Objectives: To report the quarterly incidence of hospital‐identified Clostridium difficile infection (HI‐CDI) in Australia, and to estimate the burden ascribed to hospital‐associated (HA) and community‐associated (CA) infections. Design, setting and patients: Prospective surveillance of all cases of CDI diagnosed in hospital patients from 1 January 2011 to 31 December 2012 in 450 public hospitals in all Australian states and the Australian Capital Territory. All patients admitted to inpatient wards or units in acute public hospitals, including psychiatry, rehabilitation and aged care, were included, as well as those attending emergency departments and outpatient clinics. Main outcome measures: Incidence of HI‐CDI (primary outcome); proportion and incidence of HA‐CDI and CA‐CDI (secondary outcomes). Results: The annual incidence of HI‐CDI increased from 3.25/10 000 patient‐days (PD) in 2011 to 4.03/10 000 PD in 2012. Poisson regression modelling demonstrated a 29% increase (95% CI, 25% to 34%) per quarter between April and December 2011, with a peak of 4.49/10 000 PD in the October–December quarter. The incidence plateaued in January–March 2012 and then declined by 8% (95% CI, − 11% to − 5%) per quarter to 3.76/10 000 PD in July–September 2012, after which the rate rose again by 11% (95% CI, 4% to 19%) per quarter to 4.09/10 000 PD in October–December 2012. Trends were similar for HA‐CDI and CA‐CDI. A subgroup analysis determined that 26% of cases were CA‐CDI. Conclusions: A significant increase in both HA‐CDI and CA‐CDI identified through hospital surveillance occurred in Australia during 2011–2012. Studies are required to further characterise the epidemiology of CDI in Australia.

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Emergence and spread of predominantly communityonset Clostridium difficile PCR ribotype 244 infection in Australia, 2010 to 2012 D W Eyre (david.eyre@ndm.ox.ac.

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(2015Mums (FASTMum) program began using short message service (SMS) to collect adverse 32 event information in pregnant women who recently received trivalent influenza vaccine (TIV). 33This study was designed to compare data collected via SMS and telephone for the purposes 34 of monitoring vaccine safety. 35Methods: 344 women who received TIV were randomly assigned to a telephone interview 36 group. They were telephoned seven days post-vaccination and administered a standard 37 survey soliciting any adverse events following immunisation (AEFI) they experienced. They 38 were matched by brand of vaccine, age group, and residence to 344 women who were sent 39 a SMS seven days post-vaccination. The SMS solicited similar information. AEFI reported by 40 SMS and telephone interview were compared by calculating risk ratios.

We report development and implementation of a short message service (SMS)-based system to facilitate active monitoring of persons potentially exposed to Ebola virus disease (EVD), whether returning from EVD-affected countries, or contacts of local cases, should they occur. The system solicits information on symptoms and temperature twice daily. We demonstrated proof-of-concept; however this system would likely be even more useful where there are many local contacts to confirmed EVD cases or travellers from EVD-affected countries.

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Purpose of reviewExertional breathlessness is common and pervasive across various chronic disease populations. To accurately assess response to intervention and optimize clinical (symptom) management, detailed assessment of exertional breathlessness is imperative. This review provides an update on current approaches to assess exertional breathlessness and presents the need for individualized assessment of breathlessness standardized for the level of exertion. Recent findingsBreathlessness assessment tools commonly invite people to recall their breathlessness while at rest with reference to activities of daily living. To directly quantify breathlessness, however, requires assessment of the dimensions of breathlessness (e.g., sensory intensity, quality, and unpleasantness) in response to a standardized exercise stimulus. Different exercise stimuli (e.g., self-paced, incremental, and constant work rate exercise tests) have been used to elicit a breathlessness response. Self-paced (e.g., 6-min walk test) and incremental exercise tests assess exercise tolerance or endurance, and are not recommended for assessment of exertional breathlessness. Constant work rate tests, however, including recently validated 3min constant-rate stair stepping and walking tests, standardize the exercise stimulus to enable the breathlessness response to be directly quantified and monitored over time.