Applied epidemiology of infectious diseases for epidemic response in Australia and the Asia-Pacific region

Abstract

My field placement for the Master of Philosophy in Applied Epidemiology (MAE) during 2017 to 2019 was with the National Health and Medical Research Council funded Centre for Research Excellence, Integrated Systems for Epidemic Response. Due to my placement being an academic institute, I also worked at the South Western Sydney Public Health Unit (PHU) in the Communicable Diseases team from 5 to 15 February 2018 to fulfil the requirements of an outbreak investigation. The six chapters within this thesis demonstrate the work I have undertaken and lessons learned as part of meeting the requirements of the MAE.

For my major epidemiological project, I designed and implemented a stakeholder survey and workshop to understand the global outbreak surveillance needs of stakeholders involved in epidemic response in selected countries in the Asia-Pacific region. This study introduced me to a mixed methods approach using quantitative and qualitative methods. Findings from the research were presented at conferences, published in the Western Pacific Surveillance and Response Journal and used to inform the development of an epidemic observatory called Epi-watch.

I evaluated the Epi-watch epidemic observatory, a new surveillance system currently in development by ISER that provides critical analysis of global outbreaks and epidemics of public health significance. This was an internal evaluation focused on identifying areas for improvement and providing recommendations to inform further development of the system into a mature tool for use by stakeholders.

I worked at the PHU to gain outbreak investigation experience. My role there involved investigating a cluster of nine food poisoning cases following a catered private house party. Two possible sources for infection were identified, a catered sushi platter served at the party and a picnic held the previous day. A pathogen was not identified during the investigation. A retrospective cohort study was undertaken and along with other evidence, contaminated sushi was identified as the most likely cause of illness and Salmonella hypothesised as the causative agent.

My data analysis project aimed to investigate the impact of repeated influenza vaccinations on vaccine effectiveness and serological response. This was a retrospective secondary data analysis using data from a case control study conducted from 2008 to 2010 by my field supervisor, Professor Raina MacIntyre. We hypothesised that there would be no difference between the number of influenza vaccinations and vaccine effectiveness and no difference between the number of influenza vaccinations and influenza A and B serological levels.

The teaching experience I gained included a lesson in the field on analysing qualitative data and being involved in a group teaching session with MAE peers for the 2018 first year cohort. Additional experiences gained included coordinating the establishment of a study to evaluate the effectiveness of a newly introduced high dose influenza vaccine compared to a standard dose during the 2018 influenza season in an aged care setting in Australia. Finally, I gained valuable experience undertaking a two-month placement as a Surveillance Officer in the World Health Organization Western Pacific Regional Office Field Epidemiology Training Program. Show more