Swine Flu in Australia/New Zealand

indigo girl · Jun 3, 2009

Swine flu will hit NZ hard

http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10576325

Everyone is being urged to stock up on food and essential medicines to prepare for the disruption of normal life when swine flu hits New Zealand hard.
Health authorities issued this advice yesterday - and said that the P&O cruise ship Pacific Sun, which is due to dock in Auckland today, is carrying a Kiwi who had tested positive on board for influenza A.
They said the type of flu was not yet known, further tests would be done in Auckland and the woman now had no symptoms. She and more than 10 close contacts would be quarantined at home.
"It is rapidly spreading internationally, especially in Australia," said Dr Julia Peters, clinical director of the Auckland Regional Public Health Service. "In Australia, the number of cases is doubling every two days. With the amount of transtasman travel, it's almost inevitable we are going to get it in the community in New Zealand.
"When that happens, because it's more infectious than seasonal influenza. It's going to spread, and a large proportion of the community is going to get this virus. Even if it's relatively mild, people will be too sick to go to work or school."
Dr Peters said that based on modelling by the World Health Organisation, it was predicted that 60 per cent of people would become infected with the new virus, A (H1N1).
"We are promoting getting prepared, not getting panicky."
She said that with so many people sick - including workers - services or businesses such as schools, health clinics, banks and supermarkets might not be at full capacity.
Parents needed to plan how they would care for their children if schools or early childhood centres were closed. Businesses needed to decide which essential parts of their operations they wanted to keep running when many staff were at home sick.
Dr Peters urged people to stock up on three to five days of long-lasting food, and to ensure they had supplies of medicines they needed personally and fever control drugs like paracetamol.
People who developed flu-like symptoms should stay at home and call a doctor for advice rather than turning up unannounced at a clinic and risking infecting others.
Ngaire Buchanan, a member of the northern regional health emergency group, said that when transmission of the virus was widespread, people would be told of their nearest community-based assessment centre.
Staff at these facilities would check patients and treat them with Tamiflu.
Four sites for these centres have been confirmed in Auckland City, five in the Waitemata health district, three in Counties Manukau, and 14 in Northland. In the Auckland region, they will mainly be at accident and medical centres.
The Ministry of Health said it would start an awareness campaign on Saturday about swine flu, advising people what preparations to make and what arriving travellers should do if they had flu-like symptoms.

indigo girl · Jun 4, 2009

Australia swine flu count soaring

http://www.physorg.com/news163315373.html

I wonder when they will limit testing to only severe cases.

Australia's swine flu tally rocketed by more than a third on Thursday to nearly 900 as officials scrambled to contain the rapidly spreading virus.
The latest official figures revealed 876 confirmed cases of A(H1N1) influenza in the world's fourth most affected country -- up from 633 a day earlier and single figures just a fortnight ago.
Other Australian states ordered children returning from flu hotspot Victoria to be quarantined, earning the wrath of Melbourne officials.
The island state of Tasmania on Wednesday joined Queensland, New South Wales and South Australia in ordering that children arriving from Victoria be quarantined for up to seven days to reduce the threat of swine flu.
"The exclusion will apply for seven days from departure from Victoria," said Tasmania's Director of Public Health Chrissie Pickin.
"It applies to all children returning from Victoria and other affected areas, whether or not they have a flu-like illness," she said.
Victoria, which has 752 cases or about 86 percent of the national total, raised its alert level on Wednesday and has shuttered 14 schools.

Maine17 · Jun 4, 2009

The rapidly evolving situation in Australia is pretty amazing.

indigo girl · Jun 5, 2009

Australian Swine Flu Count Breaks 1,000 as Victoria Cases Surge

http://www.bloomberg.com/apps/news?pid=20601081&sid=aZo4SyXmjD8Q&refer=australia

The spread of swine flu has more than met the WHO's definition of pandemic. This is way beyond ridiculous.

The number of confirmed swine flu cases in Australia rose to more than 1,000 today, as federal Health Minister Nicola Roxon said the government expects the virus to spread across the country.
Victoria, the worst-hit state, confirmed a further 122 cases overnight, taking its tally to 874, its health department said. Authorities believe H1N1 influenza will advance "in all jurisdictions," Roxon told reporters earlier in Canberra.
The cases are proving to be "mild" and the outbreak isn't severe enough to restrict interstate travel, she added.
The World Health Organization is monitoring the spread of the virus in Australia as the agency decides whether to declare the first influenza pandemic in four decades. The virus has sickened 19,273 people and caused 117 deaths since it was discovered in Mexico and the U.S. in April, the United Nations health agency said two days ago.
Australia has the highest number of confirmed cases of H1N1 influenza outside of North America. Sustained community transmission outside the Americas would give the WHO the evidence it needs to declare a pandemic.
Victoria, which has about 87 percent of Australia's cases, upgraded its pandemic response this week to reflect the spread of the virus is beyond prevention.
Victorian authorities will focus on administering anti- influenza medication to confirmed cases, the state's health department said. People with confirmed infections in the state will have to isolate themselves for three days.
About 16 schools have been closed across Australia in response to the outbreak.

indigo girl · Jun 13, 2009

“Let’s not mess around, this virus is nasty”: Dr Chris Smith

http://ozswineflu.wordpress.com/2009/06/12/lets-not-mess-around-this-virus-is-nasty-dr-chris-smith/

I am not sure that I would agree with this assessment. I have always heard that the CFR in 1918 was 2 %. At any rate, swine flu still is not wimpy in the way it is targeting certain groups of people.

