Aim: To ascertain the incidence of autism spectrum disorders in Australian children. Setting: New South Wales (NSW) and Western Australia (WA), July 1999 to December 2000. Design: Data were obtained for WA from a prospective register and for NSW by active surveillance. Main outcome measures: Newly recognised cases of autism spectrum disorders (defined as autistic disorder, Asperger disorder and pervasive developmental disorder not otherwise specified [PDD‐NOS]) in children aged 0–14 years; incidence was estimated in 5‐year age bands (0–4 years, 5–9 years, 10–14 years). Results: In WA, 252 children aged 0–14 years were identified with autism spectrum disorder (169 with autistic disorder and 83 with Asperger disorder or PDD‐NOS). Comparable figures in NSW were 532, 400 and 132, respectively. Most children were recognised with autistic disorder before school age (median age, 4 years in WA and 3 years in NSW). Incidence of autistic disorder in the 0–4‐years age group was 5.5 per 10 000 in WA (95% CI, 4.5–6.7) and 4.3 per 10 000 in NSW (95% CI, 3.8–4.8). Incidence was lower in older age groups. The ratio of all autism spectrum disorders to autistic disorder alone was 1.5:1 in WA and 1.3:1 in NSW, and rose with age (1.8:1 and 2.9:1  in 10–14‐year‐olds in WA and NSW, respectively). Conclusions: These are the first reported incidence rates for autism for a large Australian population and are similar to rates reported from the United Kingdom. Ongoing information gathering in WA and repeat active surveillance in NSW will help to monitor any future changes.

Aim:To describe the use of diagnostic labels by clinicians for children with autism spectrum disorders (ASD) and calculate the label-specific and overall agreement between diagnostic labels and Diagnostic and Statistical Manual of Mental Disorders -Fourth Edition (DSM-IV) diagnoses provided by the same clinician. Methods: State-wide active surveillance was used to ascertain children newly recognised with one or more DSM-IV criteria for autistic disorder aged 0-15 years (incident cases) in New South Wales (NSW) between July 1999 and December 2000. Clinicians were asked to supply a diagnostic label and then complete DSM-IV criteria for each child reported. Results: Questionnaires with diagnostic label and DSM-IV criteria were returned for 348 children. The agreement between labels used and diagnosis based on DSM-IV classification system was the highest for autism (97%) and lower for labels of Asperger disorder, pervasive developmental disorder -not otherwise specified or atypical autism (27%). Kappa overall agreement was 0.31. Level of agreement between label and DSM-IV diagnosis was similar for questionnaires completed by multidisciplinary teams, psychiatrists, paediatricians and psychologists working as part of a team. Conclusion: A lack of agreement between the diagnostic labelling used by clinicians and diagnosis based on DSM-IV criteria indicates a lack of consistency in diagnostic communication that is necessary to provide best clinical care, appropriate services and relevant information to parents and carers.

Percentage answering Category "yes" (n = 644) Men and women 28 Main grocery buyer 34 Women 25-49 years 42

Human immunodeficiency virus (HIV) infection is caused by a retrovirus transmitted from person to person via infected blood and body fluids such as semen and vaginal fluids. Most persons infected with HIV develop detectable antibodies within one to three months of infection. People with this disease are able to transmit HIV throughout their life. 1 The control of HIV remains an important public health challenge with an estimated 38 million persons infected worldwide. 2 NSW has approximately 57 per cent of all newly diagnosed HIV infections in Australia. 3 Surveillance for new HIV infections enables health departments to identify groups at risk and to monitor long-term trends in the disease, which in turn informs the development of prevention policies and programs. This review presents an analysis of new notifications of HIV infections among NSW residents for the period January 1994 to December 2003. metHODS In NSW there are seven HIV reference pathology laboratories. These laboratories confirm HIV infections and notify positive clinical specimens. Under the NSW Public Health Act 1991, all HIV reference pathology laboratories in NSW are required to notify the NSW Department of Health of persons newly diagnosed with HIV infection.