Improving access to surveillance data
The department's Health Protection Branch has been producing more than 200 reports on notifiable conditions every day for almost 20 years.
These daily reports provide surveillance data on communicable diseases and other conditions notifiable under public health and wellbeing legislation at statewide and local government levels.
During 2018, the branch launched the first interactive communicable disease report, powered by Microsoft's Power BI platform.
This new platform allows the branch to publish content directly to the web more efficiently and in a manner that report users can interact with.
The reports have provided an enhanced user experience for health sector, local government, researchers and students who use this data.
In 2019, the branch will fully transition from the 200 fixed PDF and Excel reports to the new interactive reporting.
Visit the interactive communicable disease reports.
Improving processes for notifiable conditions
Infectious diseases and other conditions of public health concern still occur frequently throughout the world, so constant vigilance is required to minimise their spread.
Notification is a vital step in efforts to prevent or control the spread of infection and to prevent further harmful exposures.
Medical practitioners and pathology services play a vital role in protecting public health by notifying cases of specific infectious diseases and other conditions to the Department of Health and Human Services.
Notification for all notifiable diseases:
- provides a crucial early warning of a potential threat to public health
- enables the department to respond to prevent or control the spread of disease
- allows for the identification of emerging trends and the implementation of appropriate policy responses and public health interventions.
In Victoria, the Public Health and Wellbeing Act 2008 requires medical practitioners and pathology services to notify the department of cases of specific infectious diseases and other medical conditions. These 70+ 'notifiable conditions' are prescribed in the Public Health and Wellbeing Regulations 2009.
Until mid-2018, the regulations prescribed the same list of notifiable conditions for both medical practitioners and pathology services, which meant that cases were typically notified to the department twice.
The department reviewed the prescribed notifiable conditions to identify which conditions could have the requirement for medical practitioner notification removed.
The requirement for medical practitioners to notify the department of 10 conditions was removed.
These conditions continue to be notified by pathology services.
Other changes were also made which further simplified notification requirements for medical practitioners.
Medical practitioners still play a critical role in notifications where clinical, occupational, and other information is key to determining an appropriate public health response.
During 2019–20 the department will progressively roll out electronic reporting of notifiable conditions for pathology services.
These electronic notifications will provide prompt notification supporting the move to near real-time surveillance and monitoring of potential health threats to the Victorian population.
This system simplifies the process for pathology services to fulfil their current legal requirement to notify positive pathology findings to the department.
Advances in whole genomic sequencing
Microbial genomic sequencing is revolutionising the conduct of surveillance and outbreak detection among communicable diseases.
Whole genome sequencing (WGS) enables faster, more precise surveillance, allowing rapid outbreak detection and response.
Traditional surveillance and outbreak detection require many tests to be performed to determine the type of an organism and whether it is related to other organisms.
The advantage of WGS is that organisms need only be sequenced once, and that sequence information is stored in perpetuity.
Laboratories do not need to regrow and retest an organism for further testing, saving time and money.
This one sequence replaces the many traditional tests required for public health surveillance and response.
Most results from traditional tests can be predicted by bioinformatic analysis of the microbial genomic sequence, allowing comparison with microorganisms tested in previous years.
Outbreak detection is more precise, as the sequences of isolates from the same type of organism are compared through genomic analysis to determine how related the organisms are.
As an example, when people have eaten the same food product contaminated with Salmonella and become unwell, the organisms from their clinical samples are highly related.
When the genomic analysis detects this relatedness, an outbreak investigation is conducted within the Communicable Disease Unit.
By using genomic technology, outbreaks are detected earlier, the response is faster, and fewer people consume the contaminated product as it is removed from the market.
In Victoria, WGS is also used to detect transmission of the multi-drug resistant organism, carbapenemase-producing Enterobacterales (CPE), within and across healthcare facilities.
These organisms can be carried in the gastrointestinal tract causing no harm, but some people who carry the organism, particularly the young, the elderly and the immunocompromised, can become very unwell if the organism causes an infection.
With very few choices of antimicrobials to treat these patients, their prognosis can be poor.
The department established guidelines in 2015 to ensure the capability to detect, characterise and control CPE using WGS.
When transmission is detected, healthcare facilities are required to conduct screening of ward contacts of CPE cases and enhance infection prevention and control measures in wards where there has been transmission.
These measures are helping to control CPE within Victoria.
Find out more
To find out more about genomic sequencing, please see Doherty Applied Microbial Genomics on the Doherty Institute website.