title: The risk of Ross River and Barmah Forest virus disease in Queensland: implications for New Zealand.
abstract: OBJECTIVE
  To describe the incidence of Ross River (RR) and Barmah Forest (BF) virus disease in Queensland and determine the risk of importation of RR virus from Queensland into New Zealand (NZ) via viraemic travellers.
  
  
  METHODS
  Based on routine RR and BF virus notification data of seven major urban tropical and subtropical Queensland populations, incidence rates adjusted for age, sex, season and a baseline level of immunity were used to examine the annual and seasonal risk of disease in the specific populations and selected subgroups. The risk for NZ was determined by estimating the number of infections among major visitor groups travelling from Queensland to NZ, using seroconversion rates.
  
  
  RESULTS
  In Queensland, annual rates of RR and BF virus disease ranged between 31.5-288.3 and 3.4-37.4/100,000 person years respectively and increased to between 48.4-423.5 and 3.8-40.4/100,000 person years at risk when adjusted for immunity. Our estimates indicate that more than 100 viraemic travellers may enter NZ from Queensland each year. Estimates were greatest among New Zealanders returning home.
  
  
  CONCLUSIONS
  Usefulness of notification data could be maximised by presenting more detailed information to the local governments responsible for the control and public health awareness of these pathogens. Given the high number of viraemic persons entering NZ, the abundance of possums and the emergence of Oc. camptorhynchus, transmission of RR virus within NZ is probable. Health authorities should prepare for a virgin soil epidemic of RR virus by initiating serological and clinical surveillance in key areas, enhance public and professional awareness and elevate national resources necessary to invoke emergency vector control and case management.
authors.affiliation: Queensland Institute of Medical Research and the Australian Centre for International and Tropical Health and Nutrition, University of Queensland. louiseKe@qimr.edu.au
authors.forename: Louise A
authors.initials: LA
authors.lastname: Kelly-Hope
authors.forename: Brian H
authors.initials: BH
authors.lastname: Kay
authors.forename: David M
authors.initials: DM
authors.lastname: Purdie
authors.forename: Gail M
authors.initials: GM
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000524:Alphavirus / Q000302:isolation & purification*; D018354:Alphavirus Infections / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D011634:Public Health; D011793:Queensland / Q000453:epidemiology; D018570:Risk Assessment; D012398:Ross River virus / Q000302:isolation & purification*