Disease response guidelines
Interim National Guidelines for the Prevention, Management and Control of Murray Valley Encephalitis Virus
The National Guidelines for the Prevention, Management and Control of vector-borne diseases in Australia are a series of guidelines that describe an Australian strategic approach for an arbovirus outbreak. The aims of the Guidelines are to define the steps in identifying an outbreak of arbovirus disease and detail the appropriate information to enable an effective response. This document contains the guidelines for Murray Valley encephalitis virus.
Mosquito-borne diseases information
Revision number 9
Revision date: 10 November 2005
National Guidelines for the Prevention, Management and Control of Murray Valley encephalitis virus print friendly version (PDF 327 KB)
Introduction | Nature of the disease | Surveillance and detection | Investigation | Action for containment | Actions arising from initial identification | Conclusion | References | Appendices | Glossary
Authors
Dr Annette Broom, Department of Microbiology, The University of Western AustraliaDr Moira McKinnon, Biosecurity and Disease Control Branch, Australian Government Department of Health and Ageing
Dr Megge Miller, Biosecurity and Disease Control Branch, Australian Government Department of Health and Ageing
Mr Rodney Moran, Communicable Diseases Section, Department of Human Services, Victoria
Assoc Prof Richard Russell, Department of Medical Entomology, University of Sydney and ICPMR, Westmead Hospital
Mr Peter Whelan, Medical Entomology Branch, Department of Health and Community Services, Northern Territory
Mr Phil Wright, Biosecurity and Disease Control Branch, Australian Government Department of Health and Ageing
Dr Clare Wylks, Biosecurity and Disease Control Branch, Australian Government Department of Health and Ageing
Introduction
At the request of the then National Public Health Partnership (NPHP), the National Arbovirus and Malaria Advisory Committee (NAMAC) was formed in 2001 to determine the need for a national committee covering arbovirus surveillance, information sharing, vector control and response plans for an arbovirus disease outbreak. The NPHP proposed that the Communicable Disease Network Australia (CDNA) would be the supervising body for the NAMAC.Initial terms of reference for the NAMAC included reporting and making recommendations to the CDNA on strategic approaches for arbovirus disease management and control. This included the development of national arbovirus response plans in association with jurisdictional responsibilities.
Murray Valley encephalitis virus (MVEV) disease is a mosquito-borne disease that occurs periodically in humans in Australia. Theseguidelines have been developed by a working group of the NAMAC. The aims of the Guidelines are to define the steps in identifying an outbreak of MVEV disease and detail the appropriate information to enable an effective response.
Topics included in the Guidelines include the nature of MVEV disease, surveillance and detection of an outbreak, investigation of an outbreak source, action for containment of an outbreak, and actions arising from the initial detection of an outbreak. The Guidelines are intended for use by the Australian Government, State/Territory Governments and associated agencies.
Top of page
1. NATURE OF THE DISEASE
1.1 Natural history and aetiology of the disease
The most severe form of infection caused by the Murray Valley encephalitis virus (MVEV) is encephalitis. MVEV disease is an important public health issue in Australia and it is essential to have a national contingency plan in place to deal with a potential outbreak.MVEV was first isolated from patients who died from encephalitis in the Murray Valley in Victoria and South Australia in 1951. Retrospectively, the first epidemics of disease caused by this virus are thought to have occurred in 1917 and 1918 (initially named Australian X disease). It was previously included as one of the causative agents in the disease called Australian encephalitis, which also included disease caused by Kunjin virus, another flavivirus. These viruses are now accepted as causing two separate diseases. The last Australia wide outbreak of MVEV disease was in 1974. Since then almost all cases have been in northern and central Australia (with a few cases reported in the Midwest and Murchison regions, less than 500km north of Perth, in 2000).
Serological studies have showed that only a minority of people infected with MVEV (1/800 to 1/1000) develop clinical disease. However, of those who do, about 20% die and 40% of survivors are left with permanent neurological damage. There is no specific treatment available for MVEV disease, and care is largely supportive. Therefore, prevention of infection once an increase in MVEV activity has been detected is crucial.
