Dr Beverley Paterson is an epidemiologist who consults at a senior executive level in roles requiring high-level strategic engagement and influence with counterparts. Working in developed and developing country settings, areas of expertise include health security, pandemic simulation exercises, pandemic preparedness and response, global health security, program management, policy development, surveillance system assessments and improvement, and health systems and capacity development. She has responded to or advised governments on pandemic influenza, ebola, zika virus, dengue and COVID-19 pandemics and outbreaks. She has published in high-impact, peer-reviewed journals including the British Medical Journal, New England Journal of Medicine, Vaccine, the Lancet and Science and is a regular guest commentator on Australian ABC radio. She is an academic supervisor for Masters-level Field Epidemiology students at the Australian National University.
Global health requires evidence-based approaches to improve health and decrease inequalities. In ... more Global health requires evidence-based approaches to improve health and decrease inequalities. In a roundtable discussion between health practitioners, funders, academics and policy-makers, we recognised key areas for improvement to deliver better-informed, sustainable and equitable global health practices. These focus on considering information-sharing mechanisms and developing evidence-based frameworks that take an adaptive function-based approach, grounded in the ability to perform and respond to prioritised needs. Increasing social engagement as well as sector and participant diversity in whole-of-society decision-making, and collaborating with and optimising on hyperlocal and global regional entities, will improve prioritisation of global health capabilities. Since the skills required to navigate drivers of pandemics, and the challenges in prioritising, capacity building and response do not sit squarely in the health sector, it is essential to integrate expertise from a broad range of fields to maximise on available knowledge during decision-making and system development. Here, we review the current assessment tools and provide seven discussion points for how improvements to implementation of evidence-based prioritisation can improve global health.
Global health requires evidence-based approaches to improve health and decrease inequalities. In ... more Global health requires evidence-based approaches to improve health and decrease inequalities. In a roundtable discussion between health practitioners, funders, academics and policy-makers, we recognised key areas for improvement to deliver better-informed, sustainable and equitable global health practices. These focus on considering information-sharing mechanisms and developing evidence-based frameworks that take an adaptive function-based approach, grounded in the ability to perform and respond to prioritised needs. Increasing social engagement as well as sector and participant diversity in whole-of-society decision-making, and collaborating with and optimising on hyperlocal and global regional entities, will improve prioritisation of global health capabilities. Since the skills required to navigate drivers of pandemics, and the challenges in prioritising, capacity building and response do not sit squarely in the health sector, it is essential to integrate expertise from a broad range of fields to maximise on available knowledge during decision-making and system development. Here, we review the current assessment tools and provide seven discussion points for how improvements to implementation of evidence-based prioritisation can improve global health.
The year 2007 saw the most severe influenza season since national reporting of influenza began in... more The year 2007 saw the most severe influenza season since national reporting of influenza began in 2001. Early in the season the National Incident Room was activated to provide effective national surveillance, reporting and management of the 2007 seasonal influenza outbreak. A surveillance team were tasked with establishing enhanced surveillance for the 2007 season and investigating unusual events in this outbreak. Key data required to comprehensively describe the number of cases, morbidity, mortality and virology of the influenza outbreak and the possible sources of these data were identified. In 2007 the number of laboratory-confirmed notifications for influenza was 3.1 times higher than the five-year mean. Forty-four per cent of notifications occurred in Queensland. High notification rates were reflected in an increase in presentations with influenza-like illness to sentinel general practices and Emergency Departments. Notifications and notification rates were highest in the 0-4 and 5-9 years age groups, possibly due to a bias towards testing in these age groups. The clinical morbidity of the infection in terms of complications or most affected groups cannot be determined but anecdotal reports indicate this season may have impacted young adults more than is usual. The available data suggest influenza has caused a significant burden on workplaces and the health care system as indicated by data on absenteeism and presentations for health care. The proportion of H1 strains of influenza circulating varied across Australia but was higher than 2006 in most jurisdictions. In 2007, 1,406 influenza isolates from Australia were antigenically analysed at the World Health Organization Collaborating Centre for Reference and Research on Influenza in Melbourne: 58.7% were A(H3N2), 34.4% were A(H1N1) and 6.9% were influenza B viruses. Antigenic drift away from the vaccine strain A/Wisconsin/67/2005 was observed with the A(H3N2) viruses and was also seen with most of the A(H1N1) viruses when compared with the vaccine strain A/New Caledonia/20/99. The small number of influenza B viruses examined were predominately of the B/Yamagata-lineage. Monitoring influenza through the National Incident Room during the 2007 season offered an excellent opportunity to conduct enhanced surveillance under conditions that were real and potentially serious but not an emergency. It enabled the current state of our surveillance systems to be assessed and opportunities for improvement to be identified.
