The main research interests of the Unit are:
1. COVID -19
Prof Karin Leder and Prof Allen Cheng are involved in COVID-19-related research through the COVIC-HA study, the Australian National COVID-19 Clinical Evidence Taskforce, the MRFF grant Statin Treatment for COVID-19 to optimise Neurological Recovery (STRONGER) trial (K Leder) and the REMAP-CAP trial (A Cheng). They both have a variety of roles in assisting with the outbreak, including as co-Chair of ATAGI (A Cheng).
2. Water, sanitation and health
Health issues related to contaminated environments from poorly managed sanitation are a major focus of the Infectious Disease Epidemiology Unit. Karin is leading the assessment work for a major international project, RISE (Revitalising Informal Settlements and their Environments)
This is a five-year action research program funded by a range of partners including the Wellcome Trust, MFAT and the Asian Development Bank. RISE is trialling an engineering intervention involving a water sensitive approach to water and sanitation management in 24 informal settlements across Makassar, Indonesia and Suva, Fiji. The program’s primary goals are to improve sanitation, mitigate flooding and improve dwelling and open space provision in an integrated way. RISE is designed as a randomised controlled trial, and will be assessing both environmental and human health impacts on the 12 communities which receive the intervention in the first phase compared with the 12 which receive the intervention 2 years later. Multiple benefits are anticipated, including, fewer infections, better intestinal health among children, fewer mosquito vectors, better psychological wellbeing, improved economic and psychological health, and reduced gender inequality through the provision of secure domestic sanitation facilities.
The infectious disease epidemiology unit also has a longstanding interest in understanding potential health impacts associated with exposure to drinking water, recycled water and rainwater. 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.
3. Imported infections
International travellers and immigrants play a key role in importing infections into Australia, and it is important to perform surveillance to understand changing trends in imported diseases. The role travellers play in spreading infections globally has never been more pronounced than with the SARS-CoV-2 pandemic, with travellers playing a key role as vectors of infection. In addition, travellers can be markers (or "sentinels") of disease - if an infected traveller returns to a country with good testing abilities and good and surveillance infrastructure after visiting a place where testing capabilities are poor, the traveller may provide a signal (sometimes the first signal) of infection in the country they visited. Both during outbreaks and at other times, travellers and immigrants face a variety of health risks, and research is required to better understand risk factors for various infections, effective screening practices, and appropriate preventive measures that should be taken.
4. 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.
5. Antibiotic prescribing
The Unit collaborates with the Pharmacy Department at Alfred Health to improve antibiotic prescribing. This includes the evaluation of hospital wide interventions to influence prescriber behaviour, to the evaluation of pharmacokinetic modelling software to individualise drug dosing. Recent projects have demonstrated a reduction in broad spectrum antibiotic use following the introduction of a rapid audit and feedback system, and have demonstrated the feasibility of pharmacokinetic software to predict drug doses.
6. Healthcare associated infections
The Unit is linked to the Infection Prevention and Healthcare Epidemiology Unit at Alfred Health. Recent projects have looked at the risks of contact isolation in patients with multiresistant organisms, interventions to reduce colonisation with multiresistant organisms, and the epidemiology of healthcare infections.
7. Influenza surveillance
Prof Allen Cheng leads FluCAN, a national sentinel surveillance system for severe influenza in conjunction with the Alfred Hospital and the Australian National University. Currently, this system conducts sentinel surveillance at 21 hospitals nationally to provide data in real time to public health authorities. Recent studies have estimated influenza vaccine effectiveness against hospitalization with severe influenza.
8. Vaccination issues and infectious disease notifications
Staff of the Unit are involved in providing advice to the World Health Organisation regarding global vaccination priorities, specifically with regards to infections such as measles. They are also using data linkages to assess factors associated with vaccine uptake and disease notifications in Victoria.
9. Antimicrobial resistance (AMR)
The Unit is involved with Monash’s Centre to Impact AMR, a newly-established collaboration to co-ordinate activities related to AMR across the University and beyond.