Head, Infectious Disease Implementation
BMBS DTMH GDipClinEpid PhD FRACP
Professor Tom Snelling is a paediatric infectious diseases physician at the Perth Children’s Hospital, NHMRC Career Development Fellow and Head of the Infectious Disease Implementation research team as part of Telethon Kids Institute's Wesfarmers Centre of Vaccines & Infectious Diseases.
His research addresses the implementation of health policy and clinical practice, in particular the evaluation of vaccination and other public health strategies to minimise the burden of childhood infectious diseases. This work integrates clinical trials with case-control and cohort studies and disease modelling. His current work is investigating how best to prevent and treat gastroenteritis, pneumonia, pertussis and other lower respiratory infections, and congenital rubella. Tom was awarded a Medical Research Future Fund (MRFF) grant from NHMRC earlier this year and leads this Bayesian Evidence-Adaptive Trial to optimise management of cystic fibrosis.
His work has a strong focus on Aboriginal and international child health. He is also investigating the safety of vaccination in early childhood.
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Projects
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Publications
November 2019
Choosing primary endpoints for clinical trials of health care interventions
This narrative review describes the evolution, range and relative strengths and weaknesses of endpoints used in late phase trials
Published research Infectious Disease Implementation ResearchNovember 2019Effectiveness of Palivizumab against Respiratory Syncytial Virus: Cohort and Case Series Analysis
Palivizumab appeared effective for reducing virologically confirmed respiratory syncytial virus in this high-risk cohort
Published research Infectious Diseases Infectious Disease Implementation Research Infectious Diseases Epidemiology Vaccine Trials Group Neonatal Infection and ImmunityNovember 2019An introduction to clinical trial design
This manuscript will give a brief overview of clinical trial design including the strengths and limitations of various approaches
Published research Infectious Disease Implementation ResearchOctober 2019Effectiveness of pneumococcal conjugate vaccine against hospital admissions for pneumonia in Australian children
Reductions in pneumonia-coded hospital admissions in unvaccinated children predominated in non-Aboriginal children with low incidence of pneumonia
Published research Academic Biostatistics Immunisation Infectious Diseases Infectious Disease Implementation Research Infectious Diseases EpidemiologySeptember 2019Effectiveness of rotavirus vaccines in an Australian population: A case-control study
RV1 and RV5 were both effective in preventing laboratory confirmed and notified rotavirus infections among children aged <5 years
Published research Immunisation Infectious Diseases Infectious Disease Implementation Research Infectious Diseases EpidemiologySeptember 2019Timeliness and factors associated with rotavirus vaccine uptake among Australian Aboriginal and non-Aboriginal children: A record linkage cohort study
Aboriginal children are at greater risk of rotavirus disease than non-Aboriginal children and delayed vaccine receipt is substantially higher
Published research Academic Biostatistics Immunisation Infectious Diseases Infectious Disease Implementation Research Infectious Diseases EpidemiologyAugust 2019Discrete choice experiment to evaluate preferences of patients with cystic fibrosis among alternative treatment-related health outcomes: A protocol
The aim of this study is to identify and quantify the preferences of patients with cystic fibrosis regarding treatment outcomes
Cystic Fibrosis Published research Infectious Disease Implementation ResearchJuly 2019RD-RAP: Beyond rare disease patient registries, devising a comprehensive data and analytic framework
We introduce and describe the concept of a Rare Disease Registry and Analytics Platform
Published research Infectious Disease Implementation ResearchJuly 2019Agreement between units of measure for paediatric antibiotic utilisation surveillance using hospital pharmacy supply data
Agreement between the DDD and vial-based measures of use supports the use of DDD for select antibiotics that may be targeted by antimicrobial stewardship programs
Published research Infectious Diseases Infectious Disease Implementation ResearchJune 2019Links2HealthierBubs' cohort study: Protocol for a study on the safety, uptake and effectiveness of influenza and pertussis vaccines among pregnant Australian women
Multi-jurisdictional cohort of mother-infant pairs to measure the uptake, safety and effectiveness of antenatal IIV and dTpa vaccines in three Australian jurisdictions
Published research Academic Biostatistics Immunisation Influenza Whooping Cough Infectious Disease Implementation ResearchMay 2019Impact of influenza on hospitalization rates in children with a range of chronic lung diseases
This large population-based study suggests a significant healthcare burden associated with influenza in children with a range of chronic lung diseases
Published research Influenza Infectious Diseases Infectious Disease Implementation ResearchApril 2019Identification of the determinants of incomplete vaccination in Australian children
Most parents are supportive of vaccination. Sociodemographic factors may contribute more to the risk of incomplete vaccination than attitudes or beliefs.