objective The Pacific Syndromic Surveillance System (PSSS), launched in 2010, provides a simple m... more objective The Pacific Syndromic Surveillance System (PSSS), launched in 2010, provides a simple mechanism by which 121 sentinel surveillance sites in 21 Pacific island countries and areas perform routine indicator-and event-based surveillance for the early detection of infectious disease outbreaks. This evaluation aims to assess whether the PSSS is meeting its objectives, what progress has been made since a formative evaluation of the system was conducted in 2011, and provides recommendations to enhance the PSSS's performance in the future. methods Twenty-one informant interviews were conducted with national operators of the system and regional public health agencies that use information generated by it. Historic PSSS data were analysed to assess timeliness and completeness of reporting. results The system is simple, acceptable and useful for public health decision-makers. The PSSS has greatly enhanced Pacific island countries' ability to undertake early warning surveillance and has contributed to efforts to meet national surveillance-related International Health Regulation (2005) capacity development obligations. Despite this, issues with timeliness and completeness of reporting, data quality and system stability persist. conclusion A balance between maintaining the system's simplicity and technical advances will need to be found to ensure its long-term sustainability, given the low-resource context for which it is designed.
The year 2007 saw the most severe influenza season since national reporting of influenza began in... more The year 2007 saw the most severe influenza season since national reporting of influenza began in 2001. Early in the season the National Incident Room was activated to provide effective national surveillance, reporting and management of the 2007 seasonal influenza outbreak. A surveillance team were tasked with establishing enhanced surveillance for the 2007 season and investigating unusual events in this outbreak. Key data required to comprehensively describe the number of cases, morbidity, mortality and virology of the influenza outbreak and the pos-sible sources of these data were identified. In 2007 the number of laboratory-confirmed notifications for influenza was 3.1 times higher than the five-year mean. Forty-four per cent of notifications occurred in Queensland. High notification rates were reflected in an increase in presentations with influenza-like illness to sentinel general practices and Emergency Departments. Notifications and notification rates were highest in the 0–4 ...
To the Editor: We are concerned that Yuki and Hartung (June 14 issue),(1) in their otherwise comp... more To the Editor: We are concerned that Yuki and Hartung (June 14 issue),(1) in their otherwise comprehensive review of the Guillain-Barré syndrome, have overlooked the importance of public health efforts in the surveillance of acute flaccid paralysis to the eradication of polio. Surveillance of acute flaccid paralysis, and hence Guillain-Barré syndrome, which the authors describe as the "most frequent cause of acute flaccid paralysis worldwide," is a key strategy in global efforts aimed at its eradication.(2) The recent declaration by the World Health Assembly that poliovirus eradication is a programmatic emergency for global public health(3) should convince clinicians around the . . .
Communicable diseases intelligence quarterly report, Jan 30, 2013
With eradication almost within reach, the importance of detecting every poliomyelitis case has ta... more With eradication almost within reach, the importance of detecting every poliomyelitis case has taken on additional significance. The selected surveillance strategy must be effective and efficient. A review of polio surveillance in Australia was conducted to consider whether current strategies were optimal. Document review and semi-structured key informant interviews were used to conduct the review. Interviews were recorded, transcribed and thematically analysed. The review was an iterative process with feedback on the findings sought from interviewees. Since Western Pacific Regional polio-elimination status was certified, one imported adult case was detected in 2007 in Australia, with no evidence of further transmission, and no Australian paediatric cases identified. Respondents reported that: it was not possible to prevent importations; paediatric cases were more likely to be identified than adult cases; and there may be a low level of suspicion among clinicians. Case detection and...
