No abstract

Hepatitis A (Hep A) can cause sporadic or epidemic disease and has been frequently linked to contamination of the global food chain. Global surveillance data on Hep A is unavailable, and in some countries, reporting is incomplete or not timely, either because of the lack of human resources or sensitivities around reporting. The use of vast opensource data such as news-feeds and social media however can overcome barriers to surveillance and provide timely data on global epidemics. In this study we use EpiWATCH, a semi-automated outbreak scanning service, to review the global epidemiology of Hep A reports from 2016-2018. We reviewed the EpiWATCH Outbreak Alerts database for reports on Hep A dated between August 1, 2016, to April 31, 2018, which was then analysed by outbreak clusters, location, and time. Of 5098 total entries in the database, a total of 169 non-duplicate Hep A outbreak reports were found and included for descriptive analysis. The majority of outbreak reports (68.6%; N=116/169) originated from the United States of America (USA). The largest Hep A outbreaks were multi-country outbreaks in the European region, and multistate outbreaks in USA and Australia. Homelessness (mainly in USA outbreaks) was the predominant risk factor (40.2%), followed by foodborne outbreaks (26.6%) and outbreaks in men who have sex with men (6.5%). Using EpiWATCH, we found that the emergence of outbreaks in homeless people has dominated the epidemiology of Hep A in the USA and this appears a relatively new phenomenon over the study period. Epidemic intelligence systems such as EpiWATCH are a useful proxy for global surveillance of Hep A outbreaks and using opensource data can provide epidemic intelligence and outbreak alerts where global data is unavailable.

Background The 2017 A/H3N2 influenza season was the most severe season since the 2009 influenza pandemic. There were over 591 influenza outbreaks in institutions across the state of New South Wales (NSW) in Australia. Aim To describe the epidemiology of influenza outbreaks in nine Sydney aged care facilities in 2017. Methods Study data were collected from nine Sydney aged care facilities for 2017 influenza season. Descriptive epidemiological analysis was conducted. Results From the nine sites included, with a total of 716 residents, four sites reported laboratory‐confirmed influenza outbreaks during the study period, with an attack rate in residents ranging from 6% to 29%. The outbreaks resulted in lockdowns in two facilities and hospitalisation of seven residents. No deaths were reported as a result of influenza infection. Influenza A was the most common influenza type reported across the facilities. The duration of outbreak lasted for 1‐4 weeks varied by site. Conclusion The 2017 season was a severe influenza season recorded in Australia. About half of the facilities studied experienced outbreaks of influenza, with a high attack rate among residents. Infection prevention and control measures and outbreak management plans are crucial for aged care facilities, including vaccination of staff and visitors to prevent outbreaks among the vulnerable residents.