I Have To Say I Find The Dropping Divorce Rate Hard to Explain!

This appeared last week:

Australia news

Australia’s divorce rate is lowest in 50 years and marriages are lasting longer, according to ABS data

Australian Bureau of Statistics’ 2024 figures show median marriage age was 32.8 years for men and 31.2 for women

Daisy Dumas

Wed 23 Jul 2025 19.29 AEST

Divorce rates are their lowest in 50 years and marriages are lasting longer, according to new data that reflects an increasingly selective approach to marriage and the ongoing effects of the Covid pandemic.

The Australian Bureau of Statistics’ 2024 marriages and divorces figures, released on Wednesday, reflect a downward trajectory of both marriage and divorce rates over the past two decades.

But within the data lies a case for the institution of marriage: while fewer people were getting married, marriages were both lasting longer and less likely to end in divorce.

In 2004, the marriage rate – measured per 1,000 residents over the age of 16 – was 7.1. Twenty years later, in 2024, the rate was 5.5, the same as the year before.

Last year, Australia’s divorce rate was 2.1, down from 2.3 in 2023. The number of divorces fell 3% from 2023 to 2024.

Meanwhile, marriages lasted for a median of 13.2 years – up from 12.1 in 2020 and 13 last year.

The statistics align with an Australian Institute of Family Studies report that in February found the divorce rate had in 2023 fallen to its lowest level since the implementation of the 1975 Family Law Act.

At the same time, we’re marrying and getting divorced later in life. In 2024, the median marriage age was 32.8 years for men and 31.2 for women, according to the ABS. The median age for men to divorce was 47.1 years, while for women it was 44.1.

And, while younger couples were divorcing less, divorces in the above 60 age category were rising.

There were 2% more marriages in 2024 compared to the year before – a figure that doubled to 4.1% for couples of the same or non-binary gender.

More same-sex female couples were married and divorced than male couples, while same-sex and non-binary divorces were slightly up from 1.4% of all divorces in 2023 to 1.6% in 2024.

Steep declines then a spike in marriage rates from 2020 to 2022 were a direct impact of Covid restrictions, while the pandemic saw a spike in divorce rates in 2021.

Lauren Moran, the head of health and vital statistics at the ABS, said the changing divorce rate was “a complex picture” but “2024 saw the lowest divorce rate recorded”.

She said divorce rates were heavily impacted by court administrative processes and that while the number of divorces granted was between 47,000 and 50,000 a year in recent years, fewer marriages meant there were fewer divorces.

“We are seeing declining divorce rates in younger couples, but increasing divorce rates in older couples. When marriages decreased significantly during the Covid-19 pandemic, the largest decreases were in marriages of younger people,” she said.

Older couples were more likely to have a longer marriage, which impacted the median length of marriage, she said.

She said there was “no clear pattern in same-gender divorce rates yet” and that the increases were “small numbers”.

Dr Jan Kabatek, a senior research fellow the Melbourne Institute of Applied Economic and Social Research, said the declining divorce rate reflected a more selective approach to marriage.

“Fewer people are getting married and the people who are getting married are usually the ones who are more committed, either through religion or because they are older and more experienced,” he said.

He said the pandemic continued to contribute to a lower divorce rate.

“The people who might have got divorced in 2023/2024 already got divorced during Covid,” he said. “If a lot of people call it quits in 2021, the couples who survived later also have longer marriage durations. Fundamentally, the pool of people who remain married has changed.”

He also commented on the most popular day to marry, according to the ABS: 1,773 marriages took place on 24/02/2024. His own research on marriages on “specifically pleasing dates” found those unions were 25% more likely to end in divorce.

This article was amended on 23 July 2025 to clarify that the divorce rate is the lowest since the Family Law Act was enacted in 1975 rather than the lowest on record.

Here is the link:

https://www.theguardian.com/australia-news/2025/jul/23/australia-divorce-rate-lowest-on-record-marriages-last-longer-abs-data

There are some really interesting figures and trends here and the  article is well worth a read! I have no idea of the underlying causes!

David.

Frankly I Would Not Trust Trump At All When It Comes To American Greed To Try And Profit From Our PBS

This appeared last week:

Australia’s PBS must ‘absolutely’ be protected in trade talks, says Make America Healthy Again medical adviser Aseem Malhotra

The chief medical adviser to Make America Healthy Again campaign has defended Australia’s PBS, as the Trump administration comes under pressure to drag the pharmaceuticals program into tariff negotiations.

Lydia Lynch

5:00 AM July 26, 2025.

Updated 7:26 AM July 26, 2025

The new chief medical adviser to the Make America Healthy Again campaign group has leapt to the defence of Australia’s Pharmaceutical Benefits Scheme, insisting medicines must remain affordable, as the Trump administration comes under pressure to drag the program into tariff negotiations.

Australia’s PBS caps the price of medicines on the scheme at $31.60 for consumers and must “100 per cent, absolutely” be protected in trade negotiations, MAHA Action medical chief and British cardiologist Aseem Malhotra said.

“All medicines need to be affordable for the regular person,” he told The Australian.

Dr Malhotra, who describes the pharmaceutical industry as “psychopathic”, has direct communication with both Health Secretary Robert F. Kennedy Jr and National Institutes of Health director Jay Bhattacharya, and could be influential in convincing US policymakers to keep the PBS out of trade talks.

In a bid to pressure big pharma to shift manufacturing and investment to the US, President Donald Trump has threatened to impose import tariffs as high as 200 per cent on the industry.

In turn, the pharmaceutical lobby in the US for months has been pushing Mr Trump to use trade negotiations as a tool to make changes to the PBS, which would drive up the price of medicines in Australia.

The Pharmaceutical Research and Manufacturers of America – which represents the US’s biggest drug manufacturers – argues US products face a system that “undervalues new, innovative medicines”, and Mr Trump should “leverage ongoing trade negotiations” to change the scheme.

During the election campaign Anthony Albanese declared the $18bn PBS, providing 930 different medicines, was “not for sale”, and vowed to lower the cap to $25 in his second term.

Treasurer Jim Chalmers this month insisted the PBS would be safeguarded in tariff negotiations, saying it was “not something that we’re willing to trade away or do deals on”.

“We see the PBS as a fundamental part of healthcare in Australia. We’re not willing to compromise the PBS. We’re not willing to negotiate or trade away what is a really important feature of the health system,” Dr Chalmers said.

Dr Malhotra, 47, is a leading critic of big pharma and represents a growing contingent inside Mr Trump’s base that believes more needs to be done to crackdown on the industry’s influence over health policy.

He believes pharmaceutical companies are “pathologically self-interested to make money” through a business model that aims to “get as many people taking as many pills for as long as possible”.

“The evidence tells us that you can have a much more efficient, high-quality healthcare system and much lower cost income at the moment, because a lot of the costs are because of excessive prices of drugs and a lot of waste in the system for unnecessary investigations, unnecessary treatments,” he said.

“What I work on, and what we need to do, is basically improve quality care at lower cost.”

Dr Malhotra has been panned by leading Australian specialists for his views on Covid-19 vaccines and belief that statin medication to lower cholesterol is being overprescribed.

