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Nationwide Influenza Pandemic Exercise

13 February 2002

DHBs About To Face Biggest Challenge During Nationwide Influenza Pandemic Exercise

District Health Boards and Public Health Services will tomorrow face their biggest challenge so far in a month-long nationwide influenza pandemic response exercise.

Ministry of Health Exercise Director Robyn Fitzgerald said at 9am tomorrow participants will be sent new and important information about the hypothetical influenza pandemic. The new information will include a number of challenging questions asking how each region will respond to the latest hypothetical events.

"Participants will have three hours to come up with answers appropriate to their region using their available resources."

Tomorrow is the last day of the month-long exercise which has seen the Ministry of Health evaluating the emergency response capabilities of the health sector by staging an influenza pandemic.

Emergency response teams from the country's 21 District Health Boards, Public Health Services, the Ministry of Health and the National Pandemic Planning Committee have been taking part.

The exercise was important, as an influenza pandemic is one of the biggest threats to public health, said Mrs Fitzgerald.

"Influenza pandemics cause high rates of death and illness, can strike with only minimum warning and require a well coordinated national and regional response."

"By trialling our response methods the public can be reassured New Zealand's health sector will have a robust pandemic plan and be prepared to minimise disruption and death."

Since 14 January 2002, an influenza pandemic scenario has been drip fed to District Health Boards and Public Health Services mimicking how an influenza pandemic might evolve in New Zealand.

"We are really pleased with the commitment shown by District Health Board and Public Health Service staff to this challenging 30-day exercise. They have acknowledged the seriousness of a pandemic and identified the value of being prepared."

She was said she was pleased with the way the exercise questions about staffing levels, bed numbers and communication strategies for example had been answered to date.

"There have been many sound and innovative ideas submitted by exercise participants as they respond to the simulated story. While some of the ideas would need to be tested to check their validity, others have true merit and could be applied in a real pandemic situation. As would be expected there are local elements factored into answers as participants strive to meet the unique needs of their different regions."

The emergency response exercise is also testing the Ministry of Health's ability to establish communication networks so information can be shared. The exercise also tests the Ministry's ability to analyse and collate information for audiences including Government Ministers, health organisations and international agencies.

About 20 observers will visit the Ministry of Health on Thursday to watch the final day of the exercise. Invited observers include representatives from Australia, New Zealand Government agencies, drug and pharmaceutical companies and Ministers' offices.

"If a real influenza pandemic were to occur there would be an all of Government response so we are pleased with the interest being shown in this exercise."

Mrs Fitzgerald said the influenza pandemic exercise was nine months in the planning. She said it is the first time a National Influenza Pandemic Plan has been tested on a national scale. International interest has been expressed from World Health Organisation members from Australia, Europe and the United States of America.

To properly trial participants' responses during the exercise the detailed scenario cannot be revealed to the media and public before the exercise finishes.

Please note: due to the influenza pandemic exercise the Ministry of Health's normal media liaison service will be operating with fewer staff on Thursday 14 February. Please bear with us. Normal service will resume on Friday.


What is influenza?
Influenza is a highly infectious illness caused by a virus.

What are the symptoms?
Influenza usually causes two or three of the following symptoms:
· Sudden onset of fever
· Aches and pains
· Severe fatigue
· Headache
· Cough
· Sore throat
· Stuffy or runny nose

How is it spread?
Influenza is very infectious. It spreads through the air by
coughing, sneezing and on hands, cups, cutlery or on other objects that
have been in contact with an infected person's mouth or nose.

Adults are infectious for five days after symptoms occur and children for
seven days.

How long does it last?
Symptoms usually start to clear up after five to seven days.

Do antibiotics help?
Antibiotics do NOT work against viruses, so they have no effect on
influenza itself. Some people may need antibiotics because they have a
secondary infection as well as influenza.

How common is influenza in the community?
Each year different strains of influenza circulate in New Zealand. Most
cases occur during the winter months.

What is an influenza epidemic?
An epidemic occurs when there are a larger number of cases of influenza
than normally expected.

What is a pandemic?
An influenza pandemic occurs when a new type of influenza virus develops
and this spreads to most countries of the world. Because the virus is new,
no one has any immunity and many people become seriously ill.

An influenza pandemic has the potential to cause widespread death and
illness as well as social and economic disruption.

Have we had a pandemic before or is it something new?
The twentieth century has seen three true pandemics. The first and
most devastating occurred in 1918-19, followed by the pandemics of 1957-58
and 1968-69.

