David J Muscatello

• PhD
• Lecturer at UNSW Sydney

Background Official statistics under-estimate influenza deaths. Time series methods allow the estimation of influenza-attributable mortality. The methods often model background, non-influenza mortality using a cyclic, harmonic regression model based on the Serfling approach. This approach assumes that the seasonal pattern of non-influenza mortality...

To rapidly describe the epidemiology of influenza-like illness (ILI) during the 2009 winter epidemic of pandemic (H1N1) 2009 virus in New South Wales, Australia, we used results of a continuous population health survey. During July-September 2009, ILI was experienced by 23% of the population. Among these persons, 51% were unable to undertake normal...

Australian epidemiologists have recognised that lay readers have difficulty understanding statistical graphs in reports on population health. This study aimed to provide evidence for graph design improvements that increase comprehension by non-experts. This was a double-blind, randomised, controlled trial of graph-design interventions, conducted as...

Objective To describe the characteristics, outcomes and predictors of a severe outcome of patients presenting with a SARS‐CoV‐2 infection to the ED of a major urban referral hospital in New South Wales, Australia, from January 2020 through February 2022. Methods Linked healthcare and death registration records were used and included any person ass...

Background: In an era of endemic SARS-CoV-2 transmission, countries are continuing to evaluate how best to schedule ongoing COVID-19 booster vaccinations. Mathematical modelling provides a useful tool to predict the benefit of future vaccination strategies, incorporating the loss of protection due to waning immunity and strain mutation. Methods: We...

Background : Evidence on the effectiveness of influenza vaccine in preventing antibiotic prescriptions for influenza-like illness (ILI) in adults is limited. Methods : A primary care-based case-control study was conducted to estimate influenza vaccine effectiveness (VE) against influenza-like illness (ILI) and antibiotic prescribing for ILI in adu...

Background: Respiratory syncytial virus (RSV) and influenza are important causes of disease in children and adults. In Australia, information on the burden of RSV in adults is particularly limited. Methods: We used time series analysis to estimate respiratory, acute respiratory infection, pneumonia and influenza, and bronchiolitis hospitalisatio...

Introduction In Australia, the 2017 and 2019 influenza seasons were severe. High-dose or adjuvanted vaccines were introduced for ≥65 year-olds in 2018. Aim To compare influenza-associated mortality in 2017 and 2019 with the average for 2010–2019. Methods We used time series modelling to obtain estimates of influenza-associated death rates for inf...

Objective To examine the impact of parental international migration on health care seeking for common childhood illnesses (diarrhoea, fever, and acute respiratory infections) and nutritional status (stunting, underweight and wasting) in young children in Nepal using the most recent nationally representative Multiple Indicator Cluster Survey. Study...

Background: The Early Warning and Response System (EWARS) is Indonesia's national syndromic and early warning surveillance system for the rapid detection of infectious diseases and outbreaks. We evaluated EWARS in the remote West Papua province of Indonesia. Methods: Structured telephone interviews were conducted with 11 key informants from West...

Background The presymptomatic transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been documented in limited clusters, and it is predicted through modelling. However, there is a lack of evidence from observations with a large sample size. Methods We used data from meticulous contact tracing of people exposed to cases o...

Purpose: The burden of influenza on primary health-care services is not well established in tropical countries, where there are no clearly defined influenza seasons. We aimed to estimate the association between influenza infection activity and polyclinic attendance rates for upper respiratory tract infections (URTIs) in the Singapore population....

Background Influenza continues to cause seasonal epidemics and pandemics in humans. The burden of influenza is underestimated by traditional laboratory-based surveillance, and modelled estimates are required for influenza-attributable morbidity and mortality. We aimed to estimate the influenza-attributable hospitalisation in Australia, by influenza...

We developed a model to predict the cyclic pattern of porcine reproductive and respiratory syndrome virus (PRRSV) RNA detection by reverse-transcription real-time PCR (RT-rtPCR) from 4 major swine-centric veterinary diagnostic laboratories (VDLs) in the United States and to use historical data to forecast the upcoming year’s weekly percentage of po...

Objective: This study aims to present overall survival rates to hospital discharge for out-of-hospital cardiac arrest (OHCA) in Tasmania and to identify predictors of survival. Methods: A retrospective observational cohort study was undertaken from 1 January 2010 to 31 December 2014. A probabilistically linked data set was created from paramedic...

