Australian Paediatric Surveillance Unit (APSU) Annual Surveillance Report 2025
DOI:
https://doi.org/10.33321/cdi.2026.50.052Keywords:
adolescent, Australia, child, communicable diseases, infant, public health surveillance, rare diseasesAbstract
For over 30 years, the Australian Paediatric Surveillance Unit (APSU) has conducted national prospective surveillance of rare conditions in children, including communicable diseases and complications, providing data that has informed changes to policy and clinical practice. In 2025, the APSU monitored seven rare communicable diseases and complications: acute flaccid paralysis (AFP); perinatal exposure to human immunodeficiency virus (HIV); paediatric HIV infection; juvenile-onset recurrent respiratory papillomatosis (JoRRP); congenital rubella infection/syndrome; congenital varicella syndrome (CVS); and neonatal varicella infection (NVI). An average of 1,313 paediatricians and other relevant clinical specialists received a report card each month listing rare conditions under APSU surveillance (including the seven described in this report), and completed a case report form for any child(ren) seen with one or more of these conditions, detailing demographics, clinical features, treatment/management, risk factors and short-term outcomes. There were 134 notifications, of which 105 were confirmed as cases, after excluding duplicate reports or errors. The annual response rate to the report card was 78.4%. The non-polio AFP incidence of 1.58 per 100,000 children aged < 15 years exceeded the World Health Organization requirement to maintain Australia’s polio-free status. Incidence of perinatal exposure to HIV remained stable, but new paediatric HIV infections increased. While there were no cases of congenital rubella or CVS, three cases of NVI and one case of JoRRP were reported, indicating ongoing gaps in vaccination despite two decades of universal vaccination in Australia. Continued APSU surveillance remains essential to assess the prevention of disease occurrence and adverse outcomes.
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References
Elliott EJ, Teutsch SM, Nunez CN, Morris A, Eslick GD, for the APSU Investigators and Contributors. Improving knowledge of rare disorders since 1993: the Australian Paediatric Surveillance Unit. Arch Dis Child. 2024;109(12):967–79. doi: https://doi.org/10.1136/archdischild-2023-326116.
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81. doi: https//doi.org/10.1016/j.jbi.2008.08.010.
Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O'Neal L et al. The REDCap consortium: building an international community of software platform partners. J Biomed Inform. 2019;95:103208. doi: https://doi.org/10.1016/j.jbi.2019.103208.
Kaye M, Hobday L, Bruggink L, McKenzie J, Nong Y, Thorley B. Australian National Enterovirus Reference Laboratory annual report, 2024. Commun Dis Intell (2018). 2025;49. doi: https://doi.org/10.33321/cdi.2025.49.047.
Thorley B, Hobday L, Morris A, Britton P. Surveillance for poliovirus is just as important as ever. Intern Med J. 2026;56(2):157−60. doi: https://doi.org/10.1111/imj.70360.
World Health Organization (WHO). Vaccine preventable diseases surveillance standards: poliomyelitis. Geneva: WHO; 4 September 2018. [Accessed on 13 March 2026.] Available from: https://www.who.int/publications/m/item/vaccine-preventable-diseases-surveillance-standards-polio.
World Health Organization Regional Office for the Western Pacific (WPRO). Polio Bulletin 2025. [Webpage.] Manila: WPRO; 2025. [Accessed on 19 March 2026.] Available from: https://iris.who.int/handle/10665/380438.
Australian Bureau of Statistics. National, state and territory population. Reference period: June 2025. [Webpage.] Canberra: Australian Bureau of Statistics; 18 December 2025. [Accessed on 6 March 2026.] Available from: https://www.abs.gov.au/statistics/people/population/national-state-and-territory-population/jun-2025.
Australian Institute of Health and Welfare (AIHW). Australia's mothers and babies. [Web report.] Canberra: AIHW; 31 July 2025. [Accessed on 5 March 2026.] Available from: https://www.aihw.gov.au/reports/mothers-babies/australias-mothers-babies.
