The Laboratory Virology and Serology Reporting Scheme, 1991 to 2000

The Laboratory Virology and Serology (LabVISE) Reporting Scheme is a passive surveillance scheme based on voluntary reports of infectious agents contributed by virology and serology laboratories around Australia. This article reports on the LabVISE data collected between 1991 and 2000 and was published in Communicable Diseases Intelligence Vol 26 No 3, September 2002. This article can be viewed in 15 HTML documents and is also available in PDF format.

Page last updated: 03 October 2002

A print friendly PDF version is available from this Communicable Diseases Intelligence issue's table of contents.


Results - Part A: General results, continued

Diagnosis

Data on diagnosis were available for 335,001 (98%) records from the study period. Of these 96,253 were coded as 'no clinical information available' and another 20,592 were coded as 'other diagnosis'. The 10 most common diagnoses (of 62 diagnostic categories accepted in LabVISE), which make up 201,959 or 90 per cent of the remaining 223,205 records are shown in Table 5.

Table 5. The 10 most common diagnoses for which samples were submitted for testing to LabVISE laboratories, 1991 to 2000

Code
Diagnosis description
n %
59 Genital disease (including sexually transmitted infections)
39,860
17.9
06 Superficial skin or mucous membrane diseases
36,677
16.4
02 Lower respiratory tract infection
36,320
16.3
11 Respiratory tract infection - unspecified
23,590
10.6
07 Gastrointestinal disease
23,177
10.4
01 Upper respiratory tract infection
20,781
9.3
17 Hepatitis
7,045
3.6
29 Bone/joint disease
5,541
2.5
G8 Malaise - general and/or mild fever
4,537
2.0
08 High fever
4,431
2.0


Although samples submitted to LabVISE for investigations of genital (STI) disease make up the largest single category, the combined number of investigations of respiratory disease total 80,691 or 36 per cent of the total. It should be noted that the diagnostic descriptions are very broadly defined and the analysis that follows should be interpreted with caution.

The most frequently reported organisms in samples from patients with the 10 most common diagnoses are shown in Table 6.

Table 6. The 10 most frequently isolated organisms in the 10 most frequently reported clinical diagnoses, LabVISE, 1991 to 2000

Genital diseases (n= 39,860) Skin/mucous membrane disease (n=36,677)
Rank
Virus/organism
Reports Rank
Virus/organism
Reports
1
Chlamydia trachomatis
18,208
1
Herpes simplex type   1†
12,029
2
Herpes simplex type   2†
14,257
2
Herpes simplex type   2†
8,596
3
Herpes simplex type   1†
5,539
3
Varicella-zoster virus
7,702
4
Herpes simplex (not typed)†
743
4
Rubella
1,768
5
Treponema pallidum
517
5
Herpes (not typed)
1,338
6
Neisseria gonorrhoeae
178
6
Ross River virus
1,324
7
Cytomegalovirus
89
7
Measles virus
1,253
8
Varicella-zoster virus
67
8
Parvovirus
601
9
Chlamydia trachomatis A-K
35
9
Enterovirus (untyped)
322
10
Chlamydia spp.
35
10
Epstein-Barr virus
173
Lower respiratory tract infection (n=36,320) Respiratory tract infection - unspecified (n=23,590)
Rank
Virus/organism
Reports Rank
Virus/organism
Reports
1
Respiratory syncytial virus
16,349
1
Respiratory syncytial virus
9,202
2
Mycoplasma pneumoniae
3,750
2
Influenza A
2,259
3
Influenza A
3,367
3
Adenovirus (untyped)
1,629
4
Parainfluenza virus type   3
2,255
4
Parainfluenza virus type   3
1,455
5
Rhinovirus
1,753
5
Mycoplasma pneumoniae
1,441
6
Cytomegalovirus
1,699
6
Rhinovirus
1,303
7
Adenovirus (untyped)
1,163
7
Enterovirus (untyped)
1,013
8
Influenza B
1,093
8
Cytomegalovirus
880
9
Bordetella pertussis
690
9
Influenza B
615
10
Parainfluenza virus type   1
478
10
Bordetella pertussis
563
Gastrointestinal disease (n=23,177) Upper respiratory tract infection (n=20,781)
Rank
Virus/organism
Reports Rank
Virus/organism
Reports
1
Rotavirus
15,887
1
Respiratory syncytial virus
5,358
2
Adenovirus (untyped)
3,033
2
Bordetella pertussis
2,913
3
Enterovirus (untyped)
1,865
3
Rhinovirus
1,898
4
Human calicivirus*
683
4
Epstein-Barr virus
1,720
5
Adenovirus type   40
188
5
Parainfluenza virus type   3
1,336
6
Cytomegalovirus
161
6
Influenza A
1,225
7
Adenovirus type   2
111
7
Cytomegalovirus
988
8
Poliovirus (untyped)
87
8
Adenovirus (untyped)
919
9
Adenovirus type   1
68
9
Enterovirus (untyped)
618
10
Coronavirus
59
10
Parainfluenza virus type   1
587
Hepatitis (n=7,045) Bone/joint disease (n=5,541)
Rank
Virus/organism
Reports Rank
Virus/organism
Reports
1
Hepatitis C†
2,805
1
Ross River virus
4,296
2
Hepatitis A
1,890
2
Barmah Forest virus
308
3
Hepatitis B antibody†
1,832
3
Parvovirus
176
4
Epstein-Barr virus
124
4
Rubella
123
5
Cytomegalovirus
124
5
Streptococcus A
119
6
Hepatitis D
103
6
Epstein-Barr virus
72
7
Coxiella burnetii
29
7
Influenza A
55
8
Hepatitis B antigen†
23
8
Cytomegalovirus
55
9
Chlamydia trachomatis
19
9
Coxiella burnetii
49
10
Hepatitis E
17
10
Dengue type   2
40
Malaise (n=4,537) High fever (n=4,431)
Rank
Virus/organism
Reports Rank
Virus/organism
Reports
1
Epstein-Barr virus
710
1
Ross River virus
1,270
2
Cytomegalovirus
699
2
Epstein-Barr virus
458
3
Ross River virus
602
3
Cytomegalovirus
380
4
Coxiella burnetii
236
4
Influenza A
280
5
Influenza A
192
5
Respiratory syncytial virus
210
6
Hepatitis C†
152
6
Coxiella burnetii
185
7
Mycoplasma pneumoniae
145
7
Adenovirus (untyped)
138
8
Rubella
143
8
Mycoplasma pneumoniae
138
9
Influenza B
141
9
Barmah Forest virus
127
10
Barmah Forest virus
125
10
Enterovirus (untyped)
99

