Epidemiology is the study of health and disease across the population and the application of findings to support the control of health problems. The NCCTRC and AUSMAT epidemiology team are experienced in assisting a range of preparedness and emergency response activities, with a focus on communicable diseases. The three pillars of the epidemiological work performed are surveillance, field investigation and research.
The role of epidemiology in disaster preparedness is to understand the needs of affected populations, the nature of potential disease or exposure, and implement or adapt effective control activities.
Aligning and agreeing on key information during outbreaks and emergency response is critical.
The NCCTRC and AUSMAT work closely with local partners and key stakeholders to understand local epidemiology, and the key components of understanding of the pattern of infection or disease in affected populations. This includes national ministries of health, local authorities and international institutions such as the World Health Organization.
Research uses more rigorous methods to investigate health problems and evaluate surveillance, health programs and health policy. The NCCTRC and AUSMAT focuses on operational research (also known as implementation science) to inform continuous improvement, preparedness and improve global understanding through contributing to scientific literature on emergency operations.
Key steps in operational research are study design (determine the appropriate methods to answer the research question of interest), investigation (data collection and management), analysis (descriptive, predictive and prescriptive), and interpretation (using findings to make recommendations).
Disasters have the potential to increase the frequency of some infectious diseases due to population displacement, overcrowding, inadequate shelter, insufficient and unsafe water and inadequate sanitation. Major diseases encountered and managed in the work of NCCTRC and AUSMAT include:
- Acute respiratory tract infections (including pneumonia)
- Diarrheal diseases
- Hepatitis A and E
- Meningococcal disease
- Louse-borne typhus
- Yellow fever
- Visceral or cutaneous leishmaniasis
- Viral haemorrhagic fevers
Disease surveillance enables the rapid identification of, and response to, potential and active disease outbreaks to contain the outbreak, prevent illness and save lives. Surveillance also captures key indicators essential to understanding a public health emergency, such as coverage of immunisation, immunity in a population through serosurveillance, and disease outcomes of hospitalisation and mortality. The NCCTRC and AUSMAT work closely with local stakeholders to identify the surveillance indicators of interest, establish or enhance the scope of surveillance, implement early warning systems, improve the quality of data, and upskill decision makers to analyse and use the data.
Following the identification of a disease outbreak or changes in the established indicators (for example, immunisation coverage or hospitalisations with a disease), field investigation commences to identify additional cases of the infection or disease, determine the mode of transmission, determine source of acquisition and assess exposure and potential risk, to prevent further transmission and mitigate impact on the community. Field investigation commonly involves upstream (who infected the case) and downstream (who may get sick in future) contact tracing and uses data collected from surveillance systems.
Partnership with Global Outbreak Alert and Response Network (GOARN)
The NCCTRC are part of the Global Outbreak Alert and Response Network (GOARN), which responds to public health emergencies with the deployment of multidisciplinary staff and resources to affected countries. The GOARN is coordinated by the World Health Organization and made up of 270 partners in technical and public health institutions, laboratories, NGOs, and other organisations that respond to outbreak and emergency response. As a GOARN partner, NCCTRC and AUSMAT contribute their clinical, public health and epidemiological expertise for preparedness and outbreak response in affected countries.