As a result, the public health response must be:
- rapid,
- informative but reassuring, and
- appropriate for the MVEV event that occurs. MVEV activity varies in each mainland State and Territory and therefore the response should be initiated by the relevant State/Territory Health Departments.
1.2 Background on the vector
The primary vector during epidemics is the fresh water breeding mosquito Culex annulirostris, the common banded mosquito. Other mosquito species,including someCulex species and some aedine mosquitoes, may be involved in other aspects of MVEV ecology.1.3 Susceptible species
The primary hosts of MVEV are thought to be water birds, which act as reservoirs for infection. In particular, the Rufous Night Heron is considered important. The principal virus cycle exists between these birds and the mosquito vectors. Macropods and domesticated animals such as fowl, horses, pigs and cattle may be infected, but their role in natural transmission cycles is not thought to be important.Humans can become infected if bitten by infected mosquitoes. There is no evidence of person-to person transmission, either directly or via mosquitoes. The incubation period has not been well-defined but may be within 5-28 days. Infection with MVEV confers life-long immunity.
Top of page
1.4 Geographic distribution of MVEV
Australia - MVEV is endemic in northern Western Australia and the Northern Territory, and possibly in northern Queensland. In these regions sporadic cases or small outbreaks of MVEV disease occur every few years, usually at the end of the season (February to July) when the mosquito vector proliferates.MVEV is thought to move from endemic areas in northern Australia to epidemic areas by the movement of infected birds or infected wind-blown mosquitoes. However, there is also evidence that the virus is able to survive for at least one or two seasons, possibly within mosquito eggs or by other unidentified mechanisms. MVEV activity occurs only occasionally in south-eastern Australia, usually after heavy rains and flooding in northern regions.
Regional - MVEV has been reported in some regions on the island of New Guinea.
1.5 Epidemiology of the disease
The majority of notifications of MVEV infection reported to the National Notifiable Disease Surveillance System (NNDSS) from 1991 to 2003 were males and one third of the cases wasaged 0-4 years (Figure 1). While severity of clinical disease is highest in infancy and older persons, fatal disease is well recognised in healthy young travelers to endemic or major enzootic areas. Inapparent or undiagnosed infection is more common at other ages.Figure 1 : MVEV disease by age group and sex, 1991 to 2003, Australia
Top of page
1.6 Diagnostic criteria (includes clinical diagnosis and laboratory tests)
The diagnosis of MVEV disease should be considered in any patient who presents with symptoms of a viral illness such as fever, fatigue, myalgias, headache and rash. A higher index of suspicion should be maintained if the patient has been in the MVEV endemic areas within the incubation period of the disease, especially in the period between November and July. As the disease can progress to involve the central nervous system, such patients should be monitored in hospital until the diagnosis is excluded. It is important to obtain the patient’s travel history.The symptoms of MVEV infection include fever, headache, nausea and vomiting. Mild disease may precede disease progression and involvement of the central nervous system, causing meningitis, or in the worst scenario, encephalitis of variable severity. Signs of brain dysfunction, such as drowsiness, confusion, fitting, weakness, or gait disturbance, indicate the onset of encephalitis. Persisting fevers and seizures are more common in children. MVEV infection is a notifiable disease. Laboratory evidence is required, however suspect cases must be notified before final laboratory results are available.
Laboratory evidence:
The high level of background flavivirus infection in endemic areas means that it is important to demonstrate a rising IgG titre or have a positive PCR or culture. The IgG sero-conversion or rise in titres is seen in two blood specimens taken seven to ten days apart. If only a one-off IgM in the CSF or serum is available, specific serology in the absence of IgM to other flaviviruses is needed to attribute the cause of the infection to MVEV. This is because of the cross-reactivity of antibodies to other flaviviruses.
Confirmation of laboratory result by a second arbovirus reference laboratory (a list of reference laboratories is at Appendix 1) is required if the case occurs in areas of Australia not known to have established enzootic/endemic activity or regular epidemic activity.