* Combines Norwalk like virus, small round virus and human calicivirus
† Data collected up to 1996 only.

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The ranking of organisms identified in different diagnoses over a 10-year period includes a number of pathogens no longer under surveillance through LabVISE. Among samples submitted with a primary diagnosis of genital disease, herpes simplex viral identifications combined comprise 20,539 (51% of the total), although data on herpesvirus were not included in LabVISE after 1996. Since the late 1970s the prevalence of herpes simplex type 2 (HSV-2) infections increased by 30 per cent in the United States of America (USA) and HSV-2 infects an estimated 86 million people worldwide.6

Among respiratory infections, respiratory syncytial virus was most frequently identified in cases of all kinds of respiratory infection, while rotavirus was the predominant organism identified in cases of gastroenteritis. Cases of hepatitis tested in LabVISE were predominantly hepatitis C, although reporting of this pathogen to the system ceased in 1996.

Specimens processed and methods used

Although data fields for type of specimen and methods used for the diagnosis were no longer required in LabVISE after 1996, many laboratories continued to send these data fields. The 10 most common specimens received by LabVISE and the 10 most common methods used in LabVISE laboratories for the detection of antigens and antibodies are shown in Tables 7, 8 and 9.

Table 7. The 10 most common specimens received by LabVISE, 1991 to 2000

Rank
Specimen
n %
1 Blood
80,019
25.0
2 Nasopharyngeal swab or aspirate
54,657
17.1
3 Other
42,937
13.4
4 Genital swab
42,782
13.4
5 Serum
34,039
10.6
6 Skin
25,462
8.0
7 Faeces/rectal swab
23,572
7.4
8 Urine
6,367
2.0
9 Eye
3,457
1.1
10 Cerebrospinal fluid
2,196
0.7


Table 8. The 10 most common methods used to detect microbial antigens in LabVISE laboratories, 1991 to 2000

Rank
Antigen description
n %
1 Immunofluorescence
69,646
29.5
2 Enzyme-linked immunosorbent assay
38,221
16.2
3 Light microscopy
36,955
15.7
4 Immunoenzymatic techniques
33,138
14.0
5 Nucleic acid detection
18,354
7.8
6 Radio-immunoassay
17,547
7.4
7 Electronic microscopy
8,487
3.6
8 Other
3,862
1.6
9 Growth characteristics
2,935
1.2
10 Latex agglutination
2,899
1.2


Table 9. The 10 most common methods used to detect antibodies in LabVISE, 1991 to 2000

Rank
Antibody description
n %
1 Enzyme-linked immunosorbent assay
71,611
42.3
2 Complement fixation
31,598
18.7
3 Immunofluorescence
26,001
15.3
4 Immunoenzymatic techniques
15,591
9.2
5 Other
9,165
5.4
6 Haemagglutination
3,230
1.9
7 Haemagglutination inhibition
3,169
1.9
8 Slide/tube agglutination
2,473
1.5
9 Radioimmunoassay
2,308
1.4
10 Latex agglutination
2,156
1.3


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Pathogens under surveillance in LabVISE, 1991 to 2000

A complete list of pathogens under surveillance for this report is shown in Appendix 3 and is summarised in Table 10.

