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Speaker 1: Now we do know that there has been two cases

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Speaker 1: of Japanese in cephalitis confirmed in the Northern Territory, including

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Speaker 1: one current case and one historical one. It's a potentially

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Speaker 1: fatal disease spread by mosquitoes and can infect animals and humans.

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Speaker 1: Now joining me from Northern Territory Health to tell us

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Speaker 1: a little bit more about the situation. It is Professor

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Speaker 1: Bart Curry, infectious disease physician from the Royal Darwin Hospital.

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Speaker 1: Good morning to you, Bart, Good morning lovely to have

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Speaker 1: you on the show. Now tell us a little bit

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Speaker 1: more about the details of the confirmed cases of Japanese

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Speaker 1: in cephalitis.

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Speaker 2: Yes, so, look, it's been a complicated story because there

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Speaker 2: was last year in February, a tragic and fatal case

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Speaker 2: of Japanese in capelitis from the top end, and it

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Speaker 2: was only a year later, earlier this year, that it

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Speaker 2: was recognized that in fact this virus, which had been

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Speaker 2: introduced into Northern Australia in a silent way, had subsequently

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Speaker 2: spread to four of the southern states of Australia. And

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Speaker 2: there was in early this year twenty twenty two, an

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Speaker 2: explosive outbreak in commercial piggeries across four southern States where

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Speaker 2: there were cases of what's called mummified piglets. In other words,

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Speaker 2: the sows were delivering dead or very sick babies. And

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Speaker 2: this was found surprising need to be Japanese in Cavlaias

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Speaker 2: and indeed in four states and then and this was

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Speaker 2: a year after there'd been this single case in the

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Speaker 2: top end of the Northern Territory. So subsequent to that

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Speaker 2: there's been an increase ofurveillance around the country and we've

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Speaker 2: now had these further two confirmed cases which were just

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Speaker 2: recently reported, one of which was an historical case, a

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Speaker 2: second case from last year, and the other is the

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Speaker 2: more recent case.

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Speaker 1: And is that more recent case was one of them a.

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Speaker 2: Child, Yes, so the most recent case, which was from

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Speaker 2: June this year, was a child who presented very unwell

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Speaker 2: and fortunately is making an excellent recovery. And so this

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Speaker 2: is something that we all need to be aware of.

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Speaker 2: And there's been a lot of work going into trying

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Speaker 2: to figure out how far this virus has spread throughout

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Speaker 2: Australia and also obviously in Northern Australia since it came

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Speaker 2: into the country, and also to make sure that our

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Speaker 2: health staff are aware. So that they can make the diagnosis,

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Speaker 2: which is a difficult diagnosis to make, And why.

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Speaker 1: Is it a difficult diagnosis to make? Well?

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Speaker 2: The thing is that the testing of blood and spinal

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Speaker 2: fluid in children who may have in cavalitis, for instance,

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Speaker 2: gives conflicting results potentially. So for instance, in these two

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Speaker 2: cases which we're just alerted the public too, it's taken

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Speaker 2: a couple of months to get them absolutely worked out

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Speaker 2: as to what it is because and we've actually had

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Speaker 2: to send samples to three different reference labs down south

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Speaker 2: to get a final confirmation. This virus behaves very similarly

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Speaker 2: and it's transmitted by mosquitoes, as is Murray Valley in cafalitis,

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Speaker 2: which your listeners will be aware has been present forever

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Speaker 2: in Northern Australia, and so this Japanese in cafaliitis is

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Speaker 2: very closely related to Murray Valley in cavaliitis, also spread

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Speaker 2: by mosquitoes, and the blood tests can are very difficult

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Speaker 2: to sort of separate the two out. So in a

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Speaker 2: number of these cases that we now recognize it has

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Speaker 2: been definitely Japanese in cafaliitis. Originally the thought was maybe

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Speaker 2: this is just our standard Murray valley in cafalidis.

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Speaker 1: Yeah. Right, And so you did say there's been those

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Speaker 1: two cases. We know, one of them a child from

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Speaker 1: a remote community in the top end. The other historical

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Speaker 1: case a Victorian man in his seventies. Do we know

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Speaker 1: how that man became infected.