What happened in 1918?
The largest pandemic in history was in 1918. An estimated 20-40
million people died of the disease, which was notorious for its rapid
onset and progression to respiratory failure and death. The highest
numbers of deaths occurred in the 20-40 age group. Studies in New Zealand
military camps showed that 30-40 percent were affected in the first wave
and 50 percent by the second wave.

What happened in 1957 and 1968?
In May 1957 the Asian influenza was identified in Singapore. By May 1958
it had spread worldwide. Infection rates were reported to range from
20-70 percent but fatalities were low ranging from 1 in 2000 to 1-10,000
infections. In New Zealand the pandemic began in Wellington in August
1957. The most at risk were people aged from 10-30 years. A second wave
hit in late 1959.

In July 1968 a new type emerged in Hong Kong - it reached New Zealand
in early 1969. Sporadic cases were reported during summer and autumn and
it reached epidemic levels in June and July.

What is the likelihood of another pandemic occurring?
The world will experience another influenza pandemic in the foreseeable
future. It could occur at any time.

Influenza is an on-going and worldwide threat to public health. The
ability of the influenza virus to change by mutation results in altered
viruses, which can cause regular epidemics. In New Zealand epidemic
influenza most commonly peaks in the winter months of July and August.

Are we at risk in New Zealand?
Everyone worldwide is at risk. New Zealand would almost certainly be
affected by an influenza pandemic.

What is the Ministry doing in preparation for the event?
There has always been an awareness of the likelihood of a future
pandemic. The Ministry of Health continues to update its Influenza
Pandemic Preparedness Plan. The New Zealand Plan has been developed in
consultation with the Australian Influenza Pandemic Planning Committee to
ensure the plans are complementary. Dr Douglas Lush, Senior Advisor,
Public Health Directorate, Ministry of Health, and Dr Lance Jennings are
the New Zealand representatives.

What is the purpose of the plan?
The purpose of the plan is to minimise the impact of an influenza pandemic
on New Zealand.

The plan includes methods for the detection and management of pandemic
influenza in New Zealand. It details surveillance techniques and
guidelines for the use of vaccine and anti-virals.

Who is taking part in the emergency exercise?
Ministry of Health staff
District Health Boards
Medical Officers of Health/Public Health Services
National Pandemic Planning Committee
A mock media supplied by Massey University School of Journalism students

Who has the Ministry of Health invited to watch?
Thoracic Society, NZ Ambulance Service, NZ Blood Service, DPMC,
Minister of Health, Civil Defence and Emergency Management, New Zealand
Police, Ministry of Defence, Coroners Office, Wellington,
BioSecurity, College of General Practitioners, New Zealand Nursing
Council, Medical Council, Australian/New Zealand Society of
Microbiologists, ESR, Ministry of Health Chief Advisers and Executive
Team, Australian influenza pandemic experts, GlaxoSmithKline, Roche.

Who will evaluate how well the exercise was carried out?
Dr Bob Boyd, Chief Advisor Safety and Regulation, Ministry of Health.
Dr Boyd will review the planning, conduct and control of the exercise and
the response to the emergency and whether the exercise met the objectives.
He will provide a report to the Minister of Health in March.

Who is on the National Pandemic Planning Committee (NPPC)?
The committee is made up of a range of experts including virologists,
microbiologists and public health specialists. The committee is able to
co-opt experts from other disciplines when necessary.

What is the role of the NPPC?
During inter-pandemic periods, the committee keeps up with advances
in scientific knowledge and reviews planning, diagnosis and the treatment
and management of influenza.

When the World Health Organization (WHO) confirms the presence of a new
virus and its potential for human transmission, the NPPC becomes
responsible for advising the Ministry of Health.

What factors decide when a pandemic occurs?
A pandemic is declared when a new virus has been shown to cause
several outbreaks in at least one country and has spread to other
countries with consistent disease patterns.

Who is most at risk?
Influenza has the potential to affect the majority of the population. As
shown in previous pandemics, the target group varies.

Why does the influenza virus change?
Evolution. The virus changes the protein on its shell (or coat) to avoid
detection by the immune system of the host ie, us.

How many people are vaccinated in New Zealand?
At present approximately 12 percent of the New Zealand population is
vaccinated annually, mostly those in the high-risk groups which includes
those 65 years and over and people with chronic illness.

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