Clinical evidence
Non-encephalitic illness
Acute febrile illness with headache, myalgia and/or rash
- OR
Acute febrile meningoencephalitis characterised by one or more of the following:
- focal neurological disease or clearly impaired level of consciousness,
- presence of pleocytosis in the CSF
Case detected as part of a serosurvey should not be notified.
Top of page
2. SURVEILLANCE AND DETECTION OF AN OUTBREAK
The following surveillance systems are currently in place. Action that should be taken if these systems detect a change in MVEV activity is outlined in sections 2.5 and 2.62.1 Human surveillance
Any suspected or proven human case of symptomatic MVEV infection is significant and is notifiable; laboratories and clinicians should contact public health units. Human cases of arbovirus infection are monitored through the National Notifiable Diseases Surveillance System (NNDSS). States and Territories each maintain separate jurisdictional surveillance, but they all report to the Australian Government Department of Health and Ageing through the Communicable Diseases Network Australia (CDNA). The national case definition for MVEV (see 1.6 above) reporting to NNDSS must include laboratory definitive evidence and clinical evidence of infection. NNDSS collects information on the demographics of the case and the State/Territory notifying the disease. Complementing the NNDSS data, the CDNA conduct fortnightly teleconferences with State and Territory health officials and their Commonwealth counterparts in which recent and local disease outbreaks are discussed and monitored.The Laboratory Virology and Serology reporting Scheme (LabVISE) is an additional surveillance tool maintained by the Department of Health and Ageing. The system relies on the voluntary contributions of participating laboratories that report on selected infectious disease agents. MVEV is one of the arboviruses on the list of agents on which laboratories report, however, the number of reports of MVEV is most likely an underestimation of the true number of infections because of the high subclinical rate.
2.2 Sentinel animal surveillance
In some jurisdictions MVEV activity is monitored by detecting antibodies to MVEV in serum samples from sentinel chickens. These sentinel chicken flocks are used to provide early warning of MVEV activity in different regions. They are maintained all year round in WA and NT, and in the summer months in northern Victoria and in southern and western NSW. SA and QLD do not have sentinel chicken flocks for MVEV. Each State/Territory should examine sentinel activity as required. Data from sentinel chicken surveillance are available on the NAMAC web-site. The location of the sentinel chicken sites is given in Figure 2.Figure 2: Location of sentinel chicken sites in Australia, 2003
Top of page
2.3 Vector surveillance
Mosquito vector surveillance includes adult mosquito trapping and virus isolation. NSW, Victoria and NT carry out adult mosquito trapping to monitor the relative abundance of potential vector species as part of their MVEV surveillance programs. Mosquitoes trapped in NSW and Victoria are also processed for virus isolation. NT processes mosquitoes for virus isolation following human cases or during other high-risk periods. WA does not carry out routine surveillance of mosquitoes in MVEV risk areas but undertakes annual adult mosquito surveys in the Kimberley region. A proportion of these mosquitoes is processed for virus isolation.2.4 Weather/Environment surveillance
Meteorological/environmental monitoring is used in the prediction of MVEV by signalling conditions that have been associated with previous outbreaks of MVEV disease in humans. Rainfall patterns (the Forbes predictive model), temperature, the Southern Oscillation (the Nicholls predictive model) and river flows are examined.States and Territories monitor weather conditions via the Bureau of Meteorology.
2.5 Action to be taken if surveillance systems indicate MVEV activity
a) Sentinel animal surveillance:- Any sero-conversion in sentinel chickens should be reported to the State/Territory health department, which will determine the significance of the results.
- The sentinel chickens should be re-bled immediately.
- Confirmation of laboratory result by a second arbovirus reference laboratory is required if the case occurs in areas of Australia not known to have established enzootic/endemic activity or regular epidemic activity.
- If the level or location of activity is considered to pose a significant threat, the State/Territory should notify the local public health units, local Government authorities, GPs and hospitals to alert them to cases, and also notify the Australian Government Department of Health and Ageing via the Communicable Disease Network Australia (CDNA) and NAMAC immediately.
- Increases in rainfall or un-seasonal rain should trigger increased attention to animal, vector and sentinel surveillance and consideration of additional surveillance.