He said doctors, mainly in the US, should be stripped of any financial incentive to prescribe medications.

“To me, that is unethical,” he said.

In 2015 the Australian Competition and Consumer Commission ordered Medicines Australia to implement a new code of conduct requiring drug companies to publicly disclose doctors to whom they provided payments and the amount paid.

Trade Minister Don Farrell on Friday defended the PBS, saying Australia would “not compromise our fundamental values and interests”, despite the decision to allow US beef imports.

“Australia is the land of the ‘fair go’, we value social justice, fairness, inclusion and equality,” Senator Farrell said.

“Programs like the PBS, which are at the heart of the health and wellbeing of our country, will never be up for negotiation under an Albanese Labor government.”

Here is the link:

https://www.theaustralian.com.au/health/medical/australias-pbs-must-absolutely-be-protected-in-trade-talks-says-make-america-healthy-again-medical-adviser-aseem-malhotra/news-story/c58dde4fa8931a618043fdeef6edd8e9

There is little doubt big US Pharma just hate the PBS and would do anything to get rid of it. For Australians it provides government buying power to even up the power of big American Pharma and, as it reduces their profits, they hate it with a passion!

We all need to make sure it remains in place for the benefit of all Australians and to prevent US big pharma costing us all squillions!

Those bureaucrats who designed it deserve a very big medal and a pension increase!

You can see how good it is for us by seeing how much US big pharma hates it!

David.

Our Strategic Environs Are Not As Settled As They Were, Even Quite Recently!

 This appeared last week:

Opinion

Australia employs ‘straddle’ diplomacy with China and the US

The approach is not doctrinal, but is about speaking frankly to both Washington and Beijing.

James Curran International affairs expert

Jul 27, 2025 – 2.17pm

Here is a foreign minister speaking about Australia’s China debate: “We Australians tend to have a habit, a cast of mind, which seeks for simplicity, and is uneasy with complexity, in foreign policy. We tend to see issues in terms of simple dichotomies – black or white, either-or, all or nothing.

“It is apparent in the ways we have traditionally debated foreign policy: imperialism or isolationism; alliance or independence; regionalism or internationalism; forward defence or fortress Australia, as if these were clear, unambiguous and exhaustive choices.

“It springs from a compulsion to simplify and exaggerate, to ignore questions of degree and qualifications, to sloganise.”

The result? Policy rendered in “schoolboy terms”.

That minister was Andrew Peacock, speaking almost 50 years ago. He was referring to reactions to then-prime minister Malcolm Fraser’s trip to Beijing in June 1976, where some believed the leader got too close to the Chinese leadership. Indeed, heads were still being scratched then about how a conservative prime minister could possibly visit China and Japan before Britain and the US. Fraser’s retort to that barb was curt: “The world changes.”

In his talks with then-Chinese premier Hua Guofeng, Fraser had proposed the formation of a quadrilateral pact – comprising China, the US, Japan and Australia – to hedge against Soviet ambitions in the Pacific and Indian oceans. It never eventuated. But the point was that an Australian leader had proposed an independent initiative without checking with Washington first.

The Sydney Sun newspaper thought Fraser had gone “all the way with Hua” and frowned on the prime minister for calling into question “our dealings with traditional connections in Washington, London and Europe”.

Half a century later and precious little has changed in terms of how these visits are discussed.

“Canberra does not need to seek permission to run its own foreign policy.”

But to fall into the trap Peacock identified in August 1976 is to miss the new Australian diplomacy that is evolving with a re-elected Labor government. It is not doctrinal, nor is it a sharp discontinuity from Prime Minister Anthony Albanese’s first term, but it is about speaking frankly to both the US and China.

It might be called the “Australian straddle”: an approach we may see emerge from Japan, too.

To Washington, the prime minister has sent a reminder of that tradition in Australian foreign policy where Canberra, knowing that great powers often play fast and loose with this country’s interests, can express its independence both within and without the alliance. So Albanese stands firm on American demands for greater defence spending, just as Trade Minister Don Farrell is emphatic on Australia wanting to do “more, not less” business with China.

To Beijing, while going in measured terms beyond the policy of stabilisation into the realm of wholehearted but selective engagement, the prime minister stood firm on foreign investment rules, ownership of Darwin Port and raising the live-firing exercises conducted by the Chinese navy earlier in the year. Albanese was clear: Australia has differences with China, but these should not define the relationship.

The prime minister knows that today’s world is not some kind of cartoonish game. He knows that most, if not all countries in the region are still balancing in some kind of way: wary of China, leery of US President Donald Trump. Though Australian officials would no doubt have briefed their Five Eyes counterparts and Japan prior to the China visit, Canberra does not need to seek permission to run its own foreign policy either, nor apologise for growing its biggest market.

But it appears that the alternative being demanded by some critics, such as John Lee, Greg Sheridan and Peter Jennings, is a return to the “drums of war” rhetoric characteristic of the Morrison years. The catastrophising over Albanese’s lack of a meeting with Trump and the fretting over his private lunch with Chinese President Xi Jinping betrays the very mindset Peacock critiqued.

The Australian straddle is by nature a delicate balancing act – especially when the Albanese government is trying to calculate the next moves of Trump – but it is designed to have a more distant but still close relationship with the US and a warmer relationship with China. It has been imposed by the Trump administration’s new and callous approach to allies, bringing the realisation that Trump may drag Australia into actions against China that are self-harming in trade, economic and strategic terms.

One hopes it continues to be carried out with guile, the ultimate objective being to prevent war in East Asia. War between the US and China is demonstrably being calculated in Washington, and China’s military build-up indicates the risks are being contemplated in Beijing.

This straddle will also be expensive. To maintain the US relationship Australia has already posted $US1 billion to Washington and now flourishes a 50-year treaty with the UK to help support the illusion that Australia will acquire nuclear submarines by the early 2030s. It is to be hoped that the treaty has a get out clause, as the UK and the US have in the existing AUKUS agreement.

The Albanese government will have to handle the inevitable risks of this new diplomacy, including managing tensions that will arise with the US. The prime minister’s increased political confidence has brought him to this course, one that is also dictated by domestic politics. But he has the backing of the Australian people and is under no serious pressure from the opposition, some of whom appear to forget the clear electoral fallout from the “China threat” hot talk of the Morrison years.

Here is the link:

https://www.afr.com/policy/foreign-affairs/australia-employs-straddle-diplomacy-with-china-and-the-us-20250727-p5mi28

The old curse saying “May you live in interesting time” really seems to have caught up with OZ with a vengeance and frankly I sense a degree of strategic uncertainty of a level not seen since the Vietnam War. The continents are moving and we need to stay pretty alert I reckon.

I suspect we are going to need to spend more and plan more on our defense and we are going to need to work hard to foster allies from all over.

I wonder why we are not making more of our advantages in critical minerals as we are really well placed in that domain.

How are people assessing our prospects over the next 20-30 years?

David.

I Am Pretty Sure We Need To Make Sure Our Alliances(s) With The UK Are Rock Solid Given How Uncertain I Am On Trump / Vance Reliability!