A key determinant of the success of influenza containment is the transmission rate of the novel s... more A key determinant of the success of influenza containment is the transmission rate of the novel strain. C. Fraser et al. [“Pandemic potential of a strain of influenza A (H1N1): Early findings,” Reports, 19 June, p. [1557][1]] estimated the basic reproduction number ( R ) of the Mexican outbreak of influenza A (H1N1) to be in the range of 1.2 to 1.6. The value of R is a key measure of transmissibility and estimates the number of secondary cases in a completely susceptible population. Their findings were comparable to lower estimates for the 1918 pandemic, where R ranged from 2 to 3 ([ 1 ][2]). To further investigate the transmissibility of this novel virus, we conducted a secondary analysis of the largest reported cluster of influenza A (H1N1) ([ 2 ][3]). We used survey data from students of the St. Francis Preparatory School outbreak in the United States to calculate the effective reproduction number ( R ) in a school-based setting. R is the average number of secondary cases generated by an infectious case during an epidemic and is usually comparable to R . This survey collected data on self-reported fever and either cough or sore throat between 8 and 28 April 2009. We used the method proposed by Vynncky et al. ([ 3 ][4]) to calculate R from the growth rate of the epidemic. We based our parameter assumptions on estimates for seasonal influenza commonly reported in the literature, because such values are not yet available for H1N1. The parameters were as follows: incubation period of 2 days; infectious period of 3 days; and a calculated serial interval of 5 days. The serial interval is the time between the onset of symptoms for first and second generation cases. Using daily data from the outbreak growth phase, we calculated R to be 2.69 [95% confidence interval: 2.20 to 3.22; degrees of freedom (df) = 13]. Increasing the estimated infectious period to 5 days results in an R of 3.45 (95% confidence interval: 2.74 to 4.28; df = 13). The confidence interval for R was derived from a Monte Carlo simulation based on the uncertainty of the slope estimate. Estimates of R were relatively insensitive to the use of data from the growth phase or entire outbreak. Our calculated R is specific to this school setting and, with the increased transmission potential of a close-contact setting such as a school, is likely to be higher than transmission rates in the community-wide Mexican outbreak. The use of parameters estimated from seasonal influenza will need confirmation for the 2009 influenza A H1N1 virus. Our analysis supports the findings from Fraser et al. that this H1N1 virus has a transmission rate comparable to the lower R estimates of 2 for the 1918 pandemic ([ 1 ][2]). 1. [↵][5] 1. G. Chowell, 2. H. Nishiura, 3. L. Bettencourt , J. R. Soc. Interface 4, 155 (2007). [OpenUrl][6][Abstract/FREE Full Text][7] 2. [↵][8] 1. T. R. Frieden , Commissioner, “St. Francis Prep Update: Swine Flu Outbreak” (New York City Department of Health and Mental Hygiene, New York, 2009); ([www.nyc.gov/html/doh/downloads/pdf/cd/h1n1\_stfrancis\_survey.pdf][9]). 3. [↵][10] 1. E. Vynncky, 2. A. Trindall, 3. P. Mangtani , Int. J. Epidemiol. 36, 881 (2007). [OpenUrl][11][Abstract/FREE Full Text][12] [1]: /lookup/doi/10.1126/science.1176062 [2]: #ref-1 [3]: #ref-2 [4]: #ref-3 [5]: #xref-ref-1-1 "View reference 1 in text" [6]: {openurl}?query=rft.jtitle%253DJournal%2Bof%2BThe%2BRoyal%2BSociety%2BInterface%26rft.stitle%253DJ%2BR%2BSoc%2BInterface%26rft.issn%253D1742-5662%26rft.aulast%253DChowell%26rft.auinit1%253DG.%26rft.volume%253D4%26rft.issue%253D12%26rft.spage%253D155%26rft.epage%253D166%26rft.atitle%253DComparative%2Bestimation%2Bof%2Bthe%2Breproduction%2Bnumber%2Bfor%2Bpandemic%2Binfluenza%2Bfrom%2Bdaily%2Bcase%2Bnotification%2Bdata%26rft_id%253Dinfo%253Adoi%252F10.1098%252Frsif.2006.0161%26rft_id%253Dinfo%253Apmid%252F17254982%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [7]: /lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6MTI6InJveWludGVyZmFjZSI7czo1OiJyZXNpZCI7czo4OiI0LzEyLzE1NSI7czo0OiJhdG9tIjtzOjI1OiIvc2NpLzMyNS81OTQ0LzEwNzEuMi5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30= [8]: #xref-ref-2-1 "View reference 2 in text" [9]: http://www.nyc.gov/html/doh/downloads/pdf/cd/h1n1_stfrancis_survey.pdf [10]: #xref-ref-3-1 "View reference 3 in text" [11]: {openurl}?query=rft.jtitle%253DInt.%2BJ.%2BEpidemiol.%26rft_id%253Dinfo%253Adoi%252F10.1093%252Fije%252Fdym071%26rft_id%253Dinfo%253Apmid%252F17517812%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [12]:…