- Increases in vector mosquito numbers in risk periods, together with other indicators such as sentinel chicken sero-conversions and rainfall, should prompt consideration of media warnings about personal protection and consideration of additional surveillance.
d) Human surveillance:
- See outbreak definition below.
2.6 Outbreak definition
Although the incidence of MVEV disease varies across the States/Territories, because it is a rare disease, any human case is indicative of an outbreak. It should prompt further action and invocation of these guidelines in the first instance by the State/Territory health department.Notification of suspect or confirmed MVEV local infection:
- Information about any suspected or confirmed human cases must be notified to the State/Territory health department.
- State/Territory health department should notify the Australian Government Department of Health and Ageing via the CDNA immediately.
- The Australian Government Department of Health and Ageingand States and Territories will use these guidelines as a basis for responding to any outbreak.
3. INVESTIGATION OF OUTBREAK
Below are the steps to be taken in identifying the source of an outbreak. Most of these steps will occur concurrently during the investigation. Epidemiological studies to begin as appropriate.(NOTE: Sections 3, 4 and 5 will occur concurrently)
3.1 Humans
a) Assessment of a possible case should include:- Clinical presentation: Signs and symptoms and their compatibility with MVEV disease.
- Laboratory tests: Ensure that the relevant tests are conducted and confirm the results. Consider the need for confirmatory laboratory tests in a second laboratory.
- Exposure to MVEV: Travel to an endemic region, outdoor activity (bushwalking, camping and proximity to water sources), mosquito precautions and memory of being bitten.
- Time frame: Onset of symptoms and compatibility with incubation period and possible contact with virus.
- Contacts: Consideration of any illness (including mild illness) in patient’ ;s contacts.
- Contact local hospitals and general practices to advise them of the outbreak and to ascertain whether other people are possibly affected.
- Consider media involvement to assist in alerting the community to the outbreak.
- Consider conducting risk assessment to define the population at risk.
- Consider milder and non-encephalitic forms of disease.
- Identify serum surveys of people younger than last regional outbreak (if there has been one).
3.2 Vectors
- Review previous vector studies.
- Review breeding site locations near at-risk areas and their productivity.
- Consider an extension of routine surveillance (eg additional sites, more sampling).
- Evaluate relative numbers and population densities of vector species in at-risk areas.
- Evaluate relative population densities of vector species at waterbird habitats and breeding areas.
- Confirm whether mosquito trapping has occurred at a distance relevant to the outbreak location.
- Ascertain the results of any virus isolations (by tissue culture or viral antigen detection by PCR) that have been done from these mosquito trapping locations.
- Consider the role of mosquito species in urban virus transmission.
- Consider any evidence of vertical (transovarial) transmission.
3.3 Animal hosts
- Analyse sentinel chicken results.
- Extend serological/virological survey to other vertebrate hosts acting as a reservoir of infection, especially water birds, and then passerine birds and whatever mammals are in the at-risk environment (this maybe inappropriate in endemic areas).
- Consider number, location, breeding status, and movement of other hosts in relation to residential areas.
- Consider an extension of current sentinel chicken surveillance.
3.4 Virus: isolates in human and vector species
- Analyse previous virus isolation data from region.
- Collect and identify virus from at-risk areas.
- Consider molecular analysis of virus isolates.
3.5 Weather
Examine relevant weather data including local and regional rainfall, temperature, humidity and wind strength and direction.4. ACTION FOR CONTAINMENT OF THE OUTBREAK
Containment is distinguished from source investigation, although both events might occur concurrently. Below are the actions that should be taken to prevent further spread of the outbreak.(NOTE: Sections 3, 4 and 5will occur concurrently)
4.1 Human disease management
- No specific treatment is available for MVEV disease and care is largely supportive.
- Given the potential for neurological deterioration, ideally patients with clinical encephalitis should be managed in hospitals with the facilities for artificial ventilation.
- No vaccine is available for MVEV infection.
- Management of patients should be discussed with a physician with experience in MVEV infections.