This appeared last week:

• Commentary
• Editorials

Defence study is a wake-up call

12:00 AM July 26, 2025

Anthony Albanese’s insistence that his government “will invest in the (defence) capability that Australia needs” should be viewed in light of the compelling case for strengthening northern Australia as an Indo-Pacific allied stronghold.

That need is set out convincingly in a new study for Washington’s Centre for Strategic and Budgetary Assessment by former US deputy assistant secretary of defence Thomas Mahnken, who served under president George. W. Bush from 2006 to 2009 and as an officer in the US Navy Reserve including tours of Iraq and Kosovo. The study, reported by Cameron Stewart, is a serious wake-up call. Lifting defence spending is not about placating Donald Trump. It is about serving the nation’s interests.

By implication the study raises questions about leadership, political will and the need for the government to make sure the public is well aware of the importance of the issue. Addressing the concerns raised would require a significant realignment of budget priorities, underlining the importance of productivity fuelling growth and the likely need to divert resources from other parts of the economy, such as subsidising high-risk green projects. That vital conversation needs to happen sooner rather than later.

The study canvasses defence infrastructure in northern Australia, going beyond the 2023 Defence Strategic Review, which was right in recommending major upgrades of the northern network of bases, ports and barracks, including RAAF bases Learmonth, Curtin, Darwin, Tindal, Scherger and Townsville. Dr Mahnken also covers the importance of a long-range strike capability and an integrated air, drone and missile defence system to protect key facilities and improve “survivability”.

Geography, which has been central to Australia’s defence strategy for the better part of a century, still works in the nation’s favour. But the possibility that Australia will be attacked can no longer be ignored, the study finds. Existing defence efforts would probably be inadequate in the event of a major conflict, which is why the Australian Defence Force needs to act with greater urgency, including investing in basic logistic support, such as additional fuel and munitions storage and the expansion of maintenance facilities.

The report also emphasises the importance of close intelligence, surveillance and reconnaissance in the region to warn of threats to Australia and its neighbours. That capability is becoming more important given the increasing level of Chinese activity near Australia’s periphery.

In contrast to the government’s relatively muted response to the PLA navy’s live-fire exercises in the Tasman Sea in February, Dr Mahnken notes that during a Senate estimates hearing in February Andrew Shearer, the head of Australia’s Office of National Intelligence, confirmed Chinese naval ships had never been spotted that far south before. “He suggested this troubling incident created a new paradigm because it is setting the stage for Beijing to regularise these activities near Australia,’’ the report says.

Beijing has steadily increased its ability to project naval power into Australia’s neighbourhood. In May 2022, for example, a Chinese spy ship operated off the coast of Australia for nearly a week, spending days near the Harold E. Holt Communications Station in Exmouth, Western Australia, which provides very-low-frequency communication transmission services to Australian and US submarines.

As Australia and Britain strengthen their AUKUS ties, co-signing a new 50-year treaty, Dr Mahnken’s study notes that the Virginia-class submarines to be acquired under AUKUS have the speed, range and endurance suited to the Pacific region. By 2035, however, the ADF will have at most two Virginia-class subs in its inventory, constraining operations in the meantime.

On Thursday, Defence Minister Richard Marles told the ABC that the current era of strategic contest was being shaped by the biggest increase in conventional defence spending seen since the end of the Second World War – from China: “without strategic reassurance, in a sense that there’s not a clear articulation of why that defence spending is occurring”. Australia needed “to be making sure that we are facing the complex strategic circumstances”. The process, Mr Marles said, included updating the National Defence Strategy every two years. It was due in the first or second quarter of next year.

Judging by the issues raised by the CSBA report, the next NDS will demand hard decisions because the time available to create an expanded, resilient defence infrastructure suited to 21st-century warfare is limited. The report’s insights and the opportunities our alliances afford must not be wasted. Business as usual, with defence on the backburner, no longer is good enough.

Here Is The link:

https://www.theaustralian.com.au/commentary/editorials/defence-study-is-a-wakeup-call/news-story/bf8d0f94dd8dfc6cbdab9314be2e60c9

Frankly I reckon if push comes to shove I am more confident of the UK than the US!

While I would like to keep both on side, with Trump as president my confidence levels are not as high with the US as I would like.

We can forget that the UK is a very well armed nuclear power in its own right (to counter Russia), and a pretty good long term friend! Maybe they have a nuclear sub or two to spare - they do have at least 5-6 already? (Note some of the UK subs, like the US, are both nuclear powered and armed - which is a pretty dramatic step up in force projection and deterrence, but unlikely to be available to us, except in pretty dire circumstances!. However, it sure can't hurt to have the Brits on our side!)

What do others think?

David.

AusHealthIT Poll Number 804 – Results – Sunday 27 July 2025.

Here are the results of the recent poll.

Was Mr Albanese's Recent Visit To China A Success For Australia's Interests?

Yes                                                                     20 (67%)

No                                                                      10 (33%)

I Have No Idea                                                    0 (%)

Total No. Of Votes: 30

A pretty clear vote – with hope that Mr Albanese did good for us all!

Any insights on the poll are welcome, as a comment, as usual!

Not bad voter turnout – question must have been decent. 

0 of 30 who answered the poll admitted to not being sure about the answer to the question!

Again, many, many thanks to all those who voted! 

David.

I Think A New Intensive Public Education Effort On Sun Exposure Risk Is Needed

This appeared last week:

The sunburn generation: Why young people are risking cancer for tans

By Kate Aubusson

July 11, 2025 — 6.00am

More than one in four young adults are getting sunburnt, and rising numbers are exposing themselves to high levels of cancer-causing UV radiation with little protection, as social media trends promote tan lines and sunbathing routines.

Almost 26 per cent of 18- to 24-year-olds reported being sunburnt in the previous four weeks, more than any older generation and significantly higher than the 14.8 per cent reporting sunburn overall, according to the Cancer Institute NSW’s latest Sun Protection Behaviours Report.

The survey of 11,297 adults in 2022 found that almost half of young adults reported frequent sun exposure (48.7 per cent versus 41.4 per cent in the overall population), and they were less likely to wear protective clothing, sun-safe hats and sunglasses.

Meanwhile, roughly 70 per cent of 18- to 24-year-olds are pro-tanning, said Matthew Warner-Smith, acting director of screening and prevention at the Cancer Institute NSW.

“An increasing number of young people have this misconception that fake tanning protects against sun exposure and sun burn; therefore, they don’t need sunscreen … more than one-third in 2024/2025, up from 23 per cent the previous year,” Warner-Smith said.

Nationally, Cancer Council research found that nine in 10 Australians aged 18 to 30 intentionally or unintentionally sunbathe. Young women aged 15 to 24 (26 per cent) were more likely to try to get a suntan than young men (15.3 per cent), an analysis of ABS data showed.

“We can’t underestimate the influence of social media,” Warner-Smith said.

About 40 per cent of young people said people they follow on social media really influence them to get a sun tan, significantly higher than other age groups.

“There’s also much more sensitivity to body image concerns around tanning than older age groups,” he said.

TikTok trends show young women proudly displaying their tan lines and sunburnt skin.

Influencers share their tanning routines, monitor UV ratings to time their sunbathing sessions for maximum UV exposure, and market apps that tailor tanning regimens powered by AI.

