Australia's notifiable diseases status, 2000: Annual report of the National Notifiable Diseases Surveillance System

The Australia’s notifiable diseases status 2000 report provides data and an analysis of communicable disease incidence in Australia during 2000. This section of the annual report contains information on vaccine preventable diseases. The full report can be viewed in 23 HTML documents and is also available in PDF format. The 2000 annual report was published in Communicable Diseases Intelligence Vol 26 No 2, June 2002.

Page last updated: 10 July 2002

A print friendly PDF version is available from this Communicable Diseases Intelligence issue's table of contents.


Vaccine preventable diseases

Introduction

This section summarises the national notification data for diseases targeted by the Australian Standard Childhood Vaccination Schedule in 2000. This includes diphtheria, Haemophilus influenzae type b infection, measles, mumps, pertussis, poliomyelitis, rubella and tetanus.

There were 6,617 notifications of vaccine preventable diseases (VPDs) in 2000; 7.4 per cent of the total notifications. Pertussis was by far the most common accounting for 5,942 notifications or 89.8 per cent of all VPD notifications. Notifications of vaccine preventable diseases to the NNDSS and notification rates for vaccine preventable diseases in Australia are shown in Tables 17 and 18.

Table 17. Trends in notifications of vaccine preventable diseases, Australia, 1991 to 2000*

Disease
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000
Diphtheria
1
12
0
0
0
0
0
0
0
0
Haemophilus influenzae type b
533
465
370
163
77
49
51
35
40
28
Measles
1,438
1,452
4,693
4,805
1,185
481
838
288
238
107
Mumps
-
-
-
-
156
125
191
182
172
212
Pertussis
343
795
4,413
5,441
4,230
4,545
10,825
5,791
4,417
5,942
Rubella
-
-
4,006
3,488
5,751
2,933
1,387
753
377
322
Tetanus
13
13
10
13
7
3
7
8
2
6

* All jurisdictions reported for all years with the following exceptions:
Haemophilus influenzae type b not reported from Western Australia (1991 to 1993).
Mumps not reported from Queensland (1995,1996, 1999 and 2000).
Rubella not reported from Tasmania (1993 to 1994).
Tetanus not reported from Queensland (1991 to 1993).



Table 18. Trends in notification rates of vaccine preventable diseases, Australia, 1991 to 2000* (rate per 100,000 population)

Disease
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000
Diphtheria
< 0.1
0.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
Haemophilus influenzae type b
3.4
2.9
2.3
0.9
0.4
0.3
0.3
0.2
0.2
0.1
Measles
8.3
8.3
26.6
26.9
6.6
2.6
4.5
1.5
1.3
0.6
Mumps
-
-
-
-
1.1
0.8
1.0
1.0
1.1
1.4
Pertussis
2.0
4.5
25.0
30.5
23.4
24.8
58.4
30.9
23.3
31.0
Rubella
-
-
23.3
20.1
31.8
16.0
7.5
4.0
2.0
1.7
Tetanus
0.1
0.1
0.1
0.1
< 0.1
< 0.1
< 0.1
< 0.1
< 0.1
< 0.1

* All jurisdictions reported for all years with the following exceptions:
Haemophilus influenzae type b not reported from Western Australia (1991 to 1993).
Mumps not reported from Queensland (1995,1996, 1999 and 2000).
Rubella not reported from Tasmania (1993 to 1994).
Tetanus not reported from Queensland (1991 to 1993).


In 2000, the following changes to the childhood immunisation schedule25 occurred:

New vaccines

New combination vaccines for:
  • diphtheria-tetanus-acellular pertussis-hepatitis B (DTPa-hepB); and
  • Haemophilus influenzae type b - hepatitis B (Hib (PRP-OMP)-hep B),
for all three doses in the primary vaccination schedule. This allowed the introduction of universal hepatitis B vaccination (commencing at birth) without requiring an extra injection.

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New schedule

  • Two alternative schedules depending on which of the above combination vaccines is used and differing only in the timing of the 4th dose of these vaccines.
  • All Australian children recommended to receive the same Hib vaccine (PRP-OMP), which reduces the number of injections and the complexity of the schedule.
  • Introduction of universal vaccination for hepatitis B beginning at birth. Infants born to hepatitis B carrier mothers receive hepatitis B immunoglobulin and vaccine at birth. Preadolescent hepatitis B vaccination now recommended at 10-13 years. Booster doses of hepatitis B vaccine no longer recommended.
  • Second booster of DTPa now recommended at 4 years, instead of 4-5 years.
  • Second dose of MMR now given at 4 years instead of 10-16 years.
  • Tetanus and diphtheria boosters no longer recommended every 10 years. A tetanus booster at age 50 is recommended if no boosters have been given within the last 10 years.
  • Inactivated poliomyelitis vaccine is an acceptable alternative to live, oral poliomyelitis vaccine (OPV) in the primary vaccination schedule. However, OPV will remain the publicly funded vaccine.
  • Influenza vaccine recommended for children with cystic fibrosis, people with severe asthma and pregnant women in the second or third trimester of pregnancy during the influenza season.
The annual report of vaccination coverage estimates for children aged 12 months and the second annual report for children aged 24 months (using data extracted from the Australian Childhood Immunisation Register-ACIR) are also included in this section. A full description of the methodology used for calculating these estimates have been described previously.42

Diphtheria

There were no cases of diphtheria notified in 2000. The last known case occurred in 1992 and was notified in 1993. There has been a dramatic decline in the incidence of diphtheria in Australia since the first half of the 20th century (Figure 27).

Figure 27. Trends in notifications of diphtheria, Australia, 1917 to 1998

Figure 27. Trends in notifications of diphtheria, Australia, 1917 to 1998

At the height of the 1921 diphtheria outbreak in Australia, there were 23,199 notifications giving a notification rate of 426 cases per 100,000 population.43 Although diphtheria hasn't been found in Australia since 1992, a recent case in New Zealand44 and the extensive outbreak in the former states of the Soviet Union in the 1990s45 highlight the potential for diphtheria to re-emerge.

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Haemophilus influenzae type b disease

Notifications of Haemophilus influenzae type b (Hib) have fallen more than 30-fold since 1991 due to the impact of Hib conjugate vaccines (Figure 28). An assessment of the impact of conjugate vaccines on the global incidence of Hib disease concluded that few vaccines have induced such dramatic declines in disease incidence in such a short time. The prevention of nasopharyngeal colonisation by Hib in vaccinated individuals under most circumstances may explain the dramatic impact on Hib disease.46

Figure 28. Trends in notifications of Haemophilus influenzae type b infection, Australia, 1991 to 2000