Immunisation Infectious Disease Implementation Research Professional StaffApril 2019Combination of clinical symptoms and blood biomarkers can improve discrimination between bacterial or viral community-acquired pneumonia in children
Combining elevated CRP with the presence or absence of clinical signs/ symptoms differentiates definite bacterial from presumed viral pneumonia better than CRP alone
Published research Infectious Diseases Infectious Disease Implementation Research Vaccine Trials Group Bacterial Respiratory Infectious Disease GroupApril 2019Research Note: Adaptive trials
This Research Note has explored the strengths, risks and potential complexity of adaptive trials
Published research Infectious Disease Implementation ResearchApril 2019Factors associated with adherence to antimicrobial stewardship after-hours
Restricted antimicrobials acquired after-hours are not routinely antimicrobial stewardship adherent at the time of acquisition or the next standard working day
Published research Infectious Diseases Infectious Disease Implementation ResearchMarch 2019Trial refresh: A case for an adaptive platform trial for pulmonary exacerbations of cystic fibrosis
This review will discuss the necessary steps required for a Bayesian adaptive platform trial to optimize treatment of pulmonary exacerbations of cystic fibrosis
Cystic Fibrosis Published research Infectious Disease Implementation ResearchMarch 2019The contribution of viruses and bacteria to community-acquired pneumonia in vaccinated children: A case - Control study
Respiratory viruses, particularly respiratory syncytial virus and human metapneumovirus, are major contributors to pneumonia in Australian children
Published research Infectious Diseases Infectious Disease Implementation Research Vaccine Trials Group Bacterial Respiratory Infectious Disease GroupFebruary 2019Perinatal Risk Factors Associated With Gastroenteritis Hospitalizations in Aboriginal and Non-Aboriginal Children in Western Australia (2000-2012)
Given the beneficial effect of infant rotavirus vaccination efforts should be taken to optimize rotavirus vaccine coverage in those at highest risk
Published research Academic Biostatistics Infectious Diseases Ear Health Infectious Disease Implementation Research Infectious Diseases EpidemiologyJanuary 2019Baseline incidence of adverse birth outcomes and infant influenza and pertussis hospitalisations prior to the introduction of influenza and pertussis vaccination
These baseline data are essential to assess the safety and effectiveness of influenza and pertussis vaccinations in pregnant women from the NT
Published research Immunisation Influenza Infectious Disease Implementation ResearchOctober 2018Midwives’ attitudes, beliefs and concerns about childhood vaccination: A review of the global literature
The majority of midwives supported vaccination, although a spectrum of beliefs and concerns emerged
Published research Immunisation Infectious Diseases Infectious Disease Implementation ResearchOctober 2018Sharing knowledge about immunisation (SKAI): An exploration of parents' communication needs to inform development of a clinical communication support intervention
The Sharing Knowledge About Immunisation project aims to develop effective communication tools to support primary health care providers' consultations with parents
Published research Immunisation Infectious Disease Implementation ResearchOctober 2018Hesitant compliers': Qualitative analysis of concerned fully-vaccinating parents
Parents interpreted pivotal vaccine-related events in the community as requiring them to take personal responsibility for vaccine decisions
Published research Immunisation Infectious Disease Implementation ResearchOctober 2018Active surveillance of 2017 seasonal influenza vaccine safety: An observational cohort study of individuals aged 6 months and older in Australia
AusVaxSafety surveillance demonstrated comparable and expected safety outcomes for the 2017 quadrivalent inactivated influenza vaccine brands used in Australia
Published research Immunisation Influenza Infectious Disease Implementation Research Infectious Diseases EpidemiologyJune 2018Assessment of on-time vaccination coverage in population subgroups: A record linkage cohort study