4.2 Reducing/preventing transmission
To reduce/prevent virus transmission, interruption of human/mosquito contact should be attempted by:a) Vector control:
- Suppression of thevector mosquito population in the affected areas, both larval and adult.
- As mosquito control activities are likely to be carried out by people other than State/ Territory Environmental Health Officers (for example, local council workers) ensure appropriate training of these people. Consideration should be given to doing this prior to an outbreak (if one is predicted/expected).
- Involvement of the media to help educate people on how to avoid mosquito contact.
- Methods the media should use include posters in public places, newspaper articles and commercials on TV or radio.
- Information to be communicated by media and others involved in the outbreak response:
- Personal protection measures (long sleeves and trousers and mosquito repellents),
- Avoid going outside when mosquitoes are biting: usually in the first few hours after sunset,
- Avoid mosquito-prone areas,
- Consider closing outdoor recreation areas.
4.3 Enhancing surveillance
- Human surveillance should be enhanced to help identify new cases.
- Vector and animal surveillance should also be enhanced.
- Encourage people with symptoms to present to a doctor.
5. ACTIONS ARISING FROM INITIAL IDENTIFICATION OF OUTBREAK
5.1 Assembling outbreak investigation team
Consider assembling an outbreak investigation team in the affected area.5.2 Use of guidelines
The Australian Government Department of Health and Ageing will use these guidelines as a basis for responding to the outbreak.5.3 Defining outbreak response teams
Define outbreak response team, regional and State/Territory reporting lines, roles and responsibilities.5.4 Monitoring
Outbreak investigation team is monitored by NAMAC who notify CDNA.CDNA and Department of Health, Biosecurity and Disease Control branch (B & DC branch) officers notify the Chief Medical Officer (CMO).
5. Responsibilities in a national outbreak
If considered a national outbreak (large outbreak of national importance or multiple States involved):- CDNA provides a coordinating role.
- States and Territories are responsible for operations in their jurisdictions.
- NAMAC provides expert advice through CDNA.
- NAMAC coordinate liaison with veterinary personnel through the Office of the Chief Veterinary Officer within the Department of Agriculture, Fisheries and Forestry.
- Coordination of data management and reporting (consider websites, list-servers, media releases and other resources) occurs at both State/Territory level (identified, operational data) with feed into national outbreak management program.
- NAMAC to inform and liaise with international authorities (WHO, Office International des Epizooties - OIE) and notify Promed immediately.
- Coordination of resources by States/Territories. They can notify the Australian Government Department of Health and Ageing if additional resources are required. The Australian Government Department of Health and Ageing coordinate resource access.
- Local media content is desirable for public and professional education and information, but if considered an outbreak of national concern, coordination of the media to be carried out by the Australian Government Department of Health and Ageing (see 5.6).
5.6 Communication strategies
During an outbreak of MVE, it will be important that clear and consistent messages are communicated with the public. Good communication during such an event is crucial to reduce public anxiety and improve the effectiveness of emergency responders and health care workers.The public should understand that a plan is being followed and they need to be given explanations for various actions being undertaken. One of the primary communication objectives is to instil and maintain public confidence by providing the public with information that addresses their questions, fears and concerns.
In the event of an outbreak that appears to be contained in one State or Territory, media management will be coordinated media advisers/managers of that particular States or Territory Health Department. Depending on the scale of the outbreak, it may be practical for media advisers to form part of outbreak response teams to assist in providing information to media and the public.
In the event of an outbreak that occurs in multiple jurisdictions or impacts on Australia’s borders or other areas of Federal Government control, the Health Issues Media Unit in the Australian Government Department of Health and Ageing would play the leading role in national coordination of media response to an MVE outbreak.
The Unit has devised communications strategies and procedures for handling multi-agency media management during an outbreak. This may include activation of the National Emergency Media Response Network and include close liaison with State and Territory Governments, health departments and allied organisations that will have a role in a large-scale outbreak.
The Health Issues Media Unit provides media liaison services to the CDNA.
