphilis – congenital	All jurisdictions
Vaccine preventable diseases
Diphtheria	All jurisdictions
Haemophilus influenzae type b	All jurisdictions
Influenza (laboratory confirmed)**	All jurisdictions
Measles	All jurisdictions
Mumps	All jurisdictions
Pertussis	All jurisdictions
Pneumococcal disease (invasive)	All jurisdictions
Poliomyelitis	All jurisdictions
Rubella	All jurisdictions
Rubella – congenital	All jurisdictions
Tetanus	All jurisdictions
Varicella zoster (chickenpox)	All jurisdictions, except ACT, NSW and Victoria
Varicella zoster (shingles)	All jurisdictions, except ACT, NSW and Victoria
Varicella zoster (unspecified)	All jurisdictions, except ACT, NSW and Victoria
Vectorborne diseases
Barmah Forest virus infection	All jurisdictions
Dengue virus infection	All jurisdictions
Flavivirus infection (NEC)‡‡	All jurisdictions
Japanese encephalitis virus infection	All jurisdictions
Kunjin virus infection§§	All jurisdictions
Malaria	All jurisdictions
Murray Valley encephalitis virus infection	All jurisdictions
Ross River virus infection	All jurisdictions
Zoonoses
Anthrax	All jurisdictions
Australian bat lyssavirus	All jurisdictions
Brucellosis	All jurisdictions
Leptospirosis	All jurisdictions
Lyssavirus (NEC)	All jurisdictions
Ornithosis	All jurisdictions
Q fever	All jurisdictions
Tularaemia	All jurisdictions
Other bacterial infections
Legionellosis	All jurisdictions
Leprosy	All jurisdictions
Meningococcal infection¶¶	All jurisdictions
Tuberculosis	All jurisdictions

* Unspecified hepatitis includes cases in whom the duration of infection could not be determined.

† In Queensland, includes incident hepatitis cases.

‡ Notified as 'foodborne disease' or 'gastroenteritis in an institution' in New South Wales.

§ Infection with Shiga toxin/verotoxin-producing Escherichia coli (STEC/VTEC).

|| Includes Chlamydia trachomatis identified from cervical, rectal, urine, urethral, throat and eye samples, except for South Australia, which reports only genital tract specimens; the Northern Territory, which excludes ocular specimens; and Western Australia, which excludes ocular and perinatal infections.

¶ Does not include congenital syphilis.

** Laboratory confirmed influenza is not a notifiable disease in South Australia but reports are forwarded to NNDSS.

‡‡ Flavivirus (NEC) replaced Arbovirus (NEC) from 1 January 2004.

§§ In the Australian Capital Territory, Murray Valley encephalitis virus infections and Kunjin virus infections are combined under Murray Valley encephalitis virus infections.

¶¶ Only invasive meningococcal disease is nationally notifiable. However, New South Wales, the Australian Capital Territory and South Australia also report conjunctival cases.

NEC Not elsewhere classified

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The national dataset included fields for unique record reference number; notifying state or territory; disease code; age; sex; indigenous status; postcode of residence; date of onset of the disease; death, date of report to the state or territory health department and outbreak reference (to identify cases linked to an outbreak). Where relevant, information on the species, serogroups/subtypes and phage types of organisms isolated, and on the vaccination status of the case was collected. While not included in the national dataset, additional information concerning mortality and specific health risk factors for some diseases was obtained from states and territories.

Notification rates for each notifiable disease were calculated using 2006 mid-year resident population supplied by the Australian Bureau of Statistics (Appendixes 1 and 2). Where diseases were not notifiable in a state or territory, national rates were adjusted by excluding the population of that jurisdiction from the denominator. For some diseases, age adjusted rates were calculated using the indirect method of standardisation, with 2001 census data as the standard population.

The geographical distribution of selected diseases was mapped using ARCGIS software. Maps were based on the postcode of residence of each patient, aggregated to the appropriate Statistical Division (Map 1). Rates for the different Statistical Divisions were ordered into 6 groups — the highest value, the lowest value above zero, those equal to zero, and the intermediate values sorted into 3 equal-sized groups. The Statistical Divisions in the Australian Capital Territory were combined to calculate rates for the territory as a whole.

Map 1. Australian Bureau of Statistics Statistical Divisions and population, Australia, by Statistical Division, 2006

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Statistical Division		Population	Statistical Division		Population	Statistical Division		Population
Australian Capital Territory			Queensland, continued			Victoria
805	Canberra*	328,817	320	Darling Downs	226,430	205	Melbourne	3,684,461
New South Wales			325	South West	27,095	210	Barwon	273,997
105	Sydney	4,293,105	330	Fitzroy	193,182	215	Western District	102,141
110	Hunter	611,935	335	Central West	12,155	220	Central Highlands	150,412
115	Illawarra	415,248	340	Mackay	151,572	225	Wimmera	50,920
120	Richmond-Tweed	227,815	345	Northern	210,943	230	Mallee	93,415
125	Mid-North Coast	297,409	350	Far North	243,948	235	Loddon	178,091
130	Northern	181,078	355	North West	34,558	240	Goulburn	207,377
135	North Western	119,276	South Australia			245	Ovens-Murray	97,497
140	Central West	181,374	405	Adelaide	1,138,833	250	East Gippsland	84,222
145	South Eastern	204,854	410	Outer Adelaide	125,903	255	Gippsland	169,133
150	Murrumbidgee	155,281	415	Yorke and Lower North	45,190	Western Australia
155	Murray	116,870	420	Murray Lands	69,066	505	Perth	1,507,949
160	Far West	23,449	425	South East	63,580	510	South West	227,981
Northern Territory			430	Eyre	34,979	515	Lower Great Southern	55,259
705	Darwin	113,955	435	Northern	77,105	520	Upper Great Southern	17,609
710	NT – balance	92,733	Tasmania			525	Midlands	52,214
Queensland			605	Greater Hobart	205,510	530	South Eastern	53,708
305	Brisbane	1,820,375	610	Southern	36,176	535	Central	60,167
310	Moreton	868,985	615	Northern	138,562	540	Pilbara	40,132
315	Wide Bay-Burnett	264,201	620	Mersey-Lyell	108,700	545	Kimberley	35,865
			910	Other territories	2,691	Total Australia		20,605,488

* Includes Statistical Division 810 'Australian Capital Territory – balance'.

Information from communicable disease surveillance is disseminated through several avenues of communication. At the fortnightly teleconferences of the CDNA the most up-to-date information on topics of interest to the network is provided. The Communicable Diseases Intelligence (CDI) quarterly journal publishes surveillance data and reports of research studies on the epidemiology and control of various communicable diseases. Disease surveillance summaries from the NNDSS are published on the Communicable Diseases Surveillance section of DoHA's web site.

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