Background: Children aged under 5 years are particularly vulnerable to influenza infection. In this study, we aim to estimate the number and incidence of influenza among young children and estimate the impact of childhood vaccination in different scenarios from 2013/14 to 2016/17 seasons. Methods: The number and incidence rate of influenza infectio...

Surveillance of influenza epidemics is a priority for risk assessment and pandemic preparedness, yet representation of their spatiotemporal intensity remains limited. Using the epidemic of influenza type A in 2016 in Australia, we demonstrated a simple but statistically sound adaptive method of mapping epidemic evolution over space and time. Weekly...

Background: Although oil-in-water adjuvants improve pandemic influenza vaccine efficacy, AS03 versus MF59 adjuvant comparisons in A(H1N1)pdm09 pandemic vaccines are lacking. Methods: We conducted an indirect-comparison meta-analysis extracting published data from randomised controlled trials in literature databases (01/01/2009-09/09/2018), evalu...

Objective Using the epidemic of influenza type A in 2016 in Australia, we demonstrated a simple but statistically sound adaptive method of automatically representing the spatial intensity and evolution of an influenza epidemic that could be applied to a laboratory surveillance count data stream that does not have a denominator.IntroductionSurveilla...

Objective Programmes that reduce the time to defibrillation are likely to improve overall survival rates from out‐of‐hospital cardiac arrests (OHCAs). This research sought to identify human factors common among community responders taking an automated external defibrillator (AED) to a victim of an OHCA that are either barriers or enablers of desire...

We analyzed surveillance data for 2 sentinel hospitals to estimate the influenza-associated severe acute respiratory infection hospitalization rate in Beijing, China. The rate was 39 and 37 per 100,000 persons during the 2014-15 and 2015-16 influenza seasons, respectively. Rates were highest for children <5 years of age.

Objectives: Annual seasonal influenza vaccine manufacturing cycles align with temperate country seasonality in each hemisphere, yet influenza seasonality is poorly defined for many countries. The study introduces a novel and universal approach to defining and classifying seasonality that can be used to classify any country's influenza vaccine cycl...

BACKGROUND Influenza causes serious illness requiring annual health system surge capacity, yet annual seasonal variation makes it difficult to forecast and plan for the severity of an upcoming season. Research shows that hospital and health system stakeholders indicated a preference of forecasting tools that are easy to use and understand, to assis...

Background Influenza causes serious illness requiring annual health system surge capacity, yet annual seasonal variation makes it difficult to forecast and plan for the severity of an upcoming season. Research shows that hospital and health system stakeholders indicate a preference for forecasting tools that are easy to use and understand to assist...

We aimed to examine the available evidence on the impact of overseas parental migration on healthcare seeking for common childhood illnesses and the nutritional status of children left-behind under five years of age. A systematic review of English language articles was conducted on PubMed, MEDLINE and EMBASE, supplemented by a manual search of grey...

Background: In 2010, influenza, influenza-like illness (ILI) and acute respiratory infection (ARI) surveillance was established by the government of Burkina Faso. We provide preliminary descriptive results from this surveillance activity. Methods: The study period was 2013 through 2015. Two primary healthcare facilities in Bobo-Dioulasso distric...

Background The benefit of school‐based influenza vaccination policy has not been fully addressed in Beijing. Objectives To evaluate the benefit of school‐based influenza vaccination policy launched in Beijing. Methods Using existing surveillance and immunization data, we developed a dynamic transmission model to assess the impact of influenza vac...

Background: Seasonal influenza is responsible for a large disease and economic burden. Despite the expanding recommendation of influenza vaccination, influenza has continued to be a major public health concern in the United States (U.S.). To evaluate influenza prevention strategies it is important that policy makers have current estimates of the e...

Background Studies conducted during the 2009 influenza A (H1N1) pandemic found that obesity increases the risk of severe influenza including hospitalization and death. In this study, we examined the relationship of BMI with having laboratory-confirmed seasonal influenza and influenza-related respiratory hospitalization. Methods We linked a cohort...

We report 1,327 probable cases of dengue in Burkina Faso in 2016. Of 35 serum samples tested by a trioplex test, 19 were confirmed dengue virus (DENV)‒positive: 11 DENV-2, 6 DENV-3, 2 nontypeable, and 1 DENV-2/DENV-3 co-infection. Molecular testing should be conducted to correctly identify causative agents in this complex infectious disease landsca...

