Infections and conditions
- Blood-borne viruses
- Emerging infections
- Enteric infections, including foodborne and waterborne pathogens
- Environmental pathogens
- Invasive diseases
- Respiratory infections
- Sexually transmissible infections
- Vaccine preventable diseases
- Vector-borne diseases
- Zoonotic diseases
Prevention
- Immunisation:
- current immunisation schedules
- design, evaluation, and management of immunisation programs
- approaches to improving vaccine coverage
- Infection control organisation and activities
- Development, commissioning, and evaluation of services required for protecting health:
- screening for other infections
- sexual health services
- tuberculosis screening
- travel health services
- Priority populations:
- Aboriginal and Torres Strait Islander peoples
- Māori (tangata whenua)
- Pacific peoples
- LGBTQIA+ people
- older persons
- pregnant people
- people of refugee and/or asylum seeker background
- others, such as:
- disabled
- immunosuppressed
- High risk settings:
- aged care facilities
- early childhood education and care facilities
- health care settings
- mass gatherings
- toher residential settings, such as boarding schools and disability accommodation
- people in custodial settings
- schools
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- assemble relevant information, particularly microbiology data
- consider the impact of the situation on individuals, workplaces, family, and the wider community when developing a management plan
- declare an outbreak
- demonstrate their understanding of the public health regulatory system with regards to food and water safety
- develop a case definition
- develop an epidemic curve
- identify relevant epidemiology, microbiology, disease manifestations and sequelae, and public health prevention and control pathways
- undertake a comprehensive case interview
- undertake an outbreak investigation
Manage
- assemble and involve multidisciplinary teams
- communicate public health messages to relevant audiences
- implement evidence-based public health management
- recognise potential complications of disease at the population level and initiate preventative strategies
Consider other factors
- identify individual, social, and cultural factors, and legal responsibilities in the management of the situation
Procedures
- Establish the situation to date
- Identify a potential outbreak according to:
- Identify and consult relevant documentation:
- disease-specific, such as national guidelines and local outbreak investigation protocol
- Understand team functions, and establish an outbreak management team
- Verify diagnoses, confirm an outbreak, and decide whether to investigate further
- Conduct a case interview
- Develop an appropriate outbreak case definition
- Ensure effective identification and management of cases (including case finding strategies), contacts, and the environment, including any vectors or contaminated food or water
- Ensure appropriate control measures of other sources of infection are in place
- Implement appropriate infection control in relevant institutional settings, such as hospitals, residential care, and childcare facilities
- Develop and test an outbreak hypothesis
- Communicate public health messages to relevant audiences
- Determine appropriate use of vaccines and immunoglobulin for post-exposure prophylaxis and broader outbreak control
- Establish an appropriate timeframe for closure of the outbreak
- Document as required
Infectious disease epidemiology
- Timeline of infection:
- latent period
- incubation period
- infectious period
- Timeline of disease:
- constructing an epidemic curve
- incubation period
- symptomatic period
- Pathogenicity:
- transmission probability
- secondary attack rate
- transmission probability ratio
- Basic and effective reproductive numbers
- Use of whole genome sequencing
- Case fatality ratio
- Analytical epidemiology for outbreak investigations, including case control and cohort studies
Surveillance
- Descriptive epidemiology of health problems
- Uses:
- detection of infectious disease outbreaks
- research, such as generating research questions
- future projections
- health advocacy
- links to services, such as notifiable diseases
- monitoring and evaluation of interventions / public health programs
- monitoring trends and patterns of behaviour and disease
- Elements of a surveillance system:
- case definition
- cycle of surveillance
- data security and confidentiality
- incentives to participation, such as for clinicians
- legislative and governance requirements
- population under surveillance
- type of surveillance
- Approaches to surveillance:
- active versus passive
- syndromic, sentinel, and rumour
- Data sources:
- information systems
- laboratory-based surveillance
- notifiable disease reporting
- record linkage
- registries
- sentinel events
- surveys
- Analysis of surveillance data:
- advanced techniques to adjust for sampling designs
- descriptive statistics
- Attributes of surveillance systems:
- fit-for-purpose
- simplicity
- sensitivity
- flexibility
- data quality
- acceptability
- accuracy and completeness of descriptive information
- predictive value
- representativeness
- timeliness
- stability
- Activities of international health and development agencies, such as World Health Organization and Centres for Disease Control
- Anti-microbial resistance:
- causes
- interventions:
- primary, secondary, tertiary
- public health implications
- significant organisms
- Human biosecurity measures:
- national and international
- relevant legislation
- known, new, and emerging infectious diseases
- One Health approaches:
- global interconnectivity
- interconnectedness of animal, human, and environmental health
- key regulatory bodies and stakeholders
- State, national, and international public health legislation and its application
- Sources of critical public health information:
- Australian Technical Advisory Group on Immunisation (ATAGI)
- Communicable Diseases Network Australia (CDNA)
- Australian Immunisation Handbook
- Aotearoa New Zealand: Immunisation Handbook
- Institute of Environmental Science and Research (ESR) Infectious Disease Intelligence & Surveillance
- Te Whatu Ora / Health New Zealand Communicable Disease Control Manual
