Re-writing infection prevention and disease control for Australia

Professor Ramon Shaban stands as a prominent internationally credentialed expert in infection control, showcasing notable strengths in high-consequence infectious diseases, disease control, emergency care, and health protection.

As the Clinical Chair of Communicable Diseases Control and Infection Prevention at the University of Sydney and the Western Sydney Local Health District, he leads the direction and execution of infection prevention and disease control strategies.  

Professor Shaban has played an important role in shaping the way healthcare workers around Australia approach infection prevention and disease control, contributing valuable insights and expertise to elevate standards and ensure a more resilient and responsive healthcare system.

Professor Shaban, along with his team, played a pivotal role in identifying and managing the first cases of COVID-19 in New South Wales at Westmead Hospital. 

“Towards the end of 2019, my team and I began receiving information through our networks about the emergence of a new pathogen, initially referred to as the novel coronavirus,” says Professor Shaban.

In early 2020, the Westmead team initiated processes to identify cases, implementing laboratory testing methods specifically designed for this virus.  

The focus also extended to identifying at-risk individuals, characterised during the early stages of the pandemic by specific epidemiological factors, with travel from endemic areas, primarily Wuhan, China, being a key early risk factor for what later became known as COVID-19.

“As the pandemic spread to other areas around the world, we had to examine criteria for individuals who presented with a clinical illness consistent with this condition coupled with pertinent epidemiological risk factors,” says Professor Shaban. 

“In the early months of 2020, we set up these systems and identified the first cases of COVID-19 in the state. It was at this time that the processes began for the local and then state-based response for New South Wales more broadly.”

Professor Shaban and his team published two research papers on this experience.  

The first spearheaded by Professor Shaban on the early response to COVID-19 in Australia, focusing on the first cases in Queensland, New South Wales, Victoria, and South Australia. Their studies examined the presenting characteristics of the COVID-19 cases and analysed the measures taken by states and territories to respond to the infection and subsequent epidemic. 

Additionally, Professor Shaban and his team conducted a study exploring the lived experience of COVID-19 in the first patients in New South Wales. The research aimed to understand the impact on patients, families, and the healthcare system, recognising the stress associated with emerging infections and ensuring a comprehensive understanding of the conditions and responses. 

“We wanted to make sure we understood what it was like to have this condition and how the health system responded to their concerns and their conditions more broadly,” says Professor Shaban. 

In line with other states and territories, New South Wales boasts facilities dedicated to managing high consequence infectious diseases (HCIDs). At the forefront of this effort is Westmead Hospital, serving as the adult facility, and the Children’s Hospital at Westmead, the paediatric facility. 

These facilities are responsible for the identification and early management of conditions identified as high consequence.

“HCIDs are typically rare but are highly communicable or infectious, transmitting easily between individuals, particularly healthcare workers or in healthcare settings,” says Professor Shaban. 

“They often look very similar to other kinds of diseases and sometimes there is limited access to definitive diagnostics to identify what disease it is.”

With a mortality rate of above 50%, there are no known treatments of HCIDs.*

“They require a whole of health system response to effectively contain the infection and to prevent disease from spreading,” says Professor Shaban.

The New South Wales Biocontainment Centre, of which Professor Shaban is the Associate Director, is a brand-new facility at Westmead Hospital that has been designed to effectively respond to future pandemics and biothreats.  

A first of its kind in Australia, the state-of-the-art facility has been built for the prevention, containment and management of HCIDs.

“I'm privileged to be part of the NSW Specialist Service for High Consequence Infectious Diseases team at the NSW Biocontainment Centre,” says Professor Shaban. 

Recently, the service was involved in managing an outbreak of Mpox (monkeypox), handling around 60 cases in the state through a diverse range of healthcare responses and networked services. 

“What was important to the response of the outbreak was the work of the team at Westmead Hospital, led by Dr Nicky Gilroy and now Dr Matthew O’Sullivan, former and current facility directors,” says Professor Shaban.

Professor Shaban and his colleagues Professor Brett Mitchell (University of Newcastle), Professor Philip Russo (Monash University) and Dr Deborough MacBeth have developed Australia’s inaugural infection control textbook, Healthcare-Associated Infections in Australia.  

The textbook was officially launched at the 2023 International Conference for the Australasian College of Infection Prevention and Control.

Crafted for accessibility across various healthcare settings in Australia, this textbook serves as a comprehensive reference for healthcare workers, students, and practitioners. Positioned as the go-to authority, it informs and guides practice in any healthcare setting where infections may arise. 

“Importantly, the textbook is specific to Australia. We draw on international literature but focus on the epidemiology of disease or infection in Australia,” says Professor Shaban

“The guidelines are context-specific to Australia and that's an important thing for a textbook in this country to be based on local epidemiology, and so we’re thrilled with that output.” 

With 45 chapters split into two sections, Section 1 delves into foundational principles, encompassing the scientific and theoretical underpinnings crucial for practicing infection prevention and disease control. 

In Section 2, the focus shifts to practical application, with chapters dedicated to diverse contexts, such as emergency care, residential aged care, acute care settings, and mental health. These chapters build upon the earlier scientific foundations, addressing specific risks and outlining measures tailored to reduce them, all within the framework of Australian-based practice settings. 

_{*ABC News, ‘NSW prepares for the next pandemic with new bio-containment centre’, https://www.abc.net.au/news/2023-07-02/nsw-prepares-for-the-next-pandemic-with-new-ward/102552760}