Background: Regression modeling methods are commonly used to estimate influenza-associated mortality using covariates such as laboratory-confirmed influenza activity in the population as a proxy of influenza incidence. Objective: We examined the choices of influenza proxies that can be used from influenza laboratory surveillance data and their i...

Background: Estimates of influenza-associated mortality are important for national and international decision making on public health priorities. Previous estimates of 250 000-500 000 annual influenza deaths are outdated. We updated the estimated number of global annual influenza-associated respiratory deaths using country-specific influenza-assoc...

Objectives: Alcohol misuse is a complex systemic problem. The aim of this study was to explore the feasibility of using a transparent and participatory agent-based modelling approach to develop a robust decision support tool to test alcohol policy scenarios before they are implemented in the real world. Methods: A consortium of Australia's leadi...

Introduction: Influenza’s impact on health and health care is underestimated by influenza diagnoses recorded in health-care databases. We aimed to estimate total and non-admitted influenza-attributable hospital Emergency Department (ED) demand in New South Wales (NSW), Australia. Methods: We used generalized additive time series models to estimate...

Vaccination is the best available way to prevent influenza infections and related complications. Little information is available on vaccination policy in the world's most populous country, China. In China, influenza vaccine is not included in the national immunization programme. Citizens seek the vaccine on their own. Since 2007, Beijing, ahead of...

Background The objective of the study was to describe an m-health initiative to strengthen malaria surveillance in a 184-health facility, multi-province, project aimed at strengthening the National Health Information System (NHIS) in a country with fragmented malaria surveillance, striving towards enhanced control, pre-elimination. Methods A remot...

Objectives: Influenza outbreaks cause overcrowding in EDs. We aimed to quantify the impact of influenza on the National Emergency Access Targets and premature patient departure in New South Wales, Australia. Methods: This was a retrospective observational study of 11 million presentations to 115 hospitals during 2010-2014, using routinely collec...

Infectious disease dynamic modeling can support outbreak emergency responses. We conducted a workshop to canvas the needs of stakeholders in Australia for practical, real-time modeling tools for infectious disease emergencies. The workshop was attended by 29 participants who represented government, defense, general practice, and academia stakeholde...

Background: Vaccination is recommended to prevent influenza virus infection and associated complications. This study aimed to estimate the influenza vaccine effectiveness (VE) against hospitalization in the 2015/16 season in Beijing. Methods: Patients who were hospitalized in the 5 study hospitals between 1 Oct 2015 and 15 May 2016 were recruite...

Objective: The objective of the present study is to demonstrate a novel method of mapping ED activity to analyse patterns presentations, occupancy and performance trends. Methods: This was a retrospective, descriptive analysis of de-identified and linked ED presentations across NSW, Australia, over five calendar years, 2010-2014. It was undertak...

Background Disposition decisions are critical to the functioning of Emergency Departments. The objectives of the present study were to derive and internally validate a prediction model for inpatient admission from the Emergency Department to assist with triage, patient flow and clinical decision making. Methods This was a retrospective analysis of...

Supporting info item

Introduction and aims: Acute harm from heavy drinking episodes is an increasing focus of public health policy, but capturing timely data on acute harms in the population is challenging. This study aimed to evaluate the precision of readily available administrative emergency department (ED) data in public health surveillance of acute alcohol harms....

Background: Influenza B is characterised by two antigenic lineages; B/Victoria and B/Yamagata. These lineages circulate together with influenza A during influenza seasons, with varying incidence from year to year and by geographic region. Objective: To determine the epidemiology of influenza B relative to influenza A in Australia. Methods: Lab...

Objectives: To describe population based trends and clinical characteristics of injury related presentations to Emergency Departments (EDs). Design and setting: A retrospective, descriptive analysis of de-identified linked ED data across New South Wales, Australia over five calendar years, from 2010 to 2014. Participants: Patients were include...

Background: A quadrivalent influenza vaccine (QIV) includes two A strains (A/H1N1, A/H3N2) and two B lineages (B/Victoria, B/Yamagata). The presence of both B lineages eliminate potential B lineage mismatch of trivalent influenza vaccine (TIV) with the circulating strain. Methods: Electronic database searches of Medline, Embase, Cochrane Central...