Hannah English, a former pharmaceutical skincare scientist, author and digital creator, was not surprised by the results.

“The tan lines trend is horrifying,” said English, whose online content promotes correct sunscreen application and encourages her predominantly female following to adopt multiple forms of sun protection.

“You watch a tanning video on social media, and [the platform algorithm] shows you more of the same and it normalises it,” she said.

Young men were particularly challenging to reach, English said.

“I’ll get messages from women asking, ‘How do I get my husband, boyfriend, brother, dad to wear sunscreen?’ ” she said.

Australia has the highest rate of skin cancer in the world, with an estimated 169,000 cases diagnosed in 2024. More than 2000 Australians die of skin cancer every year.

Grace Passfield has a photograph of the last time she breastfed her baby boy, Lucas.

Two large bruises stain her chest and arm – the outward traces of stage 4 melanoma that had spread under her skin, through her organs, including her bones and brain. She started immunotherapy three days later.

“I was an absolute hysterical mess,” the mother-of-two said of the days following her diagnosis in 2021 when she was 33.

The physiotherapist had encountered several stage 4 patients who had died in the course of her hospital and rehabilitation work.

“I thought, ‘That’s what was coming for me,’ ” she said.

Passfield recalls riding her bike in the middle of the day as a teenager, wearing a singlet top and no sunscreen.

“I got very badly burnt,” she said. “I was better than most about wearing sunscreen, but there were a few incidents like that.

“When I got a bit older, there were the odd days when I’d forget to wear sunscreen or a hat or stay out for too long in the sun.”

Passfield underwent immunotherapy over four years, enduring severe side effects.

“I’ve had two clear PET scans since my last dose in December,” she said. “Statistically speaking, I’m probably going to be all right.

“But it’s always on my mind. I will continue to have treatment and look fine, but I’m effectively living with a chronic disease and there’s always the risk of recurrence.”

Professor Tracey O’Brien, chief executive of Cancer Institute NSW, said: “Even in winter, adopting sun protection behaviours is essential, particularly at high altitudes and on reflective surfaces such as snow or ice.”

Acting NSW Premier Ryan Park said: “Australia has one of the highest skin cancer rates in the world, and we need to take the threat of skin cancer seriously and follow the simple, life-saving steps needed to reduce our risk of this deadly disease.”

The most effective defence against overexposure to UV radiation:

1. Slip on protective clothing
2. Slop on SPF50+ sunscreen. Sunscreen should always be applied 20 minutes before heading outdoors and reapplied every two hours.
3. Slap on a wide brimmed hat
4. Seek shade
5. Slide on sunglasses

Source: The Cancer Institute NSW 

Here is the link:

https://www.smh.com.au/national/nsw/the-sunburn-generation-why-young-people-are-risking-cancer-for-tans-20250709-p5mdpx.html

Sadly it seems the young – under 25 – have really not had the message rammed home that melanoma is caused by significant sun exposure and can be very dangerous to lethal. (No good being a well tanned corpse!)

The sun-safe message never goes out of date on OZ – given our beautiful (and dangerous) climate etc.

When I was growing up the risk was not appreciated clearly and I can remember multiple exposures that left me prawn red and bloody sore for 2-3 days. I have been lucky not to get a bad outcome with this! I also how the term “a health tan” was a sign of total good health – not incipient cancer!

We need to keep the sun-safe messaging going of forever, especially for our migrant population!

David.

The Author Is Right In Saying The Internet In OZ Is About To Really Change!

This appeared last week:

Face age and ID checks? Using the internet in Australia is about to fundamentally change

New codes developed by the tech sector and eSafety commissioner come into effect in December, with major ramifications for internet users

Josh Taylor Technology reporter

Sun 20 Jul 2025 10.00 AEST

As the old adage goes, “On the internet, nobody knows you’re a dog”. But in Australia it might soon be the case that everything from search engines and social media sites, to app stores and AI chatbots will have to know your age.

The Albanese government trumpeted the passage of its legislation banning under 16s from social media – which will come into effect in December – but new industry codes developed by the tech sector and eSafety commissioner Julie Inman Grant under the Online Safety Act will probably have much larger ramifications for how Australians access the internet.

Measures to be deployed by online services could include looking at your account history, or using facial age assurance and bank card checks. Identity checks using IDs such as drivers licences to keep children under 16 off social media will also apply to logged-in accounts for search engines from December, under an industry code that came into force at the end of June.

The code will require search engines to have age assurance measures for all accounts, and where an account holder is determined to be aged under 18, the search engine would be required to switch on safe search features to filter out content such as pornography from search results.

Six more draft codes being considered by the eSafety commissioner would bring similar age assurance measures to a wide range of services Australians use every day, including app stores, AI chatbots and messaging apps.

Any service that hosts or facilitates access to content such as pornography, self-harm material, simulated gaming, or very violent material unsuitable for children will need to ensure children are not able to access that content.

In her National Press Club speech last month, Inman Grant flagged that the codes were needed to keep children safe at every level of the online world.

“It’s critical to ensure the layered safety approach which also places responsibility and accountability at critical chokepoints in the tech stack, including the app stores and at the device level, the physical gateways to the internet where kids sign-up and first declare their ages,” she said.

The eSafety commissioner announced the intention of the codes during the development process and when they were submitted, but recent media reporting has drawn renewed attention to these aspects of the codes.

Some people will welcome the changes. News this week that Elon Musk’s AI Grok now includes a pornographic chat while still being labelled suitable for ages 12+ on the Apple app store prompted child safety groups to call for Apple to review the app’s rating and implement child protection measures in the app store.

Apple and Google are already developing age checks at the device level that can also be used by apps to check the age of their users.

App stores have 'huge disincentive' to remove pornography due to profits says eSafety boss – video

Founder of tech analysis company PivotNine, Justin Warren, says the codes would “implement sweeping changes to the regulation of communication between people in Australia”.

“It looks like a massive over-reaction after years of policy inaction to curtail the power of a handful of large foreign technology companies,” he says.

“That it hands even more power and control over Australians’ online lives to those same foreign tech companies is darkly hilarious.”

One of the industry bodies that worked with the eSafety commissioner to develop the codes, Digi, rejected the notion they would reduce anonymity online, and said the codes targeted specific platforms hosting or providing access to specific kinds of content.

“The codes introduce targeted and proportionate safeguards concerning access to pornography and material rated as unsuitable for minors under 18, such as very violent materials or those advocating or [giving instructions for] suicide, eating disorders or self-harm,” Digi’s director of digital policy Dr Jenny Duxbury says.

Search engines are one of the main gateways available to children for much of the harmful material they may encounter

Office of the eSafety Commissioner

“These codes introduce safeguards for specific use cases, not a blanket requirement for identity verification across the internet.”

Duxbury says companies may use inference measures – such as account history or device usage patterns – to estimate a user’s age, which would mean most users may not have to go through an assurance process.

“Some services may choose to adopt inference methods because they can be effective and less intrusive.”

However, those that do may be caught by surprise when it comes into effect, says Electronic Frontiers Australia chair John Pane.

“While most Australians seem to be aware about the discussion about social media, the average punter is blissfully unaware about what’s happening with search engines, and particularly if they go to seek access to adult content or other content that is captured by one of the safety codes, and then having to authenticate that they’re over the age of 18 in order to access that content, the people will not be happy, rightly so.”