Teutsch S, Nunez C, Morris A, Elliott EJ, on behalf of Chief Investigators of APSU. Australian Paediatric Surveillance Unit (APSU) Annual Surveillance Report 2024. Commun Dis Intell (2018). 2026;50. doi: https://doi.org/10.33321/cdi.2026.50.007.
Palasanthiran P. Human Immunodeficiency virus. In Palasanthiran P, Starr M, Jones C, Giles M, eds. Management of perinatal infections (3rd edition). Sydney: ASID, 2022;43–50.
Zurynski Y, Davey E, Elliott EJ. Australian Paediatric Surveillance Unit annual report, 2008 and 2009. Commun Dis Intell Q Rep. 2010;34(3):285−90. doi: https://doi.org/10.33321/cdi.2010.34.28.
Teutsch SM, Nunez CA, Morris A, Eslick GD, Elliott EJ. Australian Paediatric Surveillance Unit (APSU) Annual Surveillance Report 2023. Commun Dis Intell (2018). 2025;49. doi: https://doi.org/10.33321/cdi.2025.49.019.
Teutsch S, Nunez C, Morris A, Eslick GD, Elliott EJ. Australian Paediatric Surveillance Unit (APSU) Annual Surveillance Report 2022. Commun Dis Intell (2018). 2023;47. doi: https://doi.org/10.33321/cdi.2023.47.46. Erratum in: Commun Dis Intell (2018). 2023;47. doi: https://doi.org/10.33321/cdi.2023.47.64.
European Collaborative Study. HIV-infected pregnant women and vertical transmission in Europe since 1986. AIDS. 2001;15(6):761−70. Available from: https://journals.lww.com/aidsonline/abstract/2001/04130/hiv_infected_pregnant_women_and_vertical.12.aspx.
Jones R, Gazzard B, Halima Y. Preventing HIV infection. BMJ. 2005;331(7528):1285−6. doi: https://doi.org/10.1136/bmj.331.7528.1285.
Townsend CL, Cortina-Borja M, Peckham CS, de Ruiter A, Lyall H, Tookey PA. Low rates of mother-to-child transmission of HIV following effective pregnancy interventions in the United Kingdom and Ireland, 2000–2006. AIDS. 2008:22(8):973–81. doi: https://doi.org/10.1097/QAD.0b013e3282f9b67a.
Teutsch SM, Nunez CA, Morris A, Eslick GD, Khandaker G, Berkhout A et al. Australian Paediatric Surveillance Unit (APSU) Annual Surveillance Report 2020. Commun Dis Intell (2018). 2021;45. doi: https://doi.org/10.33321/cdi.2021.45.59.
King J, Kwon J, Gray R, McManus H, McGregor S. HIV, viral hepatitis and sexually transmissible infections in Australia: Annual surveillance report 2025. Sydney: University of New South Wales, Kirby Institute; 2025. [Accessed on 6 March 2026.] Available from: https//www.kirby.unsw.edu.au/research/reports/asr2025.
Novakovic D, Cheng ATL, Zurynski Y, Booy R, Walker PJ, Berkowitz R et al. A prospective study of the incidence of juvenile-onset recurrent respiratory papillomatosis after implementation of a national HPV vaccination program. J Infect Dis. 2018;217(2):208–12. doi: https://doi.org/10.1093/infdis/jix498.
National Centre for Immunisation Research and Surveillance (NCIRS). Significant events in human papillomavirus (HPV) vaccination practice in Australia. Sydney: Sydney Children’s Hospital Network, NCIRS; March 2025. [Accessed on 30 March 2026.]
Australian Centre for Disease Control (Australian CDC). National Notifiable Disease Surveillance System (NNDSS) data visualisation tool. [Webpage.] Canberra: Australian CDC; 3 October 2025. [Accessed on 27 March 2026.] Available from: https://www.cdc.gov.au/resources/apps-and-tools/nndss-data-visualisation-tool.
