Influenza A (H1N1) Swine Flu - Update Seventy-seven

While the number of cases of the new influenza H1N1 are increasing in New Zealand, there are still relatively few cases and only isolated instances of community transmission.

There has been significant public interest in the new influenza H1N1 swine flu with record numbers of calls to Healthline. Around 1500 calls were answered yesterday. This is almost double the usual number of calls. The Ministry of Health is boosting the capacity of the Healthline call centre to try to reduce waiting times and the Ministry apologises for delays experienced by some people, however, please expect delays in the short term. Callers to Healthline 0800 611 116 with no symptoms should take the "Press 1" option to hear information about influenza A (H1N1) and have the option speak to someone. Those with symptoms should "Press 2" to speak to a registered nurse.

An alternate source of information on the signs and symptoms of influenza is available on the Ministry of Health website www.moh.govt.nz
The Ministry is also moving to provide an additonal telephone advice service for GPs.

The Minister of Health, Tony Ryall, today praised the work being carried out by front-line health professonals - both public health units and GPs who are managing heavy workloads and maintaining a professional service for the public. "Case numbers are escalating across the country. This flu will take some time to peak and this will remain an ongong issue for New Zealanders. If we all act sensibly we can continue to delay the spread of flu as long as we can, and delay the impact beyond the traditional winter flu peak.

Dr Fran McGrath said "We know that while for most people, swine flu is a moderate illness that can safely be managed at home, for some people it will be severe. People with underlying medical conditions who get influenza, should seek medical advice early if their condition worsens. I encourage people to save emergency departments for genuine emergencies, and phone your doctor or medical centre for advice before turning up.

New Zealand remains in the containment phase, however planning is underway for when New Zealand moves to a "manage it" phase. At the moment there is a combination of border management (keep it out) and cluster control (stamp it out), but as more cases are confirmed in the community the focus will need to shift to boosting the way care is provided in the community. The decision on where best to direct the efforts of health professionals is reviewed daily.

Preventing, delaying and minimising the arrival of further cases of infection into New Zealand and to control any cases or clusters that are found in New Zealand remains the objective. This strategy is being kept under continual review.

Our planning is to enable health services to manage large numbers of cases as well as maintain services for those who most need them. An important part of this approach will include advising individuals how to look after themselves at home where this is possible - in the same way they would with seasonal flu.

School closures
An increasing number of schools are being affected by partial or total closure, due to the new influenza A H1N1. In some instances there may be only one or two confirmed cases in a school, however the number of other students away sick with influenza-like illnesses has been a significant factor in decisions to close or partially close a school. This decision isn't taken lightly - it's necessary to help stop the spread of virus.

The numbers
The cumulative total of confirmed cases in New Zealand is now 109 up from 86 yesterday. This number is expected increase again today. Of these 88 are current cases reported within the past seven days. There are also 21 probable cases.

There have been 23 new confirmed cases of the new H1N1 influenza in the past 24 hours. They are:

Auckland - seven cases:
A male aged 7 years
A male aged 46 years
A female aged 13 months
A female aged 3 years
A female aged 43 years
A female aged 47 years
A female - age unknown

Wellington - three cases
A female aged 11 months
A male aged 20 years
A male aged 34 years

Canterbury - 13 cases
A female aged 5 years
A female aged 12 years
A female aged 14 years
A female aged 32 years
A female aged 33 years
A female aged 34 years
A female aged 52 years
A male aged 5 years
A male aged 8 years
A male aged 11 years
A male aged 31 years
A male aged 34 years
A male aged 39 years

Travellers
The Ministry has refined advice to international travellers arriving in New Zealand. Better information about the incubation period of the disease means that only people with flu-like symptoms within four days of travel are now considered to be at risk of the new influenza A (H1N1).

Public Health professionals are present at the border and information is being provided to travellers.

Advice for workplaces
For most workplaces it is business as usual and staff should stay home only if they have flu-like symptoms or if they have received medical advice to stay home. Generally, if a staff member is suspected of having new influenza A (H1N1) public health staff will assess them and advise on appropriate action.

How to protect yourself and others
Signs and symptoms of influenza include fever, cough, sore throat, stuffy nose, body aches, headaches, chills and fatigue. Some people also experience diarrhoea and vomiting.
Try to avoid contact with sick people and reduce time spent in crowded settings.
Sick people should stay home until they are well, rather than going to school or work.
If you become sick, stay home for seven days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. This is to keep you from infecting others. Most people will be able to safely recover at home.

You should seek medical advice if necessary (by phone first), for example if you have a serious underlying health condition or your condition worsens. This is particularly important for people with underlying medical conditions, who are at greater risk of developing complications from influenza. If you need medical advice, please phone Healthline 0800 611 116 in the first instance, or your GP. Do not turn up at a hospital or medical centre before doing this as you can spread germs to other people.
If you are caring for someone with the flu, watch for signs that they may need further medical attention, including: difficulty breathing, chest pain, blueness around the lips, inability to keep fluids down, becoming less alert or developing confusion.

More information can be found on the Victorian Health website (http://humanswineflu.health.vic.gov.au/public/what_to_expect.htm) and Centre for Disease Control website (http://www.cdc.gov/h1n1flu/qa.htm)

Be prepared - This is the time for people to make sure they’re prepared to be self-sufficient for an extended period of time, should they need to. This means you should have enough food water and basic medical supplies including paracetamol or ibuprofen, as well as regular medications, nappies for babies, cleaning products, tissues and bathroom supplies for at least a week.

Hand hygiene is still the single most effective measure in protecting yourself. Wash your hands with soap and water and dry them thoroughly.
Alcohol-based cleaners are also effective. Avoid touching your eyes, nose or mouth as germs spread this way.

Practise good cough and sneeze etiquette. This means covering your nose and mouth with a tissue when you cough or sneeze, and disposing of the tissue in a lined rubbish bin with a lid or plastic bag
Checklists and advice on how individuals and families can prepare for a pandemic are available on the Ministry of Health's website: http://www.moh.govt.nz/moh.nsf/indexmh/pandemicinfluenza-resources-factsheets

International Update from the World Health Organization
On Friday, WHO announced a pandemic phase 6 – the highest phase - which means there is global spread of the virus, but it does not mean the disease is severe.

The WHO website is expected to be updated this evening. As of 07:00 GMT, 12 June 2009, 74 countries have officially reported 29,669 cases of influenza A(H1N1) infection, including 145 deaths.

The breakdown of the number of laboratory-confirmed cases by country is given in the following table http://www.who.int/csr/don/2009_06_15/en/index.html

As at 5am AEST on 16 June, the number of confirmed cases in Australia was 1853, with 1210 of these cases in Victoria.

Updates on the Influenza A (H1N1) outbreak are available on the WHO website on a regular basis (http://www.who.int)

Unless where otherwise specified, this information can be attributed to Dr Fran McGrath, Deputy Director of Public Health.

For further information please phone Ministry of Health National Health Coordination Centre, Communications Desk
+64 (04) 816 3660 or +64 (021) 243 6805

For specific health advice the public should call Healthline 0800 611 116