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HIV and AIDS Surveillance

National surveillance for HIV disease is coordinated by the National Centre in HIV Epidemiology and Clinical Research (NCHECR), in collaboration with State and Territory health authorities and the Commonwealth of Australia. Cases of HIV infection are notified to the National HIV Database on the first occasion of diagnosis in Australia, by either the diagnosing laboratory (ACT, New South Wales, Tasmania, Victoria) or by a combination of laboratory and doctor sources (Northern Territory, Queensland, South Australia, Western Australia). Cases of AIDS are notified through the State and Territory health authorities to the National AIDS Registry. Diagnoses of both HIV infection and AIDS are notified with the person's date of birth and name code, to minimise duplicate notifications while maintaining confidentiality.

Tabulations of diagnoses of HIV infection and AIDS are based on data available three months after the end of the reporting interval indicated, to allow for reporting delay and to incorporate newly available information. More detailed information on diagnoses of HIV infection and AIDS is published in the quarterly Australian HIV Surveillance Report, available from the National Centre in HIV Epidemiology and Clinical Research, 376 Victoria Street, Darlinghurst NSW 2010. Telephone: (02) 9332 4648 Facsimile: (02) 9332 1837.

HIV and AIDS diagnoses and deaths following AIDS reported for November 1997, as reported to 28 February 1998, are included in this issue of Commun Dis Intell (Tables 7 and 8).

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Table 7. New diagnoses of HIV infection, new diagnoses of AIDS and deaths following AIDS occurring in the period 1 to 30 November 1997, by sex and State or Territory of diagnosis

		State or territory								Totals for Australia
		ACT	NSW	NT	Qld	SA	Tas	Vic	WA	This period 1997		This period 1996	Year to date 1997	Year to date 1996
HIV diagnoses	Female	0	4	1	2	0	0	0	1	8		4	72	63
	Male	0	27	1	4	4	0	12	2	50		59	641	730
	Sex not reported	0	0	0	0	0	0	0	0	0		0	14	5
	Total1	0	31	2	6	4	0	12	3	58		63	728	799
AIDS diagnoses	Female	0	0	0	0	0	0	0	0	0		3	22	29
	Male	0	9	0	4	0	0	6	1	20		30	268	572
	Total1	0	9	0	4	0	0	6	1	20		33	290	601
AIDS deaths	Female	0	0	0	1	0	0	0	1	2		1	13	16
	Male	0	2	0	0	0	0	5	1	8		40	197	453
	Total1	0	2	0	1	0	0	5	2	10		41	211	469

1. Persons whose sex was reported as transgender are included in the totals.

Table 8. Cumulative diagnoses of HIV infection, AIDS and deaths following AIDS since the introduction of HIV antibody testing to 30 November 1997, by sex and State or Territory

		ACT		NSW		NT		Qld		SA		Tas		Vic		WA		Australia
HIV diagnoses	Female	21		493		8		113		46		4		186		79		950
	Male	180		10,472		92		1,776		623		78		3,593		828		17,642
	Sex not reported	0		2,057		0		1		0		0		28		1		2,087
	Total1	201		13,035		100		1,895		669		82		3,816		911		20,709
AIDS diagnoses	Female	7		157		0		42		19		2		61		23		311
	Male	80		4,311		30		749		318		41		1,512		334		7,375
	Total1	87		4,479		30		793		337		43		1,580		359		7,708
AIDS deaths	Female	2		112		0		28		14		2		43		15		216
	Male	52		3,027		23		522		214		26		1,196		241		5,301
	Total1	54		3,146		23		552		228		28		1,245		257		5,533

1. Persons whose sex was reported as transgender are included in the totals.

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Serious Adverse Events Following Vaccination Surveillance Scheme

The Serious Adverse Events Following Vaccination Surveillance Scheme is a national surveillance scheme which monitors the serious adverse events that occur rarely following vaccination. More details of the scheme were published in CDI 1997:21;8.

Acceptance of a report does not imply a causal relationship between administration of the vaccine and the medical outcome, or that the report has been verified as to the accuracy of its contents.

It is estimated that 250,000 doses of vaccines are administered every month to Australian children under the age of six years.

Results for the reporting period 16 December, 1997 to 27 April, 1998

There were 115 reports of serious adverse events following vaccination for this reporting period. Onset dates were from 1996 to 1998 the majority (68%) being in 1997. Reports were received from the Australian Capital Territory (8), the Northern Territory (9), Queensland (50), South Australia (20) and Victoria (28). No reports were available from New South Wales for this period.

The most frequently reported events following vaccination were of persistent screaming (42 cases, 37%), other events (25 cases, 22%) and hypotonic/hyporesponsive episodes (18 cases, 16%). The type of adverse event was not specified in two cases. There was also incomplete information on follow-up of two cases. All of the other cases had recovered at the time of reporting. Twenty of the 115 cases were hospitalised.

Ninety-three adverse events (81%) were associated with DTP either alone or in combination with other vaccines. Of these, 47 reports were associated with the first dose of DTP and 26 with the second dose.

A cluster of side effects associated with BCG vaccine was observed in South Australia. During this reporting period, of the 22 cases for which the adverse event was categorised as 'other', 8 had lymphadenitis associated with BCG immunisation. Since March 1995, there have been 15 cases that have had adverse events related to BCG vaccine. Of the 15 cases, 14 were reported from South Australia and one from Northern Territory. Of the 14 cases from South Australia, 12 had lymphadenitis and two had an unspecified event. The case from Northern Territory was reported to have had drowsiness.

This clustering of cases in South Australia raises the possibility of increased incidence of lymphadenitis associated with the change in the formulation of BCG vaccine introduced in 1996. While the clustering of cases in South Australia could be associated with a particular batch of BCG vaccine, the absence of data from other States and Territories and incomplete information on batch numbers from South Australia does not allow any conclusions to be drawn. South Australia has had active surveillance for this side effect associated with BCG vaccination since they first became aware of this. This may explain the high number of cases identified in South Australia. We encourage doctors and State health authorities to report any serious adverse events associated with BCG vaccine.

This cluster of adverse events is under investigation by Therapeutic Goods Administration (TGA) and the sponsor and a full report will be published in CDI.

Table 9. Adverse events following vaccination for the period 16 December 1997 to 27 April 1998

Event	Vaccines
	DTP	DTP/ Hib	DTP/ OPV/ Hib	Hib	DTP/ OPV	DTP/ Hib/ Other	MMR	OPV/ Other	Hep B	Other1	Reporting states or territories	Total reports for this period
Persistent screaming	27		11		1	2				1	ACT, NT, Qld, SA, Vic	42
Hypotonic/ hyporesponsive episode	5		7		2	2		1	1		Qld, SA, Vic	18
Temperature of 40.5°C or more	8		6			1					ACT, NT, Qld, Vic	15
Convulsions	2	1	2	1			1		2	1	NT, Qld, SA, Vic	10
Anaphylaxis	1		1								Qld, Vic	2
Shock										1	Vic	1
Death												0
Other	5	1	5	1	2		3			8	NT, Qld, SA,Vic	25
Total	48	2	32	2	5	5	4	1	3	11		1132

1. Includes influenza vaccination, DTPa, CDT, hepatitis B vaccine, pneumococcal vaccination, BCG, ADT and rabies immunoglobulin (HRIG)
2. Two cases had unspecified events

These reports were published in Communicable Diseases Intelligence Vol 22 No 5, 14 May 1998.