Companies that don’t comply with the codes will face a fine similar to that of the social media ban – up to $49.5m for a breach. Other measures such as eSafety requesting sites be delisted from search results are also an option for non-compliance.

Pane says it would be better if the federal government made changes to the privacy act and introduced AI regulation that would require businesses to do risk assessment and ban certain AI activities deemed an unacceptable risk.

He says a duty of care for the platforms for all users accessing digital services should be legislated.

“We believe this approach, through the legislature, is far more preferable than using regulatory fiat through a regulatory agency,” he said.

Warren is sceptical the age assurance technology will work, highlighting that the search engine code was brought in before the outcome of the age assurance technology trial, due to government this month.

“Eventually, the theory will come into contact with practise.”

After recent media reporting about the codes, the eSafety commissioner’s office this week defended including age assurance requirements for searches.

“Search engines are one of the main gateways available to children for much of the harmful material they may encounter, so the code for this sector is an opportunity to provide very important safeguards,” the office said.

Here is the link:

https://www.theguardian.com/technology/2025/jul/20/face-age-and-id-checks-using-the-internet-in-australia-is-about-to-fundamentally-change

It is going to be interesting to see how, over the next few months, these changes are rolled out and accepted by the public at large. We are all rather used to a pretty open and free-flowing internet and how well all this goes down will be interesting to watch.

I suppose there is harm being done now (we are told) so we need to see if any improvement and reduction of harm results from these changes. I have an open mind on this  but apparently there are nippers at risk who need protection.

I guess we wait and see just what happens and who has harm prevented!

David.

Trump’s Health Secretary Is A Global Menace And A Fool To Boot

This appeared last week:

Trump news at a glance: How Robert F Kennedy Jr is cancelling medical science

Measles on the rise and vaccination rates falling; EPA to be gutted of its crucial research function. Key US politics stories from Saturday 19 July at a glance

Guardian staff

Sun 20 Jul 2025 11.30 AEST

“The current administration is waging a war on science,” warned Celine Gounder, a professor of medicine and an infectious disease expert at New York University in a keynote talk in May to graduates of Harvard’s School of Public Health.

That war appeared to enter a new phase in the aftermath of a recent supreme court decision that empowered health and human services secretary Robert F Kennedy Jr, a prominent vaccine sceptic, and other agency leaders, to implement mass firings – effectively greenlighting the politicization of science.

Kennedy abruptly cancelled a scheduled meeting of a key health care advisory panel, the US Preventive Services Task Force, earlier this month. That, combined with his recent removal of a panel of more than a dozen vaccine advisers, signals that his dismantling of science-based policymaking is likely far from over.

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‘Making viruses great again’

“Do you enjoy getting sick from preventable diseases?” Arwa Madhawi asks in her Week in Patriarchy column. “Do you have a hankering to make once-declining viruses great again? If so, why not pop over to the US where the health secretary, Robert F Kennedy Jr, and his anti-vaccine cronies are making a valiant effort to overturn decades of progress in modern medicine.”

Measles cases are at their highest rate in 33 years in the US, and while not entirely to blame, Trump’s officials don’t seem bothered. RFK Jr has downplayed the numbers. Kennedy has announced that the federal CDC will stop recommending Covid-19 booster shots for healthy children and pregnant women. The American College of Obstetricians and Gynecologists (ACOG) said in a statement: “It is very clear that Covid-19 infection during pregnancy can be catastrophic and lead to major disability”. Leading medical associations are suing the Trump administration as a result.

Two new surveys, published as a research letter in Jama Network Open, have found that only 35% to 40% of US pregnant women and parents of young children say they intend to fully vaccinate their child. That means the majority of pregnant women and parents don’t plan to accept all recommended kids’ vaccines.

Here is the link:

https://www.theguardian.com/us-news/2025/jul/20/trump-news-at-a-glance-how-robert-f-kennedy-jr-is-cancelling-medical-science

My view – from this and other sources – is that the man is a dangerous fool, who with Trump as president for the next few years could wreak havoc and terminally damage the US and Global public health systems.

He is a clear and present danger to many globally…

David.

There is Little Doubt It Is Getting Much Tougher Out There!

Mr Albanese had a busy time last week visiting China. The relationship is surely one of our two most consequential management tasks!

Here is some analysis of our strategic situation:

In a tougher, more dangerous world, the US remains our best option

Sitting on the fence and hoping for a return to the halcyon days of the past where we were able to cash in on China’s rise while enjoying the privileges of cut-price US alliance membership is a mirage. Those days are over.

Alan Dupont

3:00 PM July 18, 2025

Contrasting the bonhomie of Anthony Albanese’s visit to China with his less than effusive embrace of Donald Trump’s America, an intergalactic visitor could be forgiven for concluding that China, not the US, is our principal ally and closest friend.

Seldom has the tension between our security alliance with the US and our trade relationship with China been so starkly exposed. The optics are damning. While the Prime Minister talks enthusiastically about increasing trade, tourism and cultural contacts, his words are jarringly at odds with the unwelcome presence of Chinese naval ships monitoring the Australian and allied Talisman Sabre training exercise off the Queensland coast.

Concerns that Australia is slowly drifting away from the US under the centrifugal pull of an increasingly powerful and ruthlessly focused China have been heightened by Albanese’s unusually long six-day visit to China and his fourth meeting with Communist Party secretary-general Xi Jinping. The Trump administration clearly is beginning to worry about Australia’s reliability as an ally as Albanese continues to resist US calls to ramp up defence spending.

Unless this drift is arrested, Australia risks moving into a national security no-man’s land freeloading off the US without a corresponding commitment to the alliance or our own defence.

That way is a values-free, security dead end. It would further weaken our already feeble defence capabilities and dilute our voice in the world – the exact opposite of the government’s professed desire to better manage what Defence Minister Richard Marles repeatedly has warned is the “most complex and challenging strategic environment since the second world war”.

Trump doesn’t help matters by his unabashed admiration for authoritarian strongmen leaders and chaotic, transactional approach to the world that gratuitously alienates allies. But asserting a faux security independence from the US, the so-called Labor way, is unconvincing. It’s belied by the stubborn refusal to increase defence spending and reverse the potentially fatal hollowing out of our defence force that becomes daily more evident. The Albanese government seems unable to differentiate between a still democratic US and an increasingly authoritarian China that shares none of our values and precious few of our interests.

Labor’s China policy has been marked by a curious and unedifying timidity uncharacteristic of a government more than willing to take potshots at US policies it doesn’t like and robustly criticise Israel, a fellow democracy, for its alleged sins. But Beijing’s many egregious assertions of its interests at the expense of other countries, including Australia, is routinely met by silence or platitudes typified by Albanese’s vacuous shibboleth: “We will co-operate where we can, disagree where we must but engage in our national interest.” Appeasement may be too strong a word. But Labor opens itself up to the criticism that it willingly self-censors, which is exactly what China wants.

Sometimes this borders on the farcical when the government bends over backwards not to mention China’s name when warning against cyber intrusions, espionage, information operations and attacks against our critical infrastructure that our security agencies know full well are largely orchestrated by Beijing.