Background Flying foxes (megachiroptera) and insectivorous microbats (microchiroptera) are the kn... more Background Flying foxes (megachiroptera) and insectivorous microbats (microchiroptera) are the known reservoirs for a range of recently emerged, highly pathogenic viruses. In Australia there is public health concern relating to bats’ role as reservoirs of Australian Bat Lyssavirus (ABLV), which has clinical features identical to classical rabies. Three deaths from ABLV have occurred in Australia. A survey was conducted to determine the frequency of bat exposures amongst adults in Australia’s most populous state, New South Wales; explore reasons for handling bats; examine reported practices upon encountering injured or trapped bats or experiencing bat bites or scratches; and investigate knowledge of bat handling warnings. Methods A representative sample of 821 New South Wales adults aged 16 years and older were interviewed during May and June 2011, using a computer assisted telephone interview (CATI) method. Frequencies, proportions and statistical differences in proportion were perf...
Global health requires evidence-based approaches to improve health and decrease inequalities. In ... more Global health requires evidence-based approaches to improve health and decrease inequalities. In a roundtable discussion between health practitioners, funders, academics and policy-makers, we recognised key areas for improvement to deliver better-informed, sustainable and equitable global health practices. These focus on considering information-sharing mechanisms and developing evidence-based frameworks that take an adaptive function-based approach, grounded in the ability to perform and respond to prioritised needs. Increasing social engagement as well as sector and participant diversity in whole-of-society decision-making, and collaborating with and optimising on hyperlocal and global regional entities, will improve prioritisation of global health capabilities. Since the skills required to navigate drivers of pandemics, and the challenges in prioritising, capacity building and response do not sit squarely in the health sector, it is essential to integrate expertise from a broad range of fields to maximise on available knowledge during decision-making and system development. Here, we review the current assessment tools and provide seven discussion points for how improvements to implementation of evidence-based prioritisation can improve global health.
Global health requires evidence-based approaches to improve health and decrease inequalities. In ... more Global health requires evidence-based approaches to improve health and decrease inequalities. In a roundtable discussion between health practitioners, funders, academics and policy-makers, we recognised key areas for improvement to deliver better-informed, sustainable and equitable global health practices. These focus on considering information-sharing mechanisms and developing evidence-based frameworks that take an adaptive function-based approach, grounded in the ability to perform and respond to prioritised needs. Increasing social engagement as well as sector and participant diversity in whole-of-society decision-making, and collaborating with and optimising on hyperlocal and global regional entities, will improve prioritisation of global health capabilities. Since the skills required to navigate drivers of pandemics, and the challenges in prioritising, capacity building and response do not sit squarely in the health sector, it is essential to integrate expertise from a broad range of fields to maximise on available knowledge during decision-making and system development. Here, we review the current assessment tools and provide seven discussion points for how improvements to implementation of evidence-based prioritisation can improve global health.