Top of page
6. CONCLUSION
Identify indicators for scaling down response and concluding the outbreak investigation.6.1 Scaling down response
Pool information from collaborating agencies to determine when risk has declined sufficiently (eg decreasing numbers of positive testing in animals or in mosquito surveillance, total reduction in number of mosquitoes, change in weather, decrease in number of humans cases).6.2 When/how to conclude
No evidence of new human infections acquired in the preceding 6 weeks and environmental conditions won’t support further transmission.AND
No new sero-conversions in sentinel animals for one month.
6.3 Reporting
The NAMAC will report to the CDNA on the following:- Review of current operation.
- Recommendations for future outbreaks.
- Consideration to changes in ongoing surveillance operations.
6.4 Work-force debrief
Within a reasonable time frame of the outbreak concluding, all parties involved in the outbreak should meet (telephone link) to debrief and determine cooperative outcomes or future actions. The debrief should focus on the success or failure of human lines of communication developed during an incident, rather than on technical or scientific issues relating to the incident. This debrief will be coordinated by the CDNA.6.5 Plan Closure
REFERENCES:
1. Bennett NM. Murray Valley encephalitis, 1974: clinical features. Medical Journal of Australia 1976; 2: 446-502. Burrow JNC, Whelan PI, Kilburn CJ, Fisher DA, Currie BJ, Smith DW. Australian encephalitis in the Northern Territory: clinical and epidemiological features, 1987-1996. Australian and New Zealand Journal of Medicine 1998; 28: 590-596.
3. Cordova SP, Smith DW, Broom AK, et al. Murray Valley encephalitis in Western Australia in 2000, with evidence of southerly spread. Communicable Diseases Intelligence 2000; 24: 368-372
4. Mackenzie JS, Smith DW, Broom AK, Bucens MR. Australian encephalitis in Western Australia, 1978-1991. Medical Journal of Australia 1993; 158: 591-595.
5. Spencer JD, Azoulas J, Broom AK, et al. Murray Valley encephalitis virus surveillance and control initiatives in Australia, a report on behalf of the National Arbovirus Committee of the Communicable Diseases Network Australia. Communicable Diseases Intelligence 2001; 25: 33-47.
Top of page
APPENDIX: 1. List of Arbovirus Reference Laboratories
Queensland
Qld Health Scientific Services39 Kessells Rd
Coopers Plains
PO Box 594 Archerfield Qld 4108
Phone: (07) 3274 9151 Contact: Dr. Greg Smith
Victoria
Victorian Infectious Diseases Reference Laboratory (Human)10 Wreckyn St
North Melbourne Victoria 3051
Phone: (03) 9342 2600 Contact: Dr Mike Catton
Department of Primary Industries (Animal/Vector)
Primary Industries Research - Animal Health
475 Mickleham Road
Attwood Victoria 3049
Phone: (03) 9217 4200 Contact: Joe Azuolas
CSIRO Livestock Industries
Australian Animal Health Laboratory
Private Bag 24 (5 Portarlington Road)
Geelong Victoria 3220
Phone: (03) 5227 5000 Contact: Dr Peter Daniels
Western Australia
The Western Australian Centre for Pathology and Medical ResearchDivision of Microbiology and Infectious Diseases (Human)
Hospital Avenue
Nedlands WA 6009
Phone: (08) 9346 3122 Contact: Dr David Smith
Arbovirus Surveillance and Research Laboratory
Department of Microbiology (Animal/Vector)
The University of Western Australia
35 Stirling Highway
Crawley WA 6009
Phone: (08) 93462213 Contact: Dr Annette Broom
New South Wales
Institute of Clinical Pathology and Medical Research (ICPMR)Westmead Hospital
Westmead NSW 2145
Phone: (02) 9845 6255 Contact: Dr Dominic Dwyer
Top of page
APPENDIX:2. Contact phone numbers:
Contact Details for Commonwealth Agencies
Chief Medical Officer – 02 6289 8408
Chief Veterinary Officer – 02 6272 5848
CDNA Secretariat – 02 6289 8564
NAMAC Secretariat – 02 6289 8234
Contact Details for State and Territory Public Health and Communicable Disease Units