Refusing to call out China publicly when our interests and values are clearly violated undermines our sovereignty. And it encourages China to believe an “America First” Trump provides a historic opportunity to decouple Australia from the alliance and neutralise us in any confrontation with the US over Taiwan. Given these risks, and the mountain of hard evidence that China’s interests often are diametrically opposed to ours, why is it that the Albanese government is so reluctant to call out bad behaviour by the People’s Republic when warranted? Four reasons spring to mind.

First is the assumption of “pragmatic realists” that China will inevitably become the dominant regional and global power. We had better get used to this reality, so the thinking goes, and stop venting about China’s behaviour.

But there are many reasons to doubt that China will dominate the region or the world, among them the Middle Kingdom’s long history of domestic instability, factional divides, economic failure and succession crises.

Pragmatic realists should familiarise themselves with recent Chinese history. In 75 years of Communist Party rule, the country has suffered the disaster of the Great Leap Forward, the Cultural Revolution, the excesses of the Gang of Four and the bloody turmoil of Tiananmen Square – all self-inflicted. No matter how powerful it becomes, China’s policies still will be shaped by the actions and resilience of others.

To wash our hands of agency or influence is entirely self-defeating. For a government that prides itself on running a moral foreign policy, willing to hold Israel to a higher standard of behaviour than anyone else, what is the moral imperative for allowing China’s many transgressions to go unremarked? Should we forget the trade coercion, “wolf warrior” diplomacy and blatant interference in our domestic affairs used to assert Beijing’s interests and desensitise us to what once would have been routinely condemned and certainly wouldn’t be tolerated in reverse?

Second, the Albanese government continually emphasises China’s position as our most important trading partner, the unstated subtext being that we can’t afford to jeopardise this trade by offending China.

Trade Minister Don Farrell recently bridled at the suggestion the Trump administration might pressure the government to reduce trade with China. In a pointed slapdown of the US and the Morrison government, he said bilateral trade “is almost 10 times more valuable to Australia” than trade with the US and that we’ve “stabilised” the relationship, claiming that trade had “effectively recovered” under his stewardship.

Albanese also played down the significance of exports to the US during his meeting with Xi, noting they made up less than 5 per cent of trade compared with China’s 25 per cent.

But there was no acknowledgment of the importance of the trillion-dollar US investment here annually, more than 10 times larger than China’s, or mention of our major trading partner’s coercive trade measures that cost us $20bn in lost exports.

Neither was there any reference to the fact Beijing literally is moving mountains to find alternatives to Australian iron ore by funding African mines in Guinea (Simandou), Cameroon and the Republic of Congo (Mbalam-Nabeba) that soon will end our iron ore dominance even in the unlikely event that “green steel” comes to the rescue.

Bilateral trade is a two-way street, meaning a mutual dependence, so Australia is not without leverage. China buys our iron ore, coal, minerals and agricultural products because they are high quality, well priced and necessary for its economy.

Even at the height of the wolf warrior attack our iron ore exports were unaffected. Given the failure of Beijing’s coercive trade practices to bring Australia to heel they are unlikely to be repeated any time soon unless Albanese mishandles his promise to cancel the 99-year lease on the Port of Darwin granted to the Chinese-owned Landbridge company.

But we should be diversifying trade, not increasing our already high dependence on a single market. This only increases our vulnerability to coercion, a lesson Xi has taken to heart by actively pursuing strategies to increase China’s self-sufficiency and reduce dependence on imports, particularly in strategic industries.

Third is perceived political advantage overlaying a sense that Labor is the true champion of the relationship stemming from Gough Whitlam’s historic decision to establish diplomatic relations with Mao Zedong’s China in December 1972.

Labor successfully weaponised the Coalition’s perceived hostility to China in the run-up to the election in May, peeling away significant numbers of ethnic Chinese voters sensitive to the imputation that they were not loyal Australians. Labor was aided by the Coalition’s overly aggressive criticism of Beijing and avoidable stumbles, notably from former frontbencher Jane Hume, who injudiciously claimed that Chinese spies were volunteering for Labor Housing Minister Clare O’Neil.

But Labor’s sweep of seats with a high Chinese-Australian population has come at the expense of foreign policy bipartisanship on China that Beijing has exploited for strategic gain. And the political win for Labor may prove short-lived. New Coalition leader Sussan Ley has quickly moved to cauterise the wound, acknowledging that the Liberals “didn’t get it right” with the Chinese community during the election: “We didn’t get the tone right.”

A fourth reason for the shift towards China is the increasingly entrenched anti-Americanism of Labor’s Left, no longer muted by the once dominant pro-American Centre-Right. Labor’s cohort of “moral equivalencers” asserts that the US is no different to China in seeking hegemony and arguably is worse under Trump, a proposition that has superficial appeal but fails the truth test.

Despite Trump’s disruptive and indiscriminate tariffs, on just about every other meaningful measure of interests and values we are far more closely aligned with the US than we can ever be with China while it remains a one-party dictatorship that brooks no dissent and squeezes the space for smaller countries to freely exercise their sovereign rights. Unlike China’s surreptitious $20bn hit on our trade, Trump’s tariffs are at least transparent. Neither are they specifically directed at Australia.

The reality is that our relationship with China is now defined by strategic competition and opposing objectives.

Writing in Foreign Affairs, American scholars Charles Edel and David Shullman document how the Chinese Communist Party promotes its avowedly illiberal governance model globally. The CCP works assiduously and strategically to hollow out our institutions; enhance tools of repression in developing countries; silence academic discourse; dilute liberal norms; erode human rights protections as the continued incarceration of Australian writer Yang Hengjun attests; and make autocrats the world over more powerful and less accountable.

That’s why Beijing supports Russia’s invasion of Ukraine; suppresses the Uighurs; denies Tibetans their autonomy; threatens Taiwan; illegally militarises the South China Sea; repeatedly infringes the borders, seas and air space of its neighbours; routinely harasses the defence forces of other states in international waters often dangerously so; and presides over the largest peacetime arms build-up in history including a doubling of its nuclear weapons inventory by 2030.

Yet China’s ambassador to Australia has the temerity to lecture us about the dangers of increased defence spending. It’s hard to see how economic, trade and cultural ties can flower in such infertile soil.

So, to borrow from Vladimir Lenin, what is to be done?

By all means trade. But don’t allow the CCP access to our strategic industries, critical national infrastructure such as ports and communications architecture or technologies that could be used against us, especially artificial intelligence. We should be thinking about how to diversify trade away from China just as China is doing and for the same reason – economic resilience and supply chain security. The last thing we should be doing is increasing our dependence on a state that has no love for democracy or democracies.

As to public diplomacy and political rhetoric, Albanese could learn a thing or two from Europe, which has stopped kowtowing to China and is standing up for its interests in a firm but measured way, recognising the dangers of dependence. Stung by China’s close ties to Russia and concerned about the avalanche of cheap, subsidised Chinese goods flooding into the continent, European officials now are far more critical of China publicly.

