Townsville Public Health Unit
Phone 4433 6900
13 November 2023
Dear Doctor
Public Health alerts: APSGN, measles, pertussis Shortage of Bicillin LA®
There have been several recent cases of acute post-streptococcal glomerulonephritis (APSGN) in North Queensland, mainly in Indigenous communities. APSGN can occur in outbreaks following circulation of ‘nephritogenic’ strains in Group A strep skin and throat infections.
APSGN has recently become a Notifiable Condition on suspected diagnosis. This means doctors must tell Public Health without relying on lab notification processes.
Most APSGN cases are between one and 16 years of age. Look for at least two of:
- facial and / or peripheral oedema
- microscopic or macroscopic haematuria
- hypertension, according to age / sex / height percentiles.
Take bacterial swabs of the throat and any skin sores. Work-up includes urgent Paediatric referral with GAS serology and complement levels.
There is a national shortage of long-acting Benzathine Benzylpenicillin. Most stock is reserved for RHD patients and infectious syphilis, making control of APSGN clusters and GAS skin infections difficult. Information about Bicillin alternatives is at https://bit.ly/3FZjMGp or contact QLD Antimicrobial Stewardship Hotline on 1300 753 229.
There have been recent North Queensland notifications of:
- Measles (with extensive community exposures in Cairns during the infectious period)
- Pertussis (expected to be a national surge in cases)
Make sure all your patients have at least two recorded doses of a measles vaccine and catch-up infants and older persons who are behind with their primary pertussis course or boosters.
Please notify your local public health unit of any suspected cases.
Yours sincerely,
Dr Steven Donohue
Director & Public Health Physician, Townsville Public Health Unit
