Enhancing surveillance of notifiable diseases in South Australia, 2023 - 2024

Abstract

From February 2023 to December 2024, I undertook a 22-month field placement within the Disease Surveillance and Investigation Section (DSIS) of the Communicable Disease Control Branch (CDCB), SA Health. During the placement, I undertook multiple projects to demonstrate the core competencies of the Master of Philosophy (Applied Epidemiology) (MAE) program including conducting an analysis of a public health dataset, investigating an acute public health problem or threat, designing and conducting an epidemiological study, and establishing and evaluating a surveillance system.

The first chapter introduces my field placement, summarises my projects and outlines my primary role within DSIS.

The second chapter describes establishing and evaluating an automated enhanced surveillance system piloted for varicella and Salmonella cases notified in South Australia. The established surveillance system utilised Short Message Service and online surveys to collect enhanced surveillance data directly from varicella and Salmonella cases which were then automatically integrated into the existing notifiable disease surveillance system in South Australia. The new system was evaluated against specific attributes as per the United States Centers for Disease Control and Prevention Guidelines. The evaluation recommended continued use of the automated enhanced surveillance system for varicella and Salmonella notifications, as well as expansion for use with other notifiable diseases. The establishment of this system was presented at the Communicable Diseases & Immunisation Conference 2024 in Brisbane, Australia.

The third chapter describes the epidemiological study conducted as part of the broader evaluation of the automated enhanced surveillance system established in Chapter 2. The nested before-and-after intervention study evaluated the data completeness and representativeness attributes of the piloted system. The study finds significant improvements to data completeness and validates the pilot populations are representative of expected disease populations for both Salmonella and varicella.

The fourth chapter describes the investigation of an acute public health problem or threat competency through the investigation of a Salmonella Virchow outbreak in a childcare centre. I was the lead investigator for the outbreak which involved epidemiological, environmental and laboratory investigations. Person-to-person transmission was the most likely mode identified in the outbreak. A literature review was conducted as part of the project to further understand non-foodborne Salmonella transmission in childcare centres. The outbreak investigation has also been drafted as a manuscript for submission to the Communicable Diseases Intelligence journal.

The fifth chapter presents the analysis of a public health data set competency through the production of the COVID-19 Annual Surveillance Report 2021 for South Australia. This project was a descriptive analysis of COVID-19 notifications between 1 January 2021 to 31 December 2021 in South Australia. During 2021, South Australia experienced almost no community transmission of COVID-19 until 23 November 2021 when the state borders were opened, and community cases increased. A lay summary was produced as part of the project and published on the SA Health website. It was the first comprehensive description of COVID-19 notifications in 2021 produced by CDCB.

The sixth chapter provides learnings from multiple teaching activities conducted during the MAE program and describes other experiences and public health activities during my placement. This includes a six-week fellowship with the World Health Organization Western Pacific Regional Office in Manila, Philippines. The teaching activities include peer-to-peer teaching to first-year MAE scholars and lessons from the field activities with fellow MAE scholars. Show more