On-time coverage of the 2-4-6 month schedule is only 50-60% across specific population subgroups representing a significant avoidable public health risk
Published research Academic Biostatistics Infectious Diseases Infectious Disease Implementation Research Infectious Diseases Epidemiology Vaccine Trials GroupJune 2018Topical versus systemic antibiotics for chronic suppurative otitis media
To assess the relative effectiveness of topical versus systemic antibiotics for people with chronic suppurative otitis media
Published research Ear Infections Ear Health Infectious Disease Implementation Research Vaccine Trials GroupMay 2018The influence of incomplete case ascertainment on measures of vaccine efficacy
A biologically active vaccine may produce a low measured vaccine efficacy under a range of epidemiological, vaccine-related and logistical conditions
Published research Infectious Diseases Infectious Disease Implementation ResearchMay 2018Effectiveness of a 3 + 0 pneumococcal conjugate vaccine schedule against invasive pneumococcal disease among a birth cohort of 1.4 million children in Australia
Our population-based cohort study demonstrates that >90% coverage in the first year of a universal 3 + 0 PCV program provided high population-level protection
Published research Academic Biostatistics Infectious Diseases Infectious Disease Implementation Research Infectious Diseases Epidemiology Vaccine Trials GroupApril 2018Paediatric antimicrobial stewardship and safe prescribing: An assessment of medical staff knowledge and behaviour
Participants demonstrated a good understanding of safe prescribing and antimicrobial stewardship
Published research Infectious Diseases Infectious Disease Implementation ResearchNovember 2017Association between respiratory syncytial viral disease and the subsequent risk of the first episode of severe asthma in different subgroups of high-risk Australian children: a whole-of-population-based cohort study
To determine the contribution of RSV to the subsequent development of severe asthma in different subgroups of children at risk of severe RSV disease.
Asthma Published research Infectious Diseases Infectious Disease Implementation ResearchMarch 2018Role of viral and bacterial pathogens in causing pneumonia among Western Australian children: A case-control study protocol
We aim to determine the contribute of bacteria and virus to childhood CAP to inform further development of effective strategies.
Published research Infectious Disease Implementation Research Vaccine Trials Group Bacterial Respiratory Infectious Disease GroupFebruary 2018The NICE-GUT trial protocol: A randomised, placebo controlled trial of oral nitazoxanide for the empiric treatment of acute gastroenteritis among Australian Aboriginal children
Diarrhoeal disease is the second leading cause of death in children under 5 years globally, killing 525 000 annually. Australian Aboriginal and Torres Strait Islander (hereafter Aboriginal) children suffer a high burden of disease.
Published research Infectious Disease Implementation Research Group A Streptococcal & Rheumatic Heart DiseaseJanuary 2018Protocol for Pertussis Immunisation and Food Allergy (PIFA): a case-control study of the association between pertussis vaccination in infancy
We therefore speculate that removal of wP from the vaccine schedule contributed to the observed rise in IgE-mediated food allergy among Australian infants
Published research Whooping Cough Infectious Disease Implementation Research Vaccine Trials Group Food AllergyDecember 2017Advances in Vaccines to Prevent Viral Respiratory Illnesses in Children
Childhood vaccination has played a critical role in the reduction of morbidity and mortality from communicable diseases, including specific respiratory pathogens
Published research Infectious Disease Implementation Research Group A Streptococcal & Rheumatic Heart Disease Vaccine Trials GroupNovember 2017Paediatrician beliefs and practices around influenza vaccination
We aimed to determine Australian paediatricians' beliefs and practices around the influenza vaccination of children.