Table 10. Summary of pathogens under surveillance in LabVISE, 1991 to 2000

Pathogen group
Specific pathogens
Measles, mumps, rubella Measles, mumps and rubella viruses
Hepatitis viruses Hepatitis A, D and E
Arboviruses Ross River virus, Barmah Forest virus, dengue (type 1 to 4), Murray Valley encephalitis virus, Kunjin virus, Japanese encephalitis virus, Kokobera virus, Stratford virus and flavivirus (unspecified)
Adenovirus Types 1-17, 19, 21-22, 24, 26-32, 34, 35, 37, 40-47
Herpesviruses Herpesvirus type   6, cytomegalovirus, varicella-zoster virus, Epstein-Barr virus
Other DNA viruses Parvovirus, papovavirus, molluscum contagiosum, orf virus, poxvirus
Picornavirus Coxsackievirus, echovirus, poliovirus, rhinovirus, enterovirus
Ortho/paramyxovirus Influenza, parainfluenza, respiratory syncytial virus
Other RNA virus Rotavirus, astrovirus, reovirus (unspecified), calicivirus/Norwalk agent, coronavirus, small virus-like particles
Other non-viral pathogens Chlamydia, Mycoplasma, Rickettsia, Streptococcus, Yersinia, Brucella, Bordetella, Legionella, Leptospira, Cryptococcus, Treponema, Entamoeba, Toxoplasma, Echinococcus


The totals for each year for each pathogen group are shown in Table 11. Figure 3 shows the relative proportions of each pathogen group in the total dataset.

Table 11. Total number of reports to LabVISE, 1991 to 2000, by pathogen group and year and percentage of each year's total

Pathogen group
  1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 Total
Measles, mumps, rubella n
%
534
2.7
1,005
4.0
1,856
6.6
2,464
8.8
957
4.1
810
2.9
469
1.6
196
0.8
375
1.4
144
0.6
8,810
3
Hepatitis viruses n
%
482
2.5
417
1.6
510
1.8
393
1.4
455
1.9
426
1.5
643
2.3
392
1.7
384
1.5
159
0.6
4,261
2
Arboviruses n
%
955
5.0
2,013
8.0
2,744
9.7
2,577
9.2
1,271
5.4
3,570
12.8
2,311
8.1
872
3.7
1,726
6.5
1,682
7.1
19,721
8
Adenovirus n
%
1,518
7.9
1,722
6.9
1,885
6.7
1,542
5.5
1,182
5.0
1,382
4.9
1,017
3.6
1,162
5.0
1,309
5.0
1,205
5.1
13,924
5
Herpesviruses n
%
3,706
19.2
4,039
16.1
4,059
14.4
4,311
15.4
4,367
18.5
4,589
16.4
4,426
15.5
3,923
16.9
5,090
19.2
4,738
20.0
43,248
17
Other DNA viruses n
%
67
0.3
206
0.8
109
0.4
121
0.4
121
0.5
282
1.0
310
1.1
272
1.2
474
1.8
414
1.7
2,376
1
Picornavirus n
%
1,902
9.9
2,341
9.3
2,630
9.3
2,678
9.5
1,885
8.0
1,559
5.6
1,119
3.9
1,190
5.1
1,631
6.2
1,527
6.4
18,462
7
Ortho/paramyxovirus n
%
3,833
19.9
5,981
23.8
5,432
19.2
6,244
22.2
6,129
26.0
6,992
25.0
8,782
30.8
8,261
35.5
6,238
23.6
5,604
23.6
63,496
25
Other RNA virus n
%
2,832
14.7
2,277
9.1
2,090
7.4
2,332
8.3
1,693
7.2
1,582
5.7
1,522
5.3
1,444
6.2
2,322
8.8
1,864
7.9
19,958
8
Other non-viral pathogens n
%
3,458
17.9
5,135
20.4
6,904
19.3
5,406
24.5
5,528
23.4
6,798
24.2
7,919
27.8
5,547
23.1
6,928
26.2
6,374
27.0
59,997
24


Figure 3. Laboratory reports to LabVISE, 1991 to 2000, by pathogen group

Figure 3. Laboratory reports to LabVISE, 1991 to 2000, by pathogen group

In the study period, reports of non-viral pathogens increased from 17.9 per cent to 27 per cent of the annual reports to LabVISE. Among viral pathogens, ortho/paramyxoviruses made up on average 25 per cent of the annual reports, herpesviruses 17 per cent and other RNA viruses 8 per cent.


This article was published in Communicable Diseases Intelligence Volume 26, No 3, September 2002

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