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Speaker 2: Yeah, Look, that's been a lot of detective work that's

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Speaker 2: been done by one of our doctors at our CDC.

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Speaker 2: She was tasked with going back over people from last

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Speaker 2: year who had undiagnosed infections pretent, particularly if they had

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Speaker 2: an encapelitis from meningitis, that being inflammation of the brain,

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Speaker 2: so people who may have fevers and confusion. And there

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Speaker 2: was this man who was a tourist who was up

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Speaker 2: here in May and he had been very civilian in

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Speaker 2: the Royal dn Hospital but had fortunately made some degree

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Speaker 2: of recovery and then returned to Victoria. When he returned

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Speaker 2: to Victoria, he was still substantially affected by the illness

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Speaker 2: that he had had, and so our CDC tracked him

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Speaker 2: down to Victoria and was able to contact him and

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Speaker 2: his wife and the good news was that he had

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Speaker 2: continued to improve, although he's not made an absolute recovery.

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Speaker 2: And then the only way we could figure out that

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Speaker 2: this was in fact Japanese in cappelitis was we had

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Speaker 2: to then organize with Victoria health colleagues to get his

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Speaker 2: GPS to take another sample of blood and then look

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Speaker 2: at the levels of antibodies to the virus, the Japanese

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Speaker 2: in kefalatis virus. So so that was done over the

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Speaker 2: last month or two. His blood was taken and his

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Speaker 2: blood was again sent to two different laboratories, and finally

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Speaker 2: it was confirmed that this indeed was the illness from

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Speaker 2: which he was recovering was Japanese in cappalitis. And he,

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Speaker 2: as a tourist, had been in a number of places

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Speaker 2: in the Top End where tourists go, where there are

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Speaker 2: heaps of mosquitos, and he recalled, as did his wife,

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Speaker 2: being absolutely smashed by mosquitoes as how I think they

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Speaker 2: put it when they are out camping.

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Speaker 1: And this is the worry, isn't it, Because you know,

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Speaker 1: you've obviously got to make sure that you protect yourself

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Speaker 1: as best you can when you are out camping or

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Speaker 1: fishing or wherever you might be outdoors. From those massies

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Speaker 1: tell us a little bit about how Japanese and cavalitis

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Speaker 1: is spread.

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Speaker 2: So it's spread by bites from mosquitoes. It does not

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Speaker 2: spread from person to person. But the question is how

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Speaker 2: does it get into the mosquitoes and what are the

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Speaker 2: other animals that it may be in. And like Murray

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Speaker 2: Valley and cavalitis, it's thought that it can be spread

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Speaker 2: from one region to the other by my gradory waterbirds,

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Speaker 2: So in other words, birds moving across Northern Australia, and

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Speaker 2: then with all the rain that's been happening over the

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Speaker 2: last year, it's thought that those migratory waterbirds in large

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Speaker 2: numbers have moved down south and they took with them

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Speaker 2: this Japanese in caffaliitis virus. Those birds themselves can then

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Speaker 2: amplify up the virus and then they get bitten by

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Speaker 2: mosquitoes who suck up the blood from the bird, and

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Speaker 2: those mosquitoes will then bite a human and then transmit

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Speaker 2: the virus. Where Japanese in cavalitis is different from Murray

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Speaker 2: Valley in cafalitis is that there's an additional important what

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Speaker 2: we call amplifying hosts, and that is pigs. So pigs

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Speaker 2: and our concent of course is feral pigs, but in

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Speaker 2: down South it was the commercial piggeries are absolute magnets

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Speaker 2: for this virus and then they amplify up the virus

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Speaker 2: and then the pig, if it's bitten by mosquito, will

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Speaker 2: will then transmit the virus back to the mosquitoes, and

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Speaker 2: then those mosquitoes will then go and buy the human.

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Speaker 2: So the addition of pigs into the cycle for Japanese

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Speaker 2: in cavalitis, which isn't an issue for murray vali in cafalitis,

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Speaker 2: is thought to be why there's been this explosive outbreak

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Speaker 2: in the Southern States and is of great concern to

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Speaker 2: us because of all the feral pigs we have in

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Speaker 2: the top end.

