VIDEO: Diphtheria outbreak spreads in Australia

SARAH FERGUSON, PRESENTER: Dr. Paul Burgess, welcome to 7.30. 

DR PAUL BURGESS, NT CHIEF HEALTH OFFICER:  Good evening. 

SARAH FERGUSON:  Can you start by giving us the latest information on the case numbers in the Northern Territory? 

PAUL BURGESS:  Yeah, thank you. As of May 20 today, we've had 155 cases, 44 of those cases have been respiratory diphtheria, and 111 have been infections of the skin or cutaneous diphtheria.

SARAH FERGUSON:  And as I understand it, this outbreak actually began last year. Why are we only talking about it more generally across the nation now? 

PAUL BURGESS:  Yeah, it's a good question. I think we've seen a sharp acceleration in case numbers, and there can be a couple of reasons for that. I think it's important to place in context, however, Australia had largely eliminated diphtheria for many years, if not decades, very successful national immunisation program for children and pregnant women and also boosters for adults. 

And in about 2022, I think we saw an incursion. We think it was an incursion of an imported case of diphtheria in Queensland and in subsequent years, that's now spread to the Northern Territory and West Australia, and most recently in South Australia also. 

The most recent uptick in case numbers has a few factors to consider. One is we have a very mobile population in the Northern Territory. I think there was some under recognition because we haven't diphtheria for many, many years. 

But importantly, subsequent to the first few cases, we've been very proactive with our messaging, public health alerts, clinician alerts, and we're seeing better case detection, but also community members understanding what diphtheria is and coming forward with symptoms that turn out to be diphtheria. 

SARAH FERGUSON:  But given that the public health emergency was declared in March, have the state and territory governments and the federal government responded quickly enough? 

PAUL BURGESS:  Yeah, look, I think the answer to that is generally yes. It's been proportionate to the case numbers. If we go back to March, it was really only a small handful of cases, two in Darwin and one in Alice Springs. 

Our public health action and response is to treat those people with infection with antibiotics and also their close household contacts and provide immunisation. 

What we did see now, however, is an acceleration of case numbers and proportionate to that, we are now seeing an acceleration of the response of state and territory governments and as well as the Commonwealth. 

SARAH FERGUSON:  We know that there has been an acute shortage, particularly of remote area nurses in the Northern Territory since COVID, after that huge burnout, you lost a lot of nurses. You haven't been able to replace them. Is that playing a role in the drop in vaccination rates we've seen in the territory? 

PAUL BURGESS:  Yeah, look, it's a really important question. I've been a clinician in Northern Territory for almost 30 years, and a long-term relationship with communities and trust is really important. And you're right, we did lose significant staff members following COVID. 

However, there's broader factors at play internationally and also nationally. We've seen particularly since COVID a rise in vaccine hesitancy and sadly also misinformation and disinformation about the effectiveness of vaccines. I think all of those have played a part. Quite pleasingly, we're seeing quite a strong community demand currently for vaccination in the context of this outbreak. 

SARAH FERGUSON:  And just a question on your more vulnerable populations in the Northern Territory, what role is housing overcrowding playing in the transmission of the disease? 

PAUL BURGESS:  Look, it's a really important respect to the epidemiology of this outbreak. And the Northern Territory sadly is 95 per cent of cases have been in our NT Aboriginal population, predominantly in remote areas of the Northern Territory. 

In those you'd be well aware of the living conditions, so quite often in overcrowded housing. And that is a potent stimulant for transmission of diphtheria, unfortunately. 

SARAH FERGUSON:  And right now, in terms of those cases that you have and that we are seeing in other states in the country, how quickly are you able to get therapeutics to people to make people better, to slow down the spread? 

PAUL BURGESS:  Yeah, look, diphtheria is an uncommon bacterial infection. It's treatable with antibiotics and vaccination is effective for preventing severe illness. 

The diphtheria bacteria produces a toxin and the vaccination is important to protect against the effects of that toxin and doesn't a 100 percent prevent transmission. So we need both, the antibiotic treatment and the vaccination to really terminate this outbreak. 

And I think what we're seeing now is earlier presentations, people who aren't as sick, there's broader understanding in the community, but also broader recognition with our clinical workforce. So we are seeing cases and treating them earlier. 

SARAH FERGUSON:  Dr. Paul Burgess, thank you very much indeed for joining us. 

PAUL BURGESS:  My pleasure.