The year 2007 saw the most severe influenza season since national reporting of influenza began in... more The year 2007 saw the most severe influenza season since national reporting of influenza began in 2001. Early in the season the National Incident Room was activated to provide effective national surveillance, reporting and management of the 2007 seasonal influenza outbreak. A surveillance team were tasked with establishing enhanced surveillance for the 2007 season and investigating unusual events in this outbreak. Key data required to comprehensively describe the number of cases, morbidity, mortality and virology of the influenza outbreak and the possible sources of these data were identified. In 2007 the number of laboratory-confirmed notifications for influenza was 3.1 times higher than the five-year mean. Forty-four per cent of notifications occurred in Queensland. High notification rates were reflected in an increase in presentations with influenza-like illness to sentinel general practices and Emergency Departments. Notifications and notification rates were highest in the 0-4 and 5-9 years age groups, possibly due to a bias towards testing in these age groups. The clinical morbidity of the infection in terms of complications or most affected groups cannot be determined but anecdotal reports indicate this season may have impacted young adults more than is usual. The available data suggest influenza has caused a significant burden on workplaces and the health care system as indicated by data on absenteeism and presentations for health care. The proportion of H1 strains of influenza circulating varied across Australia but was higher than 2006 in most jurisdictions. In 2007, 1,406 influenza isolates from Australia were antigenically analysed at the World Health Organization Collaborating Centre for Reference and Research on Influenza in Melbourne: 58.7% were A(H3N2), 34.4% were A(H1N1) and 6.9% were influenza B viruses. Antigenic drift away from the vaccine strain A/Wisconsin/67/2005 was observed with the A(H3N2) viruses and was also seen with most of the A(H1N1) viruses when compared with the vaccine strain A/New Caledonia/20/99. The small number of influenza B viruses examined were predominately of the B/Yamagata-lineage. Monitoring influenza through the National Incident Room during the 2007 season offered an excellent opportunity to conduct enhanced surveillance under conditions that were real and potentially serious but not an emergency. It enabled the current state of our surveillance systems to be assessed and opportunities for improvement to be identified.
objective The Pacific Syndromic Surveillance System (PSSS), launched in 2010, provides a simple m... more objective The Pacific Syndromic Surveillance System (PSSS), launched in 2010, provides a simple mechanism by which 121 sentinel surveillance sites in 21 Pacific island countries and areas perform routine indicator-and event-based surveillance for the early detection of infectious disease outbreaks. This evaluation aims to assess whether the PSSS is meeting its objectives, what progress has been made since a formative evaluation of the system was conducted in 2011, and provides recommendations to enhance the PSSS's performance in the future. methods Twenty-one informant interviews were conducted with national operators of the system and regional public health agencies that use information generated by it. Historic PSSS data were analysed to assess timeliness and completeness of reporting. results The system is simple, acceptable and useful for public health decision-makers. The PSSS has greatly enhanced Pacific island countries' ability to undertake early warning surveillance and has contributed to efforts to meet national surveillance-related International Health Regulation (2005) capacity development obligations. Despite this, issues with timeliness and completeness of reporting, data quality and system stability persist. conclusion A balance between maintaining the system's simplicity and technical advances will need to be found to ensure its long-term sustainability, given the low-resource context for which it is designed.