Objectives: The study aimed to analyze ambulance transportations to Emergency Departments (EDs) in New South Wales (NSW) and to identify temporal changes in demographics, acuity, and clinical diagnoses. Methods: This was a retrospective analysis of a population based registry of ED presentations in New South Wales. The NSW Emergency Department d...

Objective: The objective of this study is to describe the trends and characteristics of short-term and frequent representations to EDs in New South Wales, Australia. Methods: This was a retrospective analysis of a linked population-based registry of ED representations in New South Wales, conducted as part of the Demand for Emergency Services in...

Objective The present study aims to use a statewide population-based registry to assess the prevalence of low acuity emergency department (ED) presentations, describe the trend in presentation rates and to determine whether they were associated with various presentation characteristics such as the type of hospital as well as clinical and demographi...

Objective To demonstrate use of routine laboratory-confirmed influenza surveillance data to forecast predicted influenza-attributable deaths during the current influenza season. We also assessed whether including information on influenza type produced better surveillance forecasts. Introduction Several countries prospectively monitor influenza-attr...

Objective: This study aims to describe the general characteristics and data definitions used in a population-based data set of ED presentations in New South Wales (NSW), used to form the basis of future-trend analyses. Methods: Retrospective analysis of the Emergency Department Data Collection registry, which provided clinical and demographic in...

Aim: To assess the role of administrative police and health databases in monitoring trends in, and epidemiology of, alcohol-related violence and acute alcohol illness associated with the night time economy in the Sydney central business district (CBD) “Entertainment Precinct”, prior to the introduction of 2014 government reforms addressing “alcohol...

Death certificates provide an invaluable source for mortality statistics which can be used for surveillance and early warnings of increases in disease activity and to support the development and monitoring of prevention or response strategies. However, their value can be realised only if accurate, quantitative data can be extracted from death certi...

In Australia, a Goods and Services Tax (GST) introduced in 2000 led to a decline in the price of ready-to-drink (RTD) beverages relative to other alcohol products. The 2008 RTD ("alcopops") tax increased RTD prices. The objective of this study was to estimate the change in incidence of Emergency Department (ED) presentations for acute alcohol probl...

Australia was one of the first countries to introduce nationally funded rotavirus vaccination. The program has had a substantial impact on both rotavirus and all-cause acute gastroenteritis (AGE) hospitalisations and rotavirus laboratory tests. Evidence for an impact on Emergency Department (ED) presentations is limited. This study assessed changes...

To contrast long-term population-based trends in general practice (GP) presentations and acute inpatient admissions from the emergency department (ED) in the elderly population within the Greater Sydney Area. This was a retrospective analysis of population-based ED presentation data over 11 years, between January 2001 and December 2011, conducted w...

Background: Syndromic surveillance in emergency departments (EDs) may be used to deliver early warnings of increases in disease activity, to provide situational awareness during events of public health significance, to supplement other information on trends in acute disease and injury, and to support the development and monitoring of prevention or...

Objective: To describe trends in population-based rates of ED presentations in the Greater Sydney Area (GSA) and compare these between the elderly and non-elderly age groups. Methods: This was a retrospective study using ED presentation data from all public hospitals in the GSA and population data from the Australian Bureau of Statistics between...

Background Historically, counting influenza recorded in administrative health outcome databases has been considered insufficient to estimate influenza attributable morbidity and mortality in populations. We used database record linkage to evaluate whether modern databases have similar limitations. Methods Person-level records were linked across da...

Administrative and vital statistics databases are frequently used for public health surveillance of influenza incidence and outcomes. We used population based, probabilistic record linkage of laboratory diagnosed influenza, emergency department, hospital admission and death registration databases to determine how frequently laboratory diagnosed inf...

Background Assessing the mortality impact of the 2009 influenza A H1N1 virus (H1N1pdm09) is essential for optimizing public health responses to future pandemics. The World Health Organization reported 18,631 laboratory-confirmed pandemic deaths, but the total pandemic mortality burden was substantially higher. We estimated the 2009 pandemic mortali...

The introduction of Systematized Nomenclature of Medicine - Clinical Terms (SNOMED CT) for diagnosis coding in emergency departments (EDs) in New South Wales (NSW) has implications for injury surveillance abilities. This study aimed to assess the consequences of its introduction, as implemented as part of the ED information system in NSW, for ident...

