Mycobacterium ulcerans, the organism which causes Buruli or Bairnsdale ulcer, has never been isolated in culture from an environmental sample. Most foci of infection are in tropical regions. The authors describe the first 29 cases of M. ulcerans infection from a new focus on an island in temperate southern Australia, 1992-5. Cases were mostly elderly, had predominantly distal limb lesions and were clustered in a small region in the eastern half of the main town on the island. The authors suspected that an irrigation system which lay in the midst of the cluster was a source of infection. Limitation of irrigation was associated with a dramatic reduction in the number of new cases. These findings support the hypothesis that M. ulcerans has an aquatic reservoir and that persons may be infected directly or indirectly by mycobacteria disseminated locally by spray irrigation.

Norovirus outbreaks spread from person to person are common in LTCFs, although clinicians should be alert for foodborne outbreaks with more serious consequences. There is a need to identify effective infection control measures to assist facilities in managing outbreaks of gastroenteritis.

Salmonella is a key cause of foodborne gastroenteritis in Australia and case numbers are increasing. We used negative binomial regression to analyze national surveillance data for 2000–2013, for Salmonella Typhimurium and non-Typhimurium Salmonella serovars. We estimated incidence rate ratios adjusted for sex and age to show trends over time. Almost all states and territories had significantly increasing trends of reported infection for S. Typhimurium, with states and territories reporting annual increases as high as 12% (95% confidence interval 10–14%) for S. Typhimurium in the Australian Capital Territory and 6% (95% CI 5–7%) for non-Typhimurium Salmonella in Victoria. S. Typhimurium notification rates were higher than non-Typhimurium Salmonella rates in most age groups in the south eastern states of Australia, while non-Typhimurium rates were higher in most age groups elsewhere. The S. Typhimurium notification rate peaked at 12–23 months of age and the non-Typhimurium Salmonella notification rate peaked at 0–11 months of age. The age-specific pattern of S. Typhimurium cases suggests a foodborne origin, while the age and geographic pattern for non-Typhimurium may indicate that other transmission routes play a key role for these serovars.

Objective: To document the emergence of new foci of Mycobacterium ulcerans infection (Bairnsdale ulcer) in Victoria. Methods: From data kept by one of us (J A H) and records from the Mycobacterium Reference Laboratory, Fairfield Hospital, we reviewed cases of M. ulcerans infection in Victoria between 1980 and 1995, and identified those apparently acquired outside the east Gippsland endemic region. A case was defined as a person with a lesion suggestive of M. ulcerans infection, from which the organism had been cultured or, in the absence of culture information, from which a histological specimen characteristic of M. ulcerans infection had been obtained. Results: We identified 45 people who appeared to have acquired their infections in Victoria but outside the east Gippsland region. A new focus appeared on the northern shores of Western Port, near Melbourne, in 1982, and there was a dramatic increase in cases between 1991 and 1994 associated with foci on Phillip Island, and in the Frankston‐Langwarrin area of outer suburban Melbourne. Single cases came from Crib Point, Narre Warren and Bendigo. Conclusions: There have been at least three new foci of M. ulcerans infection within 80 km of Melbourne since 1982. Victorian clinicians should consider the possibility of Bairnsdale ulcer when dealing with unusual skin lesions.

Australia has high and increasing rates of salmonellosis. To date, the serovar distribution and associated antimicrobial resistance (AMR) patterns of nontyphoidal Salmonella enterica (NTS) in Australia have not been assessed. Such information provides critical knowledge about AMR in the food chain and informs decisions about public health. We reviewed longitudinal data on NTS in two Australian states over a 37-year period, between 1979 and 2015, and antimicrobial resistance since 1984. Overall, 17% of isolates were nonsusceptible to at least one antimicrobial, 4.9% were nonsusceptible to ciprofloxacin, and 0.6% were nonsusceptible to cefotaxime. In total, 2.5% of isolates were from invasive infections, with no significant difference in AMR profiles between invasive and noninvasive isolates. Most isolates with clinically relevant AMR profiles were associated with travel, particularly to Southeast Asia, with multiple “incursions” of virulent and resistant clones into Australia. Our findings represent the largest longitudinal surveillance system for NTS in Australia and provide valuable public health knowledge on the trends and distribution of AMR in NTS. Ongoing surveillance is critical to identify local emergence of resistant isolates.