The year 2007 saw the most severe influenza season since national reporting of influenza began in... more The year 2007 saw the most severe influenza season since national reporting of influenza began in 2001. Early in the season the National Incident Room was activated to provide effective national surveillance, reporting and management of the 2007 seasonal influenza outbreak. A surveillance team were tasked with establishing enhanced surveillance for the 2007 season and investigating unusual events in this outbreak. Key data required to comprehensively describe the number of cases, morbidity, mortality and virology of the influenza outbreak and the pos-sible sources of these data were identified. In 2007 the number of laboratory-confirmed notifications for influenza was 3.1 times higher than the five-year mean. Forty-four per cent of notifications occurred in Queensland. High notification rates were reflected in an increase in presentations with influenza-like illness to sentinel general practices and Emergency Departments. Notifications and notification rates were highest in the 0–4 ...
To the Editor: We are concerned that Yuki and Hartung (June 14 issue),(1) in their otherwise comp... more To the Editor: We are concerned that Yuki and Hartung (June 14 issue),(1) in their otherwise comprehensive review of the Guillain-Barré syndrome, have overlooked the importance of public health efforts in the surveillance of acute flaccid paralysis to the eradication of polio. Surveillance of acute flaccid paralysis, and hence Guillain-Barré syndrome, which the authors describe as the "most frequent cause of acute flaccid paralysis worldwide," is a key strategy in global efforts aimed at its eradication.(2) The recent declaration by the World Health Assembly that poliovirus eradication is a programmatic emergency for global public health(3) should convince clinicians around the . . .
Communicable diseases intelligence quarterly report, Jan 30, 2013
With eradication almost within reach, the importance of detecting every poliomyelitis case has ta... more With eradication almost within reach, the importance of detecting every poliomyelitis case has taken on additional significance. The selected surveillance strategy must be effective and efficient. A review of polio surveillance in Australia was conducted to consider whether current strategies were optimal. Document review and semi-structured key informant interviews were used to conduct the review. Interviews were recorded, transcribed and thematically analysed. The review was an iterative process with feedback on the findings sought from interviewees. Since Western Pacific Regional polio-elimination status was certified, one imported adult case was detected in 2007 in Australia, with no evidence of further transmission, and no Australian paediatric cases identified. Respondents reported that: it was not possible to prevent importations; paediatric cases were more likely to be identified than adult cases; and there may be a low level of suspicion among clinicians. Case detection and...
A key determinant of the success of influenza containment is the transmission rate of the novel s... more A key determinant of the success of influenza containment is the transmission rate of the novel strain. C. Fraser et al. [“Pandemic potential of a strain of influenza A (H1N1): Early findings,” Reports, 19 June, p. [1557][1]] estimated the basic reproduction number ( R ) of the Mexican outbreak of influenza A (H1N1) to be in the range of 1.2 to 1.6. The value of R is a key measure of transmissibility and estimates the number of secondary cases in a completely susceptible population. Their findings were comparable to lower estimates for the 1918 pandemic, where R ranged from 2 to 3 ([ 1 ][2]). To further investigate the transmissibility of this novel virus, we conducted a secondary analysis of the largest reported cluster of influenza A (H1N1) ([ 2 ][3]). We used survey data from students of the St. Francis Preparatory School outbreak in the United States to calculate the effective reproduction number ( R ) in a school-based setting. R is the average number of secondary cases generated by an infectious case during an epidemic and is usually comparable to R . This survey collected data on self-reported fever and either cough or sore throat between 8 and 28 April 2009. We used the method proposed by Vynncky et al. ([ 3 ][4]) to calculate