In 2023, former German Greens leader and foreign minister Annalena Baerbock characterised China as a “systemic rival” that behaved “aggressively” and was repressive domestically, phraseology that was later picked up in last year’s NATO summit that specifically referred to the communist state’s systemic challenge “to Euro-Atlantic security”.

We also could learn from Europe about the realities of alliance membership in today’s unruly world and how calculations of geopolitical risk will increasingly shape economic and trade policy.

Once true believers in a stable, peaceful, civilised world underpinned by treaties, deliberative bodies and international law, and famously described as coming from pleasure-loving Venus by conservative American commentator Donald Kagan, Europeans finally are hardening up. Confronted by the harsh realities of Russia’s invasion of Ukraine, they have committed to a level of defence spending and burden sharing that would have been inconceivable six months ago.

Having brought huge pressure on NATO to increase defence spending to 5 per cent of GDP, the Trump administration is about to turn up the heat on Australia to lift defence spending well beyond Labor’s comfort zone. Influential US Under Secretary of Defence for Policy Elbridge Colby has pointedly asked Australia and Japan whether they are committed to supporting the US in any conflict with China over Taiwan.

Albanese slowly is being squeezed between a rock and a hard place. Refusal to go beyond the government’s commitment of 2.4 per cent of GDP by 2033 will have serious consequences for the alliance and our broader relationship with the US. But going it alone would cost much more in blood and treasure, so the US alliance remains our best option in a tougher world. Sitting on the fence and hoping for a return to the halcyon days of the past where we were able to cash in on China’s rise while enjoying the privileges of cut-price alliance membership is a mirage. Those days are over.

If the US and China come to blows over Taiwan, we will be involved on the US side whether we like it or not because China will target US forces and supporting defence infrastructure here. They are essential to US warfighting capabilities as they were during the Pacific campaign against Imperial Japan during World War II.

Albanese would do well to reflect on this reality as well as the words of Thucydides, the great Athenian historian and strategist: “Weak states do what they must, and strong states do as they please.”

Alan Dupont is chief executive of geopolitical risk consultancy the Cognoscenti Group and a non-resident fellow at the Lowy Institute.

Here is the link:

https://www.theaustralian.com.au/inquirer/in-a-tougher-more-dangerous-world-the-us-remains-our-best-option/news-story/596f55c1f6a7f92d692f3b7095635535

I agree with Dr DuPont that our relationship with China is an evolving work in progress and that the relationship is by no means settled. China is heading towards becoming a global hegemon and there is little we can do but watch its rise – that is the reality of where we are and really means we need to work hard to define and preserve our independence and way of life over the next 20-30 years. To not be alert to the risks of domination and subversion would be plain stupid!

As others have said we live “in dangerous times!!

David.

Here Is An Update On Measles Since It Seems To Be About More Frequently Again!

Measles seems to be on the loose again. Here is a briefing!

Unsure about measles and vaccines? Here’s the expert guide

Australia is experiencing an increase in the number of cases of measles, but the US has had more serious outbreaks. Our GP columnist takes you through the latest on the disease and how to prevent its spread.

DR MAGDALENA SIMONIS

6:00 AM July 19, 2025.

Measles cases in Australia continue to climb, and the latest reports from Western Australia bring the number to about 80, across all states and territories.

The detection of measles in flight staff and a few miners in a remote mining town in WA, coupled with the recent announcement of suboptimal childhood and adolescent immunisation rates, raises concerns around the potential for a return of the measles epidemic we witnessed prior to the 1970s vaccination program.

Most people these days don’t realise how contagious or serious measles is; in fact, it is one of the most contagious diseases in the world. An unvaccinated person who is exposed is 90 per cent likely to contract the disease from droplets spread through the air or contaminated surfaces – and the incubation period, which is when a person is asymptomatic but contagious, can be anywhere from seven to 18 days.

A person with measles will infect 12 to 18 others on average, as compared to a person with Covid-19, who can infect about three people on average.

Measles was almost eradicated in Australia and was no longer an endemic disease by March of 2014, although there were occasional cases brought back by travellers returning from countries with low vaccination rates, much like we are seeing now.

So, given it never really disappeared in the first place, why is such a ruckus being made about it?

MEASLES: WHAT YOU NEED TO KNOW

• Measles vaccinations are safe and provide lifelong protection in 99 of every 100 people vaccinated
• Measles vaccination is free for those born on or after 1966.
• Since Covid-19, Australian childhood and adolescent vaccination rates have fallen short of the 95 per cent WHO recommendation, and it’s a trend we are seeing across the globe.
• See your doctor within 72 hours of contact with a known case for immediate vaccination, if unvaccinated.
• If you have contracted measles, make sure you isolate from others for four days after the rash appears and notify your contacts also. If exposed but not ill, you should isolate for up to 14 days., 
• Measles is a severe viral illness, and you are 90 per cent likely to contract it if exposed and non-immune. 
• Measles can cause life-threatening pneumonia (one in 15) and encephalitis (one in 1000) which can lead to hospitalisation, lasting health impacts and even death.
• Vaccination for measles comes as a triad with mumps and rubella. Missing this means you miss all three.
• See your doctor prior to travel to discuss your measles vaccination status.

There is valid cause for concern from what we are seeing unfold in the US as the number of measles cases reported on July 15 has surpassed 1309, with three confirmed deaths, reaching a 33-year high. This rise in infections is partly due to vaccine hesitancy, which is strongly driven by widespread vaccine misinformation, although this might not be the only explanation for the cases we are seeing in Australia.

The 20 to 49-year-old age group is heavily represented among the recent measles cases in Australia, due to incomplete vaccination and overseas travel, usually to southeast Asia where national uptake of vaccinations is lower.

Catching up with family and friends or just returning to work or university after a holiday escape can expose those who are at greatest risk, which is children under 24 months along with other under-vaccinated adolescents, young adults and pregnant women.

Those born before 1966 from countries with similar national vaccination programs to Australia are assumed to be immune to measles due to the national immunisation programs that were in place throughout schools at that time and the measles epidemics that swept across the globe.

If you come from another country and are not sure about your vaccination status, it is safe to get another vaccination – although a blood test can confirm your immune status. Those who contracted measles are considered immune for life, as are those who have received two vaccinations, which provide 99 per cent lifelong immunity.

Declining vaccination rates are a concern for population health

Since Covid-19, Australian childhood and adolescent vaccination rates have fallen short of the 95 per cent World Health Organisation recommendation and it’s a trend we are seeing across the globe. The latest Australian childhood immunisation rates are 92.14 per cent for one-year-olds, 90.44 per cent for two-year-olds and 93.63 per cent for five-year-olds.

These are the lowest rates we have seen since 2016, which is concerning because herd immunity requires 95 per cent vaccination rates against preventable communicable diseases such as polio, tetanus, measles, rubella, diphtheria, haemophilus influenza, and pertussis.

Herd immunity protects the most vulnerable who can’t have vaccines for a variety of reasons, those where vaccination has been ineffective and people, especially children under two years, who are not yet fully vaccinated.

One can reasonably say that the highest risk at present is from overseas travel. However, despite our overall effective immunisation campaigns, we do risk facing another measles epidemic if national efforts fail to improve our vaccination uptake rates.

What is measles and how does it present?