Published research Influenza Vaccine Trials GroupOctober 2017A 15-Year Old Burmese Girl With Hemoptysis: A Case Report
A 15 year old girl, born in Hakha, Myanmar, presented with 2 months of intermittent hemoptysis 3 years after immigrating to Australia, via Malaysia.
Published research Infectious Disease Implementation Research Group A Streptococcal & Rheumatic Heart Disease Skin HealthSeptember 2017Comprehending the Health Informatics Spectrum: Grappling with System Entropy and Advancing Quality Clinical Research
We outline three scenarios from across the health spectrum where issues with health informatics are exemplified.
Published research Infectious Disease Implementation ResearchSeptember 2017Predictors of pneumococcal carriage and the effect of the 13-valent pneumococcal conjugate vaccination the Western Australian Aboriginal population
The PCV7 was introduced to prevent IPD in WA Aboriginal people in 2001 to a lesser extent in older people.
Published research Ear Health Infectious Disease Implementation ResearchSeptember 2017Probabilistic linkage of national immunisation and state-based health records for a cohort of 1.9 million births to evaluate Australia’s childhood immunisation program
To describe the process for assembling a linked study that will enable the conduct of population-based studies related to immunisation and immunisation policy.
Published research Academic Biostatistics Infectious Disease Implementation Research Infectious Diseases EpidemiologySeptember 2017Dose-Banding of Intravenous Piperacillin-Tazobactam in Pediatric Surgical Inpatients
Dosing errors are the most commonly reported medication error in children. Dosing is often prescribed per weight or based on body area.
Published research Infectious Disease Implementation ResearchJune 2017Nurses are underutilised in antimicrobial stewardship - Results of a multisite survey in paediatric and adult hospitals
Nurses consider antimicrobial stewardship activities within their roles, but are underutilised in antimicrobial stewardship programs
Published research Infectious Diseases Infectious Disease Implementation ResearchNovember 2016Informing rubella vaccination strategies in East Java, Indonesia through transmission modelling
A single dose of rubella vaccine will take longer to reduce the burden of rubella and will be less robust to lower vaccine coverage
Published research Infectious Diseases Infectious Disease Implementation ResearchJuly 2016Transiently increased IgE responses in infants and pre-schoolers receiving only (DTaP) vaccines compared to those initially receiving at least one dose of DTwP vaccine
Confirm the generalised IgE-trophic activity of the DTaP vaccine in pre-schoolers and demonstrate similar (albeit transient) effects in infants
Published research Academic Biostatistics Immunisation Human Immunology Infectious Disease Implementation Research Group A Streptococcal & Rheumatic Heart Disease Vaccine Trials GroupJune 2016Australian trachoma surveillance annual report, 2013
National Trachoma Surveillance and Reporting Unit to collate, analyse and report trachoma prevalence data and document trachoma control strategies in Australia
Published research Infectious Diseases Infectious Disease Implementation ResearchJune 2016High burden of RSV hospitalization in very young children: a data linkage study
RSV was associated with substantial burden of childhood hospitalization specifically in children aged <3 months and in Indigenous children and pre-term children
Published research Infectious Disease Implementation ResearchJune 2016Risk factors associated with RSV hospitalisation in the first 2 years of life, among different subgroups of children in NSW
Data on risk factors for respiratory syncytial virus (RSV)-associated hospitalisation in Australian children may be informative for preventive measures.
Published research Infectious Diseases Infectious Disease Implementation ResearchJanuary 2016Respiratory syncytial virus is present in the neonatal intensive care unit
The results suggest that though the risk for RSV in the NICU remains low, personnel clothing are contaminated with RSV-RNA and may have a role in transmission
Published research Infectious Diseases Infectious Disease Implementation ResearchNovember 2015Whither pertussis?