Fran Kelly has a great interview with Dr Chris Smith, here, on ABC Radio National Breakfast. Smith is a virologist in Cambridge.
He politely disagrees with Laurie Garrett’s assessment yesterday: “Let’s not mess around, this virus is nasty…”. It still has a “mortality rate” associated with it – about 0.5%, which, according to Chris Smith, puts it on a par with Spanish Flu in 1918. It’s not, therefore, “completely wimpy”.
Fran Kelly then asks him about the danger of mutations. Smith agrees it’s a risk: “the thing about flu is that it’s a moving target…” . The virus uses RNA as its “genetic material”, which is just a single strand of material. This is unlike DNA, which has two strands – one a mirror image of the other. These strands act as an error checking system. In other words, flu, because it is RNA based, not DNA based, more easily makes mistakes as it passes on. So we will see new variants that are “potentially more virulent”.
At the moment Australia is is the “virological canary in the cage” – everyone’s watching our flu season here to see how things go.

indigo girl · Jun 13, 2009

New Zealand

http://www.stuff.co.nz/the-press/news/national/2497159/Demand-exceeds-Tamiflu-supply

Seasonal flu mixed with swine flu in the same host can result in a Tamiflu resistant strain if both are H1N1. The other seasonal influenzas, B and H3N2 are still susceptible to Tamiflu. It is wise to get as many people as possible vaccinated for seasonal flu.

Heavy demand for anti-viral drug Tamiflu has left some Canterbury pharmacies running low, but new stock is due next week.
Emergency supplies had also been put aside for those needing urgent prescriptions filled, said the deputy chairman of the Canterbury Community Pharmacy Group, Peter Fear, said.
"New stocks will be arriving in Canterbury late on Tuesday, and wholesalers tell us that they are more than adequate to cope with anticipated demand," he said.
The Ministry of Health has 1.2 million doses of Tamiflu in reserve in the national stockpile to be released by district health boards when required.
Meanwhile, health experts urged people to get vaccinated against normal winter flus to reduce their risk of a "double whammy" if seasonal flu mixed with swine flu.
Communities also needed to look at limiting physical contact, such as hongi, to limit the spread of the virus, deputy director for Public Health Darren Hunt said.
"Historically, in previous pandemics, we have seen large numbers of cases amongst the Maori community, so that's something to keep in mind."
Maori Affairs Minister Pita Sharples said some iwi and hapu had discussed the risks of swine flu, and whether protocol relating to hongi on marae should be changed to reduce the risks.
New Zealand's Catholic bishops have issued new restrictions banning parishioners from receiving communion wafers on the tongue, communion wine from the chalice and from shaking hands as the sign of peace at masses.
The Government was also in "close contact" with WHO about accessing a swine flu vaccine when one was ready.
A Swiss pharmaceuticals company said it had successfully produced its first batch of swine flu vaccine. It was being considered for clinical trials.
General practitioners have requested improved access to masks, gloves and gowns to treat patients with swine flu.
Not all health boards had released funds to ensure general practices remained fully stocked with supplies, Medical Association chairman Peter Foley said.
Officials estimate seasonal flu hits 760,000 New Zealanders each year, causing 350 to 450 deaths.

indigo girl · Jun 13, 2009

New Zealand: First domestic H1N1 cases

http://crofsblogs.typepad.com/h5n1/2009/06/new-zealand-first-domestic-h1n1-cases.html

New Zealand: First domestic H1N1 cases
Via Radio New Zealand News: Latest NZ swine flu cases unrelated to overseas travel. Excerpt:
The first cases have appeared in New Zealand of people with swine flu who have not been overseas, nor been in contact with returning travellers.
Health officials have followed up the cases of two separate people in Wellington who had gone to their local GP and an emergency department.
Health Minister Tony Ryall says neither had any link with people who had returned from overseas, and had not been travelling themselves.
Mr Ryall says this is an early indication there may be what the Health Ministry calls community transmission of swine flu in the Wellington region. Another three cases in Wellington are being investigated.
Mr Ryall expects the number of cases of swine flu to increase exponentially in the next few days as the situation is rapidly changing.

