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Epidemic gonococcal conjunctivitis in central Australia
Author(s) -
Merianos Angela,
Condon Robert J,
Tapsall John W,
Jayathissa Sisira,
Mulvey Graeme,
Lane J Michael,
Patel Mahomed S,
Rouse Ian
Publication year - 1995
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1995.tb126016.x
Subject(s) - outbreak , serotype , transmission (telecommunications) , medicine , odds ratio , epidemiology , demography , neisseria gonorrhoeae , penicillin , gonococcal infection , environmental health , sexually transmitted disease , antibiotics , virology , biology , human immunodeficiency virus (hiv) , syphilis , electrical engineering , microbiology and biotechnology , sociology , engineering
Objectives To describe an epidemic of gonococcal conjunctivitis in central Australian Aboriginal children, the responsible phenotypes of Neisseria gonorrkoeae, factors facilitating spread and treatment efficacy. Design Prospective study of patients with laboratory confirmed or clinical gonococcal conjunctivitis diagnosed from January to July 1991. Setting The Alice Springs and Barldy Tablelands Health Districts of the Northern Territory, the Anangu Pitjantjatjara Lands of South Australia and the Ngaanyatjarra Homelands of Western Australia. Methods Cases were identified from surveillance data and laboratory notifications, and by active case finding. A community survey explored risk factors. Main outcome measures Age‐specific attack rates, auxotype/ serovar characterisation of isolates, and clinical response to single dose treatment. Results We identified 432 cases. The highest attack rate was in the 0‐4 year age group (86 per 1000), and the risk of conjunctivitis decreased with age. The odds ratio of secondary infection in household compared with community contacts was 14.5 (P< 0.002; 95% Cl, 1.8‐120.0). Disease was less common in children with clean faces and hands. The outbreak occurred after unseasonable rains and large community gatherings. Isolates were predominantly LA serovars, less common among central Australian serovars. Conclusions The trigger for non‐sexually transmitted gonococcal conjunctivitis epidemics remains obscure. Age is a significant risk factor and social and ecological factors may also contribute. Active case finding within affected households and treatment with a suitable penicillin is effective in stopping transmission.