This article discusses the rising prevalence of pertussis disease in countries which have switched to acellular vaccines.
Published research Whooping Cough Infectious Diseases Infectious Disease Implementation ResearchOctober 2015Real-time safety surveillance of seasonal influenza vaccines in children, Australia, 2015
This paper reports the results from the safety surveillance of influenza vaccines in children in Australia, in 2015.
Published research Immunisation Influenza Infectious Disease Implementation ResearchFebruary 2015Impact of high coverage of monovalent human rotavirus vaccine on Emergency Department presentations for rotavirus gastroenteritis
The program was associated with a substantial decline in rotavirus attributable non-admitted AGE presentations to ED among children aged <5 years.
Published research Immunisation Infectious Diseases Infectious Disease Implementation ResearchDecember 2014Characterization of G2P[4] rotavirus strains causing outbreaks of gastroenteritis in the Northern Territory, Australia, in 1999, 2004 and 2009
Outbreaks of rotavirus diarrhea cause a large disease burden in the Alice Springs region of the Northern Territory, Australia.
Published research Immunisation Infectious Diseases Infectious Disease Implementation ResearchNovember 2014Management of invasive group A streptococcal infections
Invasive group A streptococcal disease in children includes deep soft tissue infection, bacteraemia, bacteraemic pneumonia, meningitis and osteomyelitis
Published research Infectious Disease Implementation Research Group A Streptococcal & Rheumatic Heart DiseaseNovember 2014Prevalence and determinants of influenza vaccine coverage at tertiary pediatric hospitals
This study aimed to examine the uptake of influenza vaccination amongst a cohort of Australian children and factors associated with vaccine acceptance.
Published research Influenza Infectious Disease Implementation ResearchOctober 2014Parental Tdap boosters and infant pertussis: a case-control study
Case households had fewer immunized mothers (22% vs 32%) or fathers (20% vs 31%) but were more likely to include additional and older children. After...
Published research Immunisation Infectious Disease Implementation ResearchAugust 2014Assessing the effect of meningitis prevention and treatment.
In high-income countries serious bacterial infections such as meningitis are uncommon, but their severity has led to prompt adoption of vaccines for...
Published research Infectious Diseases Infectious Disease Implementation ResearchAugust 2014Waning vaccine immunity in teenagers primed with whole cell and acellular pertussis vaccine: Recent epidemiology
The recent epidemics of pertussis (whooping cough) in parts of the USA and Australia have led to the largest numbers of annual cases reported in over half a...
Published research Whooping Cough Infectious Disease Implementation ResearchJune 2014Nitazoxanide for the treatment of infectious diarrhoea in the Northern Territory, Australia 2007-2012
This paper examines the use of a new antibiotic to treat diarrhoea cause by Cryptosporidium infection in Australian Indigenous children.
Published research Aboriginal Health Infectious Disease Implementation Research Group A Streptococcal & Rheumatic Heart DiseaseFebruary 2014Duration of protection after first dose of acellular pertussis vaccine in infants
Without a booster dose, the effectiveness of 3 doses waned more rapidly from 2 to 4 years of age than previously documented for children >6 years of age who...
Published research Immunisation Whooping Cough Infectious Disease Implementation ResearchJanuary 2014Characterization of a G1P[8] rotavirus causing an outbreak of gastroenteritis in the Northern Territory, Australia, in the vaccine era
In 2010, a large outbreak of rotavirus gastroenteritis occurred in the Alice Springs region of the Northern Territory, Australia.
Published research Immunisation Infectious Diseases Infectious Disease Implementation ResearchJanuary 2014Effectiveness of Palivizumab in Preventing RSV Hospitalization in High Risk Children: A Real-World Perspective
This review supports the recommended use of palivizumab for reducing RSV-associated hospitalisation rates in premature babies born at gestational age <33 weeks.
Published research Infectious Diseases Infectious Disease Implementation Research -
Education and Qualifications
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Awards/Honours