The following numbers should be contacted by medical practitioners for the reporting of communicable disease cases and for assistance in the management of disease outbreaks:State and Territory Health Department Communicable Disease Contacts
Australian Capital Territory(02) 6205 2155
New South Wales
See list below
Northern Territory
(08) 8922 8044 a/h Royal Darwin Hosp: (08) 8922 8888
Queensland
(07) 3234 1155
South Australia
(08) 8226 7177
Tasmania
0408 532 708
Victoria
1300 651 160
Western Australia
(08) 9388 4999 (bh) (08) 9328 0553 (ah)
Top of page
New South Wales
The reporting of communicable disease cases in New South Wales is facilitated by the individual Public Health Units listed below:Public Health Units
Northern Sydney/Central Coast PHUPhone: (02) 4349 4845
Fax: (02) 4349 4850
Sydney South West PHU
(02) 9515 9420
(02) 9515 3182
Justice Health Service PHU
(02) 8372 3006
(02) 9344 4151
Greater Western Broken Hill PHU
(08) 8080 1419
(08) 8080 1683
Hunter/New England PHU
(02) 4924 6477
(02) 4924 6490
South Eastern Sydney /Illawarra PHU
(02) 4255 2200
(02) 4255 2222
Greater Western Dubbo PHU
(02) 6841 2216
(02) 6884 7223
North Coast Pt Macquarie PHU
(02) 6588 2750
(02) 6588 2837
Greater Western Bathurst PHU
(02) 6339 5500
(02) 6339 5555
Top of page
Hunter/New England PHU
(02) 6766 2288
(02) 6766 3003
North Coast Lismore PHU
(02) 6620 7500
(02) 6622 2552
Northern Sydney/Central Coast PHU
(02) 9477 9400
(02) 9482 1650
South Eastern Sydney /Illawarra PHU
(02) 9382 8333
(02) 9382 8334
Greater Southern PHU Queanbeyan
(02) 6124 9942
(02) 6299 6363
Greater Southern PHU Albury
(02) 6021 4799
(02) 6021 4899
Sydney South West PHU
(02) 9828 5944
(02) 9828 5955
Sydney West PHU Nepean
(02) 4734 2022
(02) 4734 3300
Sydney West PHU Parramatta
(02) 9840 3603
(02) 9840 3608
Glossary
The following glossary uses terms from AUSVETPLAN and the Australian Quarantine Inspection Service (AQIS) to harmonise the use of terminology amongst organisations within Australia.Barrier detection: When a vector or disease is detected within the limits of the national quarantine barrier and does not spread further.
Breach: When the entry through the quarantine barrier of a prohibited pest, disease or goods has occurred. This is taken to mean that the vector or disease has been detected beyond the limits of the national quarantine barrier, but has not spread beyond the original host shipment in which it was imported.
Emergency disease: Includes exotic diseases and endemic diseases that warrant a national response.
Exotic disease: A disease affecting animals or humans that does not normally occur in Australia.
Incursion: An incursion is deemed to have occurred when a vector or disease is detected outside national quarantine barriers and spreads beyond the recognised limits of quarantine operations.
Outbreak: An outbreak is an unusually greater number of cases than expected. An outbreak includes:
- One case of an exotic disease in an animal or human in Australia
- Vector incursion
- An increase above the normal incidence of an endemic disease
- Local human transmission of a disease that is commonly imported into Australia from overseas but is not endemic
Vector: A living organism (often an arthropod) that transmits an infectious agent from one host to another
Help with accessing large documents
When accessing large documents (over 500 KB in size), it is recommended that the following procedure be used:
- Click the link with the RIGHT mouse button
- Choose "Save Target As.../Save Link As..." depending on your browser
- Select an appropriate folder on a local drive to place the downloaded file
Attempting to open large documents within the browser window (by left-clicking)
may inhibit your ability to continue browsing while the document is
opening and/or lead to system problems.
Help with accessing PDF documents
To view PDF (Portable Document Format) documents, you will need to have a PDF reader installed on your computer. A number of PDF readers are available through the Australian Government Information Management Office (AGIMO) Web Guide website.