Methods for calculation of confidence intervals and all-age mortality estimates and Tables S1–S4. (PDF)

Background Little is known about the potential of syndromic surveillance to provide early warning of pertussis outbreaks. We conducted a time series analysis to assess whether an emergency department (ED) cough syndrome would respond to changes in the incidence of pertussis in children aged under 10 years in New South Wales (NSW), Australia, and to...

Background In Australia, the 2009 epidemic of influenza A(H1N1)pdm09 resulted in increased admissions to intensive care. The annual contribution of influenza to use of intensive care is difficult to estimate, as many people with influenza present without a classic influenza syndrome and laboratory testing may not be performed. We used a population-...

From January 30-February 6, 2011, New South Wales was affected by an exceptional heat wave, which broke numerous records. Near real-time Emergency Department (ED) and ambulance surveillance allowed rapid detection of an increase in the number of heat-related ED visits and ambulance calls during this period. The purpose of this study was to quantify...

Table S1. List of SNOMED codes used to identify ED visits for dehydration and heat-related syndromes.

In 2010, intense focus was brought to bear on febrile convulsions in Australian children particularly in relation to influenza vaccination. Febrile convulsions are relatively common in infants and can lead to hospital admission and severe outcomes. We aimed to examine the relationships between the population incidence of febrile convulsions and inf...

This study measured the frequency and geographical extent of peaks in asthma presentations to emergency departments in inland NSW; it assessed the characteristics of patients who presented at peak presentation times during the rye grass pollination season (October-November) and at other times of the year. Data describing over 13 years of daily emer...

To assess the short-term temporal relationship between emergency department (ED) attendances for acute alcohol problems and assaults reported to police. Cross-sectional time-series analysis. Population of New South Wales (NSW), Australia between 2003 and 2008. All patients who attended any of 56 large NSW public hospital EDs and had a recorded diag...

In NSW, fall-related injury costs the health system more than any other single cause of injury. A public health surveillance database containing information routinely recorded by the Ambulance Service of NSW was used to define the epidemiology and characteristics of fall-related calls in the Sydney metropolitan area in 2008. The dataset contained 3...

Exponentially weighted moving average (EWMA) plans for non-homogeneous negative binomial counts are developed for detecting the onset of seasonal disease outbreaks in public health surveillance. These plans are robust to changes in the in-control mean and over-dispersion parameter of the negative binomial distribution, and therefore are referred to...

Automated public health surveillance of disease counts for rapid outbreak, epidemic or bioterrorism detection using conventional control chart methods can be hampered by over-dispersion and background ('in-control') mean counts that vary over time. An adaptive cumulative sum (CUSUM) plan is developed for signalling unusually high incidence in prosp...

Exponentially Weighted Moving Average (EWMA) plans for negative binomial counts with a non-homogeneous (time-varying) mean are developed for monitoring disease counts. These plans are used to identify unusual disease outbreaks or unusual epidemics. Time-varying means are typical for disease counts. The recommended surveillance plan in this article...

Meningococcal infection causes severe, rapidly progressing illness and reporting of cases is mandatory in New South Wales (NSW), Australia. The NSW Department of Health operates near real-time Emergency Department (ED) surveillance that includes capture and statistical analysis of clinical preliminary diagnoses. The system can provide alerts in res...

Daily counts of computer records of hospital emergency department arrivals grouped according to diagnosis (called here syndrome groupings) can be monitored by epidemiologists for changes in frequency that could provide early warning of bioterrorism events or naturally occurring disease outbreaks and epidemics. This type of public health surveillanc...

Robust Regression Model, Confidence Intervals for the All-Age Predicted Baseline Rates, and Sensitivity Analyses

In temperate countries, death rates increase in winter, but influenza epidemics often cause greater increases. The death rate time series that occurs without epidemic influenza can be called a seasonal baseline. Differentiating observed death rates from the seasonally oscillating baseline provides estimated influenza-associated death rates. During...

Surveillance has a fundamental role during public health emergencies to provide accurate and relevant information to guide decision making. For each phase of the NSW response to the pandemic H1N1 (2009) influenza there were significant differences in the public health surveillance objectives and response mechanisms. Consequently each phase placed a...

In the field of disease mapping, little has been done to address the issue of analysing sparse health datasets. We hypothesised that by modelling two outcomes simultaneously, one would be able to better estimate the outcome with a sparse count. We tested this hypothesis utilising Bayesian models, studying both birth defects and caesarean sections u...