R from the growth rate of the epidemic. We based our parameter assumptions on estimates for seasonal influenza commonly reported in the literature, because such values are not yet available for H1N1. The parameters were as follows: incubation period of 2 days; infectious period of 3 days; and a calculated serial interval of 5 days. The serial interval is the time between the onset of symptoms for first and second generation cases. Using daily data from the outbreak growth phase, we calculated R to be 2.69 [95% confidence interval: 2.20 to 3.22; degrees of freedom (df) = 13]. Increasing the estimated infectious period to 5 days results in an R of 3.45 (95% confidence interval: 2.74 to 4.28; df = 13). The confidence interval for R was derived from a Monte Carlo simulation based on the uncertainty of the slope estimate. Estimates of R were relatively insensitive to the use of data from the growth phase or entire outbreak. Our calculated R is specific to this school setting and, with the increased transmission potential of a close-contact setting such as a school, is likely to be higher than transmission rates in the community-wide Mexican outbreak. The use of parameters estimated from seasonal influenza will need confirmation for the 2009 influenza A H1N1 virus. Our analysis supports the findings from Fraser et al. that this H1N1 virus has a transmission rate comparable to the lower R estimates of 2 for the 1918 pandemic ([ 1 ][2]). 1. [↵][5] 1. G. Chowell, 2. H. Nishiura, 3. L. Bettencourt , J. R. Soc. Interface 4, 155 (2007). [OpenUrl][6][Abstract/FREE Full Text][7] 2. [↵][8] 1. T. R. Frieden , Commissioner, “St. Francis Prep Update: Swine Flu Outbreak” (New York City Department of Health and Mental Hygiene, New York, 2009); ([www.nyc.gov/html/doh/downloads/pdf/cd/h1n1\_stfrancis\_survey.pdf][9]). 3. [↵][10] 1. E. Vynncky, 2. A. Trindall, 3. P. Mangtani , Int. J. Epidemiol. 36, 881 (2007). [OpenUrl][11][Abstract/FREE Full Text][12] [1]: /lookup/doi/10.1126/science.1176062 [2]: #ref-1 [3]: #ref-2 [4]: #ref-3 [5]: #xref-ref-1-1 "View reference 1 in text" [6]: {openurl}?query=rft.jtitle%253DJournal%2Bof%2BThe%2BRoyal%2BSociety%2BInterface%26rft.stitle%253DJ%2BR%2BSoc%2BInterface%26rft.issn%253D1742-5662%26rft.aulast%253DChowell%26rft.auinit1%253DG.%26rft.volume%253D4%26rft.issue%253D12%26rft.spage%253D155%26rft.epage%253D166%26rft.atitle%253DComparative%2Bestimation%2Bof%2Bthe%2Breproduction%2Bnumber%2Bfor%2Bpandemic%2Binfluenza%2Bfrom%2Bdaily%2Bcase%2Bnotification%2Bdata%26rft_id%253Dinfo%253Adoi%252F10.1098%252Frsif.2006.0161%26rft_id%253Dinfo%253Apmid%252F17254982%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [7]: /lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6MTI6InJveWludGVyZmFjZSI7czo1OiJyZXNpZCI7czo4OiI0LzEyLzE1NSI7czo0OiJhdG9tIjtzOjI1OiIvc2NpLzMyNS81OTQ0LzEwNzEuMi5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30= [8]: #xref-ref-2-1 "View reference 2 in text" [9]: http://www.nyc.gov/html/doh/downloads/pdf/cd/h1n1_stfrancis_survey.pdf [10]: #xref-ref-3-1 "View reference 3 in text" [11]: {openurl}?query=rft.jtitle%253DInt.%2BJ.%2BEpidemiol.%26rft_id%253Dinfo%253Adoi%252F10.1093%252Fije%252Fdym071%26rft_id%253Dinfo%253Apmid%252F17517812%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [12]:…
Background Flying foxes (megachiroptera) and insectivorous microbats (microchiroptera) are the kn... more Background Flying foxes (megachiroptera) and insectivorous microbats (microchiroptera) are the known reservoirs for a range of recently emerged, highly pathogenic viruses. In Australia there is public health concern relating to bats’ role as reservoirs of Australian Bat Lyssavirus (ABLV), which has clinical features identical to classical rabies. Three deaths from ABLV have occurred in Australia. A survey was conducted to determine the frequency of bat exposures amongst adults in Australia’s most populous state, New South Wales; explore reasons for handling bats; examine reported practices upon encountering injured or trapped bats or experiencing bat bites or scratches; and investigate knowledge of bat handling warnings. Methods A representative sample of 821 New South Wales adults aged 16 years and older were interviewed during May and June 2011, using a computer assisted telephone interview (CATI) method. Frequencies, proportions and statistical differences in proportion were perf...
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