Influenza A (H1N1) Swine Flu - Update Eighty-three

New Zealand now has more than 300 confirmed cases of Influenza A (H1N1) infection, with the majority of people experiencing relatively mild to moderate symptoms. The number of confirmed cases in New Zealand, as in the rest of the world, has risen rapidly.

There is no need for alarm, but there is a need to prepare to manage this influenza in the community.

Health authorities are well-prepared in the event the outbreak becomes more severe. We had prepared for this since four years ago and our response will remain coordinated and thorough.

We expect the numbers will continue to rise as the pandemic continues over coming months. The virus is expected to cause many more infections than are seen with seasonal or ordinary winter flu because most people have no or little immunity to it.

The vast majority who contract this flu are experiencing relatively mild to moderate symptoms. Most people recover from infection without the need for hospitalisation or medical care.

Influenza can cause more severe symptoms for some people. A person should seek medical care if they develop flu and have other significant health problems, or if they become seriously ill (for example, if they experience shortness of breath).

As the virus continues to spread through our communities, individuals and communities can help limit the spread of infection through good personal hygiene. This includes covering your nose and mouth when coughing or sneezing, washing your hands frequently with soap and water, and cleaning hard surfaces like door handles frequently. If you are sick, stay home until you have fully recovered as you can easily spread the germs to others.

Health authorities are keeping a close eye on the spread and the behaviour of the virus through the national surveillance system of the Institute for Environmental Science and Research (ESR).

General information on the signs and symptoms of the new influenza, and advice on limiting the spread of infection and how to care for yourself at home are available on the Ministry of Health website (www.moh.govt.nz). Health information and advice can also be accessed through Healthline 0800 611 116.

Latest numbers
The cumulative total of confirmed cases in New Zealand is 303, up 45 from 258 yesterday. The number of probable cases remains unchanged at 17. The number of current active cases reported in the past seven days is 219.

A 30-year-old woman with Influenza A (H1N1) infection remains in critical condition at Wellington Hospital. She has an underlying health condition.

Most of the 45 new confirmed cases are in the following regions:
Auckland – 22 cases
Wellington – 10 cases
Bay of Plenty – 9 cases
The cumulative total of confirmed cases by region are:
Northland (0); Auckland (91); Waikato (9); Bay of Plenty/Lakes (13); Gisborne (1); Hawkes Bay (2); Taranaki (0); Wanganui/Palmerston North (1); Wellington (118); Nelson/Marlborough (1); Canterbury (67) and Otago/Southland (0).

National Non-Seasonal Novel Influenza A(H1N1) case and contact numbers for New Zealand

Notes:
Confirmed, probable and suspected numbers from EpiSurv
Suspected includes those that are reported as under investigation
* Number includes all cases confirmed for ≤7 days from report date

Seasonal Influenza Vaccination Programme
As part of the management of the Influenza A (H1N1) outbreak, the Ministry of Health has purchased an extra 125,000 doses of the seasonal influenza vaccine.

The fewer people who contract seasonal influenza, the fewer hospitalisations will occur. The people most at risk of complications are those who are in the group eligible for the free programme. The programme has been extended until the end of September 2009. If more of this group are vaccinated, it means there will be a better chance of being able to deal with the increasing numbers of people likely to be hospitalised with complications from Influenza A (H1N1).

The Ministry of Health is strongly encouraging frontline health workers to be vaccinated for seasonal influenza. This means hospitals and other frontline health services will be better able to cope with the increased demand over the winter months.

Advice for workplaces
It is business as usual for most workplaces. Staff should stay home only if they have flu-like symptoms or if they have received medical advice to stay home.
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 flu, watch for signs that they may need further medical attention, including: shortness of breath, chest pain, blueness around the lips, inability to keep fluids down, becoming less alert or lightheadedness. More information can be found on the websites of the Department of Human Services of the State Government of Victoria in Australia (http://humanswineflu.health.vic.gov.au/public/what_to_expect.htm) and the Centers for Disease Control in the US (http://www.cdc.gov/h1n1flu/qa.htm).

Be prepared – at home and in the workplace
Be prepared - This is the time for people to make sure they’re prepared to be self-sufficient for a week, 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

International Update from the World Health Organization
On 11 June 2009, the WHO raised the level of influenza pandemic alert from phase 5 to phase 6 on the basis of available evidence and expert assessments of that evidence. At this time, WHO considers the overall severity of the influenza pandemic to be moderate. The assessment reflects the fact that most people recover from infection without the need for hospitalisation or medical care.

The WHO has not updated the case numbers since 7:00 GMT on 19 June, when nearly 90 countries reported 44,287 cases of influenza A(H1N1) infection, including 180 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_19/en/index.html)

As at 5am AEST on 22 June, Australia has reported 2462 confirmed cases of Influenza A (H1N1) influenza, including 1230 cases in Victoria. A 26-year-old man from Western Australia with a number of pre-existing chronic diseases in addition to having Influenza A (H1N1) infection died on 19 June 2009, becoming the first person in Australia to have been killed by the virus.

Regular updates on the Influenza A (H1N1) pandemic are available on the WHO website (http://www.who.int).

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

For health information and advice, the public should call Healthline 0800 611 116.

For latest updates on Influenza A (H1N1) Swine Flu, visit www.moh.govt.nz

Follow us on Twitter: http://twitter.com/minhealthnz

For media queries related to this update, please call the National Health Coordination Centre, Communications Desk at +64 (04) 816 3660 or +64 (021) 243 6805