The first health impact assessment (HIA) performed on a high level local government policy in New Zealand was undertaken on the Greater Christchurch Urban Development Strategy in 2005. This report describes its development and implementation and the results from the process evaluation including some recommendations made in the assessment. We concluded that HIA is a useful tool for local government policy analysts and we recommend it.
During 2012, Christchurch experienced a dramatic increase in cases of infectious syphilis among men who have sex with men. This was accompanied by some novel trends; notably, the acquisition of infection in a younger age group, with local sexual contacts, commonly via the use of social media. This study is a report on an approach to case identification and public health communication as a component of a multifaceted outbreak response. Enhanced syphilis surveillance data on public health responses to outbreaks of sexually transmissible infections was collated and reviewed, alongside clinical records and literature. Reported outbreak response methods were adapted for the Christchurch cohort. A Facebook page was created to raise awareness of infectious syphilis, the importance of screening and where to get tested. Twenty-six males were diagnosed with infectious syphilis in 2012, an increase from previous years, of which 22 reported only male sexual contact. High use of social media used to find potential sexual contacts was reported. Enhanced syphilis surveillance characterised in detail an infectious syphilis outbreak in Christchurch. Index cases were identified, contact tracing mapping was used to identify transmission networks and social media was also used to educate the risk group. There was a decrease in infectious syphilis presentations, with no cases in the last 3 months of 2012.
S treptococcus pyogenes, or group A Streptococcus (GAS), is a gram-positive, human-adapted opportunistic bacterial pathogen. GAS causes a wide variety of clinical manifestations, from relatively benign self-limiting infections of the nasopharynx or skin to life-threatening invasive infections such as bacteremia, pneumonia, and necrotizing fasciitis (1). The incidence of invasive GAS infections is highest among older adults (2,3), particularly those living in longterm care facilities (2,4). Outbreaks of GAS infections are often linked with distinct epidemiologic markers such as emm type (5,6). emm typing is a sequence-based method that analyzes heterogeneity in the 5′ end of the ubiquitous emm gene that encodes the Mprotein (7). Although emm typing provides useful information about the potential relatedness of outbreak isolates, whole-genome sequencing enables outbreak investigations to proceed with a far greater level of discrimination than single-gene typing of GAS isolates (8,9). For this study, we used multiple wholegenome-based approaches to examine the genetic relationships and molecular drivers of a biphasic GAS outbreak in an eldercare facility in which 14 persons became ill and 5 died. Methods Setting During winter 2014, an outbreak of invasive and noninvasive GAS disease occurred in an eldercare facility in South Island, New Zealand. The outbreak was recognized by a senior laboratory scientist who noted the sudden increase in positive blood cultures from the facility. The outbreak occurred in 2 phases. The first phase started in late May 2014 and ended when the last case-patient (a resident) was hospitalized in early June 2014. The initial 3 case-patients were admitted within 24 hours of each other, and GAS was isolated from blood or tissue cultures from all 3 case-patients. During the first phase, 6 casepatients with confirmed GAS infection were hospitalized; 5 died of presumed sepsis. Outbreak investigations and control measures were subsequently implemented and included screening staff members and residents by collecting throat swab samples and providing targeted chemoprophylaxis for residents and staff members who were in direct contact with case-patients. These interventions continued until early July 2014; however, in late July, the outbreak recurred
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