Deverell M, Phu A, Zurynski YA, Elliott EJ, all chief investigators of APSU surveillance studies. Australian Paediatric Surveillance Unit annual report, 2015. Commun Dis Intell Q Rep. 2017;41(2):E181–5. doi: https://doi.org/10.33321/cdi.2017.41.22.
NCIRS. Significant events in measles, mumps and rubella vaccination practice in Australia. Sydney: Sydney Children’s Hospital Network, NCIRS; July 2025. [Accessed on 30 March 2026.]
Khandaker G, Zurynski Y, Jones C. Surveillance for congenital rubella in Australia since 1993: cases reported between 2004 and 2013. Vaccine. 2014;32(50):6746–51. doi: https://doi.org/10.1016/j.vaccine.2014.10.021.
WHO. Singapore wipes out measles; Australia, Brunei Darussalam and Macao SAR (China) eliminate rubella. [Media release.] Geneva: WHO; 31 October 2018. [Accessed on 27 March 2026.] Available from: https://www.who.int/news/item/31-10-2018-singapore-wipes-out-measles-australia-brunei-darussalam-and-macao-sar-(china)-eliminate-rubella.
Glynn-Robinson A, Knapp JK, Durrheim DN. How Australia's measles control activities have catalyzed rubella elimination. Int J Infect Dis. 2022;114:72–8. doi: https://doi.org/10.1016/j.ijid.2021.11.003.
NCIRS. Significant events in varicella vaccination practice in Australia. Sydney: Sydney Children’s Hospital Network, NCIRS; July 2018. [Accessed on 30 March 2026.] Available from: https://www.ncirs.org.au/sites/default/files/2018-11/Varicella-history-July-2018.pdf.
Khandaker G, Marshall H, Peadon E, Zurynski Y, Burgner D, Buttery J et al. Congenital and neonatal varicella: impact of the national varicella vaccination programme in Australia. Arch Dis Child. 2011;96(5):453−6. doi: https://doi.org/10.1136/adc.2010.206037.
Walker J, Teutsch S, Morris A, Eslick GD, Al Imam MH, Khan A et al. Active prospective national surveillance for congenital and neonatal varicella in Australia shows potential prevention opportunities. Vaccine X. 2023;13:100278. doi: https://doi.org/10.1016/j.jvacx.2023.100278.
Elliott EJ, Robins-Browne RM, O'Loughlin EV, Bennett-Wood V, Bourke J, Henning P et al. Nationwide study of haemolytic uraemic syndrome: clinical, microbiological, and epidemiological features. Arch Dis Child. 2001;85(2):125–31. doi: https://doi.org/10.1136/adc.85.2.125.
Buttery JP, Danchin MH, Lee KJ, Carlin JB, McIntyre PB, Elliott EJ et al. Intussusception following rotavirus vaccine administration: post-marketing surveillance in the National Immunization Program in Australia. Vaccine. 2011;29(16):3061−6. doi: https://doi.org/10.1016/j.vaccine.2011.01.088.
McMullan BJ, Palasanthiran P, Jones CA, Hall BM, Robertson PW, Howard J et al. Congenital cytomegalovirus–time to diagnosis, management and clinical sequelae in Australia: opportunities for earlier identification. Med J Aust. 2011;194(12):625−9. doi: https://doi.org/10.5694/j.1326-5377.2011.tb03144.x.
WHO, Global Polio Eradication Initiative. Global Polio Surveillance Action Plan 2025–2026. Geneva: WHO; 2025. [Accessed on 20 March 2026.] Available from: https://polioeradication.org/global-polio-surveillance-action-plan-2025-2026-2.
Kennett ML, Brussen KA, Wood DJ, van der Avoort HG, Ras A, Kelly HA. Australia's last reported case of wild poliovirus infection. Commun Dis Intell. 1999;23(3):77–9. doi: https://doi.org/10.33321/cdi.1999.23.9.
