Skip to the content
 

Infectious Disease Epidemiology Unit

Department of Epidemiology and Preventive Medicine

Head: Dr Karin Leder MBBS(Hons) FRACP PhD MPH DTMH

Contact details

Infectious Disease Epidemiology includes the study of the prevalence of infections in populations, the identification of risk factors, and the development and evaluation of effective treatment measures and prevention strategies.

The unit focuses on areas of water quality and public health, environmental impacts on infections, travellers’ health, health issues in immigrants/refugees and infectious disease transmission modelling. The unit is also involved in studies on infectious diseases which represent important problems in clinical practice, including nosocomial infections and influenza.

Through its partnership with Water Quality Research Australia Limited (WQRA), the Infectious Disease Epidemiology Unit is a leading centre for research on public health issues relating to drinking water quality. Research projects in this area include the health impacts of microbial pathogens in drinking water, and the development of improved monitoring and risk management systems for drinking water supplies.  More recently the research activities of the unit have expanded to include public health aspects of alternative water sources (including rainwater, greywater and recycled water). These lower quality water sources are being increasing used in urban areas for non-potable uses to conserve precious supplies of high quality drinking water, and as a result the potential for public exposure to these water types is increasing.

Staff

·     Assoc Prof Allen Cheng

·     Dr Martha Sinclair  Senior Research Fellow

·     Dr Robert Hall  Senior Research Fellow

·     Dr Joanne O'Toole  Research Fellow

·     Dr Katherine Gibney  Research Fellow

·     Dr Amanda Brass  Research Fellow 

·     Dr Nusrat Najnin  Research Assistant

·     Mr Surenda Karki PhD Student

·      Ms Pam Hayes  Research Assistant

 


 

Publications

Research

The main research interests of the Unit are: 

1. Water and health – Health issues related to drinking water, recycled water and rainwater are a major focus. Research has consisted of large randomised controlled trials, experimental work, data modelling, and questionnaires to better understand potential exposures and potential health risks associated with using different water sources. Outputs have significant implications on water guidelines and water policy in Australia.

2. Imported infections – International travellers and immigrants play a key role in importing infections into Australia. Surveillance to understand changing trends in imported diseases is very important, as has been highlighted recently by the 2009 influenza pandemic. Travellers and immigrants face a variety of health risks, and research is also required to better understand risk factors for various infections, effective screening practices, and appropriate preventive measures that should be taken.

3. Infections in immunocompromised hosts – There are a number of infections for which immunocompromised patients are at high risk. As an example, splenectomised patients have a significant risk of developing overwhelming and life-threatening infections from certain encapsulated bacteria. In conjunction with the Alfred hospital, staff of the ID Epidemiology Unit are involved in overseeing a state-wide “spleen registry”, which captures patients undergoing splenectomies and provides them with advice to minimise their risks of infectious complications.

4. Antibiotic prescribing – The Unit is involved in efforts to improve antibiotic prescribing by using pharmacokinetic modelling software to predict the appropriate dose of vancomycin. Additionally, the Unit is involved in the implementation and evaluation of antibiotic stewardship programs using point-prevalence surveys and drug usage evaluations.

5. Infectious disease transmission modelling – The Unit is involved in estimating the effectiveness of interventions (including vaccination and antibiotic use) on pneumococcal carriage and otitis media in Indigenous children. A current study is examining the impact of mass drug administration of ivermectin on scabies, skin sores and strongyloides in a remote Indigenous community.

6. Nosocomial infections – Members of the Unit are involved in surveillance and research in nosocomial infections. Current research interests include the evaluation of chlorhexidine bathing to reduce transmission of vancomycin resistant enterococci in hospital wards. Additional work is examining the epidemiology of new strains of community-acquired methicillin-resistant Staphylococcus aureus (caMRSA) in northern Australia.

7. Influenza surveillance – The Unit was involved in setting up a national sentinel surveillance system for severe influenza in conjunction with the Alfred Hospital and the Australian National University. Currently, this system involves active surveillance at 13 hospitals nationally. Current interests include real-time reporting to assist public health responses, and estimation of influenza vaccine effectiveness.

8.  Management of severe sepsis – The Unit is involved in the development and evaluation of a management protocol for severe bacterial infections in developing countries, co-ordinated by the World Health Organisation.

9.  Vaccination issues - Staff of the Unit are involved in providing advice to the World Health Organisation regarding global vaccination priorites, specifically with regards to infections such as measles. 

 

 

 

Some examples of current water-related projects

 

·     Establishing Australian Health Based Targets For Microbial Water Quality
It is of great public health importance to ensure that our drinking water supplies are safe. This is true both for conventional drinking water supplies and for supplies derived from alternative water sources, including water derived from recycled sewage. National guidelines exist for management of drinking water and recycled water supplies, but currently there are no targets for determining whether water has an acceptably low level of infectious agents. This project involves a number of steps to develop national consensus on health targets for microbial water quality.

·     Exposure assessment using cyanuric acid
This project will determine whether it is feasible to measure actual water ingestion by spiking the water with a non-toxic chemical (cyanuric acid) and measuring the amount of the chemical subsequently excreted in urine. Cyanuric acid is widely used in outdoor swimming pools to “stabilise” chlorine by protecting it from UV degradation. When ingested, this compound is not metabolised but is 100% excreted in the urine within 24 hours. Measurement of cyanuric acid in urine has been successfully used to estimate water ingestion during swimming.

·     Greywater use in the backyard: what are the health risks?

This project involves administering a survey to Melbourne householders asking them about their greywater use and monitoring greywater quality at selected households. This information will feed into a mathematical model to predict greywater related infection risk and disease burden.

Report to Participants (PDF)

List of some past projects

 

Teaching

The Unit is actively involved in teaching both at the undergraduate and postgraduate levels, and coordinates the Masters of Clinical Research Methods program and a course entitled “Infectious Disease Epidemiology” for MPH students. Unit staff also supervise honours, doctoral, and post-doctoral students.