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Speaker 1: Yeah, goodness, mate, And so bar what is the best

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Speaker 1: way for people to protect themselves?

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Speaker 2: Yeah, So, first of all, it's preventing and bites to mosquitoes,

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Speaker 2: So wearing loose, light colored protective clothing, long sleeves is better, trousers, socks,

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Speaker 2: enclosed shoes, and then applying insect repellent. And it's important

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Speaker 2: with insect repellent that you use the right repellents because

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Speaker 2: there's a lot of stuff advertised or salt out there

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Speaker 2: which is pretty dodgy and does not actually repel the mosquitoes.

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Speaker 2: So the specific three ingredients which can be in So

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Speaker 2: if you have a product containing one of these three

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Speaker 2: ingredients then it's okay and you can always ask in

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Speaker 2: the pharmacy. So either containing deep or containing per carotin,

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Speaker 2: or there's also extract of lemon eucalyptus and if any

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Speaker 2: of the products contain those and they're adequate products to

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Speaker 2: use on exposed skin before going outside, particularly in the

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Speaker 2: evenings because these the mosquitoes that transmit this virus bite,

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Speaker 2: particularly from dusk when the sun goes down overnight until

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Speaker 2: dawn and in the early hours of the morning.

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Speaker 1: Yeah, I mean, look, it sounds like a concern. It

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Speaker 1: does sound like our health authorities are on quite high

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Speaker 1: alerts as well over this one.

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Speaker 2: Yes, And the thing is that there's been fantastic work

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Speaker 2: done by our venary colleagues out at our primary industries

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Speaker 2: and also by the North Australian Quarantine Survey team who

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Speaker 2: have gone out and sampled feral pigs. And that's the

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Speaker 2: concern is that they've now found positive feral pigs where

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Speaker 2: the virus is present in a substantial number of locations

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Speaker 2: across the top end all the way from out the

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Speaker 2: west in the daily region. The Victoria region and over

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Speaker 2: to West Arnham and including the TV Island. So they've

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Speaker 2: now had a total I think of fifty two feral

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Speaker 2: pigs which are for the virus over those regions. So

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Speaker 2: it's out.

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Speaker 1: There and so but I know that we've spoken about

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Speaker 1: this earlier in the year, and you know, obviously we've

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Speaker 1: got these two confirmed cases now from what you're saying

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Speaker 1: as well, there are increased numbers in feral pigs, so

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Speaker 1: we on than you know what we were earlier in

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Speaker 1: the air.

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Speaker 2: Yes, I think that. I guess one of the things

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Speaker 2: is the mosquito numbers are dropping off a little and

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Speaker 2: indeed in Southern Australia people are not as concerned right

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Speaker 2: now in winter because there's no missies around. However, our

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Speaker 2: mosquito colleagues tell us that there's still some parts out

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Speaker 2: in the top end, around around the areas where there's

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Speaker 2: water and standing water and obviously where people often camping

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Speaker 2: by the rivers and creeks where there are still lots

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Speaker 2: of mossies at night. So the potential is in Northern

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Speaker 2: Australia this virus will continue over our cooler season and

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Speaker 2: then we'll maybe amplify up next wet season and indeed

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Speaker 2: will then basically emerge again in southern Australia. That's the

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Speaker 2: great concern. So we will know that over the next

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Speaker 2: twelve months as to whether this is going to escalate

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Speaker 2: or whether it's going to just remain at a lower level.

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Speaker 2: But our concern is that there is still a potential

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Speaker 2: in the top end because of our environment, the mosquito

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Speaker 2: is still being present for transmission.

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Speaker 1: Yeah, so make sure that you cover up if you

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Speaker 1: are out and about and make sure that you have

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Speaker 1: got that mossy repellent on bart Curry. We really appreciate

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Speaker 1: your time this morning. Thank you so much for having

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Speaker 1: your chat with us.

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Speaker 2: No, thanks very much for speaking with you.

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Speaker 1: Thank you