Stewardson AJ, Roberts JA, Beckett CL, Prime HT, Loh PS, Thorley BR et al. Imported case of poliomyelitis, Melbourne, Australia, 2007. Emerg Infect Dis. 2009;15(1):63−5. doi: https://doi.org/10.3201/eid1501.080791.
WHO. Disease Outbreak News: Circulating vaccine-derived poliovirus type 2 (cVDPV2) – Papua New Guinea. [Media release.] WHO: Geneva; 20 May 2025 [Accessed on 26 March 2026.] Available from: https://www.who.int/emergencies/disease-outbreak-news/item/2025-DON571.
Hull B, Hendry A, Macartney K, Beard F. Annual Immunisation Coverage Report 2024. Commun Dis Intell (2018). 2026;50. doi: https://doi.org/10.33321/cdi.2026.50.023.
Girotto J. Polio vaccination rates in some areas of the US hover dangerously close to the threshold required for herd immunity – here’s why that matters. [Online article.] Melbourne: The Conversation Media Group Ltd, The Conversation; 21 September 2022. [Accessed on 30 April 2026.] doi: https://doi.org/10.64628/AAI.ejeyg6cpc.
Longbottom K, Lyall H. Neonatal varicella. Arch Dis Child. 2024;109(8):610−5. doi: https://doi.org/10.1136/archdischild-2022-324820.
Accelerating measles and rubella elimination in southeast Asia. [Editorial.] Lancet Reg Health Southeast Asia. 2025;41:100682. doi: https://doi.org/10.1016/j.lansea.2025.100682.
WHO. Strategic Plan for measles and rubella elimination and sustenance in the WHO South-East Asia Region: 2024–2028. New Delhi: WHO Regional Office for South-East Asia. [Accessed on 19 February 2026.] Available from: https://www.who.int/publications/i/item/9789290229476.
Gailani AE, Dehority W, Katz SE. Clinical progress note: Rubella. J Hosp Med. 2026;21(2):179−82. doi: https://doi.org/10.1002/jhm.70169.
Shykhon M, Kuo M, Pearman K. Recurrent respiratory papillomatosis. Clin Otolaryngol Allied Sci. 2002;27(4):237−43. doi: https://doi.org/10.1046/j.1365-2273.2002.00555.x.
WHO. Global health sector strategies on, respectively, HIV, viral hepatitis and sexually transmitted infections for the period 2022–2030. Geneva: WHO; 18 July 2022. [Accessed on 27 March 2026.] Available from: https://www.who.int/publications/i/item/9789240053779.
WHO. Introducing a framework for implementing triple elimination of mother-to-child transmission of HIV, syphilis and hepatitis B virus: policy brief. Geneva: WHO; 1 March 2024. [Accessed on 27 March 2026.] Available from: https://www.who.int/publications/i/item/9789240086784.
WHO, United Nations Children’s Fund (UNICEF). Country guidance for planning triple elimination of mother-to-child transmission of HIV, syphilis and hepatitis B virus programmes. Geneva: WHO; 14 July 2025. [Accessed on 27 March 2026.] Available from: https://www.who.int/publications/i/item/9789240112490.
Hengel B, McManus H, Monaghan R, Mak DB, Bright A, Tolosa X et al. Notification rates for syphilis in women of reproductive age and congenital syphilis in Australia, 2011–2021: a retrospective cohort analysis of national notifications data. Med J Aust. 2024;221(4):201−8. doi: https://doi.org/10.5694/mja2.52388.
Hanson J, Radlof S, Coffman J, Lort-Phillips K, Smith S, Hempenstall A et al. Mother-to-child transmission of hepatitis B in Far North Queensland, 2013–2023. Commun Dis Intell (2018). 2025;49. doi: https://doi.org/10.33321/cdi.2025.49.026.
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