indigo girl · Jun 13, 2009

New Zealand Considering Vaccine

http://www.stuff.co.nz/national/2498191/NZ-undecided-on-flu-vaccine

Health officials are still thinking about whether the pandemic declared yesterday by the World Health Organisation (WHO) means they should order eight million doses of vaccine from Australian manufacturer, CSL Ltd.
"The use of a vaccine is still being considered," Steve Brazier, the Ministry of Health's national incident controller, told NZPA.
Though the present form of the A H1N1 swine flu is spreading rapidly in populations where there is community transmission, symptoms have been reported to be no worse than seasonal flu in most cases.
The ministry must decide whether to use vaccine to protect particularly vulnerable people expected to fall ill -- or wait in case the swine flu virus later changes to a more virulent form, or one resistant to the Tamiflu anti-viral drug.
The Australian government has already ordered vaccine supplies for 10 million people. Normally CSL would conduct trials over six months to decide the best dosage and seek regulatory approval, but a company spokeswoman, Rachel David, said the Australian government may allow vaccinations to start earlier if the pandemic worsens.
On this side of the Tasman, officials have not made a decision, despite the ministry having taken an option to purchase up to eight million doses of vaccine from CSL.
Director of public health Mark Jacobs announced in 2005 that the nation had been "guaranteed" a vaccine against pandemic influenza.
"We have a formal arrangement with Australia's CSL Ltd.. .which gives us a guaranteed supply if we need a pandemic vaccine," he said.
New Zealand expected to get access to a vaccine within four to six months of the WHO declaring the existence of a pandemic, he said.
The nation is third on the priority list for CSL -- after Australia and a small country which put in its order before NZ.
Last night, Mr Brazier said: "the ministry will hold discussions with disease epidemiologists and vaccine experts before making any decisions".
But deputy director of public health, Darren Hunt said he didn't think the vaccine would be available until after winter.
"We do not have an epidemic in New Zealand at present," he said.
All of the new cases are reported as having mild symptoms, but Health Minister Tony Ryall has said it is inevitable that swine flu will spread, possibly hitting up to a third of the population.

(hat tip Avian Flu Diary)

indigo girl · Jun 26, 2009

Masks protect against swine flu?

http://www.ashburtonguardian.co.nz/index.asp?articleid=13010

Whoa! Where are their N95 masks? The masks that they are wearing are appropriate only for use by the patients to help stop spread of the virus in in the waiting room. The staff is wearing the wrong type of mask for protection from influenza.

They make your spectacles steam up and give your voice a slightly muffled quality. But the downsides of wearing face masks are just a minor consideration for Mid Canterbury medical centre staff. Receptionists, nurses and doctors at practices throughout the district began donning the protective devices this week to protect themselves and their patients against contracting swine flu or seasonal influenza.
The staff are following the advice of the Canterbury pandemic planning team, which says swine flu patients can be infectious for two days before developing symptoms. So while those with flu are being told to stay away from medical practices, infectious patients may still be present in surgeries.
Allenton general practitioner Malcolm Wootton said the practice was going through dozens of masks daily as they had to be changed every two hours. He said the practice of ‘social distancing’ was the first defence in a virus transmitting from one person to another, but face masks were also effective.
And doctors and nurses could not maintain the social distancing minimum space of one metre between themselves and their patients as they treated them. He said practising thorough hygiene procedures was all in a day’s work, it’s just that staff had to be even more vigilant now. “For us it’s another day at the office,” Dr Wootton said.

(hat tip PFI/monotreme)

indigo girl · Jun 26, 2009

Emergency Department Stats from Australia

http://afludiary.blogspot.com/2009/06/emergency-department-stats-from.html

We've charts from two Children's hospitals in and around Sydney, Australia (Westmead is a suburb of Sydney) showing the number of influenza-related emergency room visits over the past 6 years.
The increase during the June-September period coincides with their influenza season.
There are two things of interest here.
First, and most obvious, is the huge spike in emergency room visits at both hospitals over the past couple of weeks. Some of that may be the `worried well', but reports indicate that these hospitals are seeing a lot of sick kids.
This spike is nearly double the highest numbers seen during the previous 6 years.
Less obvious, perhaps, but just as important is that in years past, mid-to-late June has been a relatively quiet time for Emergency Department visits in Sydney. The peak for flu-related visits normally doesn't come until late July or August.

indigo girl · Jun 26, 2009

Swine H1N1 Crowding Out Seasonal Flu in Australia?

http://afludiary.blogspot.com/2009/06/victoria-h1n1-crowding-out-seasonal-flu.html

As the H1N1 virus spreads globally, particularly in the Southern Hemisphere where it is their regular flu season, we will watch carefully to see how it acts, and whether it begins to replace the existing flu strains.
According to this report by Jason Gale of Bloomberg news, in the early going in Victoria, Australia, the novel H1N1 virus appears to be driving the other viruses out.