There are two types of measles: the measles which we are witnessing a resurgence of is caused by the virus “rubeola”, and the other is called “rubella” (formerly “German measles”). They are two distinct viruses with different presentations and complications. Measles is usually a more severe viral illness with potential complications such as pneumonia, encephalitis and even death. Rubella is a milder viral illness but causes severe birth defects in unvaccinated pregnant women.

The first symptoms of measles (rubeola) are fever, sore throat, runny nose, red stinging eyes and dry cough. At first this can appear like a severe viral illness of any kind, until the characteristic rash appears. The flat, spotty rash over the torso and face is a typical feature of measles and usually appears four days into the infection. The spots then coalesce to form a generalised redness on the face and body and there can be small white spots on the inside of the mouth and throat called Kolpiks spots.

Secondary complications are more likely to affect unvaccinated adults and young children, rather than adolescents and young adults. These are usually severe and include middle ear infection, pneumonia (one in 15), and even a serious form of brain inflammation called encephalitis (one in 1000).

An early warning sign of measles-related encephalitis is severe headache and irritability which can progress, causing behavioural changes, confusion and convulsions. Lasting intellectual disability occurs in 40 per cent of those with encephalitis, and 10 per cent will die from the inflammation. It’s a devastating disease and can sometimes lead to subacute sclerosing panencephalitis, or SSPE, which is a rare immune-mediated deterioration of the brain that develops six to 15 years later. So for those who fear the measles vaccine, it’s important to understand that the risk of vaccine-related encephalitis is 1000 times lower, at a rate of 1 in a million, than catching the disease and leaving it to chance. Having the vaccine is much safer than having the disease.

What to do if exposed to measles

If you have been exposed and are not sure what to do, see your general practitioner within 72 hours for post-exposure prophylaxis. Diagnosis is made by clinical presentation and laboratory testing which includes taking swabs of the throat and nasal passages for PCR (polymerase chain reaction) and blood for serology testing and the presence of antibodies.

The serology test measures immunoglobulin levels which can detect recent infection (IgM) or long lasting immunity (IgG), due to previous infection or immunity. PCR tests are most sensitive within the first few days after the rash appears. Serology testing for IgM antibodies may need to be repeated if negative in the early stages of the illness.

It is a reportable disease, so we can track its progress through the community and it is important that you notify your contacts immediately and get them to see their doctor.

As with other viral illnesses, symptomatic relief is recommended along with rest, fluids, simple analgesia and isolation for up to four days after the rash appears. Those who have been in contact with a case might need to isolate for up to 14 days after the last contact with the infectious person.

It’s important to know your vaccination status but if uncertain or unvaccinated, the measles mumps rubella vaccine (MMR) should be administered within 72 hours of exposure, as this can reduce the severity of infection or even prevent it. The MMR vaccine is government-funded for people born on or after 1966. Make sure you isolate from others to prevent spread and notify your contacts also.

Immunoglobulin can be administered within six days to those unable to have the vaccine, or who are beyond the 72-hour window, or if they are immunocompromised, are a pregnant woman, or an infant.

Measles Mumps Rubella vaccine MMR – it’s a triad

It’s important to know that the measles vaccine is delivered as a triad along with mumps and rubella combined. This means that if a child or adolescent misses their measles vaccine, they’re not getting the mumps and rubella vaccines either.

One of the greatest successes of the national immunisation programs in all nations has been the prevention of congenital rubella syndrome, which is a cluster of birth defects that occur when pregnant women contract the virus. The rubella virus can cross the placenta, infecting the unborn child and causing disastrous complications such as nerve deafness, heart deformities, mental retardation, spasticity, paralysis, cataracts and blindness, as well as miscarriage and late-pregnancy fetal loss, to name a few. The impact of rubella is worse the earlier in the pregnancy the woman is exposed, and the best way to prevent this is to be fully vaccinated prior to pregnancy. The measles mumps rubella vaccine cannot be given when pregnant.

Vaccination recommendations (Australian Immunisation Handbook)

Know your vaccination status

It is important that you ascertain your immunisation status. This can be accessed from the Australian Immunisation Register inquiries line (1800 653 809), or you can access this from your electronic health record.

The catch-up vaccination program for children up to the age of 10 years can be accessed here:

https://immunisationhandbook.health.gov.au/contents/catch-up-vaccination#using-the-catchup-worksheet-for-children-aged-10-years

Children who have not received a measles-containing vaccine at the recommended schedule points may need an alternative schedule

Catch-up vaccination for measles

Measles-containing vaccine is recommended for:

•  Children ≥12 months of age
•  Adolescents and adults born during or since 1966 who have not received two doses of measles-containing vaccine, particularly
  – healthcare workers
  – childhood educators and carers
  – people who work in long-term care facilities
  – people who work in correctional facilities
  – travellers

Children:

Measles-containing vaccine is recommended for children

•  at 12 months of age as MMR (measles-mumps-rubella) vaccine, and
•  at 18 months of age as MMRV (measles-mumps-rubella-varicella) vaccine.

Measles-containing vaccines are not routinely recommended for infants younger than 12 months of age. This is because maternal antibodies to measles persist in many infants after birth, declining progressively over the first year of life. These may interfere with active immunisation before 12 months of age.

Adolescents and adults:

All adolescents and adults born during or since 1966 should have either:

•  documented evidence of two doses of measles-containing vaccine given at least four weeks apart and with both doses given ≥12 months of age, or
•  serological evidence of immunity to measles, mumps and rubella

People born before 1966 do not usually need to receive measles-containing vaccine (unless serological evidence indicates that they are not immune). This is because circulating measles virus and disease were very prevalent before 1966, so most people would have acquired immunity from natural infection.

Travel

For travel purposes now, it is important to ensure that you are fully vaccinated against measles and have the MMR vaccine at least two weeks prior to departure. The vaccines provide full protection and should be administered 28 days apart.

Travellers born during or since 1966 are recommended to have received two doses of measles-containing vaccine.

Associate Professor Magdalena Simonis AM is a leading women’s health expert and adviser, a senior honorary research fellow at the University of Melbourne department of general practice, and a longstanding member of the Royal Australian College of General Practitioners’ expert committee on quality care.

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This column is published for information purposes only. It is not intended to be used as medical advice and should not be relied on as a substitute for independent professional advice about your personal health or a medical condition from your doctor or other qualified health professional.

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References:

• Doherty M, Buchy P, Standaert B, Giaquinto C, Prado- Cohrs D, Vaccine impact: Benefits for human health, Vaccine, Volume 34, Issue 52, 2016, Pages 6707-6714, ISSN 0264-410X
• Ongoing decline in childhood immunisation rates sparks concerns
• Childhood Immunisation Coverage
• Immunisation Handbook: Measles
• Immunisation Handbook: Catch-up Vaccination

Here is the link:

https://www.theaustralian.com.au/health/medical/unsure-about-measles-and-vaccines-heres-the-expert-guide/news-story/d6aef3d7e1e502ed7e8267db636eca27

Seems old age has one benefit! I seem to have very probably already had the disease (I do have a vague memory of an itchy rash as a 7-8 year old) so it probably won’t come back!

It is worth finding out if you need vaccination as it can be a pretty nasty, as you read above!

David.