Burden of influenza and other respiratory viruses among Aboriginal children in the Top End

Aboriginal infants in the Northern Territory suffer from the highest rate of influenza morbidity in the world. This disease is vaccine preventable, but universal vaccination against influenza is not currently recommended in Australia. This project aims to define the exact burden of severe influenza and other respiratory viruses by prospectively studying Aboriginal children admitted to hospital and using the best available methods to determine the cause of illness. A nested costing study will also occur which will help define the cost of hospitalisation due to influenza, an important consideration if vaccination policy is to be changed to include influenza immunisation for Aboriginal children. The impact of influenza and other respiratory viruses on clinical outcomes and on the interplay between viral infection and chronic bacterial carriage will be studied, as this impacts on chronic ear disease and lung disease.

The aim of this project is to determine accurately the true burden of influenza in terms of morbidity, mortality and cost, so that a solid argument may be made for the introduction of influenza immunisation for Aboriginal children. Information gained from this project will directly inform immunisation policy at the level of the NT’s Centre for Disease Control, and will further be fed back to the Australian Technical Advisory Group on Immunisation for consideration of national policy.

This two-year project involves a prospective cohort study of children younger than 3 years of age admitted to Royal Darwin Hospital. Participating children have a nose swab performed. Information about the child’s illness is obtained from the parent or carer, from the medical notes and from any pathology tests performed as part of routine clinical care. Swabs are sent to University of Queensland for molecular testing to determine the cause of illness